660 HARBOR ISLAND ELEVATION CERTI�ICATF ����'-��0`°�
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� , I nportant: Read the instructions on pages 1-9.
�C�P��1 I- ��3 �
• SECTION A-PROPERTY INFORMATION `'�'�s�����°�
A1. Building Owner's Name RICHARD W.COPE AND JILL FISHER COPE '����
A2. Buiiding Street Address(induding Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. �'�:��'
660 HARBOR ISLAND
City CLE4RWATER State FL ZIP Code 33767
A3. Property Descxiption(l.ot a B Numbers,Tax Paroei Number,Legal ' ,etc.)
LOT 89,ISLAND ESTATES OF CI.F�4RWATER UNITS 6D,7A AND 7C-PB 64,PG 001
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Acx�essory�etc.)RESIDEI+ITIAL
A5. Latitude/Longitude:Lat. 7. 8°N Long. 2.8 8165°W Horizontal Datum: � NAD 1927 � NAD 1983
A6. Attach et least 2 photogrephs of the building if the Certificate is being used to obtain flood insurence.
A7. Buildinp Diagram Number �
A8. For a buildin8 writh a cxawispaoe or endosure(s): A9. For a�ildir�p wittt an atfad�ed garage:
a) Squere footage of cxawlspaoe or endosure(s) WA sci ft a} Square footage of attac�d gerage 4B2 �i�
b) No.of permane�t fbod czpenmgs in tha crawlspaEe QE b) No.af RermaneM f�d upeni�gs in ihe a�ed garage
�ure(s)wdh�1.0 fo�above ad�aoeM grade WA within 1.0 foot above�aoar�t grade WA
c) Total�t atea of flood openings in A8.b �L sq in �) Tot�l net area of ilood opanings'sn A9.b N!A sq in
d) Engineered flood openings? [� Yes �' No d) Engineered flood openings? []i Yes � No
SECTIW�1 B-FLOOD INSURANC�RATE MAP(F1RN1)INFQRMATtON
B1.NFIP Cortmlwti�I Name&Community Nwnber 62.CouMy Name �.S�
CL,EARWATEF�t-125096 PIMELLAS �-O��
B4.Map/Panei Number B5.Suffoc B6.FIRM Index B7.FIRM Panel 68.Flood �'.�ese�locdi�osrQ���e�e
�2�pg�p�p2 G Date Effective/Revised Date Zone(s) AO,use base flood depth)
8/78/09 9/3/03 AE 11'
B10. indicate the souroe of the Base Flood Elevation(BFE)data or base flood depth erdered in I`-°°^
[J' FIS Profile � FIRM Q Community Determined � Other(L1esc
611. Indicate elevation datum used for BFE in ltem B9: [I!NGVD 1929 � NAVD 1988 �� �C_7`v I`/ -_._.
812. Is the building located in a Coastal Barrier Resouroes System(CBRS)area or Otherwise Pi
Designation Date � CBRS Q OPA ��
BEGTION C-BUILDtNG ELEVATION INFORIIfAT10N �� � �� _
C1. Building ebvations are based on: [j' Construction Drawings' � Building Un �
"A na�nr Elevation Certiificete will be required when construdion of the building is complete. �"'r
C2. Eleveti0ns-Zones A1-/430,AE,AH,A(w�h BF�.VE,V1 V30,V(wfth BF�,AR,AR/A,AR ��
beiaw acco[�d'at�t�#ha buildinQ diagram speaC�in[tem A7. Use MS same d�m�the Sl
���.�����:�.� � �Y� �l�o�l�i- �)
ConversioNCommerrts NAW �
a) Top of bottom floor(inciuding basernent,crawlspace,or enclosure floor)f.7�5 �' i� $`[ �
b) Top of the next higher floor N.A �'' �.�fY���.n C.� SC4/Vl
c Bottom of the lowest horizontal sWdural member(V Zones only) �.A I�'± � �
)
d) Attached garege(top of slab) 6.31 ��
e) Lpv�estelevation of machinery or equipment servicing the buifding �.� �i
(D9scribe type of equipment and location in Comments)
� Lowest adjaceM(finished)grade next to buiiding(LAG) ¢.TQ �feet Q meters(Puerto Ricb only)
g) Hi�hest adjacent(finished)grede next to building(HAG) f.40 �feet ❑meters(Puerto Rico only)
h) Loweat adjacent grade at bwest elevation of deck or stairs,including j�,A �feet �'meters(P,��t��tico Anly)
sGu�,ra� rt
SECTION D-SURYEYOR,ENGINEER,OR ARCHITECT CERTIFlCATION . 'a04�$�at+ri: ;�
This certification is to be signed and sealed by a land surveyor,eFlgineer,or ar�hked authorized by law to oertify eIQ ' ' �
information. l oertify that the iMn►mation on this Certificete rep�esents my best effi�rts te ir►terpret the date availabJe .` ,��§r ,.��°•*+'•, , � "-
1 understand it�at any false stetement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1DOf:��- : /� � ��
� Chedc here if comments are provided on back of form. Were latitude and longitude in Section A providet�b�.�9'� �� ���"� ��;��-8a',
licensed land surveyor? � Yes ❑ No �: : � ,K:. �+ * � .
� �
Certifiers Name JOHN C.BRENDLA License Number 1269 .;�� :�' 3� =
mCi.. �"'
Title STERE ND SURVEYOR Company Name N C.BRENDLA 8�ASSOCIATES,INC. �, �
,�� � "
A 4015 AVENUE NO Ciiy PINELLA ARK State FL ZIP Code 33�1 � ' � - q'.,''�, , �
�� � 07/13/11 Telephone 727-576-7546 '. ,
'���-s -
F F rm 81-31,Mar See reverse side for continuation. � css all previous editions
ELEVATION CERTIFICATE ��-�� ��'`°�
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�n .Q��' I� ��3�I � nportant: Read the instructions on pages 1-9.
li
• SECTION A-PROPERTY INFORAAATION `�c�'�'n�Ge�rc►Pari�w;C�.
,A1. Building Owner's Name RICHARD W.COPE AND JILL FISHER COPE ��i±'�
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box Na '��`�'
660 HARBOR ISIAND _
City CLF�4RWATER State Fl ZIP Code 33767
A3. ProPertY DescxiPtion(Lot and B Numbers,Tax Paresl Number,L.ega�De�ip�on,etc•)
LOT 89,ISLAND ESTl1TES OF CLEARWATER UNtTS 6D,7A AND 7C-PB 64,PG 001
A4. Building Uae{e.g.,Residantial.Nan-Residential,Additior►,A�ry,etc.)RESIDE�IT�P►L
A5. Latitude/Longitude:Lat.27. °N Long.82.8165°W Horizontal Datum: � NAD 1927 � NAD 1983
A6. Attach at kast 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Buildi�q Diaprem Number 1=A
A8. For a bui�ing with a cxawlspace or enGosure(s): A9. For a�ilding with an attached garage:
a) Squara footsge of cxawlsPace or endosure(s) WA sq ft a) Squate foot�e of altac�ed garage 462 sq ft
b) No.of pem�aner�t flood c�enings in tfie crawispac�e Qr b) No.of permaneM floQd Qpenin�in the attact�ed garage
endosure(s)wi�hin 1.0 foot above adjacent grade WA within 1.0 foot above adjac�nt grade t�lA,
c) Total net area of flood openir�s in AB.b 'L scl in c) Total net area of flond openings in A9.b WA sq in
d) Engineered flood openings? � Yes � No d) Engineered flood openings? [� Yes � No
8ECTION B-FLOOD lNSURANG�RATE MAP(FlRM)lNFORMATION
�1.NFIP Communty Narne&Commun�y Number BZ.CowKy Name �.�
CI.EARWATF�-1250�6 PIMELLAS FLOf�IDA
B4.Map/Panel Number B5.Suffix B6.FIRM Index 67.FIRM Panel 68.Flood �.Base Ff��io�rQs��o�e
12103C0102 G Date Effedive/Revised Date Zone(s) AO,use base flood depth)
8/18/09 9/3/03 AE ���
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in item 69.
[} FIS Profile �f FIRM Q Community Determined � Other{Describe)
B11. Indieate elevation datum used for BFE in Item 69: ��NGVD 1929 � NAVD 1988 ❑ Other(Descnbe)
612. Is the building located in a Coastal Bartier Resourcrc�s System(CBRS)area or Othervvise Protected Area(OPA)? [] Yes � No
Designation L?ate � CBRS Q OPA
SECTION C-BUILDING ELEYATIDN INFORMATION(SURVEY REQUIRED)
C1. Building ebvations ere based on: []� Construdion Drawings* [J; Building Under Construction` �' Finished Construction
•A newElevation Certificete wf��be required when construction of the buiiding is complete.
CZ. Elevati0ns-Zones A4-A30.AE�AH�A(w�h BF��VE,V1 N30�V(wfth BF�,AR,AR/A,AFt/AE.AR/A1-,A30,AR/AH�AR/AO. Complete Iterns C2.a-h
beiaw acxot�dil�fio the buiWing diagraR►speafied in lte�t A7. Use tt�sact�e datum a�Me 6FE.
tlJ��i��Mp.�e�i9�,"��fiZ:��ea#•€�� �
ConversioNCommeMs NA1/D
Chedc the measurement used.
a) Top of bottom floor(induding basement,crawispace,or enclosure floor)¢.75 �'feet [}meters(PueRo Rico only)
b) Top af the next higher floor N.A �;feef [�meters(Pueno Rico only)
c) Bottom of tha Iowest horizontal structural member(V Zones only) I�.P� �feet Q meters(Puerto Rico onry)
d) Attached garage(top of slab) 6.31 �feet �meters(Puerto Rico only)
e) Loweat ebvation of machinery or equipment servicing the building f.� �feet 0 meters(Puerto Rico only)
(D9sd�ibe type of equipment and Ixation in Comments)
� Lowest adjacent(flnished)grade next to building(LAG) f.?Q �feet L�meters(PueRo Rico only)
g) Highest adjacent(finished)grede next to building(tiAG) �.40 �feet Q meters(Puerto Rico only)
h) Lowest adjacxnt grade at Ipwest elevation of dedc or stairs,including �A �feet [�meters(P�ko�tico onry)
stiucxu�l s R .^.
SECTION D-SURVEYOR,ENGINEER,OR ARCHiTECT CERTIFlCATION .,�,c�?�"r'°g'3°= ��w� .
This oertification is to be signed and sealed by a land surveyor,engineer,or archited authorized by law to certify eleva� -a •" ' '
information. l os►ti!y that tire ir�fOnnation on this Certificete represents my best ef�ts to ir►terprot the data availab/e. ;` �»!4. ,.•�°•••� �t 4�
l understand that any fatse statement may be punishable by fine or imprisau�►rt►ent under 18 U.S.Code,Section 1001: s„'°: ,/� � ,�
` f,, :
� Chedc here ff comments are provided on back of form. Were latitude and longitude in Sedion A providett b�� q "� ��� Y���' "
� �} ,., � .
licensed land surveyo� � Yes ❑ No; "Y : � ,� �` � .
� �� � �,
Certifiers Name JOHN C.BRENDLA License Number 1269 „� ;� �
� . ,� ,
T'dle STERE ND SURVEYOR Company Name N C.BRENDLA�ASSOCIATES,INC. ��, «„ � -� � `� - °°
� �
A 4015 AVENUE NO City PINELLA ARK State FL ZIP Code 33 81 ,� � ��: - �, r'�� ,
.��-�� Vi
�� � 07/13/11 Telephone 727-576-7546 . ., , .
F A F rm 81-31,Ma� See reverse side for oontinuetion. `�" ces aU pcevious editions
IMPORTANT: In these spaces,copy the corresponding information from Section A. F�s��:�araipa�+y=t�e
Building Street Address(induding Apt.,Unit,Suite,and/or Bldg.No J or P.O.Route and Box No. Pc�trc��N�
660 HARBOR ISLAND ' ' ` `� � 4
City CLEARWATER State FL ZIP Code 33767 �smpa���t��e►�tser
; , t
, � � �.
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUEO}
Copy both sides of this Elevation Cert�cate for('I)community official,(2)insur ce agenUcompany,and(3)building owner.
Co en c2e:A/C AD
NCH RK: B-1-03-5(CITY CLEARWATER) ELEV.6.4 NAVD 1988 DATUM
ure Date 07/13/11
• � Check here ff attachments
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITH�UT 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 avaitable. 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, crawlspace,or enclosure)is ❑feet ❑meters ❑above or�below the HAG.
b)Top of bottom floor(including basement,crawlspace,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
(elevation C2.b in the diagrams)of tfie 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 local officia�must certify this information in Section G.
SECTION F-PROPERTY OWMER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owner's authorized representative who completes Sections A,B,and E forZone�{without a FEMA-issued or community-issued BFE)
or Zone AO must sign here. The sfatements in Sec6ons 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
❑Check here if attachments
SECTION G-COMMUNITY INFORMATFON(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 Cert�cate. 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 soures 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 G4G9)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-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
Comments
❑Check here if attachments
Replaces all previous editions