1460 BYRAM DR (2) .
U.S.DE�1'ME9VT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
Feder9l Err�rnPn��������-----� - Ex'ires March 31,2012
:ant: Read the instructions on pages 1-9.
� �-/``` � �'�'�-� �'� �ECTION A-PROPERTY INFORMATION for Insuranc�e Company Use:
� � `^ � qq Policy Number
`1/'" �
��vL �
- , � ��� ( (o � I/or Bldg.No.)or P.O. Route and Box No. Gompany NAIC Number
C�wrc.,s� 4"t C�'�Q- ' � J'�P
- �� ^ �� ' ^ ` ����� �el Number,Legal Description,etc.)
�`' Cl
� n,Accessory,etc.)RESIDENTIAL
g��W Horizontal Datum: ❑ NAD 1927 � NAD 1983
r ���� icate is being used to obtain flood insurance.
G � ���� A9. For a building with an attached garage:
���J� , N/A sq ft a) Square footage of attached garage 484 sq ft
� � b) No.of permanent flood openings in the attached garage
� {�G ���, - �-�,:.:a„ N/A within 1.0 foot above adjacent grade N/A
�� N/A sq in c) Total net area of flood openings in A9.b N/A sq in
,_.__._...,{sd..��� s�� U Yes � No d) Engineered flood openings? ❑ Yes � No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name&Community Number 62.County Name B3.State
PINELLAS COUNTY 12103 PINELLAS FLORIDA
64.Map/Panel Number 85.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
12103C0107 H Date Effective/Revised Date Zone(s) AO,use base flood depth)
5/17/2005 5/17/2005 AE 16
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 Otherwise Protected Area(OPA)? ❑ Yes � No
Designation Date N/A ❑ CBRS ❑ OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under ConstrudionY � Finished 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,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 FDOT BMVertical Datum NAVD 1988
Conversion/Comments N/A
Check the measurement used.
a) Top of bottom floor(including basement,crawlspace,or enclosure floor)13.6 �feet ❑meters(Puerto Rico only)
b) Top of the next higher floor N/A. ❑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) 13.2 �feet ❑meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building 13.9 �feet ❑meters(Puerto Rico only)
(Describe type of equipment and location in Comments)
fl Lowest adjacent(finished)grade next to building(LAG) 13.0 �feet ❑meters(Puerto Rico only)
g) Highest adjacent(finished)grade next to building(HAG) 13.3 �feet ❑meters(Puerto Rico only)
h) Lowest adjacent grade at lowest elevation of deck or stairs,including N/A. ❑feet ❑meters(Puerto Rico only)
structural support _
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
infortnation. 1 certify that the information on this Certificate represents my best efforts to interpret the data available.l � � ��
understand that any fa/se statement may be punishable by fine or impnsonment under 18 U.S. Code,Section 1001.❑ •`+i�; ' ��.•� `��>`�"�,t . .
Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a F, + %
• ,�> ,.
licensed land surveyor'? � Yes ❑ No � ' �"' �� -
Certifiers Name MICHAEL D.CROW License Number PSM#5761 ` � �
� _ " ��1�i��`����
Title PRESIDENT Company Name CROW LAND SURVEYING,INC. � �-'('' f' 'r�•
;���r� �¢�
Address 2444 NICHOLS ROAD City LITHIA State FL ZIP Code 33547 • �
.� �
,�„°•F�(1��'�,.^�`���.
Signature n ' _ / Date 06/76/2010 Telephone 813-754-0505 '/,? � •- ",f1, .
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.
U.S.DER'1�!:i'ME'MT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
Feder9l EmQrgency Management Agency 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 OSCAR AND CEISA SEGOVIA Policy Number
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Gompany NAIG Number
1460 BYRAM DRIVE
City CLEARWATER State FL ZIP Code 33755
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
PARCEL I.D.#02-29-15-87768-000-0970
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)RESIDENTIAL
A5. Latitude/Longitude:Lat.27°59'35.9"N Long.82°46'38.8"W Horizontal Datum: ❑ NAD 1927 � NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 1
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage 484 sq ft
b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage
enclosure(s)within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A 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 B3.State
PINELLAS COUNTY 12103 PINELLAS FLORIDA
64.Map/Panel Number 65.Suffix 66.FIRM Index B7.FIRM Panel B8.Flood 69.Base Flood Elevation(s)(Zone
12103C0107 H Date Effective/Revised Date Zone(s) AO,use base flood depth)
5/17/2005 5/17/2005 AE 16
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 Item 69: ❑ NGVD 1929 � NAVD 1988 ❑ Other(Describe)_
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes � No
Designation Date N/A ❑ CBRS ❑ OPA
SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construdion Drawings* ❑ Building Under Construction' � Finished 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,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 FDOT BMVertical Datum NAVD 1988
Conversion/Comments N/A
Check the measurement used.
a) Top of bottom floor(including basement,crawlspace,or enclosure floor)13.6 �feet ❑meters(Puerto Rico only)
b) Top of the next higher floor N/A. ❑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) 13.2 �feet ❑meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building 13.9 �feet ❑meters(Puerto Rico only)
(Describe type of equipment and location in Comments)
fl Lowest adjacent(finished)grade next to building(LAG) 13.0 �feet ❑meters(Puerto Rico only)
g) Highest adjacent(finished)grade next to building(HAG) 13.3 �feet ❑meters(Puerto Rico only)
h) Lowest adjacent grade at lowest elevation of deck or stairs,including N/A. ❑feet ❑meters(Puerto Rico only)
structural support
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 on this Certificate represents my best efforts to interpret the data available.l � �;�
il y�
understand that any fa/se statement may be punishable by fine or impnsonment under 18 U S. Code,Section 1001.❑ •'' .�,ti�����.•• ..�`�a�'�,�
Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a �,�'� � .�..`;,,
licensed land surveyor? � Yes ❑ No " r
Certifier's Name MICHAEL D.CROW License Number PSM#5761 ` t ` °
! � � J�j����
�
' - 0,'! /���J � .j�
Title PRESIDENT Company Name CROW LAND SURVEYING,INC. �'�' �" 1' 'GGG'����-,,,
Address 2444 NICHOLS ROAD City LITHIA State FL ZIP Code 33547 ' �'�' ���/� �:��_
>`.,'•�,�(����� •��.2�
Signature �/`� Date 06/16/2010 Telephone 813-754-0505 ;'/) •• "'fs....
SS��=�74 t:
IMPOR�i!►.NT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use:
Building Str,eet Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number
1460 BYRAM DRIVE
City CLEARWATERState FL ZIP Code 33755 Company NAIC Number
SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTtNUED)
Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)building owner.
Comments SECTION C2e.IS THE ELEVATION OF THE AIR CONDITIONER PAD.
Signature Date 06/16/2010
❑ Check here if attachments
SEC ON 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 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 only,enter meters.
E1. Provide elevation information for the following 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�below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enclosure)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 building 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 conect to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The Iocal 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 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 located 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.
G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been 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
fl Check here if attachments
. •
Building Photographs
See Instructions for Item A6.
For Insurance Company Use:
Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number
1460 BYRAM DRIVE
Clty CLEARWATER State FL ZIP COd@ 33755 Company NAIC Number
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,
following.
FRONT VIEW(0611 5/2 0 1 0)
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DE�CRIPTION: N
LOT 97,`SUNSET HIGHLANDS UNIT 4, ACCORDING TO THE MAP
OR PLAT THEREOF, AS RECORDED IN PLAT BOOK 61, PAGE
43, OF THE PUBLIC RECORDS OF PINELLAS COUNTY, FLORIDA.
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� � THIS PARCEL APPEARS TO BE LOCA7ED IN FLOOD
ZONE ",4E' AS PER THE FLOOD INSURANCE RATE MAP
� � FOR PINELLAS COUNTY, FLORIDA.
DRAINAGE dc U111JTY EASEMENT � COMMUNITY PANEL: �}' 12103C0107H, DA1ED:5/17/05.
(PER PU17) \
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LEGEND �° W 1 5����
F.I.P. FOUND IRON PIPE 5 6g'AO 3 4 ��CR�
F.C.I.P. FOUND CAPPED IRON PIPE
F.I.R. FOUND IRON ROD
F.C.I.R. FOUND CAPPED IRON ROD FCIR 1/2"
F.C.M. FOUND CONCRETE MONUMENT �g�5423
S.C.I.R. SET CAPPED IRON ROD 1/2" ��
L.B.#6934 `
L.B. LICENSED BUSINESS P`(
P.S.M. PROFESSIONAL SURVEYOR AND MAPPER ���N,� P�MENT
P PLAT �(
c cn�c°uw�o � ` T'(E� RP�1 P T'fER
CONC. CONCREfE �p N R �� GU
A/C AIR CONDITIONER 6� E E
C.B. CONCRETE BLOCK rl6 CO
P.C.P. PERMANENT CONTROL POINT 2
P.F. PLASTIC FENCE
C.L.F. CHNN LINK FENCE
COR. CORNER
C.E. COVERED ENTRY
SURVEYOR'S NOTES:
1. ND UNDERGROUND FOUNDATIONS, S7RUCTURES, INSTALLA110NS OR IMPROVEMENTS HAVE
BEEN LOCA7ED UNLESS OTHERWISE SHOWN HEREON.
2. THIS SURVEY WAS PREPARED WITHOUT 7HE BENEFIT OF A T171.E SEARCH, NO INSTRUMENTS
OF RECORD REFLECTiNG OWNERSHIP, EASEMENTS OR RIGHTS OF WAY WERE FURNISHED TO
THE UNDERSIGNED, UNLESS OTHERWISE SHOWN HEREON.
3. SEE LEGEND FOR SYMBOLS AND/� ABBREVIA110NS USED HEREON.
4. BEARINGS SHOWN HEREON BASED ON PLAT(S. LINE lOT 97 BEING S 69 40'31" W).
5. 7HIS SURVEY IS NOT VALID W17FIOUT THE SICNATURE AND �IGINAL RAISED SEAL OF A CERTiFlED TO:
FLORIDA UCENSED SURVEYOR Qc MAPPER AND IS ONLY FOR INFORMA710NAL PURPOSES OSCAR AND CELSA SEGOVIA
UNLESS SO VAUDATED.
6. PURPOSE OF SURVEY.• PERMITIING.
7. 1tlIS SURVEY DOES NOT REFLECT NOR OEIERMINE OWNERSHIR
8. NO WE7LAND JURISDICTIONAL AREAS OR OTHER TOPOCRAPHIC FEATURES HAVE BEEN LOCA7ED UNLESS , ;` ;,,, �-la�� ��
OTHER WISE SHOWN HEREON •
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°RAMN BY� �` �OUNDARYSURVEY CROW LAND SURVEYING,INC � J
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usr o�rE oF Flav Mav�c e/is/io - -
�OR CER71FlCA7E oF Au1HORIZAiION�6934 N� AIICHAEL D. CRW1�!, .
s�. �� 25 OSCAR � CELSA SEGOVIA 2+++rxp+as Ro�o�unu�. �oaioa ��ss� , p���
�� �� PHONE: (813) 754-0505 •FAX: (813) 737-3508 ; ;a �µp FqppER/s76p
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