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756 ELDORADO AVE . � � � �� , c%��'�� FEDERAL EM��2GENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 . � NATIONAL FLOt�D INSURANCE PROGRAM Expires December 31, 2005 F� 2,� � ELEVATIC�N CERTIFICATE Im ortant: Ftead the instructions on a es 1 -7. SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use: B A�R Poflcy Number BUILDING STREET ADDRESS(Including ApL,Unit,Suite,andbr Bldg.No.)OR P.O.ROU1E ANb BOX NO. Company NAIC Number 756 ELDORADO AVE. CITY STATE ZIP CODE CLEARWATER BEACH FLORIDA 33767 PROPERTY DESCRIPTION(lol and Block Numbers,Tax Parcel Number,Legal Description,etc.) -- —LO-T_2,__I.ESS THF �QUTH 5 FF.F.T� $j,n('K�, MANI�AT,AY Sug�IVISION, BUtLDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Commenis area,if necessary.) RESIDENTIAL " LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: �_�GPS(Type): ( �l#°-##'-##.##" or ##.#it###°) �_I NAD 1927 �_�NAD 1983 �_�USGS Quad Map �_�Olher N.A.V.D. 1988 SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 81.NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME � B3.STATE � FLORIDA B4.MAP AND PANEL B5.SUFFIX B6.FIRM INDEX 87.FIRM PANEL BS.FLOOD B9.BASE FLOOD ELEVATION(S) NUMBER OATE EFFECTIVElREVISED DATE ZONE(S) (Zone AO,use de th oi floodinq� 12103C 0102 G 09/03/03 06/18/71-09/03/03 "VE" 4.00' NAVD �988 DATUM 610. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9. �_) FIS Profile �X� FIRM �_� Community Determined �_�Other(Describe): B11. Indicate the elevation datum used for the BFE in B9: �_� NGVD 1929 �X � NAVD 1988 �_� Other(Describe): B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? �_�Yes �X� No Designation Date: SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) �1. Building elevations are based on: �_�Construction Drawings' �X�Building Under Construction' (_�Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 6 (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 Ixem 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 CITY OF CLEARWATER BENCHMARK "I-02" ELEVAT'ION: 9.68' ADJ. Elevation reference mark used CITY "I-02" Does the elevation reference mark used appear on the FIRM? �_�Y�s ��No U a)Top of bottom floor(including basement or enclosure) GRADE BEAMS 7.00 ft.� � . ; U b)Top of next higher floor 15y 88.ft.� N •�U�. D�,,HALE � �J c)Bottom of lowest horizontal structural member(V zones only) 14.98 ft.� �o P^:L.a�,:� �/4626 � - ; �� d)Attached garage(top of slab) UNDER CONSTRUCTION _ft.(m) E� - ` �, ;,A ., U e)Lowest elevation of machinery and/or equipment W"° ` �� ' • � r;;�•. � servicing the building(Describe in a Comments area.) UNDER CONSTRUCTION ft.(m) �� U � Lowest adjacent(finished)grade(LAG) 7.3 ft.� z'N `� U g)Highest adjacent(finished)grade(HAG) 7,5 ft.� � �:�� U h)No. of permanent openings(flood vents)within 1 ft. above adjacent grade 0 � R?.-s U i Total area of all ermanent o enin s flood vents in C3.h 0 s in. s cm FEBRU'' Y.,�2�.1, 2006 ) P P 9 ( )� 4• � 4 ) SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION f ' This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. !certify that the information in Sections A, 8, and C on this certificate represenfs my best efforts to interpret the data available. I understand that any fa/se statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER GUY D HAT. . P L S �14626 TITLE COMPANY NAME PROFESSIONAL LAND SURV�YOR GUY D. HALE, LAND SURVEYING aoDRESS 1110 OVERCASH DRIVE, SUITE "C" CITY DUNEDIN STATE FLORID��P co�E 34698_- SIGNATURE DATE TELEPHONE 34-47f,h FEMA Form 81-31,Ja ary 2003 See reverse side for continuation. Replaces all previous editions ��(�� a 3 Q� � . . . ' . .. .. . ..,i_.. ,..� IMPORTANT: In these spaces,copy the corresponding Information from Section A. For Insurance Company Use; BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Policy Numb�r 756 ELDORADO AVE. , • . � C�TY STATE ZIP CODE Company NAIC Number CLEARWATER BEACH FLORIDA 33767 - - ---- - SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTI,NU`�D�� . �,i , � � � Copy both sides of this Elevation Certificate for(1)community official, (2)insurance agenUcompany, and(3)buiiding owner. ' COMMENTS — I I Check here it 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 Eb. If the Elevation Certificate is intended for use as suppo�ting 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 compfeted— 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 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 6-8 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 servicing the building is I_I_I� (m)I—I—I 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 I I No � I Unknown. The local official must certiry this information in Section G SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The prope�ty 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-issued or community-issued BFE)or Zone AO must sign here. The statements in Sections A, 8, C, and E are correct to Uie besf of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME • ADDRESS � CITY STATE ZIP CUDE SIGNATURE DATE TELEPHONE COMMENTS -- � I 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 official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3. �_�The following information(Items G4-G9)is provided for community floodplain management purposes. I 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)depth of flooding at the building site is: _ft. (m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE � COMMENTS I I Check here if attachments FEMA Form 81-31, January 2003 Replaces all previous editions C;, �' °+2' , , . �� . � �-� �-�,�� . ' Building Photographs - See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poi�cy Number 756 ELDORADO AVENUE City State ZI P Code Company NAIC Number CLEARWATER BEACH FLORIDA 33767 i � If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right � Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. EAST AND FRONT SIDE VIEW TAKEN 10/24/2007 SOUTH SIDE VIEW TAKEN 10/24/2007 .�_.. ,:�-.. �$�r�~�: f",= _."��?' ��-w�''�°� . .:G� � � �.R.:� .�:�: �i�= �II ° ° ��'��..� �a�. , ,� !�� 0 . ��:� '�� --_ �AGp� ^n,. :4 `� ��{pT!^�vrv�` .. • �� p . �� . _.._—_ � e _ � �'' ... 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