875 BRUCE AVE FEDERAL EMERGENCY MANAGEMtN i Hu�rv�� U.M.ti. N0. 3Ub/-uu��
., NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 200
�'`���t`;rt�'��'��;�:=�'�� ELEVATION CERTIFICATE
' Important: Read 1:�e instructions on a es 1-7.
SECTION A•PROPERTY QWNER INFORMATION FsH'�ns�ranoeCarnpenyUse:
Policy hiumber
�LDING OWNER'S NAME
CHOLAS FRANSEN r
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX N Y
875 BRUCE AVE IP CODE
STATE
CITY FL
CLEARWATER
PROPERTY DESCRIPTION(Lot and Blodc Numbers,Tax Paroel Number,Legai Description,etc.)
LOT 1&2 AND 1/2 OF VACATED ALLEYTO THE SOUTH AND TO THE EAST,BLOCK 43A
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if n ) N � S�/CS
RESIDENTIAL
LATITUDEILONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOUR • USGS Quad Map ❑Other:
( #!#°-#1#'-##.##" or ##.#tl###� �NAD 1927 ❑NAD 1983 �
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE
125096 PINELIAS �
64.MAP AND PANEL B7.FIRM PANL-L B9.BASE FLOOD ELEVATION(S)
NUMBER 65.SUFFIX B6.FIRM INDEX DATE EFFECTIVEIREVISED DATE B8.FLOOD ZONE(S) (Zone A0,use1depih of ilooding)
0007 D &19-91 &1191 �
B10.Indicate the source of the Base FioaJ Elevation(BFE)data or base flood depth entered in 69.
❑FIS Profile �FIRM ❑Community Detertnined ❑Other(Desaibe):
611.Indicate the eleva6on datum used for the BFE in 69:�NGVD 1929 ❑NAVD 1988 ❑Other(Describe): �
812 Is the building located in a Coastal Barrier Resources System(CBRS)area a Othen�vise Protected Area(OPA)? ❑Yes ❑No_ Designation Date ('�
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) �
N
C1.Building elevations are based on:�Construction Drawings* ❑Building Under Conshuction` �Finished Constnu�ion �
'A new Elevation CeRificate will be required when construction of the building is complete, W
�^ Building Diagram Number 1(Select the building diagram most similar to the building fa which this cerfficate is being oompleted-see pages 6 and 7. If no diagram �
urately 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-A,30,AWAH,ARIAO �
Complete Items C3:a-+below aa:ording to the building diagram specified in Item C2.State the datum used.If the datum is d'rfferent from the datum used for the BFE in o
Section B,convert the datum to that used for the BFE.Show field measurements and datum conversion calculaUon. Use the space provided or the Comments area of J
Section D or Section G,as appropriffie,to document the datum conversion.
Datum 1929 Conversion/Comments
Elevation reference mark used Does the elevation reference marlc used appear on the FIRM? ❑Yes �No
❑ a)Top of bottom floor(induding basement or endasure) 4. 4 ft.(m) �
❑ b)Top of next higher floor N.A ft.(m) 9
❑ c)Bottom of lowest horizontal structural member(V zones only) N.A ft.(m) �o
❑ d)Attached garage(top of slab) N. A ft.(m) �
w
❑ e)Lowest elevation of machinery andlor equipment d
servicing the building(Gescnte in a Commer,ts area) 5.4 ft(m) �� �
❑fl Lowest adjacent(finished)grade(lAG) 3.2 ft.(m) �y ���q-�j
❑ g)Highest adjacent(finished)grade(HAG) 4. 0 ft.(m) �
❑ h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 0 � �5-
❑ i)Total area of all permanent openings(flood vents)in C3.h 0 sq.in.(sq.cm)
SECTION D-SURVEYOR,ENGINEER,OR ARCHRECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information.
I certify that the information in Sections A,8,and C on this certificate represents my best efforts to interpret the data available.
1 undersfand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001.
CERTIFIER'S NAME M.G.MAYER LICENSE NUMBER 4495
TITLECEO COMPANY NAME FLORIDA BENCHMARK
�RESS CITY STATE ZIP CODE
,��8l1aKEVIEW RD. CLEARWATER FL 33756
SIGNATURE ` �" �--�' DATE TELEPHONE
�'� � " �...,�. �'-"� 08-16-03 727-298-0286
FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions
...- r . r� ° �. .. ...�..
BUILDING STREET ADDRESS(Indud'mg Apt,Unit Suite,andla Bkig.No.)OR P.O.ROUTE AND BOX N0. ' Policy�tumber
875 BRUCE AVE
CITY STATE ZIP CODE Company NA1C Number , ,
CLEARWATER ; FL � �
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) •
Copy both sides of this Elevation Certificate for(1)community oifiaal,(2)insurance agenUcompany,and(3)building owner.
COMMENTS �
AC 5.4
' "1 � �.�1�
❑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 cer�ficate 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(induding basement or endosure)of the building is _ft.(m)_in.(cm)�above or ❑below(check one)the highest adjacent grade, (Use
naturai grade,if available).
E3.For Building Diagrams 6�with openings(see page 7),,he next higher floor or elev�te�floor(elevatio�b)of the building is _ft.(m)_in.(cm)above the highest adjacent
grade. Complete items C3.h and C3.i on front ofform.
E4.The top of the plaiform of machinery andlor equipment serviang the building is _ft.(m)_in.(cm)❑above or ❑below(check 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 accorclance with the community's floodplain management ordinance?
❑Yes ❑No ❑Unknown. The local offiaal must certify this ir�ormaba�in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owners authorized representative who completes Sections 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,8,C,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
COMMENTS
❑Chedc here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local official who is authorized by law or ordin8nce to administe�the community's floodplain management ordinance can canplete Sections A,B,C(or E),and G of this Elevation
Certificate. Compiete the applicable item(s)and sign below.
G1.�The information in Section C was taken from ofher documentation that has been signed and embossed by a licensed suroeyor,engineer,or architect who is authorized by state
or local law to certify elevation ir�ormation. (Indicate the souroe and date of the elevation data in the Comments area below.)
G2.�A community offiaal completed Section E for a building located in Zone A(without a FEMAassued or community-issued BFE)or Zone A0.
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 COMPLIANCEIOCCUPANCY ISSUED
G7.This permit has been issued for:❑New Construcdon ❑Substantial Improvement
G8.Elevafion of as-built lowest floor(including basem�t)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 •
❑Chedc here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions
' NATIONAL FLOOD INSURANCE PROGRAM I Expires December 31, 200 I
. ��A�� �:���`�-:�:�5`� ELEVATION CERTIFICATE L
__�,L�
Important Read�ie instnictions on a es 1-7.
SECT�ON A-PROPERTY OWNER INFORMATION �r������ '
t�bU�C�tier
i �LDING OWNER'S NAME
�viCHOLAS FRANSEN
BUILDING STREET ADDRESS(Induding Apt,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX N Sl
875 BRUCE AVE ST.ATE P CODE
CITY �
CLEARWATER
PROPERTY DESCRIPTION(Lot and Biodc Numbers,Tax Parcei Number,Legal Desaiption,etc.)
LOT 1&2AND 1/'LOFVACi4TEBAtt€1`F�fiHE90UTHANDTOT#€€A�T,�I.00K43A ___—___ ___
BUILDING USE(e.g.,ResideMial,Non-residendal,Addition,Acoessory,etc• Use a Commet�s area,if ) N S�/('+S
RESIDENTIAL
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: �R • �
( #1#°-#i�'-##.#f�" or ##.�)
�NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.
SECTION B-FLOOD INSURANCE RATE MAP(FlRM)INFORMATION
61.NFIP CONWIUNITY NAME 8 COMMUNITY NUMBER ���� �'�A�
125096 PINELLAS �
B4.MAP AND PANEL $—I$— " B7.FIRM PAIv[L 89.BASE FL00�ELEVATION(S)
NUtv�ER B5.SUFFUC 86.FIRM INDEX OATE EFFECTIVE�REVISED DATE 88.ROOD ZONE(S) (Za�e A0,use deplh�flooding)
l25�(�000� � � &19-91 AE 10
810.Indicate the source of the Base Flood FJeyation(BFE�data or base flood depth entered in 69.
❑FIS Profile �FIRM ❑Community Determined ❑����)�
NAVD 1988 ❑Other(Describe �
811.Indicate the elevation datum used for the BFE in B9:�NGVD 1929 ❑ ��
B12 Is the building located in a Coastal Bamer Resouroes System(CBRS)area a Otherwise Prot�d Area(OPA)? ❑Yes ❑No Design�ion Date ('�
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) �
N
C1.Buiiding eleva6ons are based on:�Construdion Drawings' ❑Bui�ing Ur�er Construdion' �Fnished Construdia� �
'A new Eleva6on Certificate will be required when constructiat of the buil�ng is complete. W
�^ Building Diagram Number 1(Select ihe buil�ing diagram most simil�to tlie building fa which this cedificate is being completed-see pages 6�d 7. If no�iagram 1
��rately represents the bui�ing,Pmvide a sketch a photograph.) �
.ElevaUons—Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BF�,AR,AR/A,AWAE,ARIA1-A30,AR/AH,ARIAO �
Complete Items C3.-a-i below according to the bui�ing diagrxn speafied in ftem C2.State the dah�m used.If the d�um is�ifferent from the datum used for the BFE in o
Section B,convert the datum to that used for the BFE.Show field measurernents and datum conversion c�lailation. llse me sPace Provided or the Canments area of J
Sec6on D or Section G,as appropriate,to document the datum c�nve�siai.
Datum 1929 ConversionlComments
Elevation reference mark used Does the elevation r�erence mark used appear on the FIRM? ❑Yes �No
❑a)Top of bottom floa(induding basement or enclosure) 4.4 ft.(m) ;
❑ b)Top of next higherfloor N.A ft(m) �'
a c)Bottom of lowest horizont�structural member(V zones only) N.A ft.(m) ��
ao0
❑ d)Attached garage(top of slab) N.A ft.(m) �
❑ e)Lowest elevation of machinery andlor equipment W -
' the buildin Gc�ibe in a C�mm�,ts ar�a 5.4 ft.(m) E W t � :
serv�ang 9( )
0�Lowest adjacent(finished)grade(LAG} 3.2 ft.(m) m y ��y�-�j
❑g)Highest adjacent(finished)grade(HAG) 4. 0 ft.(m) �
❑ h)No.of perm�ent openings(flood vents)within 1 ft.above adjacent grade 0 � S5—
❑ i)Total area of ali permanent openings(flood vents)in C3.h 0 sq,in.(sq.cm)
SECTION 0-SURVEYOR,ENGINEER,OR ARCHRECT 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 certiflcate represenfs my best efforfs to interpret the data available.
1 understand thaf any false sfatement may be punishable by fine or imprisonment under 18 U.S.Code,Section f001.
CERTIFIER'S NAME M.G.MAYER UCENSE NUMBER4495
TITLECEO COMPANY NAME FLORIDA BENCHMARK
�DRESS CITY STATE ZIPCODE
�z98 IAKEVIEW RD. CLEARWATER FL 33756
SIGNATURE y/� v � TELEPHONE
L �, . oe-�s-o3 rn-2se-o2as
FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions
BUILDING STREET ADDRESS(Indudrtg Apt,Unit,Suite,ancl/a Bkig.No.)OR P.O.RWTE AND eOX NU. raircy Numcer
875 BRUCE AVE '
CITY STATE ZIP CODE 'Compar�y;NR1C[�umber ' � �
CLEARWATER , FL � •
SECTION D•SURVEYOR,ENGINEER,OR ARCHRECT CERTIFICATION(CONTINUED)
Copy both sides af this Elevation Cerfificate fa(1)canmunity offiaal,(2)insurance agenUcompany,ar�(3)building oumer.
COMMEM'S � i
AC 5.4
f.f� �� S � �
� ❑Chedc here if attachments
SECTION��BUI�aI �LEVATIOIV INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(1MTHOUT BFE)
Fa Zone AO and Zone A(�without BF�,canpiete Items E1 ihrough E4. If the�evation Cer�ficate is intended fa use as suppating information fa a LOMA or LOMR-F,
Section C must be completed.
E1.Buildng Diagram Number_(Select the bui�ing�agr�n most similar to the building fa which this certificate is being completed–see pages 6 and 7. If no diagr�n accurately
represents the buildng,provide a sketch a photograph,)
E2.The top of the bottan floa(ndudng basement or endosure)of the building is _ft(m)_in.(cm)�above or ❑below(chedc one)the highest adjacent grade. (Use
natural grade,if av�lable).
E3.For Building Diagrams 6-8 w'rfh openmgs(see page�,�e next higher floor or eleval�flow(elevatio�b)of the building is _ft.(m)_in.(cm)above the highest adjacent
grade. Comple�e items C3.h�d C3.i on front�fam.
E4.The top�the pla�am of machine�y andla equipment serviang the building is _ft(m)_in.(an)❑above or ❑belav(chedc one)the highest adjacent grade. (Use
natural grade,if available).
, E5.For Zone AO only: If no flood depth number is avai►able,is the top af the bottom floor elevated in accordar�ce with the communitys floodpiain management ordinance?
❑Yes ❑No ❑Unknovm. The bc�l otfiaal must certify this infonnation in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property ovmer a ownei's authorized repre.sentative who oompletes Sections A,B,C(Items q.h and C3.i only),and E for Zone A(without a FEMA-issued or community-
issued BF�or Zone AO must sign here. The stafements in Sections A,B C,and E are car�t to the 6esf of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE (� �
\
SIGNATURE DATE TELEPHONE
I:UIVIIVItN I S
❑Chedc here if attachments
SECTION G•COMMUNfTY INFORMATION(OPTIONAL)
The local official who is authaized by law or ord'inance to adr�nister the canmunity's floodpl�n management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Certificate. Complete the applicable iterr�(s)and sign below.
G1.Q The inform�on in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authorized by state
or local law to cerGfy elevatia�ir�orrna6on. (Indcate the sour�e�d date af the elevation data in the Comments area below.)
G2.0 A community offiaal oompfeted Section E f�a building bcated in Zone A(without a FEMA-issued or communityassued BFE)or Zone A0.
G3.❑The following information(items G4-G9)is provided for oommunity floodplain management purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6.DATE CERTIFICATE OF COMPUANCE/OCCUPANCY ISSUED
G7.This permit h�been issued fa:❑New Construdion ❑Substar�tial Imprwement
G8.Eleva�on of as-built lowe.st floor(induding basement)of the buikling is: _._ft.(m) Datum:
G9.BFE or(in Z.aie AO)depth af flooding�the buil�ng site�s: _._ft.(m) Datum:
tOGRt6�iGtRC�l�R1�1€- __.-----� — ---- -- — -- --—_
—TTfCE----
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
.
COMMENTS �
�
❑Chedc here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions
y
' '� C ITY OF C LEARWATER
��.
� "r "�� DEVELOPMENT & NEIGHBORHOGD SERVICES DEPARTMENT
.Y" ... A� _-,; �. p
POST OFFICE BOX 474C7� CLEARWATER� FLO�DA 33758-4748
MUNICIPAL SERVICES BUILDING, IOO SOUTH MYRTLE AVENUE,CI.EARWATER,FLO�unn 33756
TELEPHONE��J2� SGZ-4567 Fa,�c(72� 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 completion prior to
acceptance by the community. This complete form shall be attached to all eievation 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
X 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,andlor Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
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 63.STATE
I
64.MAP AND PANEL 67.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER g5.SUFFIX B6.FIRM INDEX DATE EFFECTIVE/REVISED DATE B8•FLOOD ZONE(S) �Zone AO,use depth of flooding)
125096-0007 8/18/1992
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 B9:0 NGVD 1929 ❑ NAVD 1988 ❑Other(Describe)
612. Is the building located in a Coastal Barrier Resources S stem(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 buiiding is complete.
C2. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being compieted-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,Vi-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 eievation 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)1 ft.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 certifrcates shall be maintained by the community and copies with the attached memo made availab/e by request
FRANK HIAI3ARD,MAYOR
GEORGE N.CRE'1'EKOS,COUNCILMEMABR JOIIN DORAN,COUNCILMEMBER
PAUL F.GIASON,COUNCILMEMRER � CAR[.EN A.PE7'ERSEN,COUNCILMEMBER
��EQUAL EMPLOYMEN"f AND AFFIRMAI7VE ACTION EMYLOYER��
__
, } �/ � �,�c� ��— � ,�'��
CERTIFIED t0: ROSS H. & FLORENCE CONCKLIN w,�• 3779
SEC. 5 ,TWP. 29 S, RNG. 15 E
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SURVEY CORNERS AS PER
1=GM __---------
"BOUNDARY SURVEY"
Q"`� k�p���U p�-Zp� EXISTING OCCUPATION.
Ft.R.=FOUND IRON ROD; F.C.I.R.= FOUNO CAPPED IRON R00; S.C.I.R.� SET CAPPEp IRON R00; F.I.P.m f0UN0 IRON PIPE;
LEGEND:F:c.i.a.-FOUND CAPPED IRON PIPE; F.N.D.=FOUNO NA�L k DISK; S.N.D.= SET NAIL 8 OISK: F.C.M.a FWND CONCREIE MONUMENT;
P.R.M.= PERMANENT REFERENCE MONUMENT: P.C.P.�PERMANENT CONTROL POINT; P.I.=POINT OF INTERSECTION; R/W = RIGIiT OF WAY:
EI.EV.¢ ELEVAl10N; C.B.S.a CONCRETE BIOCK STRUCTllRE; CONC.= CONCRETE; ASPH.a ASPHALT; PAVT.= PAYEMENi;
CQVr COVERfO; D� DEEO: SEC.� SECiION; TWP.� TOWNSHIP; RGEr RANGE; P�PUT; Mr MEASURED; ESMT.� EASEMENT; �COVERED AREA
R.� RA�IUS; A.= ARC; C.=CHORD• C.B.= CHORO BEARING• STY.a STORY; C.LF.a CHAIN UNK FENCE: W.F.� W000 FENCE
A SuRVEY OF LOT 1 ONE-HALF
OF VACATED ALLEY , BLOCK "49" MANDALAY
AS RECORDED IN PLAT BOOK�, PAGE.3Z��, OF THE PUBLIC RECORDS OF PINELLAS COUNTY, FLORIDA.
I, WiLL1AN C.HEATING, THE SURVEYUN 1N RESPONSBI.E CNARQE,(YRTIfY R1AT ME SUR�EY REPRESENIED ttENEON. AS MF£TING TME MINNIUY TE(�1WCAL 5TANOMDS SET FORM BY
ME FLOR�DA BOANO OF LM10 SURVEY0ft5,PURSUANT i0 SECTION 472M7 Of 1HE FIORID�S7ATUTES�S PRESf7i18E0 IN CFiM1ER 61C17-6 DEPi.OF PROFES90NAL HEq1LATI0N.
(N0�VWD UNtESS SEALEO M1N�Jd EMBOSSED SURVfYOR'S SEAL)
ELEVATION STATEMENT: 1HI5 IS TO CERTIFY iHAT WE HAVE OBTAINm 0.EVATI�NS SHOWN HEREON, OF THE ABOVE OESCRIBED LAND. THESE ELEVATIONS
SNOWN HEREON ARE BA5ED ON THE N�TIONAL VERTICAL DATUM, 1929, BENCMMARK SUPPUEO BY THE ENGINEERING
DEPT., CWNTY, FLORIDA. FL000 ZqNE OISTINCTiONS ARE BASED UPON A NCY MANAGEAIENT AGENCY'S MAPS ISSUED TO US.
DUE TO INCONSISTENCIES fOUND IN THESE AIAPS, THE ZONES ARE AN APPROXIAIATE ES71MATlON TO T11E OEST OF OUR ABIUTY.
COMNUNITY NO. PANEL No. NAP DATE: APPEARS TO 8E �' �� BASE FL000 ELEVATION
��� d ��q.,� fN f�00D 20NE: � ��p
� ORAWN BY: DATE: / A('PROVED �
ALLIED SURVEYING
AC Q4�27 Ol 2>>g E DREW STREET '
CMECKED 8Y: SCAIE: CIEARWAIER, FLORIDA, 33765
1N� 1"=30� 727-446-1263 A!( C. AT[N . �y 1528, LH // 8423
�� - e�"�'y M�k� s j OMB�067-D077
FEDERAL EMERGENCY MANAGEMENT AG 1�1;�`,Y,".;;;,, `a�` ` "' ==5 'Ex�?�res:Junel984
�! � �
( . < > NATIONAL FLOOD INSURANCE PROGR/�ilYf �� ;
a� ;�,,�'' "� � � � � ���� ��'-� �
ELEVATION CERTI FI ._�� r�,.v_�,�:-fi.�;�,�,
• ���
.. � c , ..� , , e.,,
This form is to be used for: 1) New%Emergency Program construction in Special Flood Ha rd rea�,�,�r�•FFAM,€�nstry3�liQn af er
September 30, 1982;3) Post-FIRM construction;and,4) Other buildings rated as Post-FIR ` � �,Y �`-'-'" . '�'�'�' '
Quinton Richmond (This surve Certi£icate for two story additio )
BUILDING OWNER'S
NAME ,
977 Bruce Avenue, Clearwater Beach, Florida
PROPERTY LOCATION (Lot and Block numbers and address if available)
Lot 4, Block 264, Carlouel Subdivision, Plat Book 20, pages 60-62, Pinellas Count , FL
I certify that the information 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.
SECTION 1 ELIGIBILITY CERTIFICATION (Completed by Local Community Permit Official or a Registered Professional Engineer,
Architect,or Surveyor)
COMMUNITY NO PANEL NO. SUFFIX DATE OF FIRM F�RM ZONE DATE OF CONSTR. BASE FLOOD ELEV. BUILDING IS
(In AO Zone,use depth)
❑ New/Emergency
125096 0003 C 10-1-83 A-12 ---- 11 oPostFRMRReg.
YES NO it is intended that the building described above will be constructed in compliance with the community's flood plain
❑ ❑ ordinance.The certifier may rely on community records.The lowest floor(including basement) will be at an elevation
of it, NGVD. Failure to construct the building at this elevation may place the building in violation of
the community's flood plain management ordinance.
YES NO 'Fhe building described above has been constructed in compliance with the community's flood plain management
❑ O ordinance based on elevation data and visual inspection or other reasonable means.
If NO is checked, attach copy of variance issued by the community.
• MOBILE HOME MAKE MODEL YR. OF MANUFACTURE SERIAL NO. DIMENSIONS
X
(Community Permit Official or Registered Professional Engineer,Architect, or Surveyor)
NAME ADDRESS
TITLE ' CITY STATE ZiP
S�GNATURE DATE PHONE
SECTION II ELEVATION CERTIFICATION (Certified by a Local Community Permit Official or a Registered Professional Engineer,
Architect, or Surveyor.)
FIRM ZONE A1-A30: I certify that the building at the property location described above has the lowest floor(including basement)
at an elevation of 5.60 feet, NGVD (mean sea level) and the average grade at the building site is at
an elevation of �et, NGVD.
FIRM ZONES V, V1-V30: I certify that the building at the property location described above has the bottom o1 the/owest floor beam
at an elevation of feet, NGVD (mean sea level), and the average grade at the building site
' is at an elevation of feet, NGVD.
FIRM ZONES A,A99,AH and EMERGENCY PROGRAM:I certify that the building at the property location described above has the lowest
floor elevation of feet,NGVD.The elevation of the highest adjacent grade next to the building is feet,NGVD.
FIRM ZONE AO: I certify that the building at the property location described above has the lowest floor elevation of
feet, NGVD.The elevation of the highest adjacent grade next to the building is feet, NGVD.
� SECTION III FLOODPROOFING CERTIFICATION (Certification by a Registered Professional Engineer or Architect) �
I certify to the best of my knowle8ge, information, and belief, that the building is designed so that the building is watertight,�with +
walls substantialiy impermeable to the passage of water and structural components having the capability of resisting hydrostatic
and hydrodynamic loads and effects of buoyancy that would be caused by the flood depths, pressures velocities, impact and uplift
forces associated with the base flood.
YES ❑ NO ❑ In the event of flooding, will this degree of floodproofing be achieved with human intervention? i
(Human intervention means that water will enter the building when floods up to the base flood level oc-
cur unless measures are taken prior to the flood to prevent entry of water (e.g., bolting metal shields over
doors and windows).
YES ❑ , NO ❑ Will the buiiding be occupied as a residence?
If the answer to both questions is YES, the floodproofing cannot be credited for rating purposes and the actuai fowest floor must be
completed and certified instead. Complete both the elevation and floodproofing certificates.
FIRM ZONES A,A1,-A30,V1-V30,,40 and AH; Certified Floodproofed Elevation is feet,(NGVD).
THIS CERTIFICATION IS FOR�(SECTION II ❑ BOTH SECTIONS II AND III (Check One)
CERTIFIER'S NAME COMPANY NAME LICENSE NO. (or Affix Seal) �
I Ronald L. Hu�hes Carter Plumley Engineers, Inc. 3747
TITLE ADDRESS Z�p
- Vice President 2433 Gulf-to-Bay Blvd, Suite E, 33575
� SI TURE DATE CITY STATE PHONE
5/10/85 Clearwater Florida 813-799-1763
The insurance a' t should attach the origlnal copy of the,completed torm to the ilood Insurance policy application,
the second copy should be supplied to the policyholder and the third copy retained by the agent
INSURANCE AGENTS MAY ORDER THIS FORM
FEMA Form 81-31,SEP 83 REPLACES FEMA FORM 81-31,APR 82,WHICH IS OBSOLETE.
" r:-►fi�eAt,�MERGE4C7 MAI'i�►OENfE!tiT At3EAiCY .--_...�_._. . ._..._.___�.
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�". ;,d�::a!e the�evitian datum �,ed for the 6FE in Q9 ����D i�29 � NnVO 1$6E C G�tl^�er;��scresj
8'2 �s tha cu+;din�ioca'ed m a Coasta; 9arcier Resources Sy�tere, ;�SRS��rEa nr('`.f!�nh ce fl!a.sc•,,vQ Area(Cf'� ^[_� �;;9 ,'-' .�:
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SECTION C -$ZlLDtNa ELEYA7IQ�(IYfQiiMAT101��!li3RYEY R�Qti�" } ----- -- '��. .
�
:t P,u�tid;ng e�av�a;;ors are vase+ci o�: � Ccrstruttion DrewirtQs- � Bui;d�r.�:inder�o.�shu�ticn• �inisrttc:Cons:r;.�ci�or �� \.
•A rew F�erva:ior,Gerrircnte w�t1 ae requrr,ac yr,nen c�n'tr�rtior o�th�puil�ing;s comp:ete
�2 su:�o,rg��ag�an+NumDer�(Se�eet t►te bw4��nc, di�grim most aim�lar to!ha Cuildmg for whir.h thit_ceRi�ca'e i� �a��, -�ri^platr,ct- see
C�Ces 8 end 7. tf no��agrgm accura±ery reersser►is tha D�rtdin�, provido a sketcs� c�Photogrsc� ;
-�vat�c,ss-Zones A1-A30. AE_Ah�, A(v++iit BFE;, �E. V'-V34, Y(wrtr gF�;. AR, ARIA. AR1.�,E, �:a.+-A3�J. ;+FJ•ti.� n�,�j��
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carcu�a�+cr. J•_e the spe:e prcvidad ar thC Com.rner,!s erea o�SectiCn D ar$er„{ian G, aF a�p�Cpr.'„te t,d�;rn�,•,�e�qtu-^c.^�,ersi�n.
L'a:�r, _ � ConvenwNComments __ �
Ei�ci�:, rsir�ence marK uaed Oaee the eievition refer�nC��rt(usEC app�t :��thg�1}�,+�r,y �vej � �ye
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7 �j Attacheo gara�e (tap ot slab) ;� m �`� ;
'� e) Lowest ateyaUOn of inechin ana1o,- t ) I
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s�rvicinq;he Cuildin9 � R(m� �
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8�CTFON 8-SURVLYOR E��C�tw�ER,L1R l�R�'F{tTfCT CERTIfiCA�IQ►v
Th�s ceR;fleahon is to be signe9 and saalYd Cy a !s�e �;.rveyor. enginoa� or+rchit�Ct author�eA bY !aw to certify e�1�ws!i�et;�;fot�f!t8'!a�
I c9rtrry lhet thz lnnxmsfAon n 5er!wns A, 8. anQ C on thrs ce�!4PCate r�or�soni�my bea� ef.'�ts tv�n:erprf,t rhe Ja�a et s�G'e.
!unCarst9r!d fhs�t a�� fa+se etatemmnt may�e►pe.rnrshs�bl�i by l�ns a,�»prrso^mairt un�er�8 v S. Ccx�e. Secxrcn ;:h?t.
Cc'�r:FiER'S HAME�a�vn SwrdbA:Csrl M. SmiC+ L�r���SE N1JM�ER 3�11! 376��------ ----`--
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e'.�,rtier. �r arc��t�c�rvP,o as �sesn ��r.ed anQ anncASSd �,y a ?�csn;ca ;�.*.;_1.,.
rs authnt�,t� Dr st�t�Cr !o.:si 6w�o ;.ar74� �ia�ation�nh�r,r,at��n !Fr, sov�ca � �
p!ev�;;p;} �at� m th6�crnrnlf+!s area be�cw � i{nfliea;F t�� .,� e cr t:•e
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� New/Enlergenr.y Program Construction: � "
I
For the purposes of determining insurance rates, buildings for which the start of construc�i�n �ar S.UT�tantial impro ement
commenced after September 30, 1982, �re N�w/Fm�ryency buiidings. � �
Pre-FIRM Construction: �"�"`�' Au� � 6 ����
Fnr the �xnE�osE�s of de�terrnininy insuranr,e rat�s, buildings tor which the start of con^tri�c 'on or substttntiaf irnprovemr,nt s
v,��, c?n or h��(oro Dec,r,rnt,�r :�1, 197�1 r�r llu��.ff�cli�-�� drat� o( fl�n liiili�l f i,nc1 In,iir;anr�. Fi�t �� ;{c1�4kr71mfqted KYnt;t�ittY1'm�.,°� �
nity�FIRM),whi<•liev�r ir;laler.Spnclal Nole: It an ap��tovr�d huilrlin����r���rn�l i�r1�1��„I ��ri!,r tn f c r_��fj���,�� `�7"¢ Cons,tru,cttnti� � �
inus� liav�� a�ininrnr;c�l �i��l Inlci Ih;�n lZq �l.i,�. ;�fl��i �li�� �1;it�� u( Ilir .��,��i v��r1 hiiil�linr� �u�n ii �Gx�^ �nr}•�oh�5lriiP.7ibft ��i"h�t.'__
.`('re�FlRft1 C�n�U��.tctiort"l�a��e r�/r:nfical rnr.�nrng.a /nr Uu?/�ur� G>ses n/the NaUont�l Flt�qrl In.st�t�nce Prvgranl.
Post-F1RILi Conshuctron: �
For insur�nr;^ rating p��rpnge�s b!ii,lding., f�,i v.�hicf� the sl�rt oF��on�Nuclion or suhst�4ntial im�irrvem�nt Commenced t�ft�r �
peceniC�r.;r 31, 197�1 or the cfiecfi,�e c{r,tF ,>f tl�� ii�iti:zl f lood In�sr�r�nc F� Rr+tr�� �Aap (�tale �arinted on corn_inw�iity_FIfiM),which-
� � •� over��is laier. "New Cons�ruetion" and "Pv:��l Fllr�1 Cr7nstruction"hav� identicai meaninds lo'r the��urposFS o/the'Natronal
Flood Msurance Prcgram.
Substeri!�al In�pr�,�v�meni: � �
Any repair, iecrnistruction, or impruverne�nt c,1 � building, the c�,st of wliir,li eq�ials ^t exceeds 5�� ����rcent of tL�� market
value o( II�� I,t��'�linu �,;��icrr (a) F�r�{nr�� tlic� in�����_�����u,��r,f�.�r reF=air is �:tait��d, or (hl ii !i��� t����l,lin�y ha^ he��n �I�r��aged, and is
� heinq r��t�red t1�ie mnr��ct val�ie bef�rr t�•^ �t�mage !?ccurr��d. For l l��d!r-c��ranca �'r�rrnm�r�r�rns�s substantial improve-
rne��t is ;I��rt�d ����h�n tlie first t�lteratii�n <�f �n�• ���a,lt, cciling. 8��^r, �r ���thcr ,iri��t�ii?I prart nf tLF b!.ii�rling comrrienc•�s,
Wlteth�c or not tt,,.' ?ltc�ra�icn a((��cts Ilif� c�rt�,�r�nl �f�i �%�nsi��n3 oi i.i�� siii�cti-n�, ��I�n� ;vc�i, tii^ tr>��n dees i�vT in�(u�-l� eitf�ier �
�ny projecl Ir�r li��allh, s�nnitary, :�r�:;it�,��., , {�, ��,,,rifi�:ati��ns �,��i�;cli ��rP �-�:�I�ly ns�cessa�y tr, :as��.ire sa�e� living conditions;
or anv aitE�!alion of ti huil�,iin� list2d cu lli�� t�lali.nnr-il fieyist�t� af f�lis!oric f'IacF�s nr�� StatF� Inventory��f Histr�iic F'laces.
� Lowest Ffovr - The I���uest Floor is th��i<��a���st (f�or (including ba-�nnient) of tha �ru-losed rare�- Tli� fol[uwing modi-
ficatir,:!n�pt thr� lovai�st flnnr�I��(inifi�n ar��� �?��r�nitted in Ur�l�r t�� m�r,l c�mmunity�>Frmit �rartir.es'
(I) In ?ones ,�., nC�, ;'��I. 11 �30. !3. ('. D, and F-�r,�.rrency P�oyram are�js which �r�� �ot oc;eansi�e buildiny Sites.
(a) Tlie fio<�r o� a.�� un(inisi��d cncio,ecl area at_y�ound !�:�-eJ ar ahove, which is a crav�l space,or spar.e witliin tl�s foun-
�lalioi, �.^�all;;, i�sahl� ; r�r�ns (Ur building maini��nanc�, ac:��ss, pa king �..hicles, cn� storing of articles and rnair.trnanre
e��t�i��ninnt (n��t ;'�It���h",{ t-, tli�, hiiil�fln�.11 ���"",i in c��nnec�i��i� ��eilii tli����,ir�n,� n�; ;�, n!i �!ui;i<aere�l the riuildir�n�s lownst fl�or �
il fi � e:-s�ll�:; ot !lir� unri.��shr,� ���icic� �J tura; arn �.,�n�huc<<r.l ���it!i r��i^ning; (°�n��li < ;�;ri�'� ��^rallcl .�:h�nr v�r�ll�, opori laltir,e
w^II_, ri,�r-,r+iioi,i��ns f��un�l=�in�i t�•dnll^, ai�r1 r���nihin;�il„ris tii�.i�r.,O (, (, . �t���i1,, �I�r� ii i!,��,.,,�,,,� ni��v��,��i„i4r �•i fl�c!d w�3t^ts or
� t��it� �v�lls nie I�;rc��tf;���.����y w�iils
(b) flic� fio��i r�i ,�,ri atlach���d unfir��;h���f rp:�r:aqc ��s�d i�_>r Friil:in,? .��;I�i�:l��5 ��i�i =�,ro�iuy aiti�:les and insiintcn�nce er�uip_
�ment u.^>�d in ;,ni�n�,ction v✓ith tYi<� �,r���ni��.n�;�nt! nnt ntlach^d t�, rl��-� ' �t�i��,�� +� not�qn.i�1�.;��� fIi„ huildihc�'s lowest floor.i(
� thR v�iall' t,f II,�, iif>`���i .,. -�{ nrl' .�d :,rr�� . - �� ..� .�ii� -I� il ,.,islt .�. ,� �ln' � .i, , �.✓i��� ����81Ir:`I .�I�r��i ..rlll� c;�,frn la(tir,e
. � ,.� r
w.+ll., �li_ �linu„i�,; tr����r' �linn �,,;ill',, c-�r il�in:��!r�n_ iliri�,�,ll I�� �n-�i�il�il�, thr, „�i;i�i��:�,��,.� �i„r�r;�i�r,iil �F( � i��I �.�;�tir'rs rrr
tlie vaalls �io bre<iktiv✓,.�y walls.
(2� in 7_nn�:� V �nd Vrl-At,^O; an�l Ein^m<�n��y Pi<�gr;�,n are^� wliir,h •n„ ,. . c�an?����� t,t�il�ling lot^. tlic. fc,ll�,�vin-t �xr�ptions
apply: .
� (a) Fnr florad plain n�ian•ir�r�mc�nt �,!.irF�o ^s. !I�F� fl.,��� ���f ;�n unhi!�^` ^�+ ^n�.lr�c�rl �rn�� is not con,^,id�red the huilding's
lowF,<.t fic�nr if th�arEa's ��v!ilis t�re consh��_i, i,,,l aa l,real;avda��w-ilis. I�, ,r��r.�i. fr,i iri��nt�n�e ratiny purpo�es:
(i) Tl�p fioor of an ��nfinished encl��sed :�r?� less th�n 30f1 s��uare (�Pt iG ni�t ConsidPred thr:' btiildi��ig's lowest
floor if the walls are breakaway walis.
(ii) Th��� floor of an untinishc�d encic�s�����i �r�a F�qual to or greater ihan 300 sq!iai��� f��;t is consid�red [he building's
lowest floor even if ihe walls are break�way walls.
� (t�) The flo��r of an unfinished enclosAd are� with walls made c�f ins�ct screering or open wood consteucted break-
away lattice work (regardless �i the size of the area enclos�d) is not considered the h�iilding's lowest tlnor.
Lowest Floor Elevation - The lowest fioor elevation is the elevation ot the bottorn oi the iloor bearn of the lowest floor in
Zones V,V1-V30. In all other zones,the lowest iloor elevation is the elevation of the top of the lowest floor.
ora wirH or� ora
SLAa OASF_MEN7' PIERS SLAB
� l.0 W E ST
7._ONES / V
ZONES "r'��=� A ZUNES Fl_OOR
� --_ __ y
�� ZONES '
LObvEST FLOOR WINUUW � LOVJLST FLOOR � � �� ZONES
- /� - -
_ __ =_ l \ ,.,�r ��
1 � ._`� _,� y _ __ , . ,
�'�`:�'`�`�� FLFVA fIOtJ OI' �
R
' P�Vf'R�GP GRAbE` LOWEST FLOOR IF i --� I.QWEST
F�LOOD BASE «n��LMEN I� !S d� ,� FLOOR
FLOODF ROOFED FIASE
ELEVATION FLOOD FLOOU
E�FVATION �� AVERAGE FLEV/�TION
� �I GRADE
��
ELEVATION OF LOWEST FLOOR � �-�
IF NOT FLOODPROOFED y .�� "
�l ....... _
,�""1'�'( 7+""T ,. •
NOTE: .
_ A Zanes - A, AO,AH, A1-A30,A99,Enierg2nCy Frogram other th8n Oceansidd Building Sites .
V Zones - V, V1-V30, Emergericy Proyram Oceanside E3uilding Sites (beach �rea,suf�jer.t to V�av��ction during severe
._ storms)
Base Flood Elevation - Flood piain management requirements including the Base Flood Elevation are sFiown on the
� FIf�M for 7_ones AFI, n1-n30,V1-V30. For FIF�M Zone A,V,and Emergency Fragram Spncial FJood Hazard Areas the com=
tnuniry permit oificial or tlie builder h�is estima(ed this elevatiori by the reasonable interpretatiof� �f available data.
Fnier that estirnated elevatiom in the space provid2d in Section I of the Elevation Certiticatiph fot Ciase�lood �levatiorl.�
- If this comrnunity permit official or the builder has not selected an estimated Base Flood Elevation,enter N.A::--
�
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