145 BRIGHTWATER DR UNIT 5 a C t� �'L �'�— � � ��� l FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
� � ` . Expires December 31, 2005
t i s• ' 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
Linda M. Fletcher
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
145 BRIGHTWATERDRIVE uNfTS
CITY STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lotand Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 5, 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 B2.COUNTY NAME B3.STATE
City of Clearwater 125096 PINELLAS FLORIDA
B4.MAP AND PANEL B7.FIRM PANEL 69.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 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 Bartier 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 Construdion* �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,AWA,AR/AE,ARIA1-A30,AR/AH,AWAO
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 NAVD 1988 Conversion/Comments N/A
Elevation reference maric used LP-15, EL.=4.191 Dces the elevation reference mark used appear on the FIRM? ❑Yes �No �,���� , .
o a)Top of bottom floor(including basement or enclosure) 5.75 . Ff ft.(m) � -�' s,.�'3 �`��,
�n °k�' 9` '"
o b)Top of next higher floor 15.91 F=f ft.(m) � f.,� �; �,; ,
o c)Bottom of lowest honzontal structural member(V zones only) N/A . FT ft.(m) N� ; �' :j1� r�� '�. .-,
o d)attached garage(top of block) 5.75 . FT ft.(m) �� �`d �, j;., "�".�� �
o e)Lowest elevation of machinery and/or equipment -�� �`��� ��' -
serviang the building(ELEVATOR EQUIPMENT) 11 75, FT ft.(m) � _.-� �" ,'�,t;. °�
� � c I � a�J�1 r:+-'� �:al ,
o fl Lowest atljacent(finished)grade(LAG) 4.2 . FT ft.(m) �� '�°�',,,;Y�:5��Q6a�i��w`
o g)Highest adjacent(finished)grade(HAG) 5.1 FT ft.(m) � !;a�V'� 05/03
�_-
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 14 J ��`►�1���,,,,,,*,�~`
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.
I cerfify that the information in Sections A,B,and C on this certificafe represents my best efforts to inferpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Secfion 1001.
CERTIFIER'S NAME LICENSE NUMBER
JACK W.SMITH PSM 6140
TITLE COMPANY NAME
�ROJECT SURVEYOR KLEIN&STAUB SURVEYING,INC.
DDRESS CITY STATE ZIP CODE
8016 Old County Road 54 New Port Richey FL 34653
SIGNATURE ,� DATE TELEPHONE
- „� �,.,� G�• � 05-05-06 (727)834�140
,-
�
FEl��orm 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 company use:
, Bl.';,�ING ST�EET ADDRESS(Induding Apt,Un�,Suite,and/or Bk1g.No.)OR P.O.ROUTE AND BOX N0. Policy Number
'145 BRIGHTWATER DRIVE UNIT No.1-9
� � CITY STATE ZIP CODE Company NAIC Number
CLEARWATER FLORIDA 33767
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
py both sides of this Elevation CeRificate for(1)community official,(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(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�with openings(see page 7),the next higher floor or elevated floor(elevation b)of the builtling 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(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 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 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 Secfions A,B,C,and E are corr�ct to the best of my knowledge.
ROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
, DRESS 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 suroeyor,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 Construdion ❑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
JMMENTS
❑Check here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions
��v�C?`���—�, — r�-=�''� 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 Forinsurance Company Use:
BUILDING OWNER'S NAME Policy Number
PARADISE COVE, INC. UNIT No. 5
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 5, 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 Ma
❑ P ❑Other._-----
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.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 EFFECTIVE/REVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depm 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 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):_
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)
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 certifcate 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 specrfied 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 tlatum 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
„ a _.
Elevation reference mark used LP-15, EL.=4.191 Does the elevation reference mark used appear on the FIRM? ❑Yes �No `�F,;,.��:.;��;;9,r
o a)Top of bottom floor(including basement or enclosure) 575 . FT ft.(m) � °� � ° '%t .
o b)Top of next higherfloor 15.91 . FT ft.(m) �' '�' ,tC�r "
o c)Bottom of lowest horizontai structural member(V zones only) N/A . FT ft.(m) o o �t ,�� �r ,� ' '
o d)attached garage(top of block) 575 . FT ft.(m) w� �� '� "�� ���=�
o e)Lowest elevation of machinery and/or equipment , _ ' » �"�
servicing the building(ELEVATOR EQUIPMENT) N/A FT ft.(m) � ' `''� •�•'✓ �'� �" �' " .
�� . � y •� »
o fl Lowest adjacent(finished)grade(LAG) 4.2 . FT ft.(m) �� � �y�,��' PLS 50�2•• �
o g)Highest adjacent(finished)grade(HAG) 5.1 . FT ft.(m) � -v� °•��/��. .
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent gratle 14 � � ,� ��
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 cerfify that the information in Sections A,8,and C on this cerfificate represents my besf efforts to interpret the data available.
I understand thaf any false statement may be punishable by�ne 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 Coun 54 New Port Richey FL 34653
SIGNATURE DATE TELEPHONE
,, ' 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. Forinsurance 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.5 ' • '
��n 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 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.Builtling 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 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 next higher floor or elevated floor(elevation b)of the building is _ft.(m)_in.(cm)above the highest atljacent
grade. Complete items C3.h antl 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 communiry'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 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 statemenfs in Secfions A,8,C,and E are corr�ct 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 o�cial who is authoiized 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 th�appi!;,zble itemis)and sign below.
G1.�The infcrmation 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 locai law to cerfify elevatici�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 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 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 is: _._ft,(m) Datum:_
G9.BFE or(in Zone AO)tlepth of flootling at the building site is: _._ft.(m) Datum:_
LOCAL OFFICIAL'S NAME ,;` x� E;� TITLE
� t;�
COMMUNITY NAME � ° � "' !,;,� �� TELEPHONE
SIGNATURE �-� q�:��' � "�"'�^ °���_°`� DATE �
�;w,� � , �.���
COMMENTS
�� g . . E� t�*�,",�
k�--'�-----� d`x e� f 'r-6 �e�`�"w �wJ
4`��.� p s.—i ��s �i�,.^!f G_r°k
❑Check here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions
��� " ���`� 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 ForinsuranceCompanyUse:
BUILDING OWNER'S NAME Policy Number
PARADISE COVE, INC. UNIT No.5
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 5, 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 ##.#l�##°) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other:
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
61.NFIP COMMUNITY NAME 8�COMMUNITY NUMBER B2.COUNTY NAME 63.STATE
City of Clearwater 125096-(Ja{�2-6—� PINELLAS FLORIDA
64.MAP AND P L 67.FIRM PANEL 89.BASE FLOOD ELEVATION(S)
NUMBER B5.SUFFIX B6.FIRM INDEX DATE EFFECTIVFJREVISED DATE 68.FLOOD ZONE(S) (Zone A0,use depih of flooding)
12103C0102 G SEPTEMBER 03,2003 SEPTEMBER 03,2003 AE EL.11.0
B10.Indicate the so ce 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 in a Coastai Bamer Resou�ces 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 E�evation CeRificate will be required when construction of the building is complete.
.,2.Building Diagram Number 7 (Select the building diagrarn most similar to the building for which this certificate is being completed-see pages 6 and 7. �f 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,AR/AE,AR/A1-A30,AR/AH,ARIAO
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 NAVD 1988 ConversionlComments N/A
Elevation reference madc used LP-15, EL.=4.191 Does the elevation reference ma�C used appear on the FIRM? ❑Yes �No
o a)Top of boflom floor(including basement or endosure) 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 ft.(m) o 0
o d)attached garage(top of block) 5.75 . FT ft.(m) ��
o e)Lowest elevation of machinery and/or equipment W v
serviang the building(ELEVATOR EQUIPMENT) N/A . FT ft.(m) E�
o fl Lowest adjacent(finished)grade(LAG) 4.2 . FT ft.(m) �N � PLS 5052
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 �
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 that the information in Sections A,8,and C on this cerfificate 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.
CERTIFIER'S NAME LICENSE NUMBER
BRUCE A. KLEIN PLS 5052
TITLE COMPANY NAME
PRESIDENT KLEIN&STAUB SURVEY�NG,INC.
— ADDRESS CITY STATE ZIP CODE
8016 Old Coun 54 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�nsurance company Use:
BUILDING STgcET ADDRESS(Induding Apt.,UnA,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX N0. Policy Number
145 BRIGHTWATER DRIVE UNIT No.5
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 agenVcompany,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 diagr�n most similar to the building for which this cefificate 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 floa(induding basement or enclosure)of the building is _ft.(m)_in.(cm)�above or ❑below(chedc 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 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 communit�s floodplain management ordinance?
❑Yes ❑No ❑Unknown. The local offia�must cer6fy 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 a community-
issued BFE)or Zone AO must sign here. The sfafements in Sections A,B,C,and E are correct fo the best of my krrowledge.
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 authorz�,:d by ia�:✓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 th�app!::;able itemis)and sign below.
G1.�The information in Seetion 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 l��u to cert�y elevatioii informa6on. (Indicate the source and date of the elevation data in the Comments area below.)
G2.❑A community official comple[ed Section E for a building located in Zone A(without a FEMA-issued or communiiy-issued BFE)or Zone A0.
G3.0 The following informa6on(Item;�G4-G9)is provided for community floodplain management purposes.
G4.PERMff NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCEIOCCUPANCY ISSUED
G7.This permit has been issued for: ❑New Construdion ❑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 � " ' "; E �,, �a ;' e� TITLE
� , �
COMMUNITY NAME F " � �" '! �� TELEPHONE
NATURE �:� �;�� � ,� �,��',��'� `"` DATE
COMMENTS
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� �.�
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❑Check here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions
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��� ��� DEVELOPMENT & NEIGHBORHOOD SERVICES DEPARTMENT
��S'`',�,�' r���� ,#�`c�;���' PosT OFFicE Box 4748, Ci�wn�e, Ftio�unn 33758-4748
`�'+',r"�;����,�"��� MUNICIPAL SERVICES BUILDING, IOO SOUTH MYRTLE AVENUE,CLEARWATER,FLORIDA 33756
�`�`��'"' TELEPxotvE(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 INSURANCE RATE MAP(FIRM)INFORMATION
.NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE
City of Clearwater 125096
B4.MAP AND PANEL g5.SUFFIX B6.FIRM INDEX DATE g7.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
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 69:� NGVD 1929 ❑ NAVD 1988 ❑ Other(Describe)
B12. Is the buitding iocated 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:________� i"" Community Official: �
A evation certificates shall be maintaine by the community and copies with fhe attached memo made available by request
FRANK HIRRARD,MAYOR
GEORGE N.CRE'I'EKOS,COUNCILMEMBER JOIIN DORAN,COUNC[LMEMBER
PAUL F.GIRSON,COUNCILMEMRCR � CARLEN A. PE7'ERSEN,COUNCIL�fEMRGR
��EQUAL EMYLOYMENT AND AFFIIZMA'1'1VE AC1'ION EMPLOYER�
. _ _
�
. , FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
^ ��7 �'" NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
� 'c�oc��- �c�y ELEVATION CERTIFICATE
� Important: Read the instructions on pages 1 •7, JOB No.030084.2
SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDWG OWNER'S NAME PolicyNumber
PARADISE COVE, INC. UNIT No.5
BUILDING STREET ADDRESS(Inciuding Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
145 BRIGHNVATER DRIVE
CIIY STATE ZIP CODE
CLrARWATER FLORIDA 33767 _
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcei Number,Legal Description,etc.)
LOT 5, 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):
� �°_��_+�,��� o� #�.�°) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.____
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NrIP COMMUNfiY NAME&COMMUNITY NUM3ER B2.COUNTY NAM� B3.STATE
City of Cleanvater 125096 PIN�LLAS FLORIDA
B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER B5.SUrFIX B6.FIRM INDEX DATE EFFECTIVEIREVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depth of flooding)
125095-0102 G SEPTEMBER 03,2003 SEPTcMBER 03,2003 AE EL.11.0
B10.Indicate the source of the Base Fiood Elevafion(BFE)data or base floai depth entered in B9.
❑FIS Profile �FIRM ❑Community D2termined ❑Other(Describe):
B11.Indicate the elevation datum used ior the BFE in B9;❑NGVD 1929 �NAVD 1988 ❑Other(Describe):_
612.!s 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)
�C1.Building elevations are based on:0 Construction Drawings° �Building Under Construc'tion" ❑Finishetl Constru�iion
'A new Elevation Ceriificate will be requir�d when construction of the building is complete.
C2.Building Diagram Number 7 (Szl�t the building diagram most similar to the building for which this ceRficate is being completed-see pages 6 and 7. If no diagram
axurately represents the buiiding,provide a sketch or photograph.) ,
C3.Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AWA,AWAE,AR1A1-A30,AR/AH,AWAO
Complete Items C3;a-i b21ow axording to the building tliagram specined in Item C2.State the datum used.If the dalum is different from the datum used for the BFE in
Se�fion B,convert the datum to thai used ior the BFE.Show f eld measuremenis and datum conversion calculafion. Use the space provided or the Comm2nis area of
S�„fion D or 5ection G,as appropriate;to document the datum conversion.
Datum NA\�D 1988 Conver�ionlComments N/A ° ' �
Elevation rererence mark used LP-15. EL=4.191 D�s the elevafion reierence mark used appear on the FIRN? ❑Yes �No � ���� �- �
o a)Top of bottom floor jincluding basem�nt or enclosure) 5.75 FT ft.(m) � . ,.;�. ,;,,.•�`' . �'*
0 0)Top of rnx1 higher foo� 15.91 FT ft.(m) � ,� L� �� �� ��� �'�_
o cj Botiom of towesi horizonial struciural membar(V zon2s oniy) NIA �T ft.(m) N� '� :'�� �'j �
n�� ��`� c3 ..,.,.�
o d)atta�hed garage(top of bl�k) 5.75 . FT ft.(m) �� � _� � `
o e)Low2st el2vation of machinery and/or equipment �',��, ;z�- '' ..�- > °
servicing the building(ELEVATOR EQUIPMENT) N/A . FT ft.(m) ��:•. �,F � �" � �
o fl Lowest adjacent(finished)grade(LAG) 4.2 . F7 ft.(m) ���� � .� W`� �,•"���:`
o g)Highest adjacent(finished)grade(HAG) 5.1 FT ft.(m) � ', y' j� •,..j.����1 F�Q�' '�'"
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 14 � �'� �.:� �c �
o i)Total area of all permanent openings(flood vents)in C3.h 1280 sq.in. ►`�.���;;w-°°"'
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 cerfify that the information in Sections A,B,and C on this certificate represents my besf efforfs fo interpret fhe data available.
I understand thaf any false stafement may be punishable by fine or imprisonmenf 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 54 New Port Richey FL 34653
SIGNATURE DATE 7ELEPHONE
� , 05/11/05 (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 Insu2nce Company Use:
BUILDING STREET ADDRESS(Induding Apt.,Unit,Sufle,and/or Bldg.No.)OR P.O.ROUTE AND BOX N0. Poliry Number •
145 BRIGHTWATER DRIVE UNIT No.5 %,
CITY STATE ZIP CODE Company NNIC 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 ownec �
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 NO and Zone A(without BFE),complele liems E1 through E4. If the Elevation Certifcaie is intended ior use as supporfing iniormation for a LOMA or LOMR-F,
Section C must be completed.
E1.Building Diagram Number_(Sel�t the building diagram most similar to the building for which this certifcate is being compteted–see pages 6 and 7. If no diagram axurately
represents the building,provide a sketch or photograph.)
E2.The top of the bottom floor(including basement or enclosure)of the building is _fl.(m)_in.(cm)�ab�ve or ❑b�low(check one)the highest atljacent grade. (Use
natural grade,if available).
E3.For Building Diagrams 6�with openings(see page 7),the ne�higher floor or elevated flo�r(elevafion 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 piaiform of machinery and/or equipment servicing the building is _ft.(m)_in.(cm)�ab�ve or ❑balow(che�k one)the highest adjacent grade. (Use
natural grade,if available).
E5.For Zone AO only: If no flood deptn number is availabie,is the top of the boriom floor elevated in accordance with thz community's floodplain management ordinance?
❑Yes ❑No ❑Unknown. The local oificial must cerfify this information in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owners authonzed 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 Secfions A;B,C,and E are correcf to the best of my knowledge.
- PP,OPERTI'OWNER'S OR OWNER'S AUTHORIZED REPRESENTATN�'S NAME �
ADDRESS GTY STATE ZIP CODc
SIGNNTURE DHTE TELEPHONE
COMMENTS —
__._ ❑Check here if attachments
_ _ SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The laai�nicia!wno is autnonzed bj law ur ordinance to adminisier the community s floodplain management ordinance can complete Sections A,B,C(or E),and G o�this El2vation
Cerfificafe. Co;nplete ihe app�icable itpm(s)ar,�sign below.
G1.[�The informatic^in Sertion C w�s taken�rom other do�umentation that hzs been sianed and embossed by a licensed surveyor,engin�r,or archilect who is authorized by slate
or laai law to certify elevatior�infor,nation. (indicate the source and date of tne elevation data in the Comments area below.)
G2.[�/�community ufficia!�:�mplet�ii Sfc.fion E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�The�ollowing informatior,(Itzms G4-�9)is provided for community floodplain management purp�ses.
G4.PERMIT NUMB�R 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 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
❑Check here if attachmenfs
FEMA Form 81-31,January 2003 Replaces all previous editions