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301 GULFVIEW BLVD U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB NO. 1660-0008 Federal Emergency Management Agency Ex�ires Februarv 28.2009 National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1. Building Owners Name NJR DEVELOPMENT Policy Number A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. C S.GULFVIEW BLVD u City CLEARWATER State FL 21P Code 33767 A3. Property Description(Lot and Blodc Numbers,Tax Parcel Number,Legal Description,etc.) PARCEL ID NUMBERS 07/29/15/52380/000/0570 8�07/29/15/52380/000/0580 8 07/29/15/52380/000/1050 A4. Buildin g Use(e.g.,Residential,Non-Residential Addition A , ccessory,etc.) Non-Residential DEVELOPMENT SERI/ICES DEPT A5. Latitude/Longitude:Lat.N27°58'25.7" Long.W.82°49'45.0" Horizont 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 crawl space or enGosure(s),provide A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s) 7.810 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 0 watls within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b 0 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&Community Number 62.County Name CITY OF CLEARWATER 125096 0102 PINELLAS 63.State FL B4.Map/Panel Number 65.Suffix 66.FIRM Index 67.FIRM Panel 68.Flood 69.Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 12103C0102 G MAY 17,2005 JANUARY 28,2009 VE 8�AE 11', 12',8�13' B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69. ❑FIS Profile �FIRM ❑Community Detertnined ❑Other(Describe) B11. Indicate elevation datum used for BFE in Item B9: ❑NGVD 1929 �NAVD 1988 ❑Other(Describe) � W 612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Proteded Area(OPA)? ❑Yes Designation Date N/A ❑CBRS ❑ppq �N0 (7 � � SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) p � C1. Building elevations are based on: ❑Construction Drawings" �Buil��er'�ie�tf�A�/� p � *A new Elevation Certificate will be required when construction of the building is com�pl� COpE �pM�L��N�� ,��.,��'��" O C C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,A$JQ�/��p.f, 1 r- below accorcling to the building diagram specified in Item A7. s��(;��g C2.a �p � Benchmark Utilized Clearwater Benchmark G-02 Vertical Datum NAVD 1988 ��'��C��{`��' '��;, ` `��! �y'�G'�-:;F?S. W � Conversion/Comments NONE l � � ��. Chedc�I'fe mea u ment used. mS �� ,.� C a) Top of bottom floor(induding basement,crawl space,or endosure floor)_ 4.10 � 9��y� �feet ❑meters(Puerto Rico only� ' � b) Top of the next higher floor 15.��.F,�T� t meters(Puerto Rico only) �Z-v,�U � c) Bottom of the lowest horizontal structural member(V Zones only) 13.72 �feet ❑meters(Puerto Ri o on� °�-° r d) Attached garage(top of slab) y� � � N�A• ❑feet ❑meters{Puerto Rico onty) e) �owest efevation of m a c h i n ery or equipment servicing the building �, Q (Describe type of equipment in Comments) � ��et ❑meters(Puerto Rico only) � Lowest adjacent(finished)grade(LAG) 4.1 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade(HAG) 5.4 �feet ❑meters(Puerto Rico onty) SECTION D-SURVEYOR,ENGINEER�AR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or archRed authorized by law to certify elevation r�� j` information. I certify that the information on this Certificete ieprosents my best efforts to inteip►et the data available. ��'' I understand that any false statement may be punishable by Bne or imprisonment under 18 U.S. Code,Section 9001. �••� ;' � ��.• o.� � Check here'rf comments are provided on badc of fortn. �� . �`" °�•, . Certifier's Name JEFFERY A.COPELAND • � F" License Number 5279 : r- . �� '� : ;,� � �:-. �; �+ ,{ - Title FLORIDA REGISTER�D L A N D S U R V E Y O R Company Name Suncoast Land Surve "M��f ,,`��I g ' „�'�� ° `�� Y"'a1�'..•K �+S r y ."' ` Address 111 F O R E S T L A K E S B LVD. City OLDSMAR State FL ZIP Code 34677 , � �~f `� �� '✓�,�a� , � �»� ; Si nature Date 8/3/09 Telephone 813-854-1342 •• lg6. � � ,c�,,�,�,,t ,��:'.�v ��.;:�. � IMPORTANT: in these spaces,copy the corresponding information from Section A. For insurance Company Use: Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number S.GULFVIEW BIVD. City CLEARWATER State FL ZIP Code 33767 SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION( Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)buildin Comments A8.ELEVATORS,STAIRWELLS and OTHER ENCLOSED AREAS ON GROUND LEVEL PARKING A 68.FLOOD ZONES BASED ON"LETTER OF MAP REVISION DETERMINATION DOCUMENT'CASE N0.08-04 , FFECTIVE DATE 1/28/09. C2e.ELECTRIC TRANSFORMER PAD ELEVATION �" DEVELOpM�NT SERV�CES DEPT CITY�F CLEAf�WATER Signat Date 8/3/09 ❑ Chedc here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(1MTHOUT 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. Chedc the measurement used. In Puerto Rico only,enter meters. E1. Provide elevation information 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 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(inGuding basement,crawl space,or enclosur�e)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 available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑ Unknown. The Iocal official must certify this infortnation in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or ownets 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 ❑Chedc here ff attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The loc.al official who is authorized by law or ordinance to administer the�mmunity'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. Chedc 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 infortnation. (Indicate the source and date of the etevation 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.PeRnit Number G5. Date Permit Issued G6. Date Cert�cate Of Compliance/Occupancy Issued G7.This pertnit 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 Official's Name Title Community Name Telephone Signature Date Comments f-1 Check here if attachments Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt, Unit,Suite, and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number S.GULFVIEW BLVD. Clty CLEARWATER State FL ZI P COd@ 33767 Company NAIC 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 VievW' and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. NORTH SIDE BUILDIN�G 7i31/09 _ �_�� !y � . � � �� ' ' ' �' � � : ,; �� •��..� � c � �, r�� I ��N .� �1 � iii �� I { � - �! � � �'� ,► �� -� �. 11 `'� ' I �� 1 � --- ��- "' � s' � p1 � � � ,� � � �i�� ■� �� - � ;�;j ;��; �� , �� ii :� '� � �,� ;;w� n i >ir � _ �_ ,�,.° Ibl IsH ��3s i _ .-_._ ,� �; �,. ,,;,<« � i�� _. .s*1��,, :'' �R �� :.��11�1�i#� a ,� '� : ;l��. �s :.. ��. �� ,,> >.�>� �� - --� a�,�;:-..__ �, EAST SIDE BUILDING 7131/09 M�"� 16 �� ' t r � ;��'� � � � � � � �r, ; � � � � � _ �� ;�;'' :i _ " `� �� , � �� _ � �� ; � �� -��. �'� � Y �,��_� ` ;�;;; - �� ,� �: �, ��., � , �,��_ _ � � _� ��ii � �� V, � ;� ��` �� 4+ .�4-�`;.� i � r��r � .�...''�,.� �ir� ��, '� ��, .. ._,. . _. .,.�,�.�°�`"�. � . ; .. � � , . -_ _� .. _ -__ -- - ��.-!-''`,�� ., �,� `� �~ -� '}�g�:i'�'' D � V �� -) y�W� � � � �� n� � � � i4 t �`'�� AUG 0 7' 2009 �� .� �`'.� � ::.;� �i �EVFIOPMEN�T SERVl��0� CITY O�Ct^�.ARWATER , � . . il in Photo ra hs Bu d g g p 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 S.GULFVIEW BLVD I Clty CLEARWATER S�t@ FL ZI P COd@ 33767 Company 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." SOUTH SIDE BLDG 7/31/09 �� r � �� ;��,� � � � � � '�_�� '� ��"� rrrr► �' , �,,� �,,� �, ;� r -�,°w� ,, � i`� '"�'� .= - � �� -� r��..-, � � _ . � � � - - � � i rre - �- ---- ;� . .-.-�-�,�; , � - �-�- �. �, 5� �� :.� �_ �� Y� �� -.�� ,,, �s; -r ,. <�;� ,� _��, ';#,fi` .r '� •.�� , � `��.� ; °' �9___„ �� ",�1� f ,r�"� '�` �.,�x • . �, � , s —A� � ' . �'; �~ �,1it,y��da* ,. ��,�� '�=�� ... �' ..��wr�+��"'� � ,,,� WEST SIDE BUILDING 7/31/09 - � _ , ��<� ., � . �� 11 N' ; , _ , � , ,; 1 �- . 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