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195 DEVON DR � � FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 . NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 ELEVATION CERTIFICATE . . Im Read the insbvctions on 1-7. � ��--��'° �'�� SECTION A-PROPERTY OWNER INFORMATION For Insurar�ce Compery Use: 11LDING OWNER�NAME �,�N�� /d/J� ��REET ADDRESS(IncN�ding Apt,Und,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Compeny NqIC Nurnbe� C(TY�GEA/ly(/I��Q �AC� STATE ZIP CODE �• PRO�t TY DESCRIPTIon�(Lat and Bbdc Nurribers,Tax Pa�el Nurnber,Legal Description,etc 4err 3o KFic.4r .�� srv� Seo,�.s.o�✓ �B 2'3 �G /8 BUIW�NG USE(ag.,Re�der►bal,Non�de�al, roon�aooessorY�etc. use a Garm�ents area,d r�ecessary.) -"` ' `��3/YEO�`f//�!� � . LATIhJDEILONGITUDE(OPTIONAL� HORIZONTAL DATUM: SOURCE: GPS(rYPeY . {#t�!'-#7�'.-##.�" ar #1�.� ❑NAD 1927 ❑NAD 1983 ❑USGS Quad MaP ❑Other: SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION � Bt.NFIP COMMUNITY NAME 8 COMMUNfTY NUMBER g2,COUW7y WqME g3 �A� Ct,��N/gr&'� 2 so �'..✓E�,t �"zo,t.oA B4.MAP AND PANEl B5.SUFFIX 87.FIRM PANEL B9.BASE FL000 ELEYATION(S) NUMBER 86.FIRM INDEX DATE EFFECTIVEh2EVISED DATE B8.FLOOD ZONE(S) (2one A0,use depfh of Appding) O DD � � D�i �I 2 /� �'2. B10.Indica�te the souroe d the Base Fbod Elevatlon( FE)daka ar base flood depth n 89. ❑FIS Profile �'FIRM ❑ p� �p��p�q��. 611.Indicate tl�e eleva6on dahm used for fhe BFE in B9��VD 19Q9 ❑NAVD 1988 ❑Of�(Desaibe): B12.Is the building bcated in a Coastal Banie�Resources System(CBRS)area or OU�eiwise Protected Mea(OPA)?�Yes L�'No ' Date SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl.Bull�l(1g elevahOfls 81�e bHSed Ofl:Q COf1SUuc.'ti0(t DfdWlflgs' Bui�l(1g U�1de�COftshlJCU0f1' ❑Fullsfled CO�1ShUCU011 -_ "'.'°`._�. "_`..'. •:rr"'�,.'•.i � 'A new Eleva6on Certificate will be requi�ed wt�en oa�structian d the buildirg is complete. � _ ;_� . . D�a�ar�Number�(Seled 1he buildirg dia9'dm most sintilar�o the buildirg for whic;h tlus c�rtificate is beirx�oortipleGed- pages 6 and 7. ff no diac�arn,�_ ��eN r�r�Cs the buiking�wiovide a sketct►a photograpn.) JU N Z �: 2001 .Elevations—Zones A1�A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,ARIA,ARIAE,ARIA1-A30,ARIAH,AWAO k+ Complete Iterns q.-ai bebw acxading to the building diagram specif'�ed in Item C2.State the dalum used.If the dah�m is d'rfferent ��:4sQd fa the B��in � S e c t i o n B,c o n v e r t t h e d a h u n�o tl�a t used t o r the BFE.Show field measu�►nents and dalum conversion cak;ula6on. Use the ' - f i�W�� ` : Section D or Section G,�appropriate,to doaunent the dah�m carversion. 1 �A� i oaa,m��„�;o�rco��/�9�n�ic �p �o B�!�'/ 6c6vAr,o�= �/65' � Elev ' mark used_��Does the eleva6on refe�nce madc used appear on the FIRM? ❑Yes [�]'1Vo �, " F '' ' ,.,� a)Top d bd6om floor(including base�nerd a aiclosure ��t j ,;��, ,; �)Top d next higherfloor ' , Lb�/ /Lft(� ��,, ;�' � � �., ' �W{14JIII��JlIM1L4J1114.��wlu10111G11RIC1 N��l, /{// ��J �� k`... ., r� . ry., .`'''�'� ,• � 7"": a ia �^p � �� AUa�ed 9ar'age(�oP d slab) f�. �R(p� $� '� �� ;� -- �' ❑ e)lowest elevation aF inaclur�y andlor ' . ° , ^' savicirg the buildirg(Desaibe n a Camne�area) �,A �.� � � '�a ' :� *^ , �' �. ��6� � `: � � - �c�s�M�) �.�tt�r Z N Pc:S: .� �c�G,�<,c�"h ti —��4gh�adjao�rt(firyshed>9iade(HAG) �.. o ft!,,,,� � � ,�, ;,� s �� )No.of perrnar�ent ape�rrgs lflood vadsl wi�in 1 ft above adjacer�t 9rade�j r,' � �T d a l a r e a d a q p e r m a r�e n t �/ � 0/ /D 0 _ o p e n i r g s(fl o o d v a i t s)in q.h sq.in.�q r c fi) 2� 3 O Y' �• /n/: SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or ar�hitect authorized by law to certify elevation infortnation. 1 certify that the information in Sections A,B,and C on this ce�t'r�cafe represents my best effoRs to inte�pret the data available. 1 understand that an felse sfatement ma be nishable 6 fine or im risonment under 18 U.S Code,Section 1001. CERTIfIER'S NAME � � ' LICENSE NUMBER / � COMPANY NAME �...� _�� 8 �J � CITY ' �TATE LP COOE r� / S URE � a � d/ 0 �E 7L - 7g7- FEMA Form 81-31,JUL 00 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS Fa Insurarxe CanPanl+� IMPORTANT: In these spaces�copY the corresponding information irom Section A. Pd�y Nurr� . BUILDING STREET ADORESS(Induding ApL,Urrt,Suite,andla Bidg.No.)OR P.O.RWTE AND BOX N0. CfTY�/ E ON � STATE ZIP CODE �H�� I�'f6t �!��l`f SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides af ttus Flewation Certificate for(1)c;orrur►unih�a�al.(2)i�s��°OmP�Y��3��°N�' � COMMENTS ❑Chedc hene if attachments SECTION E-BUILDING ELEVAl10N INFORMATION(SUftVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(IM�HOUI'BFE) For Zaie AO and Znne A(wiUaut BFE),comptete Items E1 through E4. If the Elevation Certficate is intended fa use as s�PP°��9��0��fa a LOMA a LOMR-F, Section C must be uar�pleted. � 6 and 7.If no diagram accuratelY E1.Building Dia9ram Number—(Seled the buildirx,�diagram most similarto 1he building fa which this certifica�e is being canpleted— P� reaesents the buildirg,p'nvicle a sketch a ptatagraPh•) E2.The top of the boltom tba(u�dudirg ba�r�t or enclos�ue)d the bWldirg is it(m)_in.(cm)[I�a ❑below(c��edc one)the t�est adjace�d 9rade• l� natix-al gade,�arailal�le)• E3.For Buikting Diagrarns 68 with openings lsee pa9e�,the next highe�'floor or elevated floor(elevaGon b)of the building is _R(m)_.in.(an)abo+re fhe higt�st adlaoent grade. Cortiplet,e items p.h and C3.i on ftont af fam. e E4.For Znne AO ony: If no flood depth number is available�is the top of the bottom floa eleva�ed m accordarx:e wdh the canmun�ty's floodPlain managert►ent ordinance ❑Yes ❑No ❑Unk�. The bcal oificial must ' ihis infama6on in Section G. SECTION F-PROPERTY OWNER(OR OYVNEaS REPRESENTATNE�CERTIFICATION The propeAy o�wner or owners autl�orized�presenlaUve who canpletes Sec�ons A,B�C(Items q.h and C3.i ony)�and E for Za�e A(wiUwut a FEMA-issued or oanmunity- issued BFE)or Zaie AO must sign hene. The sta�rnents in Sections A,B,C�and E are cortect to the best of my kr�awlecige, pRQpERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME . CITY 5iATE LP CODE ADDRESS DATE �E • SIGNATURE COM�AEI�ITS ❑Chedc here'rf attachments SECTION G•COMMUNITY INFORMATION(OPTbNAL) The bcal o�iaal who is auU�aized bY law or adinarxe to adminisUa the oarurwnil�s floodPlai�man�g�t adinarxe can comPlete Sections A,B,C(a E),and G d th�iss Ele�rabon �• ��5�� and�sed M a licensed surveyor,ergine�,ar arr.tutec�who is authaized bY GL�The�fortr�atio�►in Section C was taken from other doaur�►lhak has been signed state a bcal la�to certity elevalion ir�amatan. (Indicate the sou�e and date of the elevaUon data in the Commen��BFE�a Zaie A0. G2.CI A o�h��E fa a building IocaGed in Za►e A(witlaut a FEMA�ssued ar oanrnunily' G3.�The�9 ir�amatan(Items G4-G9)�s�xw�led for conununity floodPlain m�ag�t W�' Cy4.pERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPIIANCEJOCCUPANCY ISSUED G7.This permit has been issued for:�New Construction ❑Substantial Imprauement . R�m� p�: G8.Ele+ration d as-b�ult b�west floa(u�ckrd�9��1°��: — g�m� Dahm: G9.BFE a(�n Za�e AO)depth d floodir�g at the buildirg sibe is: -- TfT1.E LOC.+4l.OFFICU1l5 W�ME 7ELEPHONE COMMUNITY NAME DATE ' SIGNATURE COMMENTS ❑Chedc here if attachmen�� REPLACES ALL PREVIOUS EDITIONS FEAAA Form 81-31.JUL 00 U.S.�EPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE °�'��. 1�� a��.��,,�� Federai Emergency Management Agency National Flood Insurance Program important: Read the instructions on pages 1-9. + SECTION A-PROPERTY INFORMATION ��"��= A1. Building Owner's Name MARK S.AND DIANNE P.B�UM `�� A2. Building Street Address(inGuding Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. `��lf'��'�� 195 DEVON DRIVE City CLEARWATER State FL ZIP Code 33767-2439 A3. Property Description(Lot and Blodc Numbers,Tax Parcel Namber,Legal Description,etc.) LOT 30 AND PART OF LOT 29,A REPLAT OF BAY5IDE SUBDIVISION-PB 23,PGS 18 AND 19 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)ADDI I N A5. LatitudetLongitude:Lat.27.9737°N Long.82.8228°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 buitding with a crawlspace or enGosure(s): A9. For a building with an attadied garage: a) Square footage of crawlspace or endosure(s) N/A sq ft a) Square footage of attached garage 359 sq ft b) No.of permanent flood apenings in the cxawlsRa�Q� b� �m 1 0 foot above d�a�n�t grade e a 6��9arage enclosure(s)within 1.0 foot above adjac:ent grade WA c) Total net area of flood openings in AS.b t�/A sq in c) Total net area of flood openings in A9.b 2304 sq in d) Engineered flood openings? [] Yes � No d) Engineered flood openings? []' Yes �J No SECTION B-PLOOD INSURANCE RATE MAP(FIRM)INFORMATION 61_NF1P Community Name 8�Communih+Number B2.CouMy Name B3•� CLEARWATER-125096 PINELLAS FLORIDA B4.Map/Panel Number B5.Suffi�c 66.FIRM Index 67.FIRM Panel 68.Flood B'9•�F��e.wa5ro�s��orre 12103CU102 G Date Effective/Revised Date Zone(s) AO,use base flood depth) 8l18/09 9/3/03 AE B10. lndicate the spurce of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. [❑ FIS Profile � FIRM ❑ Community Determined ❑ Other(Describe) B11. Indicate elevation datum used for BFE in Item B9: �NGVD 1929 � NAVD 19B8 � Other(Describe) B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes � No Designation Date [�' CBRS ❑ OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on; � Construction Drawings' �' Buildi�g Under Construdion* �' Finished Construdion *A new Elevation Cert�cate will be required when construction of the building is complete. C2. Elevations-Zones A1-A30,AE,AH,A(with 8FE},VE,V1-V30,V(with BFE),AR,AWA,AWAE,AR/A1-A30,AR/AH�AR/A0. Canplete Items C2.a-h below acxording to the building diagram sPecified in ttem A7. Use the same datum as the BFE. B�rr�teaY�@A�¢e.� �Jt115�F:�-��'ex�ieat p��?m� 'N� ConversionJComments NAVD Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor)5.63 �f faet [,�meters(Puerto Rico only} b) Top of the next higher floor N.A �fest [7 meters(Pusrto RicO only) c) Bottom of the lowest horizontal structural member(V Zones only) N.A �feet �meters(Puerto Rico onfy) d) Attached garage(top of slah) NA �feet �meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building N.A �feet Q meters(Puerto Rico only) {pescribe type of equipment and location in Comments) � Lowest adjacent(finished)grade next to building(LAG) 5.30 �feet �meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 5.50 �feet �meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including N.A �feet ❑meters(Puerto RicR'only) . strudural su R SECTION D-SUR1/�YOR,ENGINEER,OR ARCHITECT CERTIFICATIO �s�;s�xo",►�,, This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certiy el�Jati�n �:�y��¢9 ' ,f information. 1 certify that the information on this Cerfificate►epnesents my best efforts to interpret the data ava�la�Te,,v�, �„„� _ I undersfand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section�IO�.�, `' �."�' �`� + p� � � Check here if comments are provided on back of form. Were latitude and longitude in Section A provid�,q ae�+-�' �':� �v� �. � licensed land surveyor'? � Yes ❑�No,�°�,, j _ �° � � �', � r' r � Certifier's Name JOHN C. BRENDLA License Number 1269 .} � �, „„ , P � � i � '_y�'� +�c.. Title REGISTERED LAND SURVEYOR Company Name JO C.BRENDLA�ASSOCIATES,INC. . u�,A r,°. ;. �. '� ;' �. ;:� � Address 1 82 A E NORTH City PINELLAS P K State FL ZIP Code 3 �'�� „ " ��•.� � � 'q✓y Signature M Dat O6I20h 1 Telephone 727-576-7546 ,,F ; ' "' FEMA F 81- , 09 See reverse side for continuation. Rep s all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. Fr,r frasurance Carnpany Llse: Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. -Polic�Nurr�ber 195 DEVON DRIVE City CLEARWATER State FL ZIP Code 33767-2439 f;Ct��p�tpanq-�4�t�:Nur�ber SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTIR�JED) Copy both sides of this Elevation Certificate for(1)community official, (2)insurance agenUcompany, and(3)building ownec Com e ts c2e:N/A B NC ARK: # 4(DE-2)ELEV 5.714'NGVD ADJUSTE O ELEV.4.92'NAVD-MSL=0.00 Sig re Date 06/20/1.1 ❑ Check here if attachments SECTION 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, compiete 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 0 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 officiai 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, and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO m ust sign here. The statements in Sections A,8,and E are correct to the best of my krtow/edge. 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 INFaRMATION(OPTIONAL) The local o�cial 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 seated by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (Indieate the source and date of the elevation data in the Comments area below.) G2. ❑ A community officiai 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 ,0 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 � ❑Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions