600 BAYWAY BLVD , �ERALEMERGENCY MANAGCMENT AGENCY
• � NATIONAL'FLOOD INSURA"`_^�PROGRAM � � M.B. No. 3067-0077
�`������� s ����� ELE�I'ATIC�N CERtIFICATE E'�pires December 31, 2005
Important: Read the instructions on pages 1-7. JOB No.04.0075.2
SECTION A-PROPERTY OWNER INFORMATION Forinsurance Company Use:
BUILDING OWNER'S NAME Poiicy Number
Bay Harbor,A Condominium, LLC
� BUILDING STREET ADDRESS(Induding Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
4 �Bayway Boulevard
CITY STATE ZIP CUDE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
Lots 6-8,Biock A Bayside Subdivision No.5 P.B.38,Pgs.38-39
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( ##°-##'-##.##" or ##.#####°) ❑ NAD 1927 ❑ NAD 1983 ❑USGS Quad Map ❑Other:_
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME 63.STATE �
City of Clearwater 12103C0104G PINELLAS FLORIDA
B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER B5.SUFFIX B6.FIRM INDEX DATE EFFECTIVEIREVISED DATE B8.FLOOD ZONE(S) (ZoneAO,use depth of flooding)
125096 G SEPTEMBER 03,2003 SEPTEMBER 03,2003 AE EL.11.0
610.Indicate the source of the Base Floal Elevation(BFE)data or base flood depth entered in B9.
❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe):___
B11.Indicate the elevation datum used for the BFE in B9:❑NGVD 1929 �NAVD 1988 ❑Other(Describe):_
B12.Is the building located in a Coastal Bamer Resources System(CBRS)area or Othenvise Protected Area(OPA)? ❑Yes �No Designation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1 Building elevations are based on:0 Construction Drawings' �Buiiding Under Construction' ❑Finished Construdion
• 'A new Elevation CeRificate will be required when construction of the builtling is complete.
2.Building Diagram Number 6 (Select the building diagram most similar to the building for which this certificate is being completed-see pages 6 and 7. If no diagram
accurately represents the building,provide a sketch or photograph.)
C3.Elevations—Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AWA,AWAE,AR/A1-A30,AR/AH,AR/AO
Complete Items C3.-a-i below according to the building diagram specfied in Item C2.State the datum used.If the datum is different from the datum used for the BFE in
Section B,convert the datum to that used for the BFE.Show field measuremer�:s and datum conversion calculation. Use the space provided or the Comments area of
Section D or Section G,as appropnate,to document the datum conversion.
Datum NAVD 1988 Conversion/Comments N/A ���� � -
Elevation reference mark used LABINS EL.=4.191 Does the elevation reference mark used appear on the FIRM? ❑Yes � t, ,, r
o a)Top of bottom fioor(including basement or enclosure) __6.97 FT ft.(m) � '�'r J• ,�r
o b)Top of next higher floor 16.97 FT ft.(m) `� "'� '�" �:�s 4•>` '-�•"
o c)Bottom of lowest horizontal structural member(V zones only) N/A FT ft.(m) � � w .: � "' �' r'' `'
o d)attached garage(top of block) 6.97 FT ft.(m) �� � �s:.. ` s , � r-`�
c� e)Lowest elevation of machinery andlor equipment W `° '�' � � `
� � r�,.� � �� ..
servicing the building(Descnbe in a Comments area) N/A FT ft.(m) E� �, � ��'�
o�Lowest adjacent(finished)gratle(LAG) 5.1 FT ft.(m) z� � � `PL S.Nc�,.����
o g)Highest adjacent(finished)grade(HAG) 5.4 FT ft.(m) � '' ,�p����0��
o I�)No.of permanent openings(flood vents)within 1 ft.above adjacent grade N/A J
o i)Total area of all permanent openings(flood vents)in C3.h N/A sq.in. •
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.
I cerfrfy fhaf the information in Sections A,8,and C on fhis cerfificate represents my best efforts to interpret the dafa available.
I understand that any false statement may be punishable by fine or imprisonmenf under 18 U.S. Code, Secfion 1001.
CERTIFIER'S NAME LICENSE NUMBER
BRUCE A.KLEW PLS 5052
TITLE COMPANY NAME �
•°RESIDENT KLEIN&STAUB SURVEYING,JNC.:.
ADDRESS CITY STATE ' ZIP CODE
8016 Old County ad 54 New Port Richey FL 34653
SIGNATURE ; DATE TELEPHONE
' , 04/18/06 (727)834�140
FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces ail previous editions
IMPORTANT: In these spaces,copy the corres �iing information from Section A. For insurance com�any use: .
SUILDING STREET ADDRESS(Induding Apt.,Unit,Su,te,andl��.No.)OR P.O.ROUTE AhG BOX N0. , Policy Number •
612 Bayway Boulevard � 7
CITY STATE ZIP CODE Company NAIC Number _
CLEARWATER FLORIDA 33767
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) �
Copy both sides of this Elevation Certifcate for(1)community official,(2)insurance agenVcompany,and(3)building owner.
COMMENTS
NIA ' � '
y
❑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 CeRificate is intended for use as supporting information for a LOMA or LOMR-F,
Section C must be completed.
E1.Building Diagram Number_(Select the building diagram most similar to the building for which this certificate 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 Boor(including basement or enclosure)of the building is _ft.(m)_in.(cm)❑above or ❑below(check one)the highest adjacent grade. (Use
natural grade,if available).
E3.For Building Diagrams 6�with openings(see page 7),the ne�higher floor or elevated floor(elevation b)of the building is _ft.(m)_in.(cm)above the highest adjacent
grade. Complete items C3.h and C3.i on front of form.
E4.The top of the platform of machinery and/or equipment servicing the building is _ft.(m)__in.(cm)0 above or ❑below(check one)the highest adjacent grade. (Use
naturai grade,if available).
E5.For Zone AO only: If no floocl 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 propeRy owner or owners authorized representative who completes Sedions A,B,C(Items C3.h and C3.i only),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,C,and E are correct to the besf 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 attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The loca!official who is authonzed by law or o�dinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Certificate.. C�mplete G�e appiicable ite�r�;s)ar��sign below.
G1.�The irfo�natia^in Section C ti��,s taken from other documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authonzed by state
. or Ixal la�.v to certify elevatii;n inf�rrnation. (Indicate the source and date of the elevation data in the Comments area below.)
G2.❑A communiry o�cial completec;Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�The following inf,�rmati��n(Itenis G4-G9)is provided for community floodplain management purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED 1
1
G7.This permit has been issued for: ❑New Construction ❑Substantial Improvement
G8.Elevation of as-built lowest floor(including basement)of the building is: _._ft.(m) Datum:_
G9.BFE or(in Zone AO)depth of flooding at the building site is: _._ft.(m) Datum:_
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE •
COMMENTS ;
DEV�t- ❑Check here if attachments
FEMA Form 81-31,January 20 Replaces all previous editions
�, _ � �
�.�° {���" i.,�'� �� i�>�''`� �OERAL.EIVIERGENCY MANAGEMENT AGENCY
+ ,, ' , NATtONAL'FLOOD INSUR�"`YF PROGRAM O M.B. No. 3067-0077
Expires December 31, 2005
' ELE`VATION CER�IFICATE
• Important: Read the instructions on pages 1 -7. JOB No.04.0075.2
SECTION A•PROPERTY OWNER INFORMATION Forinsuranoe CompanyUse:
BUILOING OWNER'S NAME Policy Number
Bay Harbor,A Condominium, LLC
��� DING STR T ADDRE�S(Includin Apt.,Unit,Sui an /or ldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
� Bayway B vard ' � r /� r�;��' ,x;,�=�
STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
Lots E8,Block A Bayside Subdivision No.5 P.B.38,Pgs.38-39
BUILDING USE(e.g.,Residentiai,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.)
RESIDENTIAL
LATITUDElLONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( ##°-##'-##.##" or ##.�°) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Ofher:
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
61.NFIP COMMUNITY NAM &COMMUNITY NUMBER B2.COUNTY NAME B3.STATE
City of Clearwater 1����G ��,,,,��'�� PINELLAS FLORIDA
64.MAP AND PANEL 87.FIRM PANEL 89.BASE FLOOD ELEVATION(S)
NUM R B5.SUFFIX 66.FIRM INDEX DATE EFFECTIVFJREVISED DATE BS.FLOOD ZONE (Zone A0,use depih of�9)
� ;. :'`�� r`" 1 ';d A s'�r°' G SEPTEMBER 03,2003 SEPTEMBER 03,2003 AE EL.11.0 -/
` 610.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9.
❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe):__
611.Indicate the elevation datum used for the BFE in B9:�NGVD 1929 �NAVD 1968 ❑Other(Describe):_
612 Is the building located in a Coastal Bamer Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes �No Designation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
:1.Building elevations are based on:0 Construction Drawings" �Building Under Construction` ❑Finished Construction
`A new Efevation Certificate will be required when construction of the building is complete.
2.Building Diagram Number 6 (Select the building diagram most similar to the building for which this cerhfificate is being completed-see pages 6 and 7. If no diagram
accurately represents the building,provide a sketch or photograph.)
C3.Elevations—Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AWA,AWAE,ARIA1-A30,AR/AH,ARIAO
Complete Items C3.-a-i below according to the building diagram specfied in Item C2.State the datum used.If the datum is different from the datum used for the BFE in
Section B,convert the datum to that used for the BFE.Show field measuremen:s and datum conversion calculation. Use the space provided or the Comments area of
Section D or Section G,as appropriate,to document the datum conversion.
Datum NAVD 1988 ConversionlComments N/A
Elevation reference mark used lABINS EL,=4.191 Does the elevation reference mark used appear on the FIRM? ❑Yes �
o aj Top of bottom floor(including basement or endosure) 6.97 . FT ft.(m) �
o b)Top of next higher floor 16.97 FT ft.(m) �' -^
o c)Bottom of lowest honzontal structural member(V zones only) N/A . FT ft.(m) o o .\ } -
o d)attached garage(top of block) 6.97 • FT ft.(m) E g
o e)Lowest elevation of machinery and/or equipment �j I ��
s e rv i d n g t h e b u i l d i n g(D e s c n b e i n a C o m m e n t s a r e a) N/A . F f ft.(m) E;, �
o�Lowest adjacent(finished)grade(LAG) 5.1 FT ft.(m) �N PL S No.5052
o g)Highest adjacent(finished)grade(HAG) 5.4 FT ft.(m) � 04�1�s!06
o h)No. of permanent openings(flood vents)within 1 ft.above adjacent grade N/A �
o i)Total area of all permanent openings(flood vents)in C3.h NIA sq.in.
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 in Sections A,8,and C on this cerfificate represents my best efforts to interpret the data available.
I understand fhat any false statement may 6e punishable by fine or imprisonment undei 18 U.S. Code,Section 1001.
CERTIFIER'S NAME LICENSE NUMBER
BRUCE A.KLEIN PLS 5052
�TITLE COMPAM'NAME� � P � ` �
'RESIDENT KLEIN&S7f�tJB SURt��'INE3,�: ' ' �
ADDRESS CITY STA�� ; ZIP CODE
8016 Old Counry ad 54 New Port Richey FL , 34653
SIGNATURE DATE TELEPHONE
, 04/18106' ' - - (727�834�140
FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions
el �
IMPORTANT: In these spaces,copy the corre�• ��ding information from Section A. For insurance company use:
BUI�DING S;REET AD r2ESS(Induding Apt,Un�,Sui�e,andl� �.No.)OR P.O.ROUTE ANG BOX N0. , Policy Number
612 B�ay Boulevard '
CITY � STATE ZIP C�DE Company NAIC Number
CLEARWATER FLORIDA 33767
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)building owner.
COMMENTS
N/A ' ' ,v
❑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 information for a LOMA or LOMR-F,
Section C must be completed.
E1.Building Diagram Number_(Select the building diagram most similar to the building for which this certificate is being canpleted-see pages 6 and 7. If no diagram accurately
represents the building,provide a sketch or photograph,)
E2.The top of the bottom floor(induding basement or endosure)of the building is _ft.(m)_in.(cm)❑above or ❑below(check one)the highest adjacent grade. (Use
natural grade,if available).
E3.For Building Diagrams 6-8 with openings(see page 7),the next higher floor or elevated floor(elevation b)of the building is _ft.(m)_in.(cm)above the highest adjacent
grade. Complete items C3.h and C3.i on front of form.
E4.The top of the platform of machinery and/or equipment servidng the building is _ft.(m)_in.(cm)�above or ❑below(chedc one)the highest adjacent 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 accordance with the oommunit�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 representa6ve who completes Seclions A,B,C(Items C3.h and C3.i only),and E for Zone A(without a FEMAassued or communiiy-
� ued BFE)or Zone AO must sign here. The statements in Sections A,8,C,and E are cort�ct fo the best of m,y knowledge.
OPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local official who is authonzed by iaw or o�dinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Certificate. Complete t��e appiicable ite^��!s)and sign below.
G1.�The informatior�n Section C�v�s taken from other documentation that has been signed and embossed by a licensed surveyor,engineer,or ar�hitect who is authorized by state
or local la�.v to certify elevstian inforrriation. (Indicate the source and date of the elevation data in the Comments area below.)
G2.�A community offiaal comp�eted Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�The following inf�rmatic�n(Itenis G4-G9)is provided for community floodplain management purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY 15SUED
G7.This permit has been issued for: �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 building site is: __fl.(m) Datum:_
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
�NATURE DATE
COMMENTS
DEVEL ❑Check here if attachments
FEMA Form 81-31,January 20 Replaces all previous editions
CITY OF CLEARWATER
� DEVELOPMENT & NEIGHBORHOGD SERVICES DEPARTMENT
POST�FFICE BOX 474g� CLEARWATER� F�oa�DA 33758-4748
MUNIC[PAL SERVICES BUll.D[NG, ZOO SOUTH MYRTI.E AVENUF.,CI,EARWATER, FLOa��n 33756
Tr1.F�xoNe: (72� 562-4567 F,vc(727) 562-4576
MEMO OF REVIEW FOR CORRECTNESS & COMPLETION
In accordance with participation in the NFIP/CRS program, all elevation certificates are required to be reviewed for correctness and compietion prior to
acceptance by the community. This complete form shall be attached to all elevation certificates maintained on file and provide with requested copies of
elevation certificates.
The attached elevation certificate requires corrections by the surveyor of section(s) prior to acceptance by the community
The attached elevation certificate is complete and correct
�Minor corrections have been made in the below marked sections by Community Official
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
A1. BUILDING OWNER'S NAME Policy Number
A2. BUILDING STREET ADDRESS(including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
600 BAYWAY BLVD
CITY STATE ZIP CODE
A3. PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
A4. BUILDING USE(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)
A5. LATITUDE/LONGITUDE(OPTIONAL): HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
(##°-##'-##.##" or ##.#####°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map❑Other
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE
��City of Clearwater 125096
B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER g5.SUFFIX B6.FIRM INDEX OATE EFFECTIVE/REVISED DATE B8 FLOOD ZONE(S) �Zone AO,use depth offlooding)
12103C-0104 5l17/2005
B10. 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)
B11. Indicate elevation datum used for BFE in B9: ❑ NGVD 1929 ❑ NAVD 1988 ❑ Other(Describe)
612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ❑No Designation Date
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 building is complete.
C2. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed-see pages 6 and 7. If no
diagram accurately represents the building,provide a sketch or photograph.)
C3. 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 C3.-a-i below according to the building diagram specified in Item C2.State the datum used. If the datum is different from the datum used for the
BFE in Section B,convert the datum to that used for the BFE.Show field measurements and datum conversion calculation. Use the space provided or the Comments
area of Section D or Section G,as appropriate,to document the datum conversion.
Datum Conversion/Comments
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑Yes ❑No
e) Lowest elevation of machinery or equipment servicing the building(Describe in Comments area) ft.(m)
h) No.of permanent openings(flood vents)1ft.above adjencent grade
i) Total area of all permanent openings(flood vents)in C3.h sq.in.(sq.cm)
Comments:
Date of Review: Community Official:
�vation certificates shall be maintained by the community and copies with the aftached memo made available by request
�� FRANK H1B6ARD,MAYOR
GEORGE N.CRE'I'EKOS,COUNCILMEMRER JO(W DORAN,COUNCIIMBMRCR
PALL F.GIBSON,COUNCILMEMBGR � CARLPN A. PG'fERSCN,COUNCILMEMHBR
��F.QUAL EMYI.OYME:N'I'ANI�AFFIRMA'fIVF,AC7'lUN EMYLOYEK��