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1013 ELDORADO AVEU.S. DEPARTMENT OF HOMELAND SECURITY Fed sral Emergency Management Agency National FIoo9 Insurance Program ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. OMB No. 1660-0008 Expires March 31, 2012 SECTION A - PROPERTY INFORMATION Al. Building Owner's Name JAMES & GAYE STASKIEL For Insttranca Company Use: P9Iiay Number A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1013 ELDORADO AVENUE Company>NAIC Number City CLEARWATER BEACH, State FL ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 4, BLOCK 68, MANDALAY SUBDIVISION A4. A5. A6. A7. A8. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL Horizontal Datum: 0 NAD 1927 0 used to obtain flood insurance. Latitude/Longitude: Lat. 28deq. 00' 08.3" Long. 82deq. 49' 34.8" Attach at least 2 photographs of the building if the Certificate is being Building Diagram Number 6 For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 577 sq ft b) No. of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 4 c) Total net area of flood openings in A8.b sq in d) Engineered flood openings? 0 Yes 0 No NAD 1983 A9. For a building with an attached garage: a) Square footage of attached garage 808 sq ft b) No. of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 6 c) Total net area of flood openings in A9.b 768 sq in d) Engineered flood openings? 0 Yes 0 No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number CLEARWATER / 125096 B2. County Name PINELLAS B3. State FLORIDA B4. Map/Panel Number 65. Suffix B6. FIRM Index 67. FIRM Panel 68. Flood 69. Base Flood Elevation(s) (Zone 12103 C 0064 G Date Effective/Revised Date Zone(s) AO, use base flood depth) 08-18-09 09-03-03 VE & AE 13' & 12' B10 Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69. ❑ FIS Profile 0 FIRM ❑ Community Determined ❑ Other (Describe) 1311. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ❑ NAVD 1988 0 Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes ❑ No Designation Date 0 CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings" ❑ Building Under Construction' 0 Finished Construction "A new Elevation Certificate will be required when construction of the building is complete. 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. Use the same datum as the BFE. Benchmark Utilized CITY OF CLEARWATER J-02 Vertical Datum 4.4385 (NAVD'88 datum) Conversion/Comments CITY OF CLEARWATER PUBLISHED ELEVATION a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 6.0 b) Top of the next higher floor 17.5 c) Bottom of the lowest horizontal structural member (V Zones only) 14.5 d) Attached garage (top of slab) __ Q e) Lowest elevation of machinery or equipment servicing the building 16.9 (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 5.5 g) Highest adjacent (finished) grade next to building (HAG) 5.$ h) Lowest adjacent grade at lowest elevation of deck or stairs, including _§.4 structural support Check the measurement used. ❑ feet 0 meters (Puerto Rico only) ❑ feet 0 meters (Puerto Rico only) 0 feet 0 meters (Puerto Rico only) ❑ feet 0 meters (Puerto Rico only) 0 feet 0 meters (Puerto Rico only) ❑ feet 0 meters (Puerto Rico only) ❑ feet 0 meters (Puerto Rico only) 0 feet 0 meters (Puerto Rico only) 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. / certify that the information on this Certificate represents my best efforts to interpret the data available./ understa that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑ Yes 0 No Certifier's Name LARRY L. EVANS License Number 2937 Title LAND SURVEYOR Company Name EVANS LAND SURVEYING, INC. FEMA Form 81-31, Mar 09 See reverse side for continuation. s Address 10'60 BELTREES STREET STE. 9 City DUNEDIN, State FL Signature Date 06-18-2012 Telephone (727) 734-3821 IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1013 ELDORADO AVENUE City CLEARWATER BEACH, State FL ZIP Code 33767 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments A8.b) & A9.b) : Flood openings are on only one side of ground floor enclosure. C2.e) : Are exterior A/C compressors on an elevated platform. Signature Date 06-18-2011 0 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 El -E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. El. 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 1.0 ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is Q.0 ❑ feet 0 meters ❑ above or 0 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 Q.Q ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is Q.0 ❑ feet 0 meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is Q.0 0 feet ❑ meters D 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 0 No 0 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. The statements in Sections A, 8, and E are correct 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 0 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. 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 sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. 0 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. 0 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: 0 feet 0 meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: 0 feet 0 meters (PR) Datum G10. Community's design flood elevation 0 feet 0 meters (PR) Datum Local Official's Name Title Community Name Telephone Signature Date FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions Comments ❑ Check here if attachments FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions Building Photographs See Instructions for Item A6. For Insurance Company Use: Budding Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1013 Eldorado Avenue Policy Number City Clearwater Beach, State FI ZIP Code 33767 Company MAIC Number 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. FRONT VIEW : 06-18-2012 Building Photographs Continuation Page For insurance Company Use: Building Street Address (including Apt, Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. 1013 Eldorado Avenue Policy Number City Clearwater Beach, State Fl ZIP Code 33767 Cornpany NAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." REAR VIEW : 06-18-2012 R r JUN 222012 NNiNG sz DEVE_ CITY OF CUE" ^EN i DEPT 1013 ELDORADO AVE BCP2012-05532 RESPONSE TO COMMENTS STASKIEL, JAMES Zoning: Low Medium Density Re Atlas #: 238A FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the Instructions on pages 1-7. O.M.B. No. 3067-0077 Expires December 31, 2005 SECTION A - PROPERTY OWNER INFORMATION ForinsurarceCompary Use: BUILDING OWNER'S NAME Policy Number BUILDING STREET ADDRESS (Including Apt., tint, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 1013 El Dorado Avenue Gompany:NAIC Number CITY Clearwater Beach STATE FL ZIP CODE 33767 PROPERTY DESCRIPTION (Lot and Bock Numbers, Tax Parcel Number, Legal Description, etc.) LOT 4, BLOCK 68, MANDALAY SUBDIVISION BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) ( ##° - ##' - ##.##" or ##.#####) HORIZONTAL DATUM: NAD 1927 0 NAD 1983 SOURCE: 0 GPS (Type): ❑ USGS Quad Map D Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 91. NFIP COMMUNITY NAME & COMMUNITY NLMBER CLEARWATER 125096 82 COUNTY NAME PINELLAS B3. STATE FLORIDA 84. MAP AND PANEL NUMBER 0003 65. SUFFIX D 96. FIRM INDEX DATE 8/19191 87. FIRM PANEL EFFECTIVE/REVISED DATE 8/19+02 88. FLOOD ZONE(S) AE B9. BASE FLOOD ELEVATION(S) (Zone AO, use depth of ffoodng) 11.0 B10. Indcate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. 0 FIS Profile Z FIRM 0 Carimurity Detennined 0 Other (Desate): — B11. Indicate the elevation dafun used for the BFE in B9: ® NGVD 1929 0 NAVD 1988 0 Other (Desalbe): — B12 is the buidng located in a Coastal Ranier Resources System (CBRS) area Q Otherwise Protected Area (OPA)? 0 Yes ® No Designation Date, SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Bilking etvalons are based on: 0 Construction Drawings* 0 Building Under Construction* ® Finished Constuctian *A new Elevation Certificate a+il be required when construction of the baking is ca T plete. C2. Building Dagam Number G(Select the baking dagaam most sirdar to the building fa which this certificate is being ccrnpleted - see pages 6 and 7. If no dagarn accurst* represents the butting, provide a sketch or photogaph.) C3. Elevations - Zones A1-430, AE, AH, A (with BFE). VE, V1 -V30, V Ouih BFE), AR, AR/A ARAE, AR/A1-A30, AR/AH, AR/AO Complete Items C3. -a -i belay according to the bulding elegem specified in Item C2. State the datum used If the datum is cifferent from the dal rn used for the BFE in Section 8, convert the datum to that used for the BFE. Shaw field measurements and datum conversion calculation. Use the space provided or the Corrments area of Section D or Section G, as apprcpriate, to document the datura conversion. Datum 1929 ConversionrCemmenls NONE Elevation reference mart used ON SITE Does the elevation reference mark used appear on the FIRM? 0 Yes ® No o a) Top of bottom floor (Uxfudng basement or enclosure) 7. 08 t(h1) 1 o b) Top of next higher floc( 18.23 ft(m) cr o c) Bottom of lowest horizontal structural member (V zones only) WA . _ft(m) 1 o d) Attached garage (top of slab) 7. 08 ft (m) o e) Lowest elevation of machinery aiYo equornend m m servicing the buldng (Desaioe in a Comments area) 17.98 ft(m) o f) Lowest adjacent (finished) gale (LAG) 6.84 ft(m) z' .� o g) Highest aclacent (finished) gade (HAG) 6. 95 ft(m) 8 N o h) No. of permanent openings (flood vents) within 1 ft above adjacent gade 0 o ) Total area of al permanent openings (flood vents) in C3.h 0 sq. in. (sq. an) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION 6R/04 #2984 21". - This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information in Sections A, 8, and C on this certificate 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 JOHN R BEACH LICENSE NUMBER 2984 TITLE P.LS. COMPANY NAME JOHN R BEACH & ASSOC., INC. ADDRESS 911 ST. PE i tHSBUR DR W. SIGNATURE CITY STATE ZIP CODE OLDSMAR FL 34677 DATE TELEPHONE 6/7/04 813-854-1276 FEMA Form 81-31, J. any 2 See reverse side for continuation_ Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bit. No.) OR P.O. ROUTE AND BOX NO. 1013 ELDORADO AVENUE CITY STATE ZIP CODE CLEARWATER BEACH FL 33767 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) ccnrnuliy official, (2) insurance agenVcompany, and (3) bulking owner. COMMENTS SECTION C (e) = NC ELEVATION POOL PUMP PAD ELEVATION = 6.50 Fa I nsurance CompeM Use.' Policy Numbs Company MAC Number; 0 Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) Fcr Zone AO and Zane A (wtthatt BFE), complete Item El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed El . Buldng Diagam Minter _(Select the buldng dagam most sinter to the hiking fa which this certificate's being earpleted —see pages 6 and 7. If no (lag= accurately represents the bulking, provide a sketch a photogaph.) E2. The top of the bottom Noor (ncudng basement or enclosure) of the buldng is _ ft(T) _in.(an) 0 above or 0 below (check one) the highest adjacent gads. (the natural gade, if avaikdble). E3. For Buikting D'agams 6-8 with openings (see page 7), the next higher Noor or elevated floor (elevation b) of the buidng is _ R(m) _in.(an) above the highest adjacent Bade. Carplete items C3.h and C3.1 on front of form. E4. The by of the platform of machinery arida equipment servicing the buidng is _ ft(m) _in.(an) 0 above or 0 below (chedk ons) the highest adjacent gade. (Use natural gade, if available).. E5. For Zone A0 ony: tf no flood depth numbers available, is the top of the bottom floc( elevated in accordance with the community's Nooct lain managernent ordnance? 0 Yes 0 No 0 Unknown. The tical 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, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA -issued a canmunity- issued BFE) c( Zone A0 must sigh here. The staternel is in Sections A B, C, and E are correct to the best of my knowledge. PROPERTY OWNER'S OR OWNERS AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CIN 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 ordnance to administer the annuity's floo ain management ordnance can carpiete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sigh below. G 1. ❑ The information in Section C was taken from other documentation that has been signed and a nbossed by a licensed surveyor, engineer, a architect who is authorized by state a local law to certify elevation a ifumation. Qnc ate the source and date of the elevation data n the Garments area below.) 32. ❑ A community official completed Section E for a budding located in Zone A (without a FEMA -issued or oarmuniy-issued BFE) or Zone A0. G3. ❑ The following information (Iters G4 -G9) is provided for community floocpain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G5 DATE CERTIFICATE � COMPLIANCEIOCCUPANCY ISSUED 37. This permit hes been issued tlx: 0 New Construction 0 Substantial Improvement G8. Elevation of as -built lowest floc (ncludng basement) of the bilking is: 09. BFE or (n Zone A0) depth of flooring at the btildng site is: _ft 4) T_ft(m) Datum: Datura: LOCAL OFFICIALS NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS 0 Check here if attachments FEMA Form 81-31, January 2003 Replaces all previous editions FROM :BEACH & ASSOC • Aeg2 i0/3 i6A- BUILDING OAINER'S NAME 5 6 FAX NO. : 7277993622 FEDERAL. EMERGENCY moineen AGENCY AO., NATIONAL FLOOD MANCE PROGRAM ELEVATION CERTIFICATE Impostant Reed IM ions any", 1 - 7. Jun. OS 20e4 12:01PM P1 O.M.B. No. 3067-0077 Expires December 31, 2005 SECTION A - PROPERTY OVNIER INFORMATION BUILDING STREET ADDRESS (ro:Wing Apt, Urk Sues, mkt: Bldg. No.) OR P.O. ROUTE AND BOX NO. 1013 El Dcredo Avenue ---------- CITY STATE ClematerBeecth FL ....... - ........ . - ZIP CODE 337E7 PROPERTY DESORPTION (LaaI Bloelt Numbers, Tex Parcel NuMber, Loved Descepeon, elc.) LOT 4, BLOCK ea, MANDALAY SUBDRASION BUILDING USE (e.g. Reeeteriiel, Non -reddened, Aon, Accettegy, sic Use a Comments Nee, W necessary.) RESIDENTIAL ITTUDEILONGMJOE (OPTIONAL) HORIZONTAL DATUM: SOURCE Ci dIPS (TWO_ W - IRV - or lAllikelAW) HAD 1977 0 NP 1983 D.usGSQmdYO 0 Other: SECTION FLOOD INSURANCE RATEMAP NfORMATION fFri NAD comunire NAJJE COMENTY10.42ER CI. FARWATER IMES E2 COLNTY MAME PINT1.1AS B. SKATE FILRIDA 84. PANEL NUMI',1CR 00:3 85. SUFFDI E6. FIRM INDEX DATE WW1 87. FIRM PMEL EFFECTNEREVISED DATE en= Eel RDCO ZCNE(S) B1). BASER OM ELEVATIoNis) Vale AO, stockpile Waxing) 110 910. hit* bs sane d te gees Real Boehm OWE) dila cr boo liced il erlared at B9. 0 FIS Pro* El FIRM 0 Carmody Deleinined 0 Ober pansy _ 811. Iodate the Newton Miro used torte BFE in Ba; NGVD 1929 0 Ni41110 1069 ID Mir (Describey ____ 812 .le te bulldog located in a Coastal Bailer Resources System (CMS) aw cr Otherwise Prolacbdkee (CPAP 0 Yes, Eflio Destalfat Date_ SECTION C - NUM ELEVATION IM'ORMATION (SURVEY REQUIRED) CI . Bulking *Mona ay Nodal: 0 C43nelnillen Diming? 0 Suiting (hdir Canstudiorf 0..4 Foisted Caulks; al A novElevelim Certificate el be expired efon cmsbotce of the buldng is care. C2. Ming Divorn Number if(Select to liactig degwn most shier b to baking b vkd this confab is belly =plated • see paps rind 7. If no *yarn =rat* repieleris the bulldog, wide a elsidt ar "twit) Ca Beam - Zoos Al -A33, PE, AH, A (eill SFE). 1.4E, VI-V3a V *WIFE), Ag ARA ARM, PRfAlle.33, ARAM, Aft/A0 Carpkite Mora C3.4-1 hem icaidng to the biting clam spelled in Nun C2. Se becalm well bedlam i9 diluent km the diem wed br BFE in Sidon B, caved *odium b that used kr to BFE Sam field rneastrensonts and (barn conversion calcublim. Use be space ;raided or to Comore; tree cif Sidon D or Salim 0, 103 gprprVie,V.i I1wliIein =venial. Dui CenoersioniConmanie NONE Elevation fetRIXO rrerk used JAMIE Doest1e.emimluient usaf arpear cc the FliM? 0 Yes El No u a) Tcp of Morn floor (Inducing testment endows) 1. WO) b) Top of rod NOY Moor NAM o c) Whom of boast hatailel *tetra motto (s., antis my) WA, _t o el)Atle:hed grage (tani slab) Z• gi.tin) u e) Latest simian droodinery away equtment senicirg the buicfng (Desobe in a Cornmeres wee) 1L4111-04 o Lomat aimed (hated) gaea (LAG) 6 . 6110) o g) fighest Ascent MOW) — (MA0) .6, NAM o h) Na manned cperigs (?�v*)VL 1 It. store adiacent gene 2 o Teta tree ri al parrnenint wrings (lox! volt) in C3h 0 so in. gq. cm) skim sORveraft mem 1 T certification is to be sired sailed by a land surveyor, engroar, cr archaic! eulhorized by too cob* that the infoneetion n Saban; A 8, end C on thle certificate represents my beat efforts to interpret the date waffabta 1 understand tint any te!se statement may be panidusbie by ffna or imprisonment under 18 US, Code, Sedian 1001, CERTFERS NAM .101 -INR BEACH UCENBE MIR 2964 TITLE PLS. VW" ACORESS 911 ST, PETERSBUR DR W. SIGNATURE COWAN( NAME .101+1 FL -BEACH & ASSOC., INC. CITY =WAR STA1E FL TELEPHOPE U13450275 ZPCOOE 34877 FEMA Form , JSee r R FROM. : BEACH & ASSOC FAX NO, : 7277993622 Jun. 08 2004 12:02PM P2 IMPORTANT: In 41... • • • 4 . WI* mullion from Section A. tIfIrr •rit r s • a. . . . E At, CITi cLEARWATTR Eff01 We, ander .) OR P.O. RCUTE AND BOX STATE FL OODE SECTION I. SURVEYOR, ENGINEER, OR ARCHIECT CERTIFICATION IcONITAMI) Can bat sidle ri tis Balaton Calcite far (1) cannu* insuarre agrnItTrripery, Erri (3) buiing mart. cods SECTION C (4) *NC ELEVATION POOL kw PAD tLEVATION 8.57 Plod hero If attachment, SECTION E BULDINO ELEVATION NOT REQUIRED) FOR ME iva AND ZONE A ONTIHOUT, WE) Fa Zone AO and Zone A (edhout EfE), ccrariet kris El hoar Ed. If the Bevallon Catikale is Wended ix use as slaying Inforellai *LOMA a-LGIAR-F. Becton C must be caTpaled El. BulicIng Diegsn Mater Sett* bhang Corm mart oirrier b !ie Iselhg vith Ins Cattele is brig condoled -see page: end 7. If no disown Ewe*/ renermrds bull% arcade sketch or prictirph.) E2. Ti 1:p of the bub)cftietJthng ft(m) (TOO above ar Q (dad( ams) te %hest erfecent week (Use netural gar* 1 unieble). Ea Fa Suiting Darras 8-8 vith ewer (seepage 7), /fa next Firer Icier a elevated lax (eievatn b) d the baking 114n)_Ja.(an) toe fne hired *laced grae. Canaleb lens C3.h ard C3,1 on tore el tarn Ed. The tp el he new d machinery erdor etripment semi:11g bukfng Is It(m)_11).(an) 0 abate a 0beim (chedc one) tie highret edged rade, (Use nekral red: It wobble). ES Fa Zone AO wily: If no itaxldeAr rulter Yr mist* lhe tp Ti the balm liar elessted in =tab= vott the cannwitts exdpiaii rrererment crdrence? 0 Yes Ej Kt> 0Unkrown The War Wide, must catty tis infaranka in Sellon G, SECTION F FROMM OWNER (OR OWNER'S REPRESENTATIVE) CERTIRCATION The prtperly rawer a amar's authaired recrewordothe mho ccrrpleke Sectors A, 8, C (hem fah end C3.1 arty). end E lar Zone A �tuita FEMA-bruad ar canna* Kurd ER) a Zone AD mud sir hwa The stare* iT Seams B, and E ons correct to the bast awry knowledge PRCPERTY 01$44f32'S OR DINNERS AUTI-IORIZED REPREseiTA1110E'S NAVE AIDUESS SIGNATURE DATE ST TELE COMMENTS Check here II enactinerfs SECTION 03 COIAMUNFTY ItIFORKATION fOPT/ONAL) The WM olciel via is mutated by ar adrenal bedirrs* the canna*: Ikapkin meregerrent adreocecen amble 8eztra A,B, C (cr E), and G cr tis Ebervial Gael& Carlo te 1130:101 63110 wog G1,0 The hiamelcri Se cton C vas bean torn Taw assmerdako het hes been aged end embalmed by a foamed worrior, engineer, a- actikd *to is sulferker1 by eels a WO bet verify NOWIIM Karelian. (kokair the moire all4 doh of ta deaden calm n 111Thon eras Won) G2. 0 A ccrrarriy *ad ccrnpleled Secton E b atxctig located irt &re A (eltoute FEMAriseued ccorroirkiesuad HFE) cr Tore AO. 133. 0 The foloming intatnike (lane 04 -GO) is prodded kr osmium)/ ficcetien meragernerd I:emcees. r6 DATE CSITFIcATE CF DOnfilft8COSIPAwiraCto DATE PEW ISSUED G7. This Nand hos been blued tic 0 Nam CeInghdol 0&lixbrilal krcrolament-, 08.. Denial is-buit bared kralirck:Ing lamemeng Tithe tukthg ix --.• _t@ Ge, 13FE a (In Zore AO) dep.) foxIng gibs bold% srer ir fl -01) LOCAL cFnciAvsueF 0014AUNITY NAME TELEPHOTE SIGNATURE COMMENTS FEMA Form 81-31, January 2033 Replacer ea previous editions U.S:DEPARTMENTOFHOMELANDSECURITY ELE�/ATION CERTIFICA�'E FEDERAL EMERCiENGY MANAOEMENT AQENCY Naeonalx7oodlnsuranceProgram �mpprtant: Read the instruciions on pages 1-8. ame A2. Building Street Address (inclu l � 13 ��---Do I c�ry G �� R W�4T A3. Property Dgscriptlon (Lot and M�s � iing Apt,, Unit, =/k DO � �-. i�� SECTION A = PROPERTY INFORMATION :: ST�k 5 K I 1= i-.- r Bid� g. No.) or P.O. Route and Box No. UE� state ( L ziP code � � �o 7� ' 7 OMB No. 1660-0008 Expiration Date: July 31, 2015 u '" '"� � � � t�� V, O N A4. Bullding Use (e,g., Reaidentia� Non-ResidenH N, Addition, Aacesaory�e c. A5. Latitude/Longitude: Lat. .� %� �pj ��j Long. �i 3 B Horizontal Datum: ■ NA� 1l27 NAD 1993 A6. Attach at least 2 photographs of the bulld(ng if the Certiflcate la be(nD uaed to obtain 800d inaurance. A7. Buiiding Diagram Number � , ' A8. For a building wfth a crawisPace or enclosure(s); A9. For a building with an attaohed garage: . ' a) Square footage oF crawl�pace or enclosure(s) (p ��j 2j � � aq ft a) Square footage of aftached garaBQ aq ft b) Number of permanent �It��i'openin8s In the crawlspace b) Number of permanent tlood openings in the ttached garage or enclosure(s) within 1 f3 foot`above adjacent gFade within 1 A foot above adj�cent grade c) Total net area of flaod ob�i�(nga in Ag. • �,� $a �n c) Total net area of tiood openings in A9. ��, aq in ' d) Engineered flood openings? �es ❑ No • d) Engineered.flood openings7 G�Yea � No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFQRMATION B1. NFIP Community Name & Commun(ty Number B2. County Name B3. State G LE141� W%�T�-i2 I 125 Q 9 Co p i��L,� 5 �FL , - B+l. Map/Panel Number B5, Sufflx 86. FIRM index Date B7. FIFtM Panel 88. Flood B9, Base Flood Etevation(s) (Zone � Z � o�j G(%� � � �- � n�_ �� Effectiv�/R��ed�Date � e(s � A� use b s� � od depth) • ' 810. Indlcate the source ofthe Beae Flood Elevatlon (�FE) data or 6ase flood depth entered In Item BB. ❑ FIS Profile C�IRM : � Oommunity Determined ❑ OthedSOUrce: .. 611. Indicate elevation datum used for BF� in Item B9: O N�VD 1929 I..y NAVD 1988 C7 OtheNSource: J 812. Is the building locatad in a Coastai Barrier Reaources System (CBR9) area or Othervvise Protected Area (OPA)? ❑ Yes L7 No Deslgnation Date: �] C�iRS . ❑ OPA , � SEGTION G- BUILDINC3 ELEVATIQN INFORMATION (SURVEY REQUIRED) .�. C1. Building elevations are ba8ed on: � Conatruction Drawings' C�Suilding Under Construction" ❑ FiNshed Construction "A new Elevation Certiflcate will be required when conatfuction of the building is complate. C2. Elevations -�onee A1-A30, AE, AH, A(with BFE), VE, Vt-V30, V(with BFE}, AR, AR/A, ARlAE, AR/A1-A30, AR/AH, AR/AO. Complete items C2.a-h below according to the building dle ram specifled n Item A7. In Puertb Rico only, ente me eis. Benchmark Ut(Iized: G� G� c�' 0 2 Vertical Datum: �_ � 5 Indicate elevatfon datum uaed for the elevatfo�s n Rems a) through h) belpw. � NOVD 1929 NAVD 1988 � Qther/Source: Datum used for buliding elevatiqns must be the same as that uged for'the BFE. , Check the measurement used. a) Top of bottom floor (Including basement, crawlspece, or enclosure floor) �.� CB'�eet ❑ meters b) Top ot the next hlgher floor C� [�eet [I meteis . c) Bottom of tNe lowest horizontal structurai member (V Zones only) �,� G+�T�e t ❑ meters � d) Atteched garage (top of slab) �, Q L�'Feet ❑ meters e) Lowest elevatfon of machinery or equipment servicing the buiiding Uh4 DL(Z_�AN�'(", ❑ feet ❑ meters (Deacrfbe type of equipm�nt and Iocation in Commenta) � Lowest adjacent (finished) grade next to building (LAC3) �. 5 �eet ❑ meters g) Highest adjacent (Finished) grade next to bufiding (HAG) _�._� Q'�et � metecs . h) Lowest adjacent grade at Iowest elevatlon ot deck or stai�s, fncludin8 strueiural support _.(,�. b. C�eet ❑ metera SECTION D- SURVEYOR, ENOINEER, OR ARCWIT�CT CERTIFICATION "- `' .��11 . �fr4�.�' This certiflcation is to be signed and sealed by a land sufveyor, engineer, or architect authorized by law to certify elevatio Information. ! cerflly fhat the lnformatlon on fhls Certlficate represents my best e�orts to Interpret fhe dafe avallable. I undersfand thaf any false stafement may be punlshable by fine or Jmprfsonment under 18 U.S. Code, Sectlon 1001. [�*� Check here if comments are provided on back of form. Were latitude and longitude in Section A provfded by a C�'f Check here if attachments. Iicensed land surveyor� �Yes ❑ No Certffier's Name LARRY L. EVANS Title LAND SURVEYOR Address 1460 BEL 5lgnature License Number PLS # 2937 Company Name EVaN3 LANb SURVEYINO, INC. 9 City DUNEDIN, State FL ZIP Code 34698 ;� Date 'I D I O� I I�i' Telephone (727) 7343821 --- h . � � � �� . . . *s��. y� � �`��`�-�� `'� I �� 4�� '� ': ..3 �, d �, . � �� `• ,� �, �x• �. s• � r� '�� ` a ��+ � t�: ��n_ � — � t�� ,, - �,a l a �s^ k , `r � 4�y. � ,. �,� � � •;.t � •.ti�s.' I��kvA i �uro �ktt � ir��A � t, pa9� %� IW��RTANt: ln these spaces, copy the corresponding information from Section A. �' �?� �'. ' ,�, ,"�� Buildfng Street Address (including Apt., Unit, Suite, and/or Bid . No.) or P.O. Raute and Box No. � q�� r�,� �� l013 ��-�d2�D0 V�N+�� ' � t Ciiy State ZIP Oode �` ' �`"' p� k�' GLE/�IZ-Wf'��T�2� ��E�4G�-{- �� 337f� 3EG710N D— SURVEYOR, ENC3INEER, OR ARCHITEGT CERTIFICATIdN (CONTINUED) � Gopy both 91des of thia EleJation Certiflcate for (1) community oiflclal, (2) Insurahce agent/company, and (3) building owner. Comments � g ��SM�R-(' V��S A1z�. �I"o $� 1 N`JT�' 1,�.;�,[,�,, N�1' ��e �`� g�s'�� p Al,.� Z� V��N� iJ�J' ��Z�—Se C"'Z'C�'J �l�%��%��.1'iw�i01"�j /`�QI ��°� �N�I �t�.�1�,�+ G 2.h) �NT�y �oy�.2 E.L�V�hT�o,�.l � I�j, 4� � i,5� Q�"'�'� Signature - Date I a _ � � _ ( � � BECTION — LDINO ELEVATION INFORMATION (8URVEY NOT REqUiR�D) fOR ZONE AO ANQ ZON� A(WITHOU BFE) . , For 2ones AO and A(without BFE), compiete items E1—�5. If the Certiticate Is intended to support a LOMA or LOMR-F request, complete 38Ct1o�8 A, B, and C. For Items Et—�4, use �atu�al grade, if aveilable: Check the measurement used. In Puerto Rico oniy, enter meters. . " E1. Provide elevation intormation for the foliowing and check the appropriate boxes to ahow whether the e�evatlon Is above o� below the higheat adjacent grede (HAa) and the loweat adjacent grade (lAG). a) Top of bottom floor (including basement, orawispace, or enclosure) is O feet p meters CJ above or O below the HAG. b) Top of bottom floor (including besement, crawlapace, or enciosure) Is . � feet ❑ meters C� above or L� below the LAG. E2. For Building Diagr�ma 6-9 witfi permanent flood opentn8a provided in Sectlon A items 8 and/or 9(ae_e,.pages 8-9 of Instructions), the next h(gher floor (elevation'C2.b in the diagrams) ot the building fs �❑ feet ❑ meters ❑ above or [J belOw the HAG. E3. Attached garage (top ot slab) is I] feet ❑ meters �] above or ❑ below ihe HAG. E4. Top of platform of machinery and/or equipment aervicing the building is ❑ feet ❑ meters ❑ above or C] below the HAG. . E5. Zone AO only: If no flood depth number la available, Is the top of the bottom floor elevated In accordanoe w{th the community's tloodpiain manegement ' . ordfnance7 ❑ Yes ❑ No ❑ U�known. The lucal official must certify thia information (n Sectlan G. , SECTION F- PROPERTY OWNER (OR dWNER'S REPRE8ENTATIVE) C�RTIFICATIUN ' The property owner or owner's autlio�ized representatfve who completes 5ectlons A, B, end E for Zone A(without a FEMA-issued or.community-lssued BFE) or ZOne AO must sign here. The statements in Secttons A, 8, and E are correct to the beat of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address Signature Gomments City � Date State Telephone ZIP Code Check hera if attachments. __-- 3ECTION Ci — COMMUNI,TY INFORMATION (QPTIONA�) ' rhe local officiai who Is authorized by law or ordtnance to adminiater the comml�nity's 800dplain management ordfnance can complete Sect ons A, B� G(or E), &nd O oi this Elevation Certificate. Complete the applic8ble ltem(s) and sign below. Check the measur�ment used in Itema G8-010. In Pue�to R(co oniy, enter meters. �1. ❑ The Information in Section C was taken from other documentation that has been signed end aealed by a Ifcensed aurveyor, engineer; or architect who is authorized bylaw to aerHfy elevation Information. pntlicate the source and date o/ the elevation data in the Commenfs area below.) C�2. ❑ A community offfcia( completed Section E for a buliding Iocated in Zo�e A(without a FEMA-laeued or community-issued BFE) or Zone AO. C3. L] The followinp Informatlon ptema G�1—G10) is provided for community floodplain management purposes: G4. Permit Number O5. Date Permit Issued G6. Date Celtificate Of Compliance/Occupancy Issued G7. Thia permit hes been Issued tor. ❑ New Constructlon ❑ Subetantlal Jmprovement G8. Elevation of as-bulR IowesCfloot (including basement) of the bufiding: j] feet ❑ meters G9. BFE or (in Zone AO) depth of flooding at the buildfng aite: ❑ feet CI meters G10. Community's �lesign flaod elevation: ❑ feet � meters Local Offlcial's Name Community Name Signature Comments Tltis Telephone Date Datum Datum Datum �_ , i= = =.t°..�u��= ELEV/�1710N CERTIFICATE, page 3 Quilding Photograph� See Inst�uctions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. �'��t iNSU�t�NC� ��}MF�aNY �JS� `;i �. Building Street Adciress (including Apt., Unit, Suite, end/or Bldg. No.) or P.O. Route and Box No. �' f'ts�idy;Numbet;s �� `� _ �: C k L � � - �i l� � }�i 'Cy � � City /� ,�r State _ ZIP Code �'orrip�tiy NAIC fJ�imbe'r �� f� W �� , If using the Elevation Certificate to obtain NFIP fiood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify ali 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. _ . 4 -i ` '�, Y Y . > 4 t � � �`' . °- �. � �. y f �p �t!' � n � .�+,* °* . ,ip "``�. f �" � � � �,, � t, ` � � � � _ � j • . ,.amr.n�em�e.�an� t �,.� �'"�� 6 � ` � � � - [V� V ' ,� k� �, 7, _��A/f' � .., ...._ _:... . . r � r�R'a".. �� . �'. . �-. ^,w>., .�� . �;�..,ar-"` , . . / �." , � .,._ �_ � .m.,:'q� .. .. . .. � / r , K a�.. _ +�'''' p � .^'` ` . � 1. / ,E V �I��`„ � • .. . i � ,.. ., � ;, . `� i �� Ai � s� w . � - sl ��i rf �,: r. MI ^?; ,�'�' ``g',� � �,� V ;�.�, �.. � �, � � ;_ ; � � �� . ` �� ' �: R ! ��z- .?. ��i"�n .�� `��5�� ,6 ,.,�-`�,.�€��, ac � a. � �. . ., t� _.. . �� :,.sd4�- �. :� „� � � �� .��.: � �` : �' � � � �� .,�+. :�7.� � � �.�% � w � � �3L.. �� . . , E�EVATIDN CERTIFICATE, page 4 Building Photographs Continuation Page IMPORTANT: In these spaces, copythe corresponding Information from Section A. Building Street Address including Apt., Unit, S te, and/or Bldg� o.) or P.O. Route and Box No. I�I�a �1.=�[�;R',4�D� �V'E1�T�[J �1zY � State ZIP Code � Gt�mpany NAIC Number ��E.1��.v��YG�'� t��/��-f-� � �-� -3�7�:-7 , If submitting more photographs than will fit on the preceding page, affix the additional photographs below. �Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When appiicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. � �� .x.r`-£ -� . � a '� � � �. � � �� f e �.;��- � � � � � �� : � � �` °��, . � �� ;n_� " �� . �_._ - _ � ` �' 'i'��' � _ � � � �j � �_. , , � � � �� . , � � '- �' i�— -- � " ' I _ - -- � i � � � ,� � _ . ,.,,�I�i�� i��p"',��'� -. . . .. ,��- :�ti: r 1- r � � - Y �. ► _ .•� - . �,, � ___. _ � � �� , . � � k .T: Z� . f' ,.--- 3 �,� '� - � ;� � �.��. �� : �� ' -«z��;;�:.�as � 1� � � � CiL � � � � �� \ i.1/ (..j � _� � ��, � � �y �-� z.. �� U.i.DEPA�tTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB NO. 1660-0008 Fed�ral Emergency ManagementAgency Expires March 31,2012 National Floo;t Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION Fqr I�tr�t�a Cumpany tlse: A1. Building Owner's Name JAMES&GAYE STASKIEL PaliCytNt�t7b�' A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. GO�rtp$rijr NAIC 1013 ELDORADO AVENUE City CLEARWATER BEACH, State FL ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) LOT 4,BLOCK 68, MANDALAY SUBDIVISION A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)RESIDENTIAI A5. Latitude/Longitude:Lat.28deg.00'08.3" Long.82deq.49'34.8" 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 6 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) 577 sq ft a) Square footage of attached garage 808 sq ft b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade 4 within 1.0 foot above adjacent grade 6 c) Total net area of flood openings in A8.b 512 sq in c) Total net area of flood openings in A9.b 768 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 62.Counry Name 63.State CLEARWATER/125096 PINELLAS FLORIDA 84.Map/Panel Number 65.Suffix B6.FIRM fndex 67.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone 12103 C 0064 G Date EffectivelRevised Date Zone(s) AO,use base flood depth) 08-18-09 09-03-03 VE&AE 13'&12' B10. tndicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in ttem 69. ❑ FIS Profile ❑ FIRM ❑ Community Detertnined ❑ Other(Describe) 611. Indicate elevation datum used for BFE in Item B9: ❑NGVD 1929 ❑ NAVD 1988 ❑ 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' ❑ Building Under Construction' ❑ Finished Construction 'A new Elevation Certificate will be required when construction of the building is comptete. C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A7-A30,AR/AH,AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized CITY OF CLEARWATER J-02 Vertical Datum 4.4385 (NAVD'88 datum) Conversion/Comments CITY OF CLEARWATER PUBLISHED ELEVATION Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 6.0 ❑feet ❑meters(Puerto Rico only) b) Top of the ne�R higher floor 17.5 ❑feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) 14.5 ❑feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) 6.0 ❑feet ❑meters(Puerto Rico only) e) �owest elevation of machinery or equipment servicing the building 16.9 ❑feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) � Lowest adjacent(finished)grade next to building(LAG) 5.5 ❑feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 5.8 ❑feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including 5.4 ❑feet ❑meters(Puerto Rico only) structural support 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 on this Certificate represents my best effats to interpret the data available.!underst that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑ Yes ❑ No Certifier's Name LARRY L.EVANS License Number 2937 Title LAND SURVEYOR Company Name EVANS LAND SURVEYING,INC. FEMA Form 81-31,Mar 09 See reverse side for continuation. s Ad�lress 14fi0 BELTREES STREET STE.9 City DUNEDIN, State FL Signature Date 06-18-2012 Telephone (727)734-3821 IMPORTANT: In these spaces,copy the corresponding information from Section A. �,t�l�urar�r� '.l�e Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. P�r Nt�ttib9l'; „ 1013 ELDORADO AVENUE ''r, City CLEARWATER BEACH, State FL ZIP Code 33767 � '(VI�;��i- : :� � SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agenbcompany,and(3)building owner. Comments A8.b)&A9.b):Flood openings are on only one side of ground floor enclosure. C2.e): Are exterior A!C compressors on an elevated platform. Signature Date 06-18-2011 ❑ Chedc 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 o�LOMR-F request,complete Sections A,B, and C. For Items E1-E4,use natural grade,if available. Check the measurement used. In Puerto Rico onty,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 0..0 ❑feet ❑meters ❑above or Q below the HAG. b)Top of bottom floor(including basement,crawlspace,or enGosure)is 0.0 ❑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 0.0 ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is 0.0 ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is 0.0 ❑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 ❑ 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. The statements in Sections A,B,and E are conect to the best of my knowledge. Property Owners 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,6,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 sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (tndicate 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. G4.Permit Number G5. Date Permit Issued G6. Date Cert�cate 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 ❑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 FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions Comments ❑Check here rf attachments FEMA Form 81-31,Mar 09 See reverse side for continuation. Replaces all previous editions , . Building Photographs See Instructions for Item A6. For Insurance Company Use: Buiiding Street Address(including Apt, Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number 1013 Eldorado Avenue City ClearwaterBeach, State FI ZIP COde 33767 CanPa►�YNAICNwn6e� 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. , « �� , ��.. � � } �f' $ �, t,�e%, - . 0 �; �� . �� `! 9' .,�` ,.� , A�,1' ,, ��` �I �� ', �� ,� �� 'w` s��9 //'� S,. ��. � '. r I .:.. ` . b. �. � . . .,; �5�. `c y ... .. .. . .. ..�. ....��, i .'�. �F . �'..� ,d� i z' tf�£� '��p �.d a ,;.� !' � ,pr ,�� ; e ��'- "r� ' . a .�� ,.'.. � . �.v �v«.e, _ � �, � �✓ , ,�"� � n ''; �r �.p ' ,y,�`7w`� .-..�. � ' SE..': a � --'�...��.> a5 � � � ... ,;, 1 �"` F �. 7�,:.� f'�=5��,f$.. �'�4�" t�'.� 'h � ,..�. ,�£.. '� 'i f y � J a � t'F �y : . a �'y, "" x, � ` �", , . � .�� tl � I l�?' }A � ��'.�y �," �". 2 ��. s _._1_ __L�_. ,wli� � 'i �8 s� ��; �� _Y . ,�. ,'' �,. � ,� ' i � '�,u�`'.s,+'{,',� � � :�^ r:w, 'ytc � � ��%r .�.� a � ;t� � ��'��xx,� `� **��" r l} ��, � a�i: �' t ��= �.�u �r .,� �a. s � ' a�� ,y� . ., �.�� r f �ir�_ � -h", p� . . „ ,:: .,�. , _ ,'',f,��,�'i`�i�`�jy��,}SY�I��iiyul��I`�I,�`ii��fIlI�6�YV�lI�,�, ` ��.�.'- - . . � . � °9� ��i � �� ".�^ . i. � � ve�a':yN' Y x� � . � �' g`-, � .+ � ��`'� x ' � � V . � ' :j j �� ^'�d �, � ��., 0 I. �'. A ' Yv 4'` � � N� a.m..w � dl�' +� �j � � �4 �3� �`s}d�� ._ . �, , �� , . �� — �� ,��e � ' ,�«- ,r �` F s�k fi^ �..� �4. �, . � �„ „. i& ,r� ' . " . �. E7', � , , �.�' v� '*� . . � �,.,- �Y . ..�!� . . �� ;i�� 4 „�� ;1 �� t� .. . i' .�, S�i,v�'G+�� ' 9?� . � rv' �. ,' �ww�n :ma.�.-....+m ...., .. r�� A. ... I � �,� �� ,-,� � r+� 0� .t- .� Ix k . �5 �,'S . .`. s�.. .._._�r_.�._..._�,�..-.....�«,,.mm.� �: ..Y. .. � . � . . < . . :.ry�a . .. ., '.i.- . . . . .. � �� i'"' `°�'� � �� ; '�'�"'"a � . . . � � ' .-..�. ;. I�; .... . .. .'..�, ..,, .. � .. � .... . � ri§'. . x;�i::. . ' ."�,�'..... f .. , . ... FRONT VIEW : 06-18-2012 • a Building Photographs Continuation Page For Insurance Company Use: Building Street Address(including Apt, Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number 1013 Eldorado Avenue City Clearwater Beach, State FI ZI P Code 33767 Canpany NAIC Number If submitting more photographs than will fit on the preceding page, a�x the additional photographs below. Identify all photographs with: date taken; "Front View"and "Rear View"; and, if required, "Right Side View" and"Left Side View." REAR VIEW: 06-18-2012 }. � ;a n x �:�y�, ;;�:+�, ;� ,�. . i,��s, �� : � ��, , � �„ ,' �s'-. 4.� y,...._.. � �P s' w� � i � � �,y � , � r �s �' �ffi / - -�" p _ Py' t 4��4� �' �.r' i;, ,,f �f .�� }r' � � � ,.��, � F t `�� / /,� � �� . ._ 55�_ . � ',� .. ^, � �.,? '' ,�� `4'"�I �i'�I�T"�c �P��I�� . . �� .�� °..*�.:. . `�` I t ,1", {� F r. i : � .�._�. . �' F. � � ` 1�r� r < �. �i� ., � �,, -,� #;.5 �. b.- y: � __., `.,�.� -� .... �° ..._..�... • S �LL "^"a. } ry 'f .. pp. ,� :�.' � k/'. .� �� ;gp,i +l} S t >�� y�� 3� � .. . � __.— _"'�R�;� / y �r't� i ; � ` _ � 1 � , �. . , � , _ � � �� " �� 1013 ELDORADO AVE + � � � � I `� � � 1 BCP2012-05532 RESPONSE TO COMMENTS F �/� .IUN 2 � ZO�Z � STASKIEL, JAMES � � • ' � Zoning: Low Medium Density Re Atlas#:238A PLANNING& DEVELOPMENT DEPT CITY OF C�EA�WATER I � � � _ _ _ _ 'v J � FEDERAL EMERGENCY MANAGEMEN7 AGENCY r �/�� / `� O.M.B. No. 3067-OOi7 ��Q l0 (G NATIONAL.FLOOD II�URANCE PROGRAI41 Expires December 31, 2005 , ELEVATION CERTIFfCATE Im ortant Read 1he instructions on 1-T. SECTION A-PROPERTY OYIMER INFOFlINATION �or►nsurarlce Company ilse: BUILDING OWNER'S NAME PoGcyiNumber• ; BUILDING STREET ADDRESS(InGuding Apt.,Un�,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC:Number:: 1013 EI Dorado Avenue GTY STATE ZIP CODE Clearvuater Beach FL 33767 PROPERTY DESCRfPTiON(Lat and 81ock Numbers,Tax Parcet Number,Legal Descripti�,eto.) LOT 4,BLOCK 68,MANDALAY SUBDIVISION BUILDING USE(e.g.,Residential,Narresiden6al,Addition,Accessay,�c. Use a CanmeMs area,if necessary.) RESIDENTIAL LATITUDElLONGfTUOE(OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS{Type): ( ##°-##'-##.##" or #�.##l�� NAD 1927 ❑NAD 19�i ❑USGS Quad Map ❑Other. SEC�IOPf B-FLOOD iNSURANCE RATE MAP(FlRNIj iNFORMATION 81.NFIP COMMUNITY NAME&COMMUNITY NIdVIBER 82.COUNTY NAMF 83.STATE CLEARWATER 125096 PINELtAS FLORIDA B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S) NUMBER 85.SUFFIX B6.FIRM INDIX DATE EFFECTIVFIREVISED DATE 68.F100D ZONE(S) (Zone A0,use depth offlaoc�ng) �003 D 8/19191 9119N2 AE 11.0' B10.Inci�ate 1he sou�e aF Ute Base Flaod Elevation(BF�data or ba�flood depm�tered in 89. ❑FIS Profile �FIRNI ❑Corrxnurily De.�rmined ❑Otl�(Desa�be): a11.�rxicate ihe�evation datun use�rorthe BFE in as:�Mcw�s2s ❑NAw lsea ❑olher(Desa�be): B12.�rire buiding bcal�d in a Caasial Bamer R�s System(CBRS)��a cr Oihen�4se Pro�tedArea{OPA)? ❑Yes �No Desig►�a�n Da� SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1.Buik6ng e�evations�e ba�d on:�Construction Drawirtg�' ❑&nl�ng Urtder Construction* �Fir�shed Ca�structior� *A ne�nrElEVatiai Certiixate v►iq be requa�d u�tien constr��ction of the buic�ng is ccx�lete. c2.auildiny�iagram Nur��a(s�ect ihe rw�d�,y�gam most sQrular�o�e txakiny for wtbd,this�ficate is b�g completed-sPe pages s and 7. �f no�iagram �Y�P►esenis the bu�n9,Pro�cJe a skeiGh or ptrotogaph.) C3.Efevations—Zones A1 A30,AE,AH,A(with BF�.VE,V1-V30,V(w+tt�BFE�,AR,AR/A,ARfAE.AWA1-A30,AWAN.ARlRO Canplete Ite,r�C3.-a-i belav�cccading to ihe bukr+'ng�agam sp�ifi�in lt...tr!r.C2.&t�the�tum used.If Ihs dat�n s tftf�ent from the dahmi usad f�r ihe BFE in Section B,corniert the c�tum to that used for the BFE.Shaw t�eld me��aemer�s and dahm conversion c�cula6a�. lJse khe space prwided or ttte Carmer►�area of Section D a SecUon G,as�propriate,to doctment the daQsn conversion. Dahm 1929 ConversioNCanrnenLs NOt� Elevation refe�ernce mark u�d ON SITE Oces the elevation reterersce mazic used appear on the FIRM? ❑Yes �P!o o a)Top of bottom ftoor(nctudng f�sernenf or enclos�e) 7. OS ft.(m) � 6J7/04 #2984 o b)Tap of next higher fbor 18.23 ft(m) �' o c)Bottam of brn�est ha�¢ontal struch�ral merr�er(V zones onty) WA._ft(m) �� o c�A�garage{h�p of slab) 7. 08�.(m) E� � o e)Lowest eleeration of mad�a�ery�dlor equqxrient W`° f�. senricing the bu�ng(Desad�e in a Convr�ents�) 17.98 ft(m) E� t.l o fl Low�e.sE ad�acer�(finished?9"�N;G) 6.84 ft.(m) z.s� o g)Highest adace►�(finished�c�ade(HAG) 6. 95 ik(m) �� o h)No.of permanent openings(flood vents)w�fhin 1 ft.abwe adacent gade 0 � J o )Toiaf area of an permanent openings�lood ven�)in C3.h 0 sq.in.(sq.an) SECTION D•SURVEYOR,ENCINEER,OR ARCHITECT CERTIFlCATION This cefificafion is to be sig�ed and sealed by a land surveyor,engineer,w architect author¢ed by law to certify elevation information. 1 certify fhat the information in Sections A,8,and C on this cerfifrcate represents my besf eSorts to interpret the data availab/e. 1 understand fhat any false stafement may be punishab/e by flne orimprisonment under 18 U.S.Code,Section 1001. CERTlFIER'S NAME JOHN R BEACH LICENSE NUMBER 2984 TITLE P.LS. i;OMPANYldAME J01-�R B�ACH&ASSOC..INC. ADDRESS CITY STATE ZIP CODE 91 i ST.PErERSBUR DR W. OLpSMAR FL 34677 SIGNATURE DATE TELEPHOt� � ��ao—� 6/7l04 813-854-1276 FEMA Form 81-31,J ary 20 See reverse side fot ti;o�tinuation. Replaces all previous edftions _ . _ _ ._____ __ _ _ > IMPORTANT: in ihese spaces,copy 1he corresponding infom�ation from Section A For i�sucar�ce Com�any� BUILDING STREET ADDRESS(Ir�luc�ng Apt.,Uni�Suite,and/a Bidg.No.)OR P.O.R011TE AND BOXNO. Pdiqr Nurnbe� 1013 ELDORADO AVENUE CITY STATE ZIP CODE Comparry E�NIG Number . CLEARWATER BEACH FL 33767 5ECT10N D-SURVEYOR,ENGINEE�OR ARCFtiTECT CERTIFlCATION(CONTiNUED) Copy both sid�of this El�ration Certificate ftx(1 j canmunity of fiaaf,(2}irsurarxe agenticanpar�y,and(3)bu�ng owner. COMMENTS SECTION C(ej=PJC FIEVATtON POOL PIANP PAD ELEVATION=6.50 ❑check t�ere if attachments SECTION E-BUILDING ELEVi4TCON INFORMATION(SURVEY NOT REQUIRED)FOR Z01�AO AND ZONE A(WfTHOUT BFE) F�2one AO and Zone A(without BF�,cample�IGe�r�s E1 throu�E4. If the Elevation CertiGcate is in�fa use as suppor�rtg irdamation�Or a LOMA oc LOMR-F, Section C must be�. E1.Bulcing Diagam Nirr�er_(Select the b�ng dragatn most s�nilar b�the txel�g for wtgch Utis oertificate is being oarpl�ed—�e pages 6 and 7. If no ciagam accurately �xesen�the tw�cirru,,proride a ske,�CCh or photograph.} E2.The top of the bot�orn ftoor(mclucing basement or endosure)of the buikin9 is _ft lhaj_in.(an)0 abave a ❑b�ow(c�cic onej the fughest ad'�aeent grade. (Use natural gra�,�'available}. E3.For Buil�ng��grams 6-S with openings(see page 7},the next t�er floa a elevahed fioor{�e+ration b)of the buii�ng is _tt(mj_irt.(an)abwe ihe high�st ad�acent gade. Corr�tete iterr�s C3.h and C3.i on iront of iam. E4.Tt►e top of the plaifam of machinery and►a ec�uipment servicing tl�e bui�ng s _ft(m1_in.(cm)��ove or ❑bebw(chedc one)tfie highest ac�ac�nt gade. (llse nab�s�gade,if av�lable}. E5.For Zone AO only: Pf rm ttood ciepth nunber is avaitabfe,'s the top of the bottom ftoor elevated in accadance w�th the cammunity's Aoa�fain manag�nent orcinance? ❑Yes ❑Na d Unknown. The local oit�ial mtst certify tlus infamation in Section G. SECTION F�PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFlCATION The prq�r owner a oNmer's authaized repr�tive who canpletes Sections A,B,C Q�ns C3.h and C3.i or�y),and E for Zone A(withotet a FEMA-i�ued a canmuiily- issued BFE�or Zone AO must sigi he�e. The sfatemeMs�Sec�a�s�B,C,and E are co�d to the best ofmy knowle�lge. PROPERN OWt�ER'S OR OWNEFtS AUTHOPoZFD REPi�SENTATNE'S NAME ADDRESS CITf STATE ZIP CODE SIGNATURE DATE TELEPHOf� COMMENTS ❑Check here'rf attaachments SECTION G-CON�VIUNITY INFORMATION(OPTIONAL) The local oificial who is autho�ed by law or or�nance to a�ninister f�e carrnunihj's flooc�lain�t oRir�ance can canp�ete S�tions A,B,C(a�,and G of ttus Elevatio� Certificate. Corr�ple#e the appC�ble itern(s)and�below. G1.�The�fortnation in Section C was talcen from other doc�ar►entation ttrat tras be�en sic�ed and ar�sed 6g+a licer�sed surveyor,en�ne�,or ar�hi�ct who is eulhcxized by state a bc�law to cerfify elevation infamation.{Indcate the so�ce arxi c�ate of Uhe elevation data n U�e Car�nents area below.) G2.�A community officia[canp�eted Section E for a buil�ing located in Zone A(wilhout a FEMA-issued or oarmunity-issued BFE}a Zone A0. G3.�The fo�owing ir�om�ation(Items G4-G9)is prouided fo�conmuniiy fiooc�lain managernent purposes. G4.PERMf�NISMBER G5. DATE PERMIT 1SSUED G6.DATE CERTIFICATE OF COMPLIANCElOCCUPANCY 1SSUED G7.Ttds p�rrut has been i�ed ior:�NewCor�vction ❑s�r,�i�rr�rw�n�,t G8.Eleva6on of as-buiit lowest tf�a(mdud�ng ba�tj of tlie builc�ng�: __ft.(m) Dat�m: G9.BFE or(n Zone AO}depth of flooding at the buildng site is: __it(m) Dahm: LOCAL OFFiCIAL'S NAME TR� COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS ❑Check her�if attactgnents FEMA Form 89-31,January 2003 Replaces all previous editions r F�OM :BEACH 8 ASSOC a � � FAX N0. :7277993622 Jun. 08 2004 12:01PM P1 , 3 �. � � � �ED9iAl.�Y�RQENICY�� C�.M.B.No.3087-OQ7'7 . �/� A 0 �✓�� NAT10t�W.FiAODWSURAt�EPR�X�RAIIA Expires December 31,20Q5 -�r bl3 ��d�� LEVAT�N CERTIFICATE � !�d uie ia�llons an '�-�. . .......... .......... . SECf 10N A-PROPER'{Y Q�YYt�It�AA710N :Eat:b�x�Can�y.l1�.:..�.:,:.;:::: �':��+�!��?"�''::::::::::::::::::::.:.:: sui�.nin�awr��as nuv� .... .. ..:.:..:::.:::..�:�:::::::::.,,,.......... ...... ... ...:................::........... ............ '�..'�.,�_""��.. AIG: iuinti�:::::;:°::, SUII.�ING S�i�ADpRES$(kld�diftg Apl.,11r�,St1Me�ardld'Biag-Ido.)OR P.O.ROUTE AND 8QK NO. :�#!:....:.....:::.:.......:... ........ 1013�I Dar�do Avarxte . :• ... ............. CITY �. ... . . .. . ..�STaTE ..., .,.�.,. ZI�CADE CIeplW�lter BeBd! F� -� �� . .,.--� . PFtOPERTY ti�3CFtIPT10N(Lat and 6ioClt f�Rrbeta,TeDC Paroal N�wrlb�x,L�el D�on�e�C•) I,QT 4,g�OCK 68,MAntDAIAY SliB011A5lON r _.�,_--�-,.��°.--�...- BUILDIMO USE(e.g..Re�er�tial,Nort-i�identiel.Ad�dor�,A�°�Y,�. �a Corm�erl�area,�n�rY•) R�SIDENTIAL ..ii�rirubF�,ow��runE(oP�rbavAi.7 r�oa¢oM[n�ra�1"t�lw� -... ... scik�tc�: ciPS(rype�.,..^ (�°-�'-�ti.#l� a �►d,�) �NAD 19ZX �]7 NPoD 1963 [�.U9E�5 Qued Map C�Op1a�"�.,.. $�C11011B-Fl„�OD11�15URANCERA''f'EMAP fl�Of�AA110N -- _.+,�� -- �, R1 I�FIP COMAulJ13TY B CO�TY Ia.1u�ER ..M� 62 COIXJTY IS0.M� ��~ B3.$ATE CI,FARIAIATL•R 1?5()96 PIl�.LAS ,ROF�bA ,u ,. .,�,_.. F34.MAP At�PM1EL _.^-,--�..�.�, B%.FIRM PAI�EL 9�.BASE FL. ELEVATKJN(.�) M1NI6�R 95.suFFa Bs.FffiM AvD�X t�4T� �FF�cTwfJREVIS�D DATE P.l�Ff1JOD zCN�{� RaneAO,use1de�p�r oF�n�np) 0003 D BI19�9 9I19�Z �, .,.,, ,...T,-.... 610,kX�tiesou�cecf U�e 9eseRoodEleratio�(B�4elaarba�e Ao4dde�lh en6ar�ed inB9. []F1S Pro�e �FlRM �]Ca�m�Y D� C��'C��--� e��.i�u,e�aa,�a�m�arorr►��e:f�N�vo�� Cln�aw��ee poa��:_ 9�2.1�b�e �acaled in a coas�l�►ier�es a�ea ar oA�n�+ise Prnlecl�dAiee op ? O ves �Nn Da6g S�C710ti C-�klllDUld ELEVA110N 1[�ORMA'Y'IQN(SURVE1f�} �,.��n�� r��u�� -A new�Nre�uon ce�w�be req�:ea�wt�+cans�,�a,anr�b�rg is car�le�. cz.�d�g Di�'am l�M�r�a(Selecc�e buld�g dre�'am m�t sm�er b t+e�tor wr�cn n�isaeitiifi�a is ae�ng oorrplaesd-see pa�a snd 7. If rw� eccualaN�the►x�{i�g,P�orids a sket�a phobg�pl�) q.0eralia�s-Za�s A7�430;A�,14H,A M�►�EJ,�E,VI-1�30;V(w�18FEy,AR AWA A�►�,AWRt-E430,ARl14H,AWAO ComptaAe Nerne q_-a�ioalawa�catingto�e beic�in9 tlagrem spec�'�ied in Ilem C2.S1�e!ha dal�t t�sed It tie daiNrst is d�a�entivm ihe daham used for t�e B�in 3eC�nn B,oorn�t tlhe d�lum b�a�'u�edia lfie BFE�Show f�ld�d5 and�lunt oa�sian cald�alim. U6e tlle s�Dece praitied or�a Ca�aree al $ecGa►p ar S�xion G,as appro�xie�b daarr�er�t tie d�lun cerNerslon. �un� Caweis�iorYC�mter►�Nt3 El�rabon ieierape meik used ON SI1'E E)oes Oieeleuafa+re�er�msrk i�ed eppe�r'on�FRM? Q Yes �No 6!T/04 �2954 �� )Tap of ba�llom Aoa�'(inckldng ba�emerrk�I'erdasure) �• 1f�lE�n) � •c�b)Tap Of neDCt high6r Aloot L,•�fi(�) o c}Bdkm 4f bwest Yiori�qnlal slrt�rral mArl+ber(V�es or�►) t` •._,��r►) �� o c�qlMcF�ad+g�rAge(1opoEskb) 7. o�1L(m) W� n� o e)l,a�t ele,�ibn d�y arxY4r�q►�t �� servia��glhet�id�g(Desra�enaCamrie��aiea) 1L-�Rfm1 �� o n��(�l B-�� N�� f � o h)Na of perr�enent�(floodv�wi�ii 9�,abop�e e�ei�E gade a o�ToEal area af al peir�taper�ys lCood ve�in G3h o s4 ir�(aq,an) SECIIQN n-�1RVEYOR�ENGII'�OR ARC�."r�CATIAN This�tifi�Non is�O be sigr�d and sealed by a land s�rveyar,engine�,ar arct�,ect au�or�ed�y le�r to aerb�y e�re�on intamation. 1 cardl�ti►at the l/d�me�on�Secelo�+s A,Q and C art�s�er'b�rcate t+�wesents my bes('eNbrts to h�rstlhe d�e av�abde. !�apd�►stand Uret a►y tafse stelement m�nfsf�sble' Dy ilne w im r�under 18!I S;Code�5ecti�at tQOt. ,,, , _ _ C�1�R'S W�[u1E JOHId R�EA�CH L�9Jl�ADER 2984 TITI.� P,k.S: .� CUF�ANI(NAM� JOFN FZ.�&ASSC)C.,INC. i�ss .�� ..., .,,,.�.�„_ __. cmr_ _,.._ �. S'�A�. .. �coo� 9i1$T.PETE�39UR DR W. �``� ,,,.�... � . ��°.— SIpVA1l1RE ..,� �� .T�PFItN� �(��a�—�,...� sn,�a e��a-�zna f�MA Form 81-31,J ary SeB revel9e�ide for contfnuartion. Replat.e�all prevlaus editions FRflM. :BEACH 8 ASSOC FAX N0. :7277993622 Jun. 08 2004 12:02PM P2 .,..... -:....... .................. ' 1VP�0[rTMR: lnlfiae Ihe infocm�4onfroomSeCtlo+�A .:�;�ckiiii�!�!tk��.�':'.'.;:::: ':P�aGgtKk°�er:':;;;;;�::"'�:::::::`"":;: '9l1ItDWG STR�i ADOftESs(keA�n9 M�•.U�l Siile,ard+ar 6kp.No.)OR F'.b.ROtJTE AM BOX N0. ::.. ..:.:.::. . ,0�3�.00Rnooa�� ., , � ��::�.::.:�::.::..::......:....:: cm � sTnTE :.....G�::;;::::!::.::.:. .::::...............:::::.............:::: 3;i'l6� . FL ...... . . .:.•:.::•::....... . .. . . pFaI�WAT�R eEAGN . . . SEC7K)N D-SURVE'Y�Et,�11G1l1�ORARt;HT�CT CER'11FlCAT10N Capy bdh sidas d�is Bwation Cer�licaEe ta(1)car�cra�y didat,(�f�r�qa�t�p�y,��'�J _ COI�NI'S � SECTIODt C(e)=WC 9.E1IAT10N � _ ... ---�-�-�� -�—�"'�`" POQI.PUNp PAD ELEVAl10N=6.9D , .,. .- •„— —�.. -.- - - �..--+-.^�M...^..,, �16Ck 119I@�f 9�8C�IT1d�i18 SEC'11QN E,BU�.QINf3 EL�VATION IPFORMATqM(StNtV�Y Nd'C RE�JIR�FOR�Ot�AID AJ�ID�E A NVI'fNOltr FaZoneA(Jand7•oneA(wdho�d�,m�q�Aems�1 ha�EA. 4flheBe�llonCe�tlicab�sirl�ndadfauseass��porfrigi�onioralOMl�a1.ON�if, 8ecion C m�ntbe cart�d E1.B►�pi�'a�n Nunher_(Sele��t�b��n9 d�g'e�n most sft�la b�e tx�g 6ar wtid�H�fs ce�Is bei�g ax�'ipleled-aea pages 6 ar�d l. I�oo cf�ern a�xt�' nepcesenb�he huidr�g,pta�kle e�iae�h a phokigspf�) F1 The k�p affie bolbm iba('�fu�ing basas�E a endo�Ire)dthe buking's _tkb�)�in(an10 ebo�e ar Q beiow f c�dC ana?��N� rehrei gaQe,A aYai�ls). ��Aoar a�vsled toa,(eievsdon b)d tl►e bnidrp is _�an)_.._kr(an)�o�e A1�� p.For 8�n1�►�g Diagar�s�$v�lt►apeni�(seePa9s�?, 9�de. Car�io 11�ro q.h and q.i an 9�ait af tam. Ed.The bp ot�e phAfqm dtt�adNnery and'a equ�ent seivid►lq Ihe bu�r��S ._,�(m)._�(�'�)Q�ar �bdaw(ched�or�e)tt�a hl��t�• (� r�r�g8de,lf ei+eia6le�, �,Fa Zane AO orry: If no iboddepf►r�t�w La aiaOeF�e,ts fie topd�e dof0om 11oor eleva�ed in ao�ar�rice w�►IAeoorrs�u�'s/oac��ce� Yes ❑tJo C7t1�� ThebcaFdkl�m�st ifrsir�arnatianin8eclia►G. S�CT10N�-PROP�CYY QMVI�ER((ORONIIlEf�S�N�A'TN�!C�Ri�(:A'TION The pmperly a�a c��er's a��iced�utio oa�pl�les Secfpns l�6,C(IterRS(�h end qi ai�,and E Sar7Ane A(�M�ut a f�iasued a canrtnl�lt�. is�ued 8Fq a Zane M must sig�he�a Thestaklme�fs h 5eo6'oqs l�B,G axf Ea�e oarect 6�B+e best d my k►bw�ed9a � _ PROPEKtY 0441�6 OR ONV18�S AI,ln-IOF��SE�CtATM�'S NANE " ADDF�S3 � .. Cf'TY S7A7� zIP CODE SK�VA111RE � '�.� �� • . �� CONMENTS ,. �—... __ _. _.�..,.—"..—, � .. ,_ J �g�(ha9l�aGad'1116f1t9 sEC�tON�•col�wul�r�r n�ot�►�toN(oP'ttow►t ._...^�.— The bcaE a�CN who is awhataed by iawa'a��e�ce b adrrcisi�r qie oarrr�ea�s Aoot�i�R��a��Ser.ims�B�C(a'Ef,�ct G d�rs Elerd�pn Cerl�ic�le.Carpleb 8�e�pira�ls�r�(s)e+tdsig�bdoM' G1.�The idprr�irn In Sec�on C wes taken tmt uR►e�dqarnenhGo��Ihet hes been s�q�ed end ertt,�sed by a Nod�sedsuveyor,en��ar�ar adibdwho's autormed by sla� a local iawb cer�ty el�ua4on infaRrrie�an.(�ncicele fie a�ce and ciaba nflie dstira�ian dela in Iha Caarn�rls eree belohc) GI.�A mnrnun�Y d�l�rtqiA��'��fa a buicfing Ixalecf itt7.aneR(�tl1o�9��a cv�mt►nily�l BF�a T�ne A�. 03.[�Thetabw�g infa�iallon fMer►is 04-fB)isp�idedfar arn�xur�r Aoa�i►z�a�agnrt�tpt�P� �G4. 'M�ll(�R ..,� �.. , G6.DATEPE(�MTISSUED -. . Gs DA7EC�iFiCx1'EOFCOA�i'►.UW(�1l%CCl1PM1C1'1SSU�� _ ,_��,��.... G7.71i�permt has b�en issuedidr:[�Ne�u�►Consru�n ❑51fi�'�Me��t, ((�Elevadur►ot asbuNt bwest loar(Sidu�g b�men9 dthe bu�d��g� �„�,; 1�(�n} D��_,..� 09,B}�a�n 7AneA0)dBpTh af Aoczin�etrie tx�ldng sile i� , �—�(�} . D�►r� LOCALOFF1CiAk,'SRWV1�� ., , .., -� COMAUVf�YN4AlE , -... �� .. . _- SIGAMitJitE , -, DAIE �� _ � COA�MEMS _° ..� �. ,. � M- 1^� Q Gf16Ck h9191�� FEMA Form 81•31�Janualy 2q03 .. R�ece�ail previ0us edidOns __ . _ � U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY National Flood Insurance Program 8 ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION A2. Building Street Address (including Apt., Unit, Suke, and/or Bldg. No.) or P.O. Route and Box No. 1013 ELDORADO AVENUE City CLEARWATER BEACH, State FL ZIP Code 33767 OMB No. 1660-0008 Expiration Date: July 31, 2015 FOR INSURANCE COMPANY USE ' Poticy Ntunber: Gomparty NAtG Number: A3. Property Description (Lot and Btodc Numbers, Tax Parcel Number, Legal Description, etc.) LOT 4, BIOCK 68, of MANDALAY SUBDIVISION A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTIAI A5. Latitude/Longitude: Lat. 28dea. 00'08.3" Long. 82dea. 49'34.8" 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 f A8. For a building with a crawlspace or enclosure(s): A9. For a buitding with an attached garage: a) Square footage of crawlspace or enclosure(s) 646 sq ft a) Square footage of attached garage ,8�3 sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enGosure(s) within 1.0 foot above adjacent grade 7 within 1.0 foot above adjacent grade � c) Total net area of flood openings in A8.b 14� sq in c) Total net area of flood openings in A9.b 1200 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 CLEARWATER / 125096 PINELLAS B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel 12103 C 0064 G &18-09 Effedive/Revised Date 9-03-03 B3. State FLORIDA B8. Flood B9. Base Flood Eleva6on(s) (Zone Zone(s AO, use base flood depth) VE8�A� 13'&12' 610. tndicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69. ❑ FIS Profile � FIRM ❑ Community Determined ❑ OthedSouroe: 811. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ OtheNSource: B12. Is the building located in a Coastal Barrier Resourc:es System (CBRS) area or Otherwise Proteded 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 'A new Elevation Certificate will be required when construdion of the building is complete. C2. Elevations - Zones A1-I130, 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. Benchmark Utilized: CITY OF CLEARWATER J-02 Vertical Datum: 4.4385 Indicate elevation datum used for the elevations in items a) through h) below. � NGVD 1929 � NAVD 1988 � OtheNSource: Datum used for building elevations must be the same as that used for the BFE. Chedc the measurement used. a) Top of bottom floor (inGuding basement, crawlspace, or enclosure floor) 6.f � feet ❑ meters b) Top of the next higher floor 18.Q � feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) 14.3 � feet ❑ meters d) Attached garage (top of slab) 6.1 � feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 17.b � feet ❑ meters (Describe type of equipment and location in Comments) � Lowest adjacent (finished) grade next to building (LAG) 5.5 � feet ❑ meters g) Highest adjac�ent (finished) grade next to building (HAG) 5.8 � feet ❑ meters h) Lowest adjacent grade at lowest elevation of dedc or stairs, including structural support 6.0 � feet ❑ meters SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This ceRification is to be signed and sealed by a land surveyor, engineer, or archited authorized by law to certify elevation , information. 1 certify that the infnrmation on this Certificate represents my best efforts to interpret the data available. ��'.� .. , j''��,�' �� 1 understand that any false statement may be pun+shable by firre or imprisonment under f 8 U. S. Code, Section 1001. ,,�, _ �� or' r . ��,'� �f�'��,, • . � Check here if comments are provided on badc of form. Were latitude and longitude in Sedion A provided by a gp, _: � ��, �, � Check here 'rf attachments. licensed land surveyor? � Yes ❑ No a� _ � ��' �v7 + f Certfier's Name LARRY L. EVANS License Number FL. LS #2937 . � � ` Title IAND SURVEYOR Address 1460 BELTREES � Signature �, FEMA Form 086-0- (7/12) Company Name EVANS LAND SURVEYING, Inc. City DUNEDIN, State FL ZIP Code 34698 Date 10-29-15 Telephone (727) 734-3821 See reverse side for continuation. � � ��r�Imi � �� ,- 1q� . ,, t�' �{A� �� 0�i�'��' °�� ,n ' • . - � q� ;fl � j�,�;3;� Replaces all previous editions. ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the comesponding infoRnation from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. 1013 ELDORADO AVENUE City C�EARWATER BEACH, State FL ZIP Code 33767 FORINSURANCE Polityr Number. Company NAIC Number. SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) communiry official, (2) insurance agent/company, and (3) buiiding owner. Comments C2.e): ARE EXTERIOR A/C COMPRESSORS ON ELEVATED PLATFORM. C2.b): ENTRY FOYER ELEVATION IS 15.6' Signature SECTION !� - �IjILDING ELEVATION INFORMATION Date 10.2&15 USE � - NOT REQUIRED) FOR ZONE AO AND 20NE A(WITHOUT BFE) For Zones AO and A(without BFE), complete Items E1-E5. ff the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E1-E4, use natural grade, 'rf available. Chedc the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation infortnation for the following and chedc the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjaoent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enGosure) is ❑ feet ❑ meters ❑ above or 0 betow the HAG. b) Top of bottom floor (inGuding basement, crawispace, 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 (etevation 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 platfortn 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 ❑ Unknovm. The local official must certify this infortnation 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 must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address Signature Comments City Date State ZIP Code Teiephone ❑ Check here 'rf attachments. SECTION G - COMMUNITY INFORMATION (OPTIONAI) The local qtfiaal who is authorized by law or ordinance to administer the community's floodplain management ordinanoe can cwmplete Sections A, B, C(or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Chedc the measurement used in Items G8-G10. In Puerto Rico only, enter meters. G1. ❑ The infoRnation in Section C was taken from other documerrtation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by 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 commun'ity-issued BFE) or Zone AO. G3. ❑ The following information (Items G4-G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certficate Of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-buift lowest fl+oor (including basement) of the building: ❑ feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Communiry's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name T�le Community Name Telephone Signature Comments U Date � �/ , .LcS� �� Check here if attachments. FEMA Form 086-0-33 (7/12) - Replaces all previous editions. ELEVATION CERTIFICATE, page 3 guilding Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1013 ELDORADO AVENUE City CLEARWATER BEACH, State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Policy Number: Company NAIC 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 Vievd' and "Rear View"; and, if required, "Right Side Vievd' 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. �.. � � L'LI � � � .. -�'"�...'. � .. -' - °;jlt �� : r;sa'.�.' . �'ti _- � " _,.,�< ?� FRONT VIEW 1 �.�,��\ . _— '+�,� ,, ..� � i e 15 !� FEMA Form 086-0-33 (7/12) Replaces all previous editions. , � - . � ELEVATION CERTIFICATE, page 4 guilding Photographs Continuation Page IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1013 ELDORADO AVENUE City CLEARWATER BEACH, State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number: If submitting more photographs than will fit on the preceding page, aifix the additional photographs below. Identify all photographs with: date taken; "Front Viev�' and "Rear View"; and, if required, "Right Side VievW' 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. y. REAR VIEV1/ 10/28/2015 -�� - �_ - _,; �� ==-� ; f�� ,--....__k_ _�,.. � �..; : ..�'�:!�`- _ S o-�� . �,�� i �"` _�: R � -. J� � R .: �, ,. ; `�; � <, : > :�� ; n r�.�, '��rww,��-, � ` � ° 111�`��1111 � � � ---,_ _ � � , , . - -_ �� - �� ; � - �.�, � ; � ri �� . �� ,� � � :.. ��-� � � � .� �..� �� Ad ,: �_ . .. � � ,� � y,� , � ��,� :.�- { �. a� , �i � � � � r ��...,�_ � �� .�..�.._,.. � g��,�....,tt..� � � ��. . � � �� ` ~ � � � � � �; � �� ± � FEMA Form 086-0-33 (7/12) Replaces all previous editions. � � � � � � W � Q � L�L � N N � O w �' � J� � Wo�J M�y�w r �- `n cYn �mzc~n L V ZONE DESIGN CERTIFICATE Name �7 �iSlC /l�L. �.ruS Policy Number (Insurance Co. Uss) Building Address of Other Descriptian �D/3 ��,,�j� ��,� PermR No. gCP20/�{- Dl2 S/Y City �L1d4ti.Wtc� /.at,�4t�F State�Zip Cod� ��b�' SECTION I: Flood Insurance Rate Map (FIRM) Information Community No. f ZS`O�il. Panel No. b�6Y Suffix �s'" FIRM Date_�� FIRM Zone(s) SECTION II: Elevation Information Used for Design (NOTE: Thts secEion ciocuments the e/evatfona✓depths used or specNfed in t�e d�sign - it does not document surveyed e/evatlons and Is not equlve%nt to the as-bullt elevaSons reqrdrod fo be submltNcl during o� afl�er constnrctlon.] 1. FIRM Base Flood Elevation (BFE) ............................................................................................................................... �fe6t' � 2. Community's Design Flood Elevation (DFE) .................................................................... _ ............................................. 3. Elevation of the Bottom of Lowest Horizontal Structure AAember ............. . .............................................................. 4. Elevation of Lowest Adjacent Grade ................................................ .. .. y�• ...................................................................... ... �� GGIy i 5. Depth of Antiapaied Scour/Erosion used for Foundation Design ............................................................ . .. .................. t 6. Embedment Depth of Pilings of Foundation Below Lowest Adjacent Grade .................................................................�(,�feet ' indicate elevation datum used in 1-4: ❑ NGVD29 IgNAVD88 O Other SECTION III: V Zone Design Certification Statement 1 certify that: { 1) I have developed or reviewed the structural design, plans, and specifications for construation of the above-referenced building and (2) that the design and methods of construdion specified to be used are in accordance with aocepted standards of pracNce"" for m�ting the following provisions: • The bottom of the lowest horizoMal stn�ctural member of the lowest floor (excluding piles and columns) is elevated to or above the BFE. � The pile and c�lumn foundation and struciure attached thereto is anchored to rosist Aotation, cotlapse, and latera! moverr�ent due to the effects of the wind and water loads acting simultaneously on alf bui�ing components. Water loadi� val�s used are those associated with the base Aood'"*. Wind bading values used are those requir�d by the applicable State or local building oode. The potential for scour and erc►�ion at ihe foundation has been antiapat,ed for conditions asaoaated with the base Aood, induding wave acxion. SECTION IV: Breakaway Wall Design Certification Statemcnt jNOTE Thfs sectlon must be certf�Fed by a reqlsioned enQf»eer or archltect when br�ea�Iraway oy8/ts are deslgned to have a reslstance oJmoi+s than 20 ps/(0.96 kNhn2) detenr►Insd uaing allowable stress deslgnj 1 ceRify that: (1) I have devel�ped or reviewed the structural desg�, plans, and specifications for construct+on of breakaway walls to be constnx;ted under the above-rseferenced building and (2} that the design and methods of construction spec+fied to be used are in accordanoe with accepted standards of practica" for meeting the following provisions: • Breakaway wall c�llapse shall resuit from a water load less than that which would oocur during the base flood"•. • The elevated portion of the building and supporting foundation system shall not be subject to collapse, displacement, or other structural damage due to the effects of wind and water loads acting simuftaneously on atl buiiding componeMs {se� Section III). SECTION V: Certification and Seal This certification is to be signed and sealed by a registered professional engineer or archi authorized structural designs. I certiry the V Zone Design Certification StatemeM (Section Illj and � the B�p Certification Statement (Section IV, chedc if applicable). _��'; )� �v Certifier's Name ��w..l CtT � � �� 'j � • License Number � ; Title �• ��1 Company Name 1 l e t.J�t1�1Y d ,a ; Address Z�`?' iCJ��ss�.`l %� %b � �� ✓ �� r � � zo�s P�NiVlNG N certity �� ; �.. • � � � . = _ __�'�/��oNAi � ��