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51 CARLOUEL DRDEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency ELEVATION CERTIFICATE OMB Control Number: 1660-0008 IMPORTANT: FOLLOW THE INSTRUCTIONS ON PAGES 9-16 Expiration: 11/30/2018 opy all pages of this Elevation Certificate and all attachments for (7) community official, (2) insurance agent/company, and (3) building owner. SECTION A- PROPERTY INFORMATION FORM INSURANCE COMPANY USE A1. Building Owner's Name M�IRTIN CRUZ & C1ITHLEEN CRUZ Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number: 51 C�RLOUEL DRIVE City CLE�RW�TER State FL Zip Code 337G7 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) P�RCEL ID. 32-28-15-13464-256-0230 LOT 23 & P11RT OF 22, BLOCK 256, Cr1RLOUEL SUB PB 20, PG 60 p A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) Residencial A5. Latitude/Longitude: Lat. 28°00'02.5"N Long. 82°49'26.7"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 g 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) 3400 Sq ft a) Square footage of attached garage 550 sq ft b) Number of permanent flood openings in the b) Number of permanent flood openings crawlspace or enclosure(s) within 1.0 foot in the attached garage within 1.0 foot above adjacent grade 98 above adjacent grade � c) Total net area of flood openings in A8.b 555 Sq in c) Total net area of fiood openings in A9.b 0 sq in d) Engineered flood openings? �Yes �No d) Engineered flood openings? �Yes �No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name 63. State CIT'Y OF CLEr1RW�TER 125096 PINELI�IS FL B4. Map/Panel Number B5. Suffix B6. FIRM Index Date 67. FIRM Panel Effective/ B8. Flood Zone(s) B9. Base Flood Elevation(s) Revised Date (Zone AO, use base flood depth 12103C0064 G 8/18/2009 9/03/2003 r1E 11 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: �FIS Profile �FIRM �Community Determined QOther/Source: B11. Indicate elevation datum used for BFE in Item B9: �NGVD 1929 �NAVD 1988 �Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Othenvise Protected Area (OPA)? �Yes � No Designation Date: �CBRS �OPA SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: �Construction Drawings* �Building Under Construction' �Finished Construction 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. In Puerto Rico only, enter meters. A new Elevation Certificate will be required when construction of the building is complete. Benchmark Utilized: CITY OF CLE11RW11TER "J-03" Vertical Datum: Z•595 FEET Indicate elevation datum used for the elevations in items a) through h) below. QNGVD 1929 �NAVD 1988 Q Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) N� �- �feet �meters b) Top of the next higher floor �- 1 �feet �meters c) Bottom of the lowest horizontal structurai member (V Zones only) N�� - �feet � meters d) Attached garage (top of slab) 4- � �feet � meters e) Lowest elevation of machinery or equipment servicing the building � 1 (Describe type of equipment and location in Comments) �feet �meters f) Lowest adjacent (finished) grade next to building (LAG) 4- 3 �feet �meters g) Highest adjacent (finished) grade next to building (HAG) 5- 2 Qfeet � meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N�`� - �feet �meters FEMA Form 086-0-33 (7/15) Replaces all previous editions. Page 3 of 15 a r ELEVATION CERTIFICATE SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION OMB Control Number: 1660-0008 Expiration: 11 /30/2018 is certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify �t the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be nishable by fine or imprisonment under 18 U.S. Code, Section 1001. � Check here if attachments. Certifier's Name D�N�1 �1. WI'I.LIE Title SURVEY NL�N�1GER Address 565 S. HERCULES �1�'ENUE re Were latitude and longitude in Section A provided by a licensed land surveyor? �Yes QNo License Number LS 5874 Company Name DEUEL & �1SSOCI�TES City State Zip Code CLEARW �TER FL 33764 Date I Telephone Field Date: 4/01/2016 (727)822-4151 ...1; , ' � �� ` ♦ ` �: . �� j�;,h~ r��% r r . '/ ` ; . �. �; � �,' �. ; t.: ,6� : p,,,, r ft� • �'"�` � '� �qi �: ��; .. �:`_. � .� a r.., Q �/n� .� y� , �. +: . V � ,,ry(� * Ye�fr''r. ,'� \y�h`�r�r{�. Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner. Comments {including type of equipment and location , per C2(e), if applicable)" �15: Latitude and longitude were determined by using Google Earth. .�8: Flood openings consist of concrete blocks turned sideways (8 openings measured 0.45'x0.45' for a total of 233 square inches) & decorative blocks (15 openings estimated at 321 square inches total, see photos) C2a) No access to measure crawl space elevation C2e) Elevation shown is rlir conditioner platform Signature S,(� L � w� 1/�� Date 4/01/2016 SECTION E- BUILDING ELEVATI INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BF For Zones AO and A(without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR-F request, comple Sections A, B,and C. For Items E1 -E4, use natural grade, if availabie. 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 b) Top of bottom floor (including basement, crawlspace, or enciosure) is �feet �meters � above or � below the HAG. �feet �meters � above or Q 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 Q 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 QUnknown. 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, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name: Address Signature Comments City Date State Telephone ZIP Code ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Page 4 of 15 , - .� BUILDING PHOTOGRAPHS See Instruction for Item A6 IMPORTANT: In these spaces, copy the corresponding information from SectionA. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and BoxNo. 51 CARLOUEL DRIVE OMB Control Number:1660-0008 Expiration: 11 /30/2018 RANCE COMPANY USE Policy Number: City State Zip Code I Company NAIC CLEARWATER FL 33767 Number: If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 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." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page ,� / F . � _ y,.9i°" � , ai3'=' , ae � � � �. �� _ � �� 4 t'^� �- nT �� ^ ; � g � F � a . �� _.:.. - d,.�"F P e g� . .,..,,,�_ � �n y 1„"�� °x�$ �' �.f'ft .�f�` FC� . i '�,^.,_,� _ „ " � , � � p t 6 � �" i3 �i , s, i 3 . / �"� � �� , � � . "F �+``z � �'p �� ., ��Y.d.R.,a�'k,.Gd��"" � � � .,..+-e�^-? "'t"w.ci.#�'A � � � ., , rE. � ' . , � .� - � ;�zvy� � ��;� � �' � � � � � r �a °i �,. � �e _ E� � � �.. �' � ` � �. �� .� � �° % E � , g �I � �� F � i . a f � �_ E � ._ ,�,' g 4 i, � �` � '� � �� i '� � q „ � �� ; �� - �".. q__ %�°�' �, z � � . AR��_� �� . 3 _ c3°c t�d o . J. s '�45 � FRONT VIEW (4-01-2016) �� e✓� �� H��. .��';� �,� ,� `��>� LEFT SIDE VIEW (4-01-2016) � .�aadi�e��r� ��r�� Iii�iiY�'�II � ��ili � �� [lf�'�� !� 11 ��if! � �� ' ��a . .� � ,,, . .. �...-s a i . � �=� �_ � . . � y � x � � * 'e° � ^�. � ,� • � '� � �a � ` Y 1 � A � "P � 1�i;: REAR VIEW (4-01-2016) � RIGHT SIDE VIEW (4-01-2016) � ...~ '� i�, , , � � � ,� ; , z r�� s � d . F . t n . 7°R"' 4 _ __. � � e : � � '�,� '°� _>ax �.-_ ; ; �� °; � r;•,.,�-� �, �'� a. . .� ��`.` ��. � � >,� b e %�� j.a ,' r J � 4 t � tii . _ � P� ^ 1 � � j �. � � �, �, q �� , � �; � �� g �' � q. �� s�, . - v � � 3 �' � �? , ��. '� ,q.� � a�, `'��.� � � , a 4 � 6� �, '� �S . ,p» f � t . �.� � � . � , t f ; a� g k x < : . <<�a ,gq �' � k[ v ° � s � I�•f s � 9 W a 4 % '� ��.� VZ.�� r y �k^ / �*� �' f � �,e �g6' �. f °�q � r �� Y�3 7�� f� � ��"�`rj ' �,��' ��`1`�R� ��. ,` � '-`��.�'-K�a ��. ' ..� .� '�,. ,, � 8� � ; < � �, � = ��;'�� . : ,�",�' ,d'� 1,,. : -% �/�'�;'et a�1 �� 94s-..�� , .�e ' ; � � �� t �� _ -�g'�, �r �'�`, . , � u `B.F�� ° `��, Y�i � °`�� FLOOD VENT-BLOCK TURNED SIDEWAYS-2 OPENINGS EACH TIMES 4 (4-01-2016) � ��.,,. �� - r FLOOD VENT-DECORATIVE BLOCK-15 OPENINGS EACH TIMES 6 (4-01-2016) FEMA FORM 086-0-33 (7/15) Replaces all previous editions. Page 6 of 15 „ _ , . 96-212 � � � ELEVATiON CERTIFiCATE O.naa,NO3o67-r,077 Exp�res May 31, 1993 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ENTION: Use of this certificate does not provide a waiver of the flood insura�ce purchase requirement. This form is used only to vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate, and/or to support a request for a�etter of Map Amendment or Revision(LOMA or LOMR). Instructions for completing this torm can be found on the following pages. SECTION A PROPERTY INFORMATION , Foa�NSUanNCe coMPnNV use BUILDING OWNER'S NAME • POLICY NUMBER JOHN H. MEEK JR AND PATRICIA P. MEEK STREET AODRESS(Including Apt.,Unit,Suite and/or Bldg.Number)OA P.O.ROUTE AND 80X NUMBER COMPANY NAIC NUMBER 51 CARL�UEL DRIVE OTHEF DESCRIPTION(Lot and Block Numbers,etc.) SOUTHERLY 40'r0.. FEET OF:. LOT 22 AND ALL OF LOT 23, BLOCK 256, S'AR�C?SI.�.T_• �.tR_ C�T'y STATE ZIP CODE CLEARWATER BEACH FLORIDA � SECTION B FLO00 INSURANCE RATE MAP(FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1.COMMUNITY NUMBER ' 2.PANEL NUMBEFi 3.SUFFIX 4,DATE OF FIRMJND X 5.FIFM 20NE 6.BASE FLOOD ELEVATION j�f (in AO Zones,use depth) 125096 0003 F 8/16/92 AE 11 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): �NGVD'29 ❑Other(describe on back) 8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate the community's BFE: � � � .�feet NGVD (or other FIRM datum—see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION �Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best escribes the subject building's reference Ievel_l_ . (a). FIRM Zones A1-A30,AE,AH,and A(with BFE). The top of the reference level floor from the selected diagram is at an elevation of� I ! 6� �'�,�feet NGVD (or other FIRM datum—see Section B, Item 7). (b). FIRM Zones V1-V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of I I I I '• I.!I feet NGVD(or other FIRM datum—see Section B, Item 7). (c). FIRM Zone A•(without BFE). The floor used as the reference level from the selected diagram is � I,i I feet above❑ or below�' (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the setected diagram is � �.�feet above❑ or below� (check one)the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor(reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations:�X! NGVD'29 '� Other(describe under Comments on Page 2). (NOTE: Il the e/evation datum used in measuring!he elevations is different than that used on the F1RM (see Sectron B, Item 7J, then convert the e/evations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: ❑ Yes ❑ No (See Instructions on Page 4) 5.The reference level elevation is based on: L� actuai construction ❑ construction drawings (NOTE: Use of construction drawings is only va/id if the building does not yet have the reference level floor in place, in which case this cerii(icate will only be valid for the building during the course of construction. A post-construcfion Elevation Certificaie will be required once construction is complete.) 6.The elevation`of the lowest grade immediately adjacent ro the building is:� ' 4.•��eet NGVD (or other FIRM datum-see Section B, Item 7). . SECTION D COMMUNITY INFORMATION �If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Ite�ri 1 is not the"lowest floor”as defined in the community's floodplain management ordinance, the elevation of the building's"lowest floor"as defined by the ordinance is: ' ' ! � '.!' feet NGVD (or other FIRM datum—see Section B, Item 7). 2. Date of the start of construction or substantial improvement FEMA Fo►m 81-31�MAY 90 REPlACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION SECTION E CERTIFICATION - . This certification is to be signed by a land surveyor, engineer, or architect who is authorized by 5tate or local taw to certify elevation information when the elevation information for Zones A1—A30, AE, AH, A(with BFE),V1—V30,VE, and V (with BFE) is required. Community oflicials who are authorized by local law or ordinance to provide floodplain management information, may also sign the � certification. In the case of Zones AO and A(without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8 - Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use,wall openings, or unfinished area Feature(s),then list the Feature(s)not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. I ceriify ihat the inlormation in Sections B and C on this certificate represents my best efforts to interpret the data avai/ab/e. !understand that any false statemenf may be punishab/e by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER(or Affix Seal) GORDON F KILLION PLS # 3138 TITLE COMPANY NAME • OWNER KILLION AND ASSOCIATES ADDRESS CITY STATE ZIP 2 4—A SOUTH HI HLAND AVE . CLEARWATER, FLORIDA 34616 ': SIGNATU . � ^' DATE PHO,NE- � � •-L..�..---- 6 21 9 6 813 44 3 7�6 7 � Copi� s ould be made of this Certificate for: 1)community official, 2) fnsurance agent/company,and 3} building owner. _ �, COMMENTS: BENCH MARK USED CITY OF CLEARWATER J-3 EL . 3.421 � ON W�TH ON PILES, SLAB BASEMENT PIERS.OR COLUMNS A V A A V ZONES ZONES ZONES ZONES 20NES REFERENCE REFEfiENCE BASE LEVEL REiER�NCE LEVEL F�OOD ELEVATION _ � ;,, :�: . ..4 . . ..,. ' .':...�,.._,.:.�..,.r�;,.:. :,�r.:.........:.:.:::.:'� .��i; . :':':::';::�:.:: .�`�i: BASE BASE �ADJACENT��:°��''�^f'<.�� REFERENCE FLOpD FIOOD �....: •:::. . :;��%; EIEVATION GRADE LEVEI ELEVATION REFERENCE ADJACEM u:%�! LEVEI GRADE �`�`� ?:ri: �ic:;;��iii.�.:;if:r ' �,f1 �.:�ADJACEM�;. .. ...:� � -.� .. . . llfll:'!� GRA�E '. The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level 11oor. � Elevations ior all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2