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154 BAYSIDE DR FEDERAL EMERGENCY MANAGEMENT Au�NC:r p,M,g. No. 3U�i-uu r � NATIONAL FLQOD INSURANCE PROGRAM Expires December 31, 200 .��0��3 �°a73� ELEVATION CERTIFICATE Im ortant; Read the instructions on a es 1•7. >Forinsurancecamcanyuse: SECTION A•PROPERTY OWNER INF�RMATION Poilcy Number •BUILDING OWNER'S NAME GEORGIO MARTINOS Company NAIC.Numbe� BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. 154 BAYSIDE DR STATE ZIP CODE CITY FL 33767 CLFJ\RWATER BEACH PROPERTY DESCRIPTION(Lot and Biock Numbers,Tax Parcel Number,Legal DescripGon,etc.) LOT 13,BLOCKA,BAY5IDE SUB.NO.3 BUILDING USE(e.g.,Residen6al,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.) RESIDENTIAL SOURCE: GPS(T'ype): LATITUDE/LONGITIIDE(OPTIONAL) HORIZONTAL DATl1M: �USGS Quad Map ❑Ocher. ( ##°-##'-ti#.##" Or ##.##�#� �NAD 1927 ❑NAD 1983 SECTION B•FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B2.COUNTY NAME 33.STA7E 81.NFIP COMMUNITY NAME 8 COMMUNtTY NUMBER pINELLAS F� 125096 B7.FIRM PANEL B9.BASE FLOOD ELEVATiON(S) B4.MAP AND PANEL one A0,use de �of flooding) NUMBER B5.SUFFIX B6.FIRM 1NDEX DATE EFFECTIV��SED DATE 88.FLOOD ZONE(S) (� 12 P 0007 B Cr1�3 810.Indcate the source of the Base Flood Elevation(BFE)data or base flood depth entered in 89• �ef Descnbe: ❑FIS Profile �FIRM ❑Community Determined ❑ � 1 B11.Indicate ihe elevation datum used for the BFE in B9:�NGVD 1929 ❑ NAVD 1988 ❑Other(Descri'oe): 812.Is the buildin located in a Coastal Barrier Resources S iem CBRS area or Otherwise Protected Area OPA)7 ❑Yes ❑No Designation Date SECTION C•BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1.Building elevations are based on,[]Construdion Drawings' ❑Building Under Construction" �Finished Construction "A new Elevation Certificate wili be required when construclion of the buiiding is complete. C2.Buiiding Diagram Number 1(Seled the building diagram most similar to the building for which this ce�ificate is being comple;ed-se°pages 6 and 7. If no diagram iaccurately represents the buildng,provide a sketch or photograph.) C3.Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,ARlA,AWAE,AR/A1-A30,ARIAH,AWAO Canplete Items C3:a-i below aocording to the building diagram spea�ied in Item C2.State the datum used.If 1he datum is different from the datum used for the BFE in Section B,convert the datum to that used fa the BFE.Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Sec6on D or Sedion G,as appropriate,to document the dalum conversion. Datum 1929 Conversion/Comme�ts Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑Yes �No �{ `��<� ❑ a)Top of bottom floor(induding basement or endosure) 6. 6 ft.(m) � ❑ b)Top of next higher floor 'A �„--r-�, � (� a c)Bottom of lawest horizontal sWctural member(V zones only) � � � '!- `" � � ❑ d)Attached garage(top of siab) �' u E �`�j� -..''`�° ,�� , � e)Lawest elevation of machinery andlor equipment �! � �l � ' �-��- '' =S "�" servicing the building(Describe in a Comments area) � . ft�c�PR 0 � 2003 �° ❑fl Lowest adjac�nnt(finished)grade(LAG) ; 5 ft.(m) „�, ❑ g)Highest adjacent(finished)grade(HAG) ' t� 6 �� $V�S - ❑ h)No.of permaneni openings(flood vents)within 1 ft.above adjacent gratle_ � ' �� °��CLEARWATER ^ ❑ i)Total area of aU permanent openings jflood vents)in C3,h 0 sq.in.(sq.crn}-------°�� SECTION D•SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This ce�tification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to ceRify elevation information, f certify thaf the information in Sections A,B,and C on this ceRi�cate represents my best efforts to inierpret the data available. I undersfand that an false statement ma be unishable b fine or rm rrsonment under 18 U,S. Code, SLICENSE NUMBER 4495 CERTIFIER'S NAME M.G.MAYER TITLECEO COMPAM'NAME FLORIDA BENCHMARK ADDRESS • CITY STATE ZIP COQE • 1298 LAKEVIEW RD. CLF�ARWATER FL 33756 SIGNATURE � ,, � DATE TELEPHONE '�� n �`"'� ��,.�xrn. 04-07-03 727-298-0286 U �� —�r—=' FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions 1MPORTANT: In these spaces,copy the cnrresponding information from Section A `�o�'nSU��`,�" F� " ". BUILDING STREET ADDRESS(Induding Apt,Unit,Suite,and/or Bkig.No.)OR P.O.ROUTE AND BOX N0. Paticy Number 154 BAYSIDE DR. C� STATE ZIP CODE Company NAIC,ti;;mber CLEARWATER BEACH FL 33767 SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) ,� Copy both sides of this Elevation Certiflcate for(1)community official,(2)insurance agenUcompany,and(3)building owner. ___ COMMENTS ___• ❑Check here if attachments SECTION E•BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zone AO and Zone A(without BFE),complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting inforrnation for a LOMA or LOMR-F, Section C must be completed. Ei.Building Diagram Number_(5eled the building diagram most similar to the buiiding for which this cerVficate is being completed—see pages 6 and 7. If no diagram accurately represents the building,provide a sketch or photograph.) E2.The top of the bottom floor(indudng basement or endosure)of the building is _ft.(m)_in.(cm)❑above or ❑belrnv(check one)1he highest adjacent grade. ;Use natural grade,'rf available). E3.For Buil�ing Diagrams 6�with openings(see page 7),the next higher floor or elevated floor(elevaGon b)of the building is _ft.(m)_in.(cm)above the highest ad;acent grade. Complete items C3.h and C3.i on front of form. E4.The top of the platform of machinery and/or equipment serviang the building is _ft.(m)_in.(cm)�above or ❑be!cw(checfc one)che highest atljacent grade. (Use natural grade,if available). E5.For Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in aarordance with the communitys floodplain manage�ent ordinance? ❑Yes ❑No ❑Unknown. The local official must ce ' this informa6on in Sec6on G. SECTION F•PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner orowners aulhorized representaUve who compietes Sections A,B,C(Items C3.h and C3.i on�y),and E for Zone A(without a FEMA-issuetl or communiry- issued BFE)or Zone AO must sign here. The stafements in Sections A,B,C,and E are cronect to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE � COMMENTS ❑Check here if attachmen�s SECTlON G-COMMUNITY INFORMATION(OPTIONAL) The local official who Is authorized by law or ordinance to administer the communi�'s floodplain management ortlinance can complete Sections A,B,C(or E),and G of this Elevation Certificate. Compleie the appl'�cable item(s)and sign befow. GL�The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authenzed by st2te or bcal law to certify elevation informaiion. (Indicate the source and date of the elevation data in the Comments area below.) G2.�A community dfiaal completed Section E fa a building located in Zone A(without a FEMA-+ssued or communiry-issued BFE)or Zone A0. G3,�The following information(Items G4-G9)is provided for community floodpiain management purposes. G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6, DATE CERTIFICATE OF COMPLIANCEIOCCUPAtiCY ISSUED � I , G7.This permit has been issued for:0 New Construction ❑Substantial Improvement G8.Elevation of as-built lowest floor(induding basement)of the building is: _._ft.(m) Datum: G9.BFE or(in Zone AO)depth of flooding at the buiiding site is: _ _ft.(m) Dat,,m: LOCAL OFFIGIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS � ❑Check here if attachments FEMA Form 81-31,January 2003 Replaces all previous editions