145 BRIGHTWATER DR UNIT 2 �:�l_ (,? ��'�^t( - C�5"�-d(
� � „ FEDERAL EMERGENCY MANAGEMENT AGENCY
� , NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
� +t Expires December 31, 2005
- ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-7. JOB No.030084.2
SECTION A•PROPERTY OWNER INFORMATION For Insuranoe Company Use:
BUILDING OWNER'S NAME
Suzanne Givens Policy Number
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO.
145 BRIGHTWATER DRIVE ���'�a.. Company NAIC Number
C�� STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 2, PARADISE COVE PLAT BOOK 128,PAGES 19-20
BUILDING USE(e.g.,Residen6al,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
� ��-�"���� °f �•�#�) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other:
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
64.MAP AND PANEL 67.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER B5.SUFFIX B6.FIRM INDEX DATE EFFECTIVEIREVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depth of flooding)
12103C0102G G SEPTEMBER 03,2003 SEPTEMBER 03,2003 AE
EL.11.0
B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in 69.
❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe):_
B11.Indicate the elevation datum used for the BFE in 69:�NGVD 1929 �NAVD 1988 ❑Other(Descnbe):_
B12.Is the building located in a Coastal Bamer Resources S stem(CBRS area or Otherwise Protected Area(OPA? ❑Yes �No Desi nation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Building elevations are based on:�Construction Drawings` ❑Buildin Under Construction*
9 �Finished Construction
� �A new Elevation Certificate will be required when construction of the builtling is complete.
2.Building Diagram Number 7 (Select the building diagram most similar to the building forwhich this cerfrficate is being completetl-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 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 fieltl measurements and datum conversion calculation. Use the space provided or the Comments area of
Section�or Section G,as appropnate,to document the datum conversion.
Datum NAVD 1988 Conversion/Comments N/A
Elevation reference mark used_LP-15, EL.=4191 Dces the elevation reference mark used appear on the FIRM. ❑Yes "�`,y\�\`c��q�
o a)Top of bottom floor(including basement or enclosure � �No ., �;a T�•���,�
) 5.75 FT ft.(m) � �r'r*��oaaptl r, -.
o b)Top of next hi gherfloor 15.91 . FT ft.(m) � .. ';�,.• ���`��p� J`" �� _;
o c)Bottom of lowest horizontal structural member V zones onl � � '�* "` `�f
� Y) N/A F T ft.(m) N� ,, t A. ~'1. S '_
o d)attached garage(top of block) o o ; n,�= ,�°i�t°
5J5 FT ft.(m) �� f�� F
o e)Lowest elevation of machinery antl/or equipment w�__ � � .�. < +�.
_�. ;�" �"r"�`��..
servicing the building(ELEVATOR EQUIPMENT) 11_75. FT ft.(m) ��"_ �r, . �+=f�� •
o fl Lowest adjacent(finishetl)grade(LAG) q 2 � ft�m� Z� ' •.,�''� ;��,;i,
o g)Highest adjac�nt(finished)grade(HAG) 5� � ft�m� �� � ����, ���'�"1�_4Q� _ .
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 14 ° �'�'��'��� �
o i)Total area of all permanent openings(flood vents)in C3.h 1280 sq.in. J
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 Secfions A,8,and C on this cerfificate represents my best efforts fo inferpret the data available.
I understand fhat any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME LICENSE NUMBER
JACK W.SMITH
TITLE PSM 6140
PROJECT SURVEYOR COMPANY NAME
KLEIN&STAUB SURVEYING,INC.
ADDRESS CITY STATE
8016 Old County Road 54 ' New Port Richey F� ZIP CODE
SIGNATURE 34653
' ) DATE TELEPHONE
_ - __ —'--� 05-05-06 (727)834�140
�-'
FEMA Form 81-31,January 2003 See reverse side for continuation.
Replaces all previous editions
� INl,PORTAN�: In these spaces,copy the corresponding information from Section A. For insurance company use:
BUILDII�G STREET ADDRESS(Induding Apt,Uni�Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX N0. Policy Number
' � 145 BRIGHTWATER DRIVE UNIT No.1-9
� CITY �1 STATE ZIP CODE Company NAIC Number
CLEARWATER "�• FLORIDA 33767
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
'opy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner.
COMMENTS
N/A
❑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 suppoRing information for a LOMA or LOMR-F,
Section C must be completed.
E1.Building Diagram Number_(Select the builtling 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 floor(including 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 serviang 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 community's floodplain management ordinance?
❑Yes ❑No ❑Unknown. The local official must certiiy 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,C(Items C3.h and C3.i only),and E for Zone A(without a FEMA-issuetl or community-
issued BFE)or Zone AO must sign here. The statemenfs in Sections A,B,C,and E are co�ct to the best of my knowledge.
OPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
DDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Certificate. Complete the applicable item(s)�and sign below.
G1.�The information 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 certify elevation information. (Indicate the source 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 FEMA-issued 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 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: _._ft.(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
GNATURE DATE
.;OMMENTS
❑Check here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions
i- r� �' 'v` ._. � ,,�, ,--� '
. FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
� Expires December 31, 2005
� ` ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-7. JOB No.030084.2
SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING OWNER'S NAME Policy Number
PARADISE COVE, INC. UNIT No.2
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
145 BRIGHTWATER DRIVE
CITY STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legai Description,etc.)
LOT 2, PARADISE COVE PLAT BOOK 128,PAGES 19-20
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
61.NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE
City of Clearwater 125096-0102-G PINELLAS FLORIDA
B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER B5.SUFFIX 66.FIRM INDEX DATE EFFECTIVEIfZEVISED DATE 68.FLOOD ZONE(S) (Zone A0,use depth of flaoding)
12103C0102G G SEPTEMBER 03,2003 SEPTEMBER 03,2003 AE EL.11.0
B10.Indicate the source of the Base Flood 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 i�a Coastal Bamer 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.
��2.Building Diagram Number 7 (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,ARIA,AWAE,AR/A1-A30,AR/AH,AR/AO
Complete Items C3.-a�below according to the building diagram specifetl in Item C2.State the tlatum 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 NAVD 1988 Conversion/Comments N/A
Elevation reference mark used LP-15, EL.=4.191 Dces the elevation reference mark usetl appear on the FIRM? ❑Yes �No W , ,
o a)Top of bottom floor(including basement or enclosure) 5.75 FT ft.(m) � ����"—"E�r'.�+�, .
o b)Top of next higherfloor 15.91 . FT ft,(m) �� �, o,�ry°�' „5.j a$#`° � �,,,�
o c)Bottom of lowest honzontal structural member(V zones only) N/A FT ft.(m) �� ,,"�, , g,,<<,,� y°�
o d)attached garage(top of block) 575 . FT ft.(m) ��; � . r� `• "'• � , ,'
o e)Lowest elevation of machinery and/or equipment �� -- : ��� ��� -
servicing the building(ELEVATOR EQUIPMENT) N/A . FT ft.(m) � ,� � �� • � `�� .
o fl Lowest adjacent(finished)grade(LAG) 4.2 . F=f ft.(m) ��'1 '�f�r s� p�� ��F;,;
o g)Hig hes t a djacen t(finis he d)gra de(H A G) 5.1 F T ft.(m) � �-•,;�_ =a� 1 0/1 4�C�5�'
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 14 � ' �=� N�°°e g�°;�;��
o i)To ta l area o f a l l permanen t openings(fl o o d ven ts)in C 3.h 1 2 8 0 sq.in. `'s,�, � '
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION
This certification is to be signetl and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information.
I cerfify that the information in Sections A,B,and C on this certificate represents my best efforts to interpret the data available.
I understand fhat any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME LICENSE NUMBER
BRUCE A.KLEIN PLS 5052
TITLE COMPANY NAME
PRESIDENT KLEIN&STAUB SURVEYING,INC.
ADDRESS CITY STATE ZIP CODE
8016 Old County Road New Port Richey FL 34653
SIGNATURE � DATE TELEPHONE
/ _ „ 10/14/05 (727)834-8140
FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces,copy the corresponding information from Section A. For insurance com�any use: � ,
BUILDING STREET ADDRESS(Induding Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX N0. Policy Number
145 BRIGHTWATER DRIVE UNIT No.2 ` f �
CITY STATE ZIP CODE 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 agent/company,and(3)building owner.
COMMENTS
N/A
❑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 Certifcate 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 800r(including basement or endosure)of the building is _ft.(m)_in.(cm)0 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 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 servicing 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 accordance with the communitys floodplain management ordinance?
❑Yes ❑No ❑Unknown. The local offcial must certify this information 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 sfatements in Sections A,B,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
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local officiai whc is authr,rized by!a�M c�ordin��ce 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�iem(s;and sign 5elow.
G1.❑The ir;forriation in Sectiory;',was taken from e±her documentation that has been signed and embossed by a licensed suroeyor,engineer,or architect who is authorized by state
or la;al law to cer,fi;�elevation info�m;ation. (Indicate the source and date of the elevation data in the Comments area below.)
G2.❑A communityl�fficiai compieted 3ectiorfi for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�The followir:g information(Iteris G4-G9)is provided for community floalplain management purposes.
G4.PERMIT NUMBER T G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCEIOCCUPANCY ISSUED
�
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: _._ft.(m) Datum:
LOCAL OFFICIAL'S NAME r � ;ti , s '� ' ;`�j� TITLE
4 F ts� p�
COMMUNITY NAME r _ ` '° -�z k ja� TELEPHONE
�,
SIGNATURE • ; �'���' � �S ���� `i',`°' DATE •
COMMENTS ¢'4
�i 12' } ���}+1!f a��5 Y �r�—Gi��
�°�'� Y` � . "" .��,.�ro a�i�,"�����
v � �' � r a
❑Check here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions
_ _ _
f- ..� � � �-�,``. .. ,:' ' , I
,� ' FEDERAL EMERGENCY MANAGEMENT AGENCY
� ' NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
Expires December 31, 2Q05
� , ' ELEVATION CERTIFICATE
� Important: Read the instructions on pages 1-7. JOB No.030084.2
SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use:
� BUILDING OWNER'S NAME Policy Number
PARADISE COVE, INC. UNIT No. 2
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
145 BRIGHTWATER DRIVE
CITY STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 2, PARADISE COVE PLAT BOOK 128,PAGES 19-20
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.)
RESIDENTIAL
LATITUDEILONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( ##°-##'-##.#!#" or ##.##t###°) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other:
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNffY NAME& 0 ITY NUMBER B2.COUNTY NAN� B3.STATE
City of Clearwater 12509 PINELLAS FLORIDA
B4.MAP AND PANEL B7.FIRM PANEL 69.BASE FLOOD ELEVATION(S)
NUMBER 65.SUFFIX B6.FIRM INDEX DATE EFFECTIVE/REVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depth of floodwg)
12103C0102 G SEPTEMBER 03,2003 SEPTEMBER 03,2003 AE EL.11.0
B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in 89.
❑FIS Profile �FIRM ❑Community Deiermined ❑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 Othervuise 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' �Fnished Construdion
*A new Elevation Certificate will be required when construction of the building is complete.
�C2.Building Diagram Number 7 (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(uvith BFE),VE,V1-V30,V(with BFE),AR,AWA,ARIAE,AWA1-A30,ARIAH,ARIAO
Complete Items C3.-a�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 Sedion G,as appropriate,to document the datum conversion.
Datum NAVD 1988 ConversionlCanments N/A
Elevation reference mark used LP-15, EL.=4.191 Does the elevation reference mark used appear on the FIRM? ❑Yes �No
o a)Top of bottom floor(induding basement or enclosure) 5.75 . FT ft.(m) � �
o b)Top of next higher floor 15.91 . FT ft.(m) � ►
o c)Bottom of lowest horizontal structural member(V zones only) N/A . FT fl.(m) N� � �� , .
o r� �.
o d)attached garage(top of block) 5.75 FT ft.(m) F�
o e)Lowest elevation of machinery and/or equipment �'; ,
� 4
N
serviang the building(ELEVATOR EQUIPMENT) NIA . FT ft.(m) F�
o �Lowest adjacent(finished)grade(LAG) 4.2 . Ff ft.(m) z� �'� PL;; �p�2
o g)Highest adjacent(finished)grade(HAG) 5.1 . FT ft.(m) � 10/14/05
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 14 J
o i)Total area of all permanent openings(flood vents)in C3.h 1280 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 fhat the information in Sections A,8,and C on this cerfificate represents my best efforts to interpret the data available.
1 understand fhat any false statement may be punishable by fine or imprisonment under 18 U.S. Code,5ecfion 1001.
CERTIFIER'S NAME • LICENSE NUMBER
BRUCE A.KLEIN PLS 5052
TITLE COMPANY NAME
PRESIDENT KLEIN&STAUB SURVEYING,INC.
ADDRESS CITY STATE ZIP CODE
8016 Old County Road � New Port Richey FL 34653
51GNATURE - DATE TELEPHONE
1 _ 10/14/05 (727)834�140
FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions
�' IMPORTANT: In these spaces,copy the corresponding information from Section A. For insuranoe com�any use:
BUILDING STREET ADDRESS(Induding Apt,Unit,Suite,andlor Bldg.No.)OR P.O.ROUTE AND BOX N0. Policy Number
, 1�5 BRIGHTWATER DRIVE UNIT No.2
CIT`� STATE ZIP CODE Company NAIC Number
� CLEARWATER FLORIDA 33767
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
opy both sides of this Elevation CeRificate for(1)community offiaal,(2)insurance agenUcompany,and(3)building owner.
COMMENTS
N/A
❑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 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
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 adjaoent
grade. Complete items C3.h and C3.i on front of form.
E4.The top of the platform of machinery andlor equipment seroiang the building is _ft.(m)_in.(cm)�above or ❑below(check one)the highest adjacent grade. (Use
natural grade,'rf available).
E5.For Zone AO only: If no flood depth number is available,is the top of the bottan floor elevated in accordance with the oommuni�'s floodplain management ordinance?
❑Yes ❑No ❑Unknown. The local oflicial must cerfrfy this information in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The properry 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�ssued or community-
issued BFE)or Zone AO must sign here. The stafements in Sections A,B,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
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local offiaai whc is authonzed by!a�r e;ordin;�c2 to administer the community's Boodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Certificate. Cornplete the applicable�tem(si and sign below.
G1.�The ir;fom�a6on in Section C was taken from e!her documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authorized by state
or local law to cer:if;•elevation info�ration. (Indicate the source and date of the elevation data in the Comments area below.)
G2.❑A community officiai completed�ectior.E ior a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�The fdlowing information Qtems Ga-G9)is provided for community floodplain management purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6.DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED
G7.This peimit 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: _,_ft.(m) Datum:_
LOCAL OFFICIAL'S NAME � ; +� �� ���`� TITLE
. r��`,r �
COMMUNITY NAME � ,,; " � w�� � TELEPHONE
f. , „
SIGNATURE - � �';°"�' � � �'�;�� "'��' DATE
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�'OMMENTS r„ , � p. �
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p 6 ��� � {_i SJ'�f� t
❑Check here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions
.
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��� �'�"`��¢��� CITY OF CLEARWATER
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��� � � � t„�� DEVELOPMENT & NEIGHBORHOOD SERVICES DEPARTMENT
�
�� .� .� ,„�ty^_����� POST OFFICE BOX 474H, CL�WA�R, FLOa�DA 33758-4748
s�,������t;,,��g� MUNICIPAL SERVICES BUILDING, IOO SOUTH MYRTLE AVENUE,CLEARWATER,FLO�uDA 33756
`��'���� TECErxorrE(72� 562-4567 Fnx(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 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
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,and/or 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 1NSURANCE RATE MAP(FIRM)INFORMATION
NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE
City of Clearwater 125096
64.MAP AND PANEL g5.SUFFIX 66.FIRM INDEX DATE B�•FIRM PANEL gg.FLOOD ZONE(S) B9 BASE FLOOD ELEVATION(S)
NUMBER 5/17/2005 EFFECTIVE/REVISED DATE (Zone AO,use depth of flooding)
12103C-0102
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)
611. 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 buiiding diagram most similar to the building for which this certificate is being completed-see pages 6 and 7. If no
diagram accurate�y 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 ConversionlComments
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 maintarned by fhe community and copies with the attached memo made available by request
FRANK HtBAARD,MAYOR
GEORGE N.CRE'I'EKOS,COUNCILMEMALR JOI W DORAN,COUNCIIMEMBER
PAUL F.GIBSON,COUNCILMEMAER � CARI.EN A.PE'1'GRSBN,COUNC[LMEMRLR
��EQUAL EMYLOYMENI'AND AFFIRMA'1'IVE ACfION EMPLOYER��
,�
� � FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
, ���j ` NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
���- ��ao� ELEVATION CERTIFICATE
� ImporEant: Read the instructions on pages 1 -7. JOB No.030084.2
SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING OWNER'S NAME Policy Number
PARADISE COVE, INC. UNIT No. 2
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
145 BRIGHNVATER DRIVE
CITY STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 2, PARADISE COVE PLAT BOOK 128,PAGES 19-20
BUILDING USE(e.g.,Residential,Non-residential,Addifion,Accessory,etc. Use a Comments area,if necessary.)
RESIDENTIAL
LATITUDElLONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( �#,°-#�'-�#.#i#'r" or �.�°) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other:
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNIlY NAME&COMMUNITY NUMB�R B2.COUNTY NAME B3.STATE
Ciry of Clearwater 125096 PINELLAS FLORIDA
L�+.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER B5.SUFFIX Bo.FIRM INDEX DATE �FFECTIVFJREVISED DATE 68.rL00D ZONE(S) (Zone A0,use depth of flooding)
125090-0102 G SEPTEMBER 03,2003 SCPTEMBER 03,2003 AE EL.11.0
B10.Indicate the sour�of the Base FIoa1 Elevation(BFE)data or base flood depth entered in B9.
❑FIS Pr�file �FIRM ❑Community Determined ❑Other(Descnbe):_
811.Indicate the elevation datum used for the BFE in B9:❑NGVD 1929 �NAVD 1988 ❑Other(Describe):_
812.fs the building located in a Coastai Bamer Resources System(CBRS)area or Othenvise Protecied Area(OPA)? ❑Yes �No Designation Date_
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Building elevafions are bzsed on:�Construction Drawings` �Building Under Construction' ❑Finished Construction
� 'A new Elevafion Certificate will oe required wh2n construcfion of the building is compleie.
C2.3uilding Diagram Number 7 (Sele;,t the builtling diagram most similar to the building for which this ceriificate is being completed-s�pages 6 and 7. If no diagram
axurately represents the building,provide a sketch or photo�raph.)
C3.Elevations—Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(wiih Br�),AR,ARIA,AR/AE,AWA1-A30,AR/AH,AR/AO
Complete items C3.-a-i below axording to the building diagram specmed in Item C2,State the daium used.If the datum is different irom the datum used for the BFE in
S�iion 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
Seciion D or Section G;as appropnate,to d�ument the datum conversion.
Daium NAVD 1988 ConversionlComments N/A
=levaiion reference mark used LP-15, EL.=4.191 Does the elevaiion reference ma�C used appear on the FIRNi? ❑Yes �No,,`�+�3��� �u
o a)Top of bottom floor(induding basement or enclosure) 5.75 F7 ft.(m) � _ � ,,,.+ . ��.}
o b)Top of next high�rfloor ?5.91 FT ft.(m) `� • '� � � `'
a c)Boi[om oi low2st horizontal structural m2mb�r(V zones only) N!A . FT ft.(m) o o »"��� �d � � � _i I
o d attached ara e to of block 575 FT ft.m �� "`� �� `: c� . ��
) 9 9 � P ) � ) E •,. �
�'� ;:._ w
o e)Lowest eleva'tion of machinery and/or equipment � �, _ . ' �
servicing the building(ELEV�TOR EQUIPMENT) NIA FT ft.(m) � ' � �:,, �
o �Lowest adjacent(Tinished)grade(LAG) 42 . FT ft.(m) ��, �. r�� �' �, ; ��
o g)Nighest adjacent(nnished)grade(HAG) 5.1 . FT ft.(m) ��. ° ' y ,,a�,..0�/1'�r65 �
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 14 J ,Q *a y�'°,�
o i)Total area of ail permanent openings(flood venis)in C3.h 1280 sq.in. 'z�t�o�,,
SECTION D•SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION
This certirication is to be signed and sealetl by a land surveyor,engineer,or archiiect authorized by law to certify elevation information.
I certify that the information in Sections A, 8,and C on thrs cerfificate represenfs my best efforts fo interpret the data available.
I undersfand that any false statemenf may be punishable by fine or imprisonment under 18 U.S. Code, Secfion 1001. _
CERTIFIER'S NAME LICENSE NUMBER
BRUCE A.KLEIN PLS 5052
� TITLE COMPANY NAME
PRESIDENT KLEIN&STAUB SURVEYING,INC.
ADDRESS CITY STATE ZIP CODE
8016 Old County d 54 New Port Richey FL 34653
SI�NATURE DATE TELEPHONE
05/11/05 (727)834�140
rEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces,c�py the corresponding information from Section A. For�nsurance company use:' • -
BUILDING STREET ADDRESS Qnduding Apt,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX N0. Poiicy Number � �
145 BRIGHTWATER DRIVE UNIT No.2 ;
��n STATE ZIP CODE Company NAIC Numli�r�
CLEARWATER FLORIDA 33767
SECTION D-SURVEYOR,ENGINEER,OR ARCH(TECT CERTIFICATION(CONTINUED) �
Copy both sides of ihis Elevafion Certincate for(1)community official,(2)insurance agent�company,and(3)building owner.
COMMENTS
N/A
❑Check here if attachments
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIREDJ FOR ZONE AO AND ZONE A(WfTHOUT BFE)
r"or Zone AO and Zone A(without BFE),compiete Items E1 through E4. If the Elevation Cerfincate is intended for use as supporting information for a LOMA or LOMR-F.
Section C must be compieted.
E1.Buiiding Diagram Number_(Sele�t the building diagram most similar to the building ror which this certificate is b�ing complefed—see pages 6 and 7. If no diagram a�urately
represents the building,provide a sketch or photograph.)
E2.The top of the bottom floor(inciuding basement or enclosure)of the building is _ft.(m)_in.(cm)0 above or ❑b�low(ch�k one)the highest adjacent grade. (Use
natural grade;if available).
E3.For Building Diagrams 6�with openings(see page 7),the nexl higher floor or elevatetl flo�r(elevafion b)of the building is _ft.(m)_in.(cm)above the highest adja�ent
grade. Complete items C3.h and C3.i on front of form.
E4.The top of the piatform of machinery and/or equipment servicing the building is _ft:(m)_in.(cm)�ab�ve or ❑t�low(check one)the highest adjacent grade. (Use
naturai grade,if availabie).
E5.For Zone AO oniy: If no flood depth number is availabie,is the top of the bottom floor elevated in ac�rdan;�with the communitys floodplain management ordinanc2?
❑Yes ❑No ❑Unknown. The local official must cerfify this information in Section G.
SECTlON F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owner's authonzed representafive who completes Secfions A,B,C(items C3.h a�d C3.i only),and E for Zone A(without a FEMA-issuetl or community-
issued BFE)or Zone AO must sign here. The sfatem?nts in Secfions A;B,C,and E are correcf to fhe besf of my knowledge.
. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPR�SENTATIVE'S NAME �
ADDRESS CITY STATE ZIP CODE
� SIGNATURE DAiE TELEPHONE
COMMENTS
❑Check here if attachments
_ SECTION G-COMMUNITY INFORMATION(OPTIONAL)
I n2 local o"r:"icia who is autnorzed by law or erdinanc2 fo administer the c•�mmunity's floodplain managemeni ordinance can complete s�tions A,B,C(or�),ano G or`this Elevation
Cerfificate. Corrpl2te the applicable item(s)�;�tl sign below.
G1.❑i he inio!mation in Se�iion C wz�taken from other d�umentation fhat has bmn signed and embossed by a licens2�surveyor,engineer,or architect who is authorized by stale
o.r locai iaw to c��lify eievafion informaiion. (indicate the source and date of the el2vation data in the Commen(s area below.)
G2.0 A c�mmunity o6icial o�rrpieted 5�ctior,E for a building Ia,ated in Zone A(without a FEMA-issued or community;ssued BFE)or Zone A0.
G3.❑The followiny information(Ite.ns G4-C-�)is provided for community floo�plain management purp�ses.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCc/OCCUPANCY ISSU�D
G7.This p2rmil h2s been issued for. �New Gonstruction ❑Substanfial 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 buiiding sife is: _._ft.(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMMENTS �
❑Check here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions