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270 BAYSIDE DR �1>C ��X Cl.� T �l.r�l(J�,j c� �'�7C �J'�.``15�S, �� QMH Na 166Q-QQ08 U.S.DEPAR7MENT OF HOMELAND SECUR�TY ELEVATION CERTIFICATE Exoires Februarv 28.2009 Federal Emergency Management Agency National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INF�RMATION For Insuranc�Company Use: A iilding Owner's Name BRUCE L.DANQREW Policy Number A2�ilding Street Address(includin9 Apt.,Unit,Suite,and/or Bldg.No.)or P.Q.Rout�e a�d Box No. Gompany NAIC Numker 270 BAYSIDE DRIVE City CLEARWATER State FL ZIP Code 33767 A3. Property Description(Lot and Blodc Numbers,Tax Parcel Number,Legal Description,etc.) LOT"M",BLOCK 1,BAYSIDE SUBDIVISION NO.4,UNITA A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL AS. Latitude/Longitude:Lat.2T DEf s8'11"N Long.B�DEt�49'15"W Horizontal Datum: ❑NAD 1927 � NAD 1883 A6. Aitach at least 2 photographs of the buiiding'rf the Ce�t�cate is being used ta obtain flood insurance. A7. Building Diagram Number 6 A8. For a building with a crawi space or anclosure(s),provide A9. For e 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 4� sq ft b) No.of parmanent flood openings in the crawl space or b) No.of permanent Flood openings in the attached garage enclosure(s)walis within 1.0 foot above adjacent grade 0 walls within 1.0 foot above adjacent grade 19 c) Totaf net area of flood openings in A8.b 0 sq in C) Totai net area of flood openings in A9.b �� sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 61.NFIP Community Name 8�Community Number B2.County Name B3.State ClTY OF CLEARWATER 125096 PINELLAS FLORIDA B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone Date Effective/Revlsed Date Zone(s) AO,use base flood depth) 12103C0102G G MAY 17,2005 SEPT.3,2003 AE 11 B10. Indicate the source of the Base Flood Etevation(BFE)data or base flood depth entered in Item B9. ❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe) 811. Indicate elevation datum used for BFE in Item 69: ❑NGVD 1929 �NAVD 1988 [I Other(Describe) B12. Is the building toeated in a Coastal Barrier Resour�ees System(CBRS)area or Otherwise Proteeted Area(OPA)? �Yes �No �signaGon Date NONE ❑CBRS ❑OPA �� SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIREQ) C1. Building elevations are based on: ❑Construction Drawings* �Building Under Construction* ❑Finished Construction 'A new Elsvation Certiflcate will be required when construdion of the building is complete. C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,ARlAE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-g below according to the building diagram speafied in Item A7. ,, _..,,,,,_,w.,,,�wa�„,„,�,F,.,.:,�,_., Benchmaric Utilized SEE COMMENTS Vertical Datum NAV¢88 i ;'F ' �_� `'vM� � ConversioNComments NGVD29-0.85 FT=NAVD88. r's•� �„�,�,,,-�^�a-.� .�-�� Check the meaauremont used. �.�,'$°�'..�� ,.....� a) Top of bottom floar(induding basement,crawl spaCa,or enclosure floor)_ �.7 �feet ❑meters(Puerto Rico only) ��;� Z ��.l, b) Top of the next higher floor ,a 5.$ �feet ❑meters(Puerto Rica only) a }•�"::d�. ,C �.?�'y c) Bottom of the lowest horizontal structural mamber(V Zones only) 1�/ . ❑feet ❑meters{Puerto Rico only) �;_�,;�; � d Attachad ara e(top of slab) �.z �feet ❑meters Puerto Rico oN � �'<�•+� ��m�� ) 9 9 ( Y) ",.', _� �.-a;' %'---=;'', e) Lowest elevation of machinery or equipment servicing tha building JL,,,_/A: ❑teet ❑meEers(PueRo Rieo only) , � �, �,� (Describe type of equipment in Comments) �:�� o ��7; f� Lowest adjacent(finishedj grade(LAG) 4.4 �feet ❑metars(Puerto Rico only� °�;,,"'`'� "� ,�,..... i g) Highest adjacent(finished)grade(HAG) 4.Q �,'J feet ❑meters(Puerto Rico only) ''�C" ��°'�` il,'; ��.. w.� k SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION � «; �� ?�' Thls certification is to be slgned and sealed by e land surveyor,engineer,or archftect authorized by law to certify elevaGon � '"" "' """'`""'�"' information. 1 certify thet the infwmatlon on this Certificata represents my besf ellorts to interpiet the data evailable. �� - :.- � �, 1 understend that any false statemenl may be punistrable by fir�e vr imprisonment uneler 98 U.S. Code,Seetion 100?. �l � � � !�' � " � Check here if c�mments are provided on badc of form. % �.�� ,�� _=-_ --- --------- ---- x '' � ' �' :: Cert�er's Name MICHAEL J.BAKER License Number LS 4086 ��` �� r;,� ,�• ; ,. 7� � Title LAND SURVEYOR Company Name MICHAEL BAKER ASSOCIATES - '' ,,N ��-��- " !' �'1�{ � y 4 A s 220 5.SAFFORD AVE. Ci TARPON SPRINGS Stata FL 21P COde 34689 /�"-�� a c 4-, . l 3Cf��,�"i, �W ty �� l,; � :. Siynature -- n n �' T��- -Date NOV. 12.2007 Telephone 727-938-5026 ,x� , 'Ba�Lyg�aR�"g�`��, , , j�_� -;� ` �L-- / IMPORTANT: !n these spaces,copy the corresponding informatlon from Section A. For Insurance Gompany Use: Building Street Address(induding Apf.,Unit,Suite,and/ot Bldg.No.)or P.O.Route and Box Na Policy Number " 270 9AYSIDE DRIVE City CIEARWATER State FL ZIP Code 34676 ompany C` umber SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CON'I'INUED) Copy both sides of this Elavation Certificate for(1)community official,(2)insurance agerit/company,and(3)building owner. Comments C2.) ELEVA7lONS REFERENCED TO PINELLAS COUNTY BENCHMARK"LP15 1968"-EL ATION=4.19 FEET. C2.) FOYER ELEVATION=10.7. , // � Signa � _t - Date 11/12/2007 ❑ Check here if attachments SECTION E-BUILDING ELEYATION 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 Ce�tificate 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. Cheek the measuroment used. In Puerto Rico only,enter meters. E1. Provide elevation information for the following and check the app�opriate boxes to show whether the elevation is above or below the highest adjacent 9��de(HAG)and the lovvest adlacent gr�de(IAG�. a)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑meters []above or[�below the HAG. b)Top of bottom floor(including basement,crawl space,or endosure)is ❑fcet []meters ❑above or❑ below the IAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A ftems 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(tap af slaha is ❑feet �m�ters ❑ahQVe ar ❑aelow the HAG. E4. Top of platform of machinery and/or equipment servicing the buitding 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 efevatad in accordance with the community's floodplain management oniinan�e? ❑Yes ❑ IYo ❑ Unknown. The local official must certify this information in Section G. SEC710N F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owners authorized represantative who completes Sections A,B,and E for 2ane A(without a FEMA-issued or community-issued BFE) or Zone AD must sign here. The statements In Sections A,8,and E are conect to the best of my knowledge. • Property Owner's or Owners Authorized Representative's Name /��.1�. �L�z !�3 a sz 1 Address City State ZIP Code 2�z��.y ��(� �- �—r ��,� t,��a�,g��L ,�. 3�� .;� - Signature Date ,� Telephone y! �o b7 �j27 ? `c�'�� ?2"L� Co en ❑Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local offlcial 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. Chedc the measurement used in Items G8.and G9. G1.❑ The information in Section C was taken from other doCUmentation that has been signed and sealed by a licensed surveyor,enginesr,or architect who is authorized t�y law to certify elevation information. (Indicate the source and date of the elevation data in the Camments area helaw.) G2.❑ A community o�cial completed Section E for a building located ln 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 managament purposes. G4.Permit Number G5. Date Pertnit Issued G6. Date Gertificate Of Compliance/Occupancy Issued G7.This permtt nas Deen issued for: ❑New Construction []Substantial�mprovement G8.Elevation of as-built lowest floor(including basement)of the building: �feet (�meters(PR)Datum G9.BFE or(in Zone AO)depth of flooding at tha buildi�g site: ❑feet ❑mete�s(PR)Datum Local Official's hlame Title Corrmunity Name Telephone Signature Date Comments . � U.S. DEPARTMENTOF HOMELAND SECURITY ELEVATION CERTIFICATE OMB NO. 1660-0008 Feder2l Emergency ManagementAgency Expires March 31,2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1. Building Owner's Name BRUCE L. DANDREW Policy Number A2. Building Street Address(including Apt., Unit,Suite,andbr Bldg.No.)or P.O. Route and Box Na Co p� eF-� 270 BAYSIDE DRIVE � City CLEARWATER State FL ZIP Code 33767 �,.._ f _�,•�,, ��: A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) �'' �-�� PARCEL ID NO.08-29-15-04986-001-0130 �� r ; A4. Building Use(e.g., Residential,Non-Residential,Addition,Accessory,etc.)RESIDENTIAL ��:` y � A5. Latitude/Longitude: Lat.27°58'11"N Long.82°49'15"W Horizontal Datum 't�{�1924�� NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. T 'f N � -1 p r. - A7. Buiiding Diagram Number 6 ` t A8. For a buiiding with a crawlspace or enclosure(s): A9. For a building with an attached ga ��'} ° �i;�,;, !^ �,_.t a) Square footage of crawlspace or enclosure(s) 3176 sq ft a) Square footage of attached g ' s b) No. of permanent flood openings in the crawlspace or b) No.of permanent flood openi s hf2he �i��a� � enclosure(s)within 1.0 foot above adjacent grade 18 within 1.0 foot above adjacent ra�} �0--"-� c) Totai net area of flood openings in A8.b 2304 sq in c) Total net area of flood openin . _ sq in d) Engineered flood openings? � Yes ❑ No d) Engineered flood openings? � Yes ❑ No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 61. NFIP Community Name&Community Number 62.County Name 63.State CITY OF CLEARWATER 125096 PINELLAS FLORIDA . B4. Map/Panel Number 65.Suffix B6.FIRM Index B7. FIRM Panel B8.Flood B9. Base Fiood Elevation(s)(Zone 12103C0102 G Date Effective/Revised Date Zone(s) AO,use base flood depth) AUG 18,2009 SEPT.3,2003 AE 11 610. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69. ❑ FIS Profile � FIRM ❑ Community Determined ❑ Other(Describe) 611. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 ❑ Other(Describe) 612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Othervvise Protected Area(OPA)? ❑ Yes � No Designation Date NONE ❑ CBRS ❑ OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction' � Finished Construction. "A new Elevation Certificate will be required when construction of the buiiding 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. Complete Items C2.a-h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized PINELLAS"LP15 1968"EL=5FNertical Datum NGVD29 ��- �, ` Conversion/Comments NGVD29-0.85FT= NAVD88 V v Check the measurement used. � a) Top of bottom floor(including basement,crawlspace, or enclosure floor)5.7 �feet ❑meters(Puerto Rico only) � b) Top of the next higher floor 15.9 �feet ❑meters(Puerto Rico only) ^�, c) Bottom of the lowest horizontal structural member(V Zones only) N/A. ❑feet ❑meters(Puerto Rico only) `" d) Attached garage(top of slab) 5.7 �feet ❑meters(Puerto Rico only) � e) Lowest elevation of machinery or equipment servicing the building 11.3 �feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) � � Lowest adjacent(finished)grade next to building(LAG) 4.3 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 5.4 �feet ❑meters(Puerto Rico only) � h) Lowest adjacent grade at lowest elevation of deck or stairs, including NlA. ❑feet ❑meters(Puerto Rico only) � structural support SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION ,- , ' }� This certiflcation 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 available. '-� , sC �' ('�:�, �}',`" ` ", l understand that an y false s ta t e m e n t m a y b e p u n i s h a b l e b y f i n e o r imprisonmen t un der 1 8 U.S. Co de, Sec tion 1 0 0 1. ,�.\� > �,� � Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a � r� �-,�, licensed land surveyor? ❑ Yes � No � ` ' �� Certifier's Name MICHAEL J.BAKER ��.�� '��'�� '-�' L° �� License Number LS 4086 �• p�� , , y �, Title LAND SURVEYOR Company Name MICHAEL BAKER ASSOCIATES �`�^ ' ` � �f fJ Address 220 S. SAFFORD AVENU City TARPON SPRINGS State FL ZIP Code 34689 � �"� . , Signature �; � Date JAN.25,2010 Telephone 727-938-5026 G' ,. vy� FEMA Form 81-31, Mar 09 � See reverse side for continuation. Replaces all previoas editions % . � � , IMPORTANT: In these spaces, copy the corresponding information from Section A. Forinsurance Cnmpany Use:r Building Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Nurr►ber 270 BAYSIDE DRIVE - City CLEARWATERState FL ZIP Code 33767 � Company NAIC Number � SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides ofthis Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments C2(e). BOTI'OM OF ELECTRIC METER(AIR CONDITIONING CONDENSOR ELEV.=15.7) A9). GARAGE IS PART OF CRAWL SPACE. Signature r - Date 01/25/2010 � �`L ❑ Check here if attachments S CTION E-B LDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITIiOUT BFE) For Zones AO and A(without BFE), complete Items E1-E5. tf 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 oniy,enter meters. E1. Provide elevation information for the foliowing 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,crawlspace,or enclosure)is ❑feet ❑meters [�above or 0 below the HAG. b)Top of bottom floor(including basement,crawlspace,or anclosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 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 buiiding 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 fhe best of my know/edge. Property owners or Owner's Authorized Representative's Name Address City State ZIP Code • - �ignature Date ^ Telephone Comments ❑ Check here if attachments SECTION G-COMMUNITY INFORMATION (OPTIONAL) ^ The local official who is authonzed 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 GS and G9. 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 Iocated 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. GA. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has 6een issued for: ❑ New Construction ❑Substantial improvement G8. Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters(PR)Datum G9. BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR)Datum ' G10. Community's design flood elevation ❑feet ❑meters(PR)Datum Local Official's Name Title . Community Name Telephone Signature Date Comments "" — "'--�— " --' ❑Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions � � Building Photographs See Instructions for Item A6. For Insurance Compa�y Use: Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number 270 BAYSIDE DR. Clty CLEARWATER State FL ZIP Code 33767 CompanyNAlCNumber If using the Elevation Certificate to obtain NFIP flood 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 on the reverse. � °- � �i � � I ! � I ` �: : . , � . t _ ,.. � . - � r•- � . _ ��. i ' -� I�, � I _ , ; _ � , - �- � - �� , t; i i ( � � � 1 �F� -� _ ' , ' _ + � -- _ I �� 1 .�A _ �i� I�� • - _ J �. � >�, - .� ��"�'- �� 9 . _ _ .��_ �- ; � . � �? �� 1��_ ti �i� - �, - �' .� �i� � � -.- ,� __ . ,� ..i.�.r..� _ :��*� �� . a� , �I �F� �� " _ �II - _ ; � ,�# • i _ .; ,.. ".r..' .._- .�_-=Y . _ .�\ � _ _ ` �, • �i � _ � � � -■ � � , .� � �� r � .av. , . � ��,� � . � ;� � � � �� ;�i � j� !� � _t ��'� � � � �1 ' j � � f � � ...��.�.++�� . �.e:t�`� � � i ��_,,� + J� � 4� 4> t / �'r FRONT VIEW �� , ,i`� ,, - , � REAR VIEW _ �� ' .'{� �� u'��'�� - ��, � _ , , � Building Photographs 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 Number 270 BAYSIDE DRIVE " Clty CLEARWATER State FL ZIP COd@ 33767 CompanyNAlCNumber 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." n ' �1 �'�� ': •°�s��:,� ��; ,;� �','' �� - - • � - _ . � �� s,� ��. — - ,i: � � ' . �� d�� ; � �� I �� I I'' �� _ - -- r--�� ' _ - .:� '• � I c� E Gr::,� 1 � , � , . _ ...- : � . ��,.. .._ . r, . „ ____�. . � - _. . . . . f _. . _tv, . .,.� , � , � I r , � r / � t` r � ., � .�� .. , fi _ ,� i� �:. , J` \ 'r,C C�. �� 'J. :Lq►1� �� i: : �'�� r� L �� : : .��,� i�! `�� `� . � � � �;,�� s;,�.:.� .>.�� ,, .,..i�.:4. I SIDE VIEW , _ ' i