Loading...
259 BAYSIDE DRU.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFIC Important: Follow the instructions on page: Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2 SECTION A — PROPERTY INFORMATION Al. Building Owner's Name LINDA KAY DYER A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Rout Box No. 259 BAYSIDE DRIVE City CLEARWATER BEACH State Florida 259 BAYSIDE DR Co BCP2019-070726 DYER Uf `'cv Zoning: Low Medium Density Atlas #: 276B A3. Property Description (Lot and t3tocK NumDers, I ax Parcel Numper, Legal Description, etc.) LOT J, BLK 2, BAYSIDE SUB NO. 4, PB 35, PG 57, PINELLAS COUNTY, FLORIDA A4. Building Use (e.g., A5. Latitude/Longitude: A6. Attach at least A7. Building Diagram A8. For a building a) Square footage b) Number of permanent c) Total net area d) Engineered A9. For a building with a) Square footage b) Number of permanent c) Total net area d) Engineered Residential, Non -Residential, Addition, Accessory, etc.) Lat. 27°58'09.13" Long. -82°49'16.62" RESIDENTIAL Horizontal Datum: ❑ NAD 1927 insurance. above adjacent grade grade N/A x NAD 1983 N/A 2 photographs Number with a crawlspace of crawlspace flood of flood openings flood openings? an attached of attached flood of flood openings flood openings? of the building if the 1A Certificate is being used to obtain flood N/A sq ft or enclosure(s): or enclosure(s) openings in the crawlspace in A8.b or enclosure(s) N/A sq in within 1.0 foot foot above adjacent in 638.00 sq ft ❑ Yes x No garage: garage openings in the attached garage within 1.0 in A9.b N/A sq ❑ Yes x No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bl. NFIP Community Name & Community Number 125096 CITY OF CLEARWATER B2. County Name PINELLAS B3. State Florida B4. Map/Panel Number 12103C 0102/0104 B5. Suffix G B6. FIRM Index Date 08-18-2009 B7. FIRM Panel Effective/ Revised Date 09-03-2003 B8. Flood Zone(s) AE B9. Base Flood Eevation(s) (Zone AO, use Base Flood Depth) 11' B10. Indicate the source ❑ FIS Profile B11. Indicate elevation B12. Is the building Designation of the Base Flood Elevation ❑xj FIRM ❑ Community Determined datum used for BFE in Item B9: located in a Coastal Barrier Resources Date: ❑ (BFE) data or base flood ❑ Other/Source: ❑ NGVD 1929 System (CBRS) CBRS ❑ OPA depth entered in Item B9: ❑ Other/Source: x NAVD 1988 area or Otherwise Protected Area (OPA)? ❑ Yes x No FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 259 BAYSIDE DRIVE Policy Number: City State ZIP Code CLEARWATER BEACH Florida 33767 Company NAIC Number SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under 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, Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, Benchmark Utilized: AG0298 Vertical Datum: NAVD 1988 x Finished Construction AR/AH, AR/AO. enter meters. Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 x NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 5.90 the measurement used. x feet ❑ meters b) Top of the next higher floor N/A x feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A x feet ❑ meters d) Attached garage (top of slab) 5.30 x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 5.50 (Describe type of equipment and location in Comments) x feet meters ❑ f) Lowest adjacent (finished) grade next to building (LAG) 5.00 x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 5.20 x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A x feet ❑ meters SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by / certify that the information on this Certificate represents my best efforts to interpret the data available. statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. law to certify elevation information. / understand that any false ❑ Check here if attachments. Were latitude and longitude in Section A provided by a licensed land surveyor? x Yes ❑ No Certifier's Name License Number Miguel A. Cortes 5820 4,.., ,r i N --- A. A. Cp ?' IP* ,LAceKse Ls 51120 ____7,-) ,2 %� �4 ATE OFflLORIDA % W 4 ey W Title PSM Company Name V.I.P. Surveying, Inc. Address 4034 Laurel Branch Lane City State ZIP Code Orlando Florida 32817 Signature - '. y f,Y .- x"z, Date Telephone Ext. , - 07-29-2019 (407) 810-0838 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) Benchmark Elevation 11.82'. Equipment in C2e) is the lowest of the 3 NC Pads located outside. EC #V17398 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 259 BAYSIDE DRIVE Policy Number: City State ZIP Code CLEARWATER BEACH Florida 33767 Company NAIC Number SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1—E5. If the Certificate is intended to support a complete Sections A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters LOMA or LOMR-F request, used. In Puerto Rico only, the elevation is above or below ❑ above or ❑ below the HAG. ❑ above or ❑ below the LAG. 9 (see pages 1-2 of Instructions), ❑ above or ❑ below the HAG. ❑ above or ❑ below the HAG. ❑ above or ❑ below the HAG. with the community's certify this information in Section G. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters E3. Attached garage (top of slab) is ❑ feet ❑ meters E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must 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, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 259 BAYSIDE DRIVE Policy Number: City State ZIP Code CLEARWATER BEACH Florida 33767 Company NAIC Number SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official 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 Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. G1. ❑ 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 community 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—G10) 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: ❑ G8. Elevation of as -built lowest floor (including of the building: G9. BFE or (in Zone AO) depth of flooding at the G10. Community's design flood elevation: New Construction ❑ Substantial Improvement basement) ❑ feet ❑ feet ❑ feet ❑ meters Datum building site: ❑ meters Datum ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS See Instructions for Item A6. OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 259 BAYSIDE DRIVE Policy Number: City State ZIP Code CLEARWATER BEACH Florida 33767 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 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." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. ,..- f• ------.------ �.--.—. ----U Pj f • L7/29/2(119 Photo One Photo One Caption FRONT Clear Photo One I�F Photo Two Photo Two Caption AC and LEFT Clear Photo Two FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS OMB No. 1660-0008 Continuation Page Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 259 BAYSIDE DRIVE Policy Number: City CLEARWATER BEACH State ZIP Code Florida 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." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. Photo Three Photo Three Caption REAR Clear Photo Three Photo Four Caption RIGHT FEMA Form 086-0-33 (7/15) Replaces all previous editions. Clear Photo Four Form Page 6 of 6 ELEVATION CERTIFICATE O.M.B. No. 3067-0077 FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31, 1999 NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waivar of the flood insurance purchase requirement.This fo�m is used only to pro- vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine �the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR).You are not required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form. Instructions for completing this form can be found on the following pages. SECTION A PROPERT FOR INSURANCE COMPANY USE BUILDING OWNER'S NAME POLICY NUMBER ��1 6 ��'YE STREET ADDRESS(Including A t.,Unit,Suite an /or Bldg.Number) . OUTE AND BOX NUMBER COMPANY NAIC NUMBER z �,� s,�. �� �' 1 1996 OTHER DESCRIPTION(Lot and Block Numbers,etc.) Lv-r- J t31�.� Z, CENTRAI. PERMITTINf,� CITY CITY STATE ZIP CODE Gl�a��•tt�i E� FL SECTION B FLOOD INSURANCE RATE MAP(FIRM)INFORMATION Provide the following from the proper FIRM (See Instructions): 1.COMMUNITY NUMBER 2.PANEL NUMBER 3.SUFFIX 4.DATE OF FIRM INDEX 5.FIRM ZONE 6.BASE FLOOD ELEVATION (in AO Zones,use depth) 1250�� c�oo-�- � A�.�,�'r i�,��'i► AE II ' iz, ' � 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations(BFE): �NGVD'29 ❑Other(describe on back) 8. For Zones A or V,where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate the community's BFE:I � I I I I.U feet NGVD (or other FIRM datum-see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION ! ;1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level�— . :(a). FIRM Zones A1-A30, AE,AH,and A(with BFE). The top of the reference level floor from the selected diagram is at an elevation of� I I �� �6I.0 feet NGVD (or other FIRM datum-see Section B, Item 7). (b). FIRM Zones V1-V30, VE, and V(with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of I�.0 feet NGVD (or other FIRM datum-see Section B, Item 7). (c). FIRM Zone A(without BFE). The floor used as the reference level from the selected diagram is W.U feet above❑ or below❑ (check one) the highest grade adjacent to the building. •(d). FIRM Zone AO. The floor used as the reference level from the selected diagram is W.U feet above❑ or below❑ (check one)the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor(reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations:� NGVD'29 ❑ Other(describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the e/evations is different than that used on the F/RM �see Section 8, Item 7J, then convert the e/evations to the datum system used on the F/RM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: � Yes ❑ No (See Instructions on Page 4) 5.The reference level elevation is based on: � actual construction ❑ construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in p/ace, in which case this certificate will only be valid for the building during the course of construcfion. A post-construction E/evation Certificate will be required once construction is comp/ete.) 6.The elevation of the lowest grade immediately adjacent to the building is:� I I I I sl.U feet NGVD (or other FIRM datum-see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1 If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 �'ss not the"lowest floor"as defined in the community's floodplain management ordinance,the elevation of the building's"lowest floor"as defined by the ordinance is � i � � I �.U feet NGVD (or other FIRM datum-see Section B, Item 7). 2. Date of the start of construction or substantial improvement �-�-EM��`Z. ��o, 199� FEMA Form 81-31, AUG 96 REPLACES ALL PREVIOUS EDI110NS SEE REVERSE SIDE FOR CONTINUATION SECTION E CERTIFICATION This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones A1–A30, AE, AH, A (with BFE),V1–V30,VE, and V (with BFE) is required. � Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference levei diagrams 6, 7 and 8- Distinguishing Features–If the certifier is unable to certify to breakaway/non-breakaway wali, enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s),then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Jase r�� �� �L�►ve�-, f�e�s.�t �-u 2� CERTIF R'S NAME LICENSE NUMBER(or Affix Seal) �'�C"E"'.�lL��t"T f /�-1�f'C�JI��C� _ �I t UE'�r-1 _ ��f C��1 �._ TITLE COMPANY NAME �ZF���1 '11 �7 1�� �. t��-V��� L l C � � ` I �?'hl U'c��U� __ _ --� ��lo�� ADDRESS -�� CITY STATE �ZIP � - Iz� (�����- �l3 7 � I - 7�2� SI�GNATURE '� DATE PHONE • Copies should be made of this Certificate for: 1)community official,2) insurance agent/company,and 3) building owner. COMMENTS: — - - - � ON WITH ON PILES, • SLAB BASEMENT PIERS,OR COLUMNS A V A A V ZONES ZONES ZONES ZONES ZONES REFERENCE REFERENCE BASE �EVE� REFERENCE LEVEL FLOOD �EVEL ELEVATION I BASE BASE � � �ADJACENT ' REFERENCE FLOOD FLOOD GRADE � LEVEL ELEVATION ELEVATION REFERENCE ADJACENT LEVEL GRADE .:'�ADJACENT-''. .... /!1 . � :,� GFADE �� IT1/� The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. � Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2