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1953 FREEDOM DR U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federa�l=mergency Management Agency Expires Februarv 28.2009 Natie�al rlood Insurance Program Important: Read the instructions on pages 1-8. i SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1. Building Owner's Name Policy Number Ron,Irad Ron,Ha it Raviv A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O. Route and Box N er 1953 Freedom Dc City Clearwater StaE� I e 33755 �, r A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) � 0 1� � ;� . Lot 26,Clearvvater Village Phase One/03/29/15/16532/000/0260 -' � A4. Building Use(e.g.,Residential, Non-Residential,Addition,Accessory,etc.) Residential DEVELOPMENT SERVICES n�P7 A5. Latitude/Longitude: Lat.N 27°59'31.05"Long.W 82°46'51.62" Cl�of�r�(,��192 �NAD 1983 A6. Attach at least 2 photographs of the buiiding if the Certificate is being used to obtain flood insurance. A7. Building Diagram Numberl A8. For a building with a crawl space or enclosure(s),provide: A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s) NIA sq ft a) Square footage of attached garage N/A sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade N/A wails within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in SECTION B-FLOOp INSURANCE RATE MAP(FIRM)INFORMATION 61.NFIP Community Name&Community Number B2.County Name 63.State Cit of Clearwater/ 125096 Pinellas Fi B4.Map/Panei Number 65.Suffix B6.FIRM Index 67. FIRM Panel 68.Flood B9. Base Flood Elevation(s)(Zone 12103C 0107 H Date Effective/Revised Date Zone(s) AO, use base flood depth) 5/17/05 5/17/05 AE 15.5 610. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69. ❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe) B11. Indicate elevation datum used for BFE in Item B9: ❑NGVD 1929 �NAVD 1988 ❑Other(Describe)NGVp 1929 BFE=16.4 612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protectetl Area(OPA)? ❑Yes �No Designation DateN/A ❑CBRS C]OPA SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑Construction Drawings' ❑BUilding Under C�rt' �Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. J' I 1 v (� C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,�-A�AW�i,�t/AO. Complete Items C2. Q below according to the building diagram specified in Item A7. ' V � Benchmark Utilized PCEDBM Highland DVertical DatumNGVD 1929 � Conversion/Comments N/A O '�' Check the measurement used. Q O a) Top of bottom floor(including basement,crawl space,or enclosure floor) 17.31 �feet �meters(Puerto Rico only) W � b) Top of the next higher floor � 17.81 �feet ❑meters(Puerto Rico only) W � c) Bottom of the lowest horizontal structural member(V Zones only) N/A. ❑feet ❑meters(Puerto Rico only) �/ � d) Attached garage(top of slab) 16.35 �feet ❑meters(Puertto Rico only) � OO e) Lowest elevation of machinery or equipment servicing the building 16.38 �feet ❑meters(Puetto Rico only) N (Describe type of equipment in Comments) M a � Lowest adjacent(finished)grade(LAG) 14.4 �feet ❑meters(Puerto Rico only) �U g) Highest adjacent(finished)grade(HAG) 16.4 �feet �meters(Puerto Rico only) � m 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. I certify that the information on this Certificate represents my best efforts to interpret the data availab/e. _, �• 9� I understand that any false statement may be punishab/e by fine or impnsonment under 18 U.S. Code, Section 1001. ,I�Lt„�S#482��'}"�� .°,�..iv'��q6Nd9y« �✓1�>��.w � Check here if comments are provided on back of form. �� - ��;�� ,.y;, �`� ��,.��. �: � '"� Certifier's Name License Number . � �, . :,�.� GENE T CAUDELL PLS 4821 �� ` ' Y r.;. * ,,�; . Title Company Name t,,;;"' � �� • �" PROFESSIONAL SURVEYOR&MAPPER GEODATA SERVICES, INC. ��: �'�°oJ . ' � '%' �-�''.�' Address City State ZIP Code '',�`��„°.ba^ ji�` = 1822 DREW STREET UITE 8 CLEARWATER FLORIDA 33765 1 � °" `` y'` ` Signature Date ,� Telephone "`' f�� '`� � ✓ � � 727-447-1763 °�'�'*» FEMA Form 8 1, February 2006 See reuerse side for continuation. Replaces�all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. For In�urance Company:Jse: Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Policy Number " • � 1953 Freedom Dr. City State ZIP Code Company NAIC Number � Clearvvater FL 33755 , SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) � Copy both sides of this Elevafion Certificate for(1)community o�cial,(2)insurance agenUcompany,and(3)building owner. Comments C2 b)Residence has sunken IiVingroom- 2'�floor elev is 28.81 �.,: C2 e Lowest machine is the aif conditibn�" Signature Date .�y� (� �J ❑ Check here if attachments SECTION E- UILD NG ELEV TION INFORMATION (SURVEY NOT REQ RED) F R ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,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. 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,crawl space,or enclosure)is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9(see page 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is . ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage(top of slab)is . ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is availabie,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 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 , ❑Check here if attachments SECTION G-COMMUNITY INFORMATION (OPTIONAL) The locai 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. Compiete the applicable item(s)and sign beiow. 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. ❑ A community official completed Section E for a building iocated in Zone A(without a FEMA-issued or community-issued�BFE)or Zone AO. G3. ❑ The following information(Items G4.-G9.)is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7.This permit has been issued for: ❑New Construction ❑Substantial Improvement G8.Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters(PR) Datum G9.BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR) Datum Locaf Official's Name Title Community Name Telephone Signature Date Comments � f7Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions . . - . � � '� Building Photographs � See Instructions for Item A6. For Insurance Company Use: Building Street Address(inGuding Apt, Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number 1953 Freedom Dr City State ZIP Code ComPany NAIC Number Clearwater FL 33755 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 VievW' and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. � � � �' � �� ° � a��. �• _._ t �' � ��'� � �- � -� ' �,�- �`-- � �� «•� .. _ , . � � � ��. � r< . � ��- - . , ,... �, � „�=� . � +� � < � � �,;�. i � z ,��° � �� 'i��' { � ,.� ; n ' � �*. �� m r ' ��:�. �l€ t . �� y. � �, ` ,. �r� �� , ,e. ��... , s � k � _.__ _.__,_._- -- . E ��'��r ��-'�'� i �,:� � .��, x - , s � : �„ a,,: a��c ..,,�.,...., .;.. . : ,:.;u- „ - . :,$ FRONT VIEW � �,. �� "� ��. , � _ r-�� °,-; • . � 5 - -_ ° � ` . '�`�; w �-. �---"";'� � �� - 1 � �,.- �, � xs, .�� ' °�: �a�� , 'a• �' —.r� `i, :—�,,, `� r ,,, � i�, � �� ,�� _� �`.�n, ". � +��, � '. a #... ��a, � ��#�r � � � '� . � � �:.:,. , �.' ,� �� ,�°� x.�l �� _ � � � "� � � � � �` �.r , �; � a.. � �,., � gx; _ _ �s n � , .. - � � � ... .., a, '�j(,qFpS. � '>' wc'��1 II �°M1- � S9Yq ._ a�� i � .. . _ .,.. _ .. ..� . �-x.1�E� ._� BACK VIEW �� . � rs (_ � CITY OF CLEARWATER �� a � � '� �T" `� ��'''`"�#� CERTIFICATE OF OCCUPANCY �v� � �=�� g�Al �K �: '��•s��'` PLANNING AND DEVELOPMENT SERVICES .�:,. :�; 'q�tih. ��`; MUNICIPAL SERVICES BUILDING '��TER.;;�+ 100 SOUTH MYRTLE AVE. CLEARWATER. FLORIDA 33756 ,,.. PHONE (727) 562-4567 FAX (727) 562-4576 THIS CERTIFICATE ISSUED PURSUANT TO THE REQUIREMENTS OF SECTION OF THE FLORIDA BUILDING CODE CERTIFYING THAT AT THE TIME OF ISSUANCE, THIS STRUCTURE WAS INSPECTED FOR COMPLIANCE WITH CITY ORDINANCES, BUILDING REGULATIONS AND STATE LAWS REGULATING BUIDLING CONSTRUCTION OR USE. < < ., . , . . � Q � �. r4; ,; � �,� � �-- � ��(�N C C E 1 PREMISES LOCATED AT:1953 FREEDOM DR � � � ;�� PERMIT NO: BCP2007-09064 ` r�mu' �°� ? ��t`�� ti��4 7�^7- > ��`� _ `�c : CONTRACTOR: OWNER: �� .,` �� tY RANDY S SPEARS CBC058302 RON IRAD R S SPEARS CONSTRUCTION CONSUL I-CBC058302 °��18760 WELLS RIVE F�� ,�""�� 10416 KEY LANTERN DR PASCO#35014 � l�,� TARZANA, CA 1356 � ��r� � NEW PORT RICHEY, FL 34654 � ��,�" 310-279-9977 727-862-3443 ' ��o p �: d�� ; --- - -_-�., ___ _ _____ _ _ _ �,�G +''��-� F�LC�� DATA MISSING! �� . ,��'� Do NOT Issue CO!! �� l � � Missing Flood Zone on FEMA tab Elevation Certificates: Missing Flood Zone?? AS'�'�� Tie In Survey: OK . - ----------- _ __ THIS CERTIFICATE ISSUED ONLY FOR THE STRUCTURE AND OCCUPANCY STATED ABOVE AND IS VOID IF THERE IS ANY CHANGE IS EITHER OCCUPANCE OR STRUCTURE. DATE OF ISSUANCE May 01, 2009 BUILDING OFFICIAL • CLWCof04.rpt Ma,y 05 09 12: 51p Geodata Services, Inc. 7274464364 p. 2 �.S.DEPA�t7MENT•OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 166Q-0008 �Federal Emergency Management Agency Exnires Februarv 28.2009 National Flood Insurance P�ogram Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For insurance Company Use: A1. Buifding Owners Name Policy Number Ron, Irad Ron Ha it Raviv A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number 1953 Freedom Dr. Gity Cleanvater ��v State FL ZIPCode 33755 A3. Property Description(Lot and 81ock Numbers,Tax Parcel IVumber,Lega]Description,etc.) Lot 26,Clearwater Village Phase One/o3/29l15/16532l00010260 ___ _` A4. Buifding Use(e.g.,Residential,Non-Residentiai,Addition,Accessory,etc.) Residential A5. Latitude/Longitude:Lat.N 27°59'31.05"Long.W 82°46'51.62" 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. Buifding Diagram Numberl A8. For a building with a crawl space or enclosure(s),provide: A9. For a buifding with an attached garage,provtde: al Square footage of crawl space or enciosure(s) N/A sq ft a) Square footage of atiached garage N/A sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent ftood openings in the attached garage enclosure(s)walls within 1.�foot above adjacent grade N!A walfs within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b .N/A sq in SECTION B-FLOOD INSURANCE RA7E MAP(F1RM) INFORMATION B1. NFIP Community Name 8 Community Number 62.County Name B3.5tate City of Clearwaterl 125096 PineUas Fi B4. Map/Panel Number B5.Suffix B6.FIFtM Index B7.FIRM Panel 68.Flood B9.Base Flood Elevation(s)(Zone 12103C 0107 H Date EffectivelRevised Date Zone(s) AO,use base flood depth} 5/17l05 5l17l05 AE 15.5 810. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑FIS Profile �FIRM ❑Community Oetermined ❑Other{Describe) B11. Indicate elevation datum used for BFE in Item B9: OfVGV�5929 �NAVD 1988 ❑Other(Describe)NGVD 1929 BFE=16.4 812. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes �No Designation DateNlA ❑CBRS ❑OPA SECTION C-BUILDfNG ELEVATION fNFORMATION(SURVEY REQUIRED} C1. Building elevations are based on: �Construction Drawings' ❑Building Under Construction' ❑Finished Construction `A new Elevation Certificate will be required when construckion of the building is complete. C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,Vi-V30,V(with B�E),AR,AR/A,AR/AE,ARlA1-A30,AR/ikhi��Complete Ifems C2.a-g below according to the building diagram specified in Item A7. V �� Benchmark Utifized PCEDBM Miqhland_DVertical DatumNGVa 1929 � r. �� y � Conversion/Comments N/A Check the measurement used. � � a) Top of bottom floor(including basement,crawl space,or enclosure floor)17.31 �feet �meters(Puerto Rico onfy) �< <', b) Top of the next higher flaor � 17.81 �feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) NIA. ❑feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) 16.35 �feet ❑meters(Puerj,o Rico only) e} Lowest elevation of machinery or equipment servicing the building 16.38 �feet �meters(Puerto Rico only) (Describe type of equipment in Comments) � Lowest adjacent(finished)grade(LAG) 14.4 �feeE ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade(HAG) i6.4 �feet ❑meters{Puerto Rico only) SECTION D-SURVEYOR, ENGINEER,OR ARCHlTECT CERTtFICATION This ceRification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. 1 certify that the infonnation on this Certiiicafe represents my best effons to interpret the data availab/e. I understand that any false sfatement may be punrshab/e by frne or imprisonment under 18 U.S. Code, Sect�on�oo�. P S_# 865 � Check here if comments are provided on back of form. - - P;, t,.l '.�-:i4� � r. � ... - � �F_ k. ,�.;'�`�iG..,; Certifier's Name License Number ' - �i J ,R DENhlIS J.EYRE PLS 2865 - , '�`�'"} Title CompanyName ' � - ' � -�';ti� PROFESSI URVEYOR&MAPPER GEODATA SERVICES INC. - Address City State ZI��Ccjde� �. . � ,�� 1822 D W S7R 7 SUITE 8 ATER FLORIDA 33765 Signa r r ate Telephone � r d 727-447-1763 4- � FEMA 81-31,F ruary 2 See reverse side for continuation. ,. _ Replaces all previous editions May 05 09 12: 51p Geodata Services, Inc. 7274464364 p. 3 I.MPOftTANT: In t,�ese spaces,copy the corresponding information from Section A. For Insurance Company Use: • Building Street Address(including Apt.,Unit,Suite,andlor Bldg.No.)or P.O.Route and Box No. Policy Number 1953 Freedom Dr. �;ty State ZIP Code Company NAIC Number Clearwater FL 33755 SEC710N D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CON7INUED) Copy both sides of this Elevation Certificate for(1)cornmunity o�ciai,(2)insurance agenUcompany,and(3)building owner. Comments � G2 b Residence has sunken tivin room- 2n°floor elev is 28.81 C2 e}Lowest machinery is the air condition Signature � D te �. � () ❑ Check here if attachments SEC N -BUI D G EL ION INFORMATION (SURVEY O REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A( out BFE), omplete items E1-E5. If the Certificate is incended to support a LOMA or L�MR-F request,complete Sections A,B, and C. For Items E1-E4,use natural grade,if available. Check ihe measurement used. In Puerto Rico only,enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawl space,or enclosure)is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b)Top of bottom floor(including basement,crawl space, or enclosure)is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in 5ection A Items 8 and/or 9(see page 8 of Instructions),the next higher floor (elevation C2.b in the diagrems)of the building is 0 feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage(top of slab)is � feet ❑ mefers ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is 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 inforrttation in Section G. SECTION F-PROPERTY�WNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The properiy 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. 7he statements in Sections A, H,and E are correct to the best o(my knowledge. 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 o�cial who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B,C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8.and G9. G1. p The information in Section C was taken from other documentation thai 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 community-issued BFE)or Zone AO. G3. ❑ The following information(Items G4.-G9.)is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/pccupancy Issued �— G7.This permit has been issued for: ❑M1lew Construction ❑Substantial Improvement G8.Elevation of as-built lowest floor{including basement}of the building: ❑feet ❑rneters(PR} Datum G9.8FE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR} Datum ----- . _ _ - ------------- Local O�cial's Name Title Community Name Telephone �- a � - Signature ❑ate Comments r ____ — - -- — --- � . . .. r.�.�.-.J ❑Check here if attachments FEMA Form 81-31, Febniary 2006 Replaces all previous editions May 05 09 11 : 50a Geodata Services, Inc. 7274464364 p. 2 U.�.DEPAR7MENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1860-OOQB Federal En�tirger�i;;r,'Nanagement Agency EXDIfES F2bCU2N 2$.2009 ' National Flc,od Insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For Insurance Company Use: Ai. Building Owners Name Policy Number Ron,lrad Ron,Ha it Raviv A2. Building Street Address(including Apt.,Unit,Suite,andlor Btdg.No.)or P.O.ftoute and Box No. Company NAtC Number 1953 Freedam Dr. Ciry Clearwater 5tate FL ZIP Code 33755 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.j � Lot 26,Cleanvater Village Phase One!03129/15/16532l00�/0260 A4. Building Use(e.g.,Residentiat,Non-Residential,Addition,Accessory,etc.) Residentiaf A5. La[itudelLongitude:Lat.N 27°59'31.05"Long.W 82°46'51.62" Horizontal Datum:�NAD 1927 �NAD 1963 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Numberl A8. For a building with a crawl space or enclosure(s),provide: A9. For a building with an attached garage,provfde: a) Square footage of crawl space or enclosure{s) N/A sq ft a) Square footage of attached garage N/A sq ft b) No.of permanent fload openings in the crawl space or b) No.af permanent flood openings in the attached garage encfosure(s)walls within 1.0 foot above adjacent grade N/A walls within 1.0 foot above adjacent grade NlA c) Tota!net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name 8 Community Number 62.County Narne B3.State City of Clearwater/125096 Pinellas F� �B4.Map/Pane!Number B5.Suffix B&. FIRM Index 67.FIRM Panel B8. Flood B9.Base Flood Elevation(s)(Zone i2103C 0107 H Date Effective/Revised Date Zone(s) A0,use base flood depth) 5/17/05 5/17/05 AE 15.5 810. Indicate the source of the Base Flood Elevation(BFE)dafa or base flood depth entered in ftem B9. ❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe) B11. Indicate elevation datum used for BFE in Item B9: ❑NGVD 1929 �NAVD 1988 ❑Ofher(Describe)NGVD 1329 BFE=16.4 612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes �No Designation DateNlA ' ❑CBRS ❑OPA SEC710N C-BUILDING ELEVATION INFORMATION(SURVEY REQUIREb) C1. Building elevations are based on: �Construction Drawings' ❑Building Under Construction' ❑Finished Construction 'A new Elevation Certificate wilt 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,AR1AH,AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item A7. Benchmark Utilized PCEDBIN Hiohland DVeftical DatumNGVD i929 Conversion/Comments NIA ` Check the measurement used. a) Top of bottom floor(includi�g basement, crawl space,or enclosure floor) 17.31 �feet ❑meters(Puerto Rico only) b) Top of the next higher floor ' 17.81 �feet ❑meters(Puerto Rico only} c) Bottom of the lowest horizontal structural member(V Zones only� N/A. ❑feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) 16.35 �feet ❑meters(Puer�,o Rico only) e) Lowest elevation of machinery or equipment servicing the building 16.38 �feet �meters(Puerto Rico only) (Describe rype of equipment in Comments) � Lowest adjacent(fnished)grade{LAG} 14.4 �feet ❑meters(Puerio Rico only) g) Highest adjacent(finished)grade(HAG) 16.4 �feet �meters(Puerto Rico only) SEC7fOlY D-SURVEYOR, �NGINEER,OR ARCHITECT CERTIFICATION This tertification is to be signed and seated by a land surveyor,engineer,or architect authorized by law to certify elevation information. 1 certify Ihat the informatron on lhis Certifrcate represents my best efforfs to interpret lhe data availabfe. 1 understand fhat any false statement may be punrshable by fine or imprisonment under 1$U.S. Code, Section 100i. P S# 865 � Checl�here if comments are provided on back of form. - - � P�,�' �' LI `;=�� Certifier's Name License Number �� ''�`"� DENNlS J.EYRE PLS 2865 - �''� ��- �- �� Title Company Name - ; !-}-,,;',, PROFESSI URVEYOR&MAPPER GEODATA SERVICES lNC. �_ Address C;ty State ZIP Code � 1822 D W STR T SUITE 8 ATER FLORlDA 33765 ' Signa r r te Telephone `` �. d 727-447-1763 (� (� FEMA 81-31, F ruary 2 See reverse side for continuation. Replaces all previous editions May 05 09 11 : 50a Geodata Services, Inc. 7274464364 p. 3 IMPQRTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use: Bu�lding Str�t Ad�re�ss(including Apt.,Unit,Suite,andlor Bldg. No.)or P.O.Route and Box Na Policy Number 1�53 Freedom Dr. City State 2lP Code Company NAIC Number Clearwater FL 33755 SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTlF1CATION (CON7INUED) Copy both sides of this Etevation CeRificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments C2 b)Residence has sunken livingroom- 2n°floor elev is 28.81 C2 e)Lowest machinery is the air condition Signature � D te ` .� �3 ❑ Check here if attachments S�C N -Blll D G EL IOId INFORMATION (SURVEY O REQUIRED) FOR ZONE AO AND ZONE A(11VITHOU7 BFE) For Zones AO and A( out BFE), omplete Items E1-E5. If the Certificate is intended to support a LOMA or LON{R-F request,compleCe Sections A,B, and C. For Items E1-E4,use natural grade, if available. Check the measurement used. In Puerto Riw oniy,anter meters. E1. Provide elevation information for the foiiowing and check the appropriate hoxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the towest adjacent grade(LAG). a)Top of bottom floar(including basement,crawl space, or enclosure)is � feet ❑ meters ❑ above or ❑ below the liAG. b)Top of bottom floor(including basement,crawl space, or enclosure)is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For euilding Diagrams 6-8 with permanent flood openings provided in Section A Items S and/or 8(see page 8 of Instructions),the nexf higher floor (elevation C2.b in 1he diagrams}of the building is ❑ feet 0 meters � above or ❑ below the HAG. E3. Attached garage(top ot slab)is ❑ feet � meters ❑ above or ❑ below the HAG. E4. Top of platform ot machinery and/or equipment servicing fhe building is � feef ❑ meters [� above or ❑ below the HAG. E5. Zone AO oniy� If no flood depth num6er is available,is the top of the bottom floor efevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F-PROPER7Y OWNER(OR OWNEFt'S REPRESENTATIVE}CERTIFICATION The property owner or owner's authorized representative wha compfetes Sections A,B,and E for 2one A(withoui a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, 6,and E are correct to the best of my knowledg�. Prope�ty Owner's or Owner's Avthorized Representative's Name Address City State ZlP Code Signature Date Telephone Comments rlCheck here if attachments SECTION G -COMMUNI7Y INFORMATION(OPTIONAL} The Iocal offcial who is authorized by law or ordinance to administer fhe community's floodplain management ordinance can complete Sections A,B,C(or E), ancl G of this Elevation Cer#ificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8.and G9. G1. ❑ The infnrmatian in Section C was taken from other documentation that has heen signed and sealed by a IiCensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (tndicate the source and date of the efevation data in the Comments area betow.) G2_❑ A community official compteted Section E for a building located in Zone A(without a FEMA-issued or community-issued�FE)or Zone AO. G3. ❑ The following information(Items G4.-G9.)is provided for community floodplain management purposes. G4. Permit Number G5. Oate Permit Issued Gfi. Date Certificate Of Compliance/Occupancy Issued G7.This permit has been issued for: ❑New ConstruCtion ❑Substantial Improvement G8. Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters(PR) Datum G9. BFE or(in Zone AO)depth of flooding at the building site� ❑feet ❑meters(PR) Datum Local Offlcial's hisme Title Gommunity Name Tefephone Signature � - � Date Comments rlCheck here if attachments FEMA Form 81-37, February 2006 Replaces a!I previous editions