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U.S. DEPAR,TMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
FeJeral Emergency Management Agency Exnires Februarv 28. 2009
National Flood insurance Program Important: Read the instructions on pages 1-8.
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
A1. Building Owner's Name KEVIN BECHTEL Policy Number
_ A2._ Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Company NAIC Number
108 BAYSIDE DRIVE
Ciry CLEARWATER BEACH State FL ZIP Code 33767
A3. Property Description (Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)
08-29-15-04950-001-0010
A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. N 27.97045 Long.W 82.82751 Horizontal Datum: ❑ NAD 1927 � NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. BuilcJing Diagram Number 1
A8. For a building with a crawl space or enclosure(s), provide A9. For a building with an attached garage, provide:
a) Square footage of crawl space or enclosure(s) N/A sq ft a) Square footage of attached garage 1076 sq ft
b) No. of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage
enclosure(s)walls within 1.0 foot above adjacent grade N/A walls within 1.0 foot abbve adjacent grade 4
c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b 1612.80 sq in
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
61. NFIP Community Name&Community Number 62.County Name B3.State
CITY OF CLEARWATER 125096 PINELLAS COUNTY FL
B4. Map/Panel Number 65.Suffix 66. FIRM Index 67. FIRM Panel 68.Flood B9. Base Flood Elevation(s)(Zone
Date Effective/Revised Date Zone(s) AO,use base flood depth)
12103C-0102 G 5-17-05 9-3-03 AE 11'
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑ FIS Profile � FIRM ❑Community Determined ❑Other(Describe)
B11. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 ❑Other(Describe)
B12. Is the buiiding located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes �No
Designation Date NA ❑CBRS ❑OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REGIUIRED)
C1. Building elevations are based on: ❑Construction Drawings` ❑ Building Under Construction' � Finished Construction
`A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Com � fl.
below according to the'�building diagram specified in Item A7. w
Benchmark Utilized CLEARWATER B.M.D-2 Vertical Datum NAVD 88 0 w
Conversion/Comments NA � g ��
Check the measurement used. �
N � �
a) Top of bottom floor(including basement,crawl space,or enclosure floor)_ 11.58 �feet ❑ meters(Puerto Rico only) O �,.� � �
b) Top of the next higher floor 23.98 �feet ❑ meters(Puerto Rico only) ,� r- F- �
c) Bottom of the lowest horizontal structural member(V Zones only) N.A �feet ❑ meters(Puerto Rico only) Z z
d) Attached garage (top of siab) 6.12 �feet ❑ meters(Puerto Rico only) � _ � f
1
e) Lowest elevation of machinery or equipment servicing the building 12.58 �feet ❑meters(Puerto Rico only) � (� t°�
(Describe type of equipment in Comments) � ` j
f) Lowest adjacent(finished)grade(LAG) 4.49 �feet ❑meters(Puerto Rico only) '��Y'� p
`--' '--
g) H i g h e s t a d j a c e n t(f i n i s h e d)g r a d e(H A G) 5.9 0 �f e e t ❑m e t e r s(P u e rt o R i c o o n l y) €� ���
SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation
information. 1 certify that the information on this Certificate represents my best efforts to interpret the data availab/e.
1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
� Check here if comments are provided on back of form. � y �+"° .
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Certifier's Name GEORGE A.SHIMP III JOB fk 070185D License Number 6137 '
G� ��'� -
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Title VICE PRESIDENT Company Name GEORGE A.SHIMP II&ASSOCIATES,INC. � • _
9 tll 4�i"' 'F. .�::� .
Address 3301 DESOTO BLVD.SUITE D City PALM HARBOR State FL ZIP Code 34683 ��'°`,�,`�{ < `'� -
. ,�
i ature � � � � Date 5-20-08 Telephone 727-784-5496 �I��,i<�.���`0�
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FEMA Form 81-31, Februarv 2006 See reverse side for continuation. Replaces all previous editions
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IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use:
Building Street Address(including Apt., Unit,Suite,and/or Bidg. No.)or P.O. Route and Box No. Policy Number �
108 BAYSIDE DRIVE
City CLEARWATER BEACH State FL ZIP Code 33767 Company NAIC Number
SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
—Copy both sides of this Elevation Certificate for(1 J community official, (2) insurance agenVcompany,and(3) building owner.
Comments C2.e)AIR CONDITIONER
� � � �
Signatur�—� Date 5-20-08
� Check here if attachments
SECTION E-BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR 20NE AO AND 20NE A(WITHOUT BFE)
For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A, B,
and C. For Items E1-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only,enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade(HAG)and the lowest adjacent grade(LAG).
a)Top of bottom floor(including basement,crawl space,or enclosure) is ❑feet ❑ meters ❑ above or�below the HAG.
b)Top of bottom floor(inciuding basement,crawl space,or enclosure) is ❑feet ❑meters ❑ above or❑ below the LAG.
E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9(see page 8 of Instructions),the next higher floor
(elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑ below the HAG.
E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑ meters ❑above or� below the HAG.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B,and E for Zone A(without a FEMA-issued or community-issued BFE)
or Zone AO must sign here. The statements in Sections A,8, and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
... _..._._....,.�.....�_�..
; -•�orntiients . _... ,°;;
` ❑ Check here if attachments
' SECTION G-COMMUNITY INFORMATION(OPTIONAL)
.;The IocAl officiai who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B,C(or E),
;..�and G of this Elevatinn Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8.and G9.
, :'Gt.�❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer, or architect who
is authorized,by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A communi#y official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO.
G3. ❑ The following information(Items G4.-G9.) is provided for community floodplain management purposes.
G4.Permit Number; G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued
G7.This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)of the building: _0 feet ❑meters(PR)Datum .
G9.BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR)Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑ Check here if attachments
FEMA Form 81-31, February 2006 Replaces all previous editions
,
Building Photographs �
See Instructions for Item A6.
For Insurance Company Use:
Building Street Address(including Apt., Unit, Suite, and/or Bidg. No.)or P.O. Route and Box No. Poiicy rvumber
108 BAYSIDE DRIVE
City CLEARWATER BEACH State FL ZI P Code 33767 Company NAIC Ntgnber'
If using the Elevation Certificate to obtain NFIP fiood insurance, affix at least two building photographs below according to
the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right
Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, ',
following. '
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PICTURE TAKEN ON 5-17-2008
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` Continuation Page
For Insurance Company Use:
Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy rvumber
108 BAYSIDE DRIVE
I Clty CLEARWATER BEACH State FL ZIP Code 33767 Company NAIC Number
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all
photographs with: date taken; "Front View"and "Rear View"; and, if required, "Right Side View" and "Left Side View."
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