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971 ELDORADO AVE �"'"'_��:f] �n�,�'� _ __ �c fa .��o 0?7 Z�E3' _ 9�� I� � � � � f; � FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 � NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 `:� J U L � 3 2000 �� ELEVATION C ,, ERTIFICATE !�1 � �_�_� �` } � Im ortant: Read the instructions on a es 1 -7. ��Q� e- SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Uses B iNG OWNER'S NAME Policy Number Dominick ntricchia BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAtC Number 971 ELDORADO AVENUE C�N STATE ZIP CODE CLEARWATER BEACH FL 33767 PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) LOT 8,BLOCK 60,MANDALAY SUBDIVISION,PLAT BOOK 14,PAGE 32-35 BUILDING USE(e.g.,Residentiat,Non-residential,Addition,Accessory,etc. Use Comments sedion if necessary.) RESIDENTIAL(Addition) LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS(Type): ( ##'-##�-##•##" or ##.##�#°) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other: N/A SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 61.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME 63.STATE CITY OF CLEARWATER 125096 CLEARWATER FL B4.MAP AND PANEL 65.SUFFIX B6.FIRM INDEX B7.FIRM PANEL 68.FLOOD B9.BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO,use depth of flooding) 0003 F 08-18-92 OS-18-92 qE �� 610. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in 69. ❑ FIS Profile � FIRM ❑Community Determined ❑Other(Describe): 611. Indicate the elevation datum used for the BFE in 69:� 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) C" ding elevations are based on:� Construction Drawings* ❑ Building Under Construction* � Finished Construction ��ew Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 1 (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 C3a-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 29 Conversion/Comments na Elevation reference mark used#150 Does the elevation reference mark used appear on the FIRM? ❑Yes � Ho "''�±•° ❑ a)Top of bottom floo�(including basement or enclosure) 4.4 ft.(m) @ :�: ' 0 b)Top of next higher floor NA._ft.(m) " � �Y�' °'`�'+`�o'' `•��'�"T� ❑ c)Bottom of lowest horizontal structural member `" ♦'�° `�' '�'' `�` - • (V zones only) NA._ft.(m) o o �°�`�,� � ' �. '� �,� ❑ d)Attached garage(top of slab) NA._ft.(m) E� �� ' �` �' ,��: �; � � ❑ e)lowest elevation of machinery and/or equipment W `° °��`�`� � � � � �<` _ �� servicing the building NA ._ft.(m) � � �'� '�'�"�"" ,��"" �� ; _ 0 Lowest ad'acent rade LAG �" � 1 9 � ) 4. 1ft.(m) i� � �6�` , ❑ g) Highest adjacent grade(HAG) NA._ft.(m) �� ;� `� � s � ❑ h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade NA � �''1 "° ,� . ❑ i)Total area of all permanent openings(flood vents)in C3h NA sq. in. (sq.cm) J ��e? .�-bo SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION This certification is to lie�=�igned-and.s�aled by a land surveyor,engineer, or architect authorized by law to certify elevation in rmation. I certify that the info�on�''S�ctii��ts A, B, and C on this certificate rep�sents my best efforts to interpret the data avai/ab e. l understand that�ny�se�Af�r�ei��y be punishable by fine or imprisonment under 18 U S Code Section 1001 GERTfFIER S NAME„z;��ROL Q.fcY LICENSE NUMBER #5955 —� � �' � � T� P� e �.�:"� _ ~ COMPANY NAME FLA SPATIAL ADDRESS T � �� ' C�'�y STATE ZIP CODE 10810 72rid S E�T'S171�W'E`209r �''"9 r�.� ;; - -- LARGO FL 33777 SIGNATUR �r. -. "J A, p a - .?'� , �.' _ DATE TELEPHONE 07-11-00 797-3603 FEMA Form 81-�1,'AdlG 99 � SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS , 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 Number 971 ELDORADO AVENUE CITY STATE ZIP CODE Company NAIC Number CLEARWATER BEACH FL 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,� VERTICAL INFORMATIOM OBTAINED FROM PINELLAS COUNTY ENGR.DEPT BM#750"AURAL(1973)" EL=3 934'NGVD29 ❑ 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 E/evation Certificate is intended for use as supporting infom►ation 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 enclosure)of the building is _ft.(m)_in.(cm)� above or ❑ below(check one) the highest adjacent grade. E3. For Building Diagrams 6-S with openings(see page 7),the next highar floor or elevated floor(elevation b)of the building is _ft.(m)_in.(cm)above the highest adjacent grade. E4. 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 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. 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 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 infnrmation(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)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 attachments FEMA Form 81-31,AUG 99 REPLACES ALL PREVIOUS EDITIONS