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672 HARBOR ISLANDU.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION Al. Building Owner's Name David Peters & Jenee Peters A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 672 Harbor Island City Clearwater State FL ZIP Code 33767 OMB No. 1660-0008 Expires March 31, 2012 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 87, Units 6D, 7A, 7C ISLAND ESTATES OF CLEARWATER A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) A5. Latitude/Longitude: Lat. 27d 59' 21.19" N. Long. 82d 49' 00.60" W. A6. Attach at least 2 photographs of the building if the Certificate is being used A7. Building Diagram Number 1B A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) N@ sq ft b) No. of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b NFA sq in d) Engineered flood openings? 0 Yes ® No Residential Horizontal Datum: to obtain flood insurance. 0 NAD 1927 ® NAD 1983 A9. For a building with an attached garage: a) Square footage of attached garage )y9 sq ft b) No. of permanent flood openings in the attached garage within 1.0 foot above adjacent grade )y@ c) Total net area of flood openings in A9.b 1i6 sq in d) Engineered flood openings? 0 Yes No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Community Name & Community Number Clearwater 125096 B2. County Name Pinellas B3. State Florida 64. Map/Panel Number B5. Suffix B6. FIRM Index 87. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12103C 0102 G Date Effective/Revised Date Zone(s) AO, use base flood depth) 9/3/03 9/3/03 AE 11.0' 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM 0 Community Determined 0 Other (Describe) B11. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 ® NAVD 1988 0 Other (Describe) 912. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date ❑ CBRS 0 OPA ❑ Yes ® No 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 Vertical Datum NAVD 1988 Conversion/Comments a) b) c) d) e) f) 9) h) Top of bottom floor (including basement, crawlspace, or enclosure floor) 11.Q Top of the next higher floor N.@ Bottom of the lowest horizontal structural member (V Zones only) N.@ Z.o N.e Attached garage (top of slab) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) Lowest adjacent (finished) grade next to building (LAG) Highest adjacent (finished) grade next to building (HAG) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N.@ N•@ N.@ Check the measurement used. ® feet ® feet ® feet El feet ® feet El feet ® feet ® feet ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ 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 Interport the data available./ understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.0 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 Certifiers Name Edward D. Murphy License Number 5333 Title Professional Land Surveyor Company Name Murphys Land Surveying, Inc. Address 5750 11 Avenue N. Signature W��MOW City St. Peterab State FL ZIP Code 33710 Date 8/20/10 Telephone 727/347-8740 i'tr1Rairrt1" FEMA Form 81-31, Mar 09 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 Bldg. No.) or P.O. Route and Box No. 672 Harbor Island City Clearwater 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 Signature Date 8/20/10 0 Check here If attachments SECTION E - BUILDING ELEVATI* NFOR ION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Item 1-E5. If t - Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, 5, and C. For Items E1 -E4, use natural grade, if av- able. Check the measurement used. In Puerto Rico only, enter meters. El. Provide elevation information for the followi g and check the - •propriate 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, c-wlspace, or : closure) Is 0 feet ❑ meters 0 above or ❑ below the HAG. b) Top of bottom floor (Including basement, craw ✓ , or enclosure) is 0 feet 0 meters 0 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 (seepages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is 0 feet 0 meters ❑ above or below the HAG. E3. Attached garage (top of slab) is 0 feet ❑ meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is • 0 feet 0 meters 0 above or 0 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? 0 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, 8, 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. 0 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 07. This permit has been issued for: G8. Elevation of as -built lowest floor (including G9. BFE or (in Zone AO) depth of flooding G10. Community's design flood elevation 0 New Construction 0 Substantial Improvement basement) of the building: 0 feet 0 meters (PR) Datum at the building site: 0 feet ■ meters (PR) Datum 0 feet • meters (PR) Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑ Checc here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions 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. 672 Harbor Island City Clearwater State FL ZIP Code 33767 Policy Number 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 View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. DATE: 8/17/10 FRONT VIEW: REAR VIEW: Ur-. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flbod Insurance Program ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION Al. Building Owner's Name David Peters & Jenee Peters A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 672 Harbor Island City Clearwater State FL ZIP Code 33767 OMB No. 1660-0008 Expires March 31, 2012 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 87, UNITS 60, 7A, 7C ISLAND ESTATES OF CLEARWATER A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat. 27d 59' 21.19" N. Long. 82d 49' 00.60" W. Is being used to obtain flood insurance. Horizontal Datum: 0 NAD 1927E NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate A7. Building Diagram Number 11 AB. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) b) No. of permanent flood openings In the crawlspace or enclosure(s) within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b d) Engineered flood openings? 0 Yes :i No NA sq ft sq in A9. For a building with an attached garage: a) Square footage of attached garage 869.5 sq ft b) No. of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 8 c) Total net area of flood openings in A9.b 1244,2 sq in d) Engineered flood openings? ❑ Yes E 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 12103C 0102 B5. Suffix G B6. FIRM Index Date 9/3/03 B7. FIRM Panel Effective/Revised Date 9/3/03 B8. Flood Zone(s) AE B9. Base Flood Elevation(s) (Zone AO, use base flood depth) 11.0' B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. 0 FIS Profile E FIRM 0 Community Determined 0 Other (Describe) B11, 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 Designation Date ❑ CBRS ❑ OPA No SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* 0 Building Under Construction* E Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2, Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, ARAE, 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 Vertical Datum NAVD 1988 Conversion/Comments a) b) c) d) e) 0 9) h) Top of bottom floor (including basement, crawlspace, or enclosure floor) 11.Q N.A N•A 7.Q 11.Q Top of the next higher floor Bottom of the lowest horizontal structural member (V Zones only) Attached garage (top of slab) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) Lowest adjacent (finished) grade next to building (LAG) Highest adjacent (finished) grade next to building (HAG) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support Z•Q 8•T N.A Check the measurement used. E feet E feet CO feet E feet E feet E feet E feet feet ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ 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. 1 certify that the information on this Certificate represents my best efforts to interpret the data available.) understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.0 Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor/ E Yes 0 No Certifier's Name Edward 0. Murphy License Number 5333 Title Professional Land Surveyor Company Name Murphys Land Surveying, Inc. Address 5750 11`" Avenue N. City St. Petersburg Signature State FL ZIP Code 33710 Date 12/29/10 Telephone 727/347-8740 FEMA Form 81-31, Mar 09 ! See reverse side for continuation. STA tk.0FJ. • -,;z '-OR1DT � t./ SS 114//, rrrl r�af141�1�A Replaces all previous editions V+ U.S. DEP WENT OF HOMELAND SECURITY Federal E. agency Management Agency National Flbod Insurance Program ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. OMB No. 1660-0008 Expires March 31, 2012 SECTION A - PROPERTY INFORMATION,, `• ra21 Al. Building Owner's Name David Peters & Jenee Peters re�,t"il' 88. Flood A2. Building Street Address (including Apt., Unit, Suite, and/or Btdg. No. or P.O. Route and Box No. 672 Harbor Island 12103C 0102 G City Clearwater State FL ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 87, UNITS 60, 7A, 7C ISLAND ESTATES OF CLEARWATER A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) A5. Latitude/Longitude: Lat. 27d 59' 21,19" N. Long. 62d 49' 00.60" W. A6. Attach at least 2 photographs of the building if the Certificate Is being used A7. Building Diagram Number 1B A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) NQ sq ft b) No. of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade Ng c) Total net area of flood openings in A8.b NA sq In d) Engineered flood openings? 0 Yes ® No Residential Horizontal Datum: ❑ NAD 1927 ® NAD 1983 to obtain flood Insurance. A9. For a building with an attached garage: a) Square footage of attached garage 889.5 sq ft b) No. of permanent flood openings in the attached garage within 1.0 foot above adjacent grade B c) Total net area of flood openings in A9.b 1244.2 sq in d) Engineered flood openings? 0 Yes ►'_ No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Community Name & Community Number Clearwater 125096 B2. County Name Pinellas B3. State Florida B4. Map/Panel Number B5. Suffix B6. FIRM Index 87. FIRM Panel 88. Flood B9. Base Flood Elevation(s) (Zone 12103C 0102 G Date Effective/Revised Date Zone(s) AO, use base flood depth) 9/3/03 9/3/03 AE 11.0' 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. 0 FIS Profile IS] FIRM 0 Community Determined 0 Other (Describe) B11. Indicate elevation datum used for BFE in Item B9: 0 NGVD 1929 _i NAVD 1988 0 Other (Describe) B12. Is the building located In a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes Designation Date 0 CBRS 0 OPA ® No SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 0 Construction Drawings' 0 Building Under Construction' ® Finished Construction "A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones A1 -A30, AE, All, 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 Vertical Datum NAVD 1988 Conversion/Comments a) b) c) d) e) f} 9) h) Top of bottom floor (including basement, crawlspace, or enclosure floor) jj.Q N.6 Nil 7.Q 11.0 Top of the next higher floor Bottom of the lowest horizontal structural member (V Zones only) Attached garage (top of slab) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) Lowest adjacent (finished) grade next to building (LAG) Highest adjacent (finished) grade next to building (HAG) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support Check the measurement used. ® feet 0 meters (Puerto Rico only) ® feet 0 meters (Puerto Rico only) El feet ❑ meters (Puerto Rico only) ® feet 0 meters (Puerto Rico only) ® feet 0 meters (Puerto Rico only) 7.2 IBI feet 0 meters (Puerto Rico only) 6.7 ® feet ❑ meters (Puerto Rico only) N.9 ® feet ❑ 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. I certify that the information on this Certificate represents my best efforts to interpret the data available.) understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.0 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 Certifiers Name Edward D. Murphy License Number 5333 Title Professional Land Surveyor Company Name Murphys Land Surveying, Inc. Address 5750 11m Avenue N. City St. Petersburg Signature FEMA Form 81-31, Mar 09 State FL ZIP Code 33710 Date 12/29/10 Telephone 727/347-8740 See reverse side for continuation. • rr FFA L tit lV Jr�r�rrtltttele`\ Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. w Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 672 t•rarbor Island City Clearwater 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 C2e = A/C Signature SECTION E - BUILDING ELEV Date 12/29/10 0 Check here if attachments N INF • - ; TION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete I s 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 ailable. Ch k the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the f lowing and chec the appropriate boxes to show whether the elevation Is above or below the highest adjacent grade (HAG) and the lowest adjacen grade (LAG). a) Top of bottom floor (including bas ment, crawlspa :, or enclosure) is 0 feet 0 meters 0 above or 0 below the HAG. b) Top of bottom floor (including base s.ace, or enclosure) Is 0 feet 0 meters 0 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 0 feet 0 meters 0 above or 0 below the HAG. E3. Attached garage (top of slab) is 0 feet 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet 0 meters 0 above or 0 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? 0 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, 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 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. Gi. 0 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.) 02. 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. 04. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been Issued for: G8. Elevation of as -built lowest floor (including G9. BFE or (in Zone AO) depth of flooding G10. Community's design flood elevation 0 New Construction 0 Substantial Improvement basement) of the building: 0 feet 0 meters (PR) Datum at the building site: 0 feet 0 meters (PR) Datum 0 feet 0 meters (PR) Datum Local Official's Name Title . Community Name Telephone Signature Date Comments 0 Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions 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. 672 Harbor Island Policy Number City Clearwater State FL ZIP Code 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 View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. DATE: 12/29/10 FRONT VIEW: REAR VIEW: (PORTANT: n these spaces, copy the corresponding information from Section A. Building Street Address 672 Harbor Island uding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. City Clearwater 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 C2e = A/C Signature Date 12/29/10 ❑ Check here if attachments SECTION E - BUILDING ELEV +N INF • - ATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete It s 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 vailable. Ch the measurement used. In Puerto Rico only, enter meters. El, Provide elevation Information for the f owing and cher the appropriate boxes to show whether the elevation Is above or below the highest adjacent grade (HAG) and the lowest adjacen grade (LAG). a) Top of bottom floor (including bas ment, crawlspa ., or enclosure) Is 0 feet 0 meters ❑ above or 0 below the HAG. b) Top of bottom floor (including base ,_crawls ace, or enclosure) is 0 feet 0 meters 0 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 ❑ feet 0 meters 0 above or 0 below the HAG. E3. Attached garage (top of slab) is 0 feet 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is 0 feet 0 meters 0 above or 0 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, 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 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. 0 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. 03. 0 The following information (Items G4 -G9) is provided for community floodplain management purposes. 04. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compllance/Occupancy Issued 07, This permit has been issued for: 0 New Construction 0 Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building; 0 feet 0 meters (PR) Datum 0 feet 0 meters (PR) Datum 0 feet 0 meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: G10. Community's design flood elevation Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions 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. 672 Harbor Island Policy Number City Clearwater State FL ZIP Code 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 View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. DATE: 12/29/10 FRONT VIEW: REAR VIEW: U.S.�EPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB NO. 1660-0008 Federal Emergency Management Agency Expires March 31,2012 Nationai Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION ;'" "'� �;;��,��g�4�,�,�� A1. Building Owner's Name David Peters&Jenee Peters � x s � ; � s� �.; ,> � ».,,�, s..:,,�. . �... A2. Building Street Address(including Apt., Unit,Suite,andlor Bldg. No.)or P.O.Route and Box No. ' "" "� ° n< -�° 672 Harbor Island - �� `° �.`. �..;< .r� . �. .... ...:.... . City Clearwater State FL ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Lot 87,Units 6D,7A,7C ISLAND ESTATES OF CLEARWATER A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential A5. Latitude/Longitude:Lat.27d 59'21.19"N. Long.82d 49'00.60"W. 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 1B 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) NA sq ft a) Square footage of attached garage IVA 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 NA within 1.0 foot above adjacent grade NA c) Total net area of flood openings in AB.b NA sq in c) Total net area of flood openings in A9.b NA 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.County Name B3.State Clearwater 125096 Pinellas Florida 64.Map/Panel Number 65.SufFix B6.FIRM Index B7.FIRM Panel 68.Flood 69.Base Flood Elevation(s)(Zone 12103C 0102 G Date Effective/Revised Date Zone(s) AO,use base flood depth) 9/3/03 9/3/03 AE 11.0' 610. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑ FIS Profile � FIRM ❑ Community Determined ❑ Other(Describe) B11. Indicate elevation datum used for BFE in Item 69: ❑NGVD 1929 � NAVD 1988 ❑ Other(Describe) 612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes � No Designation Date ❑ 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 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 Citv of Clearvuater Vertical Datum NAVD 1988 Conversion/Comments Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor)11.0 �feet ❑meters(Puerto Rico only) b) Top of the next higher floor IV.A �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) 7.0 �feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building N.A �feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) fl Lowest adjacent(finished)grade next to building(LAG) N.A �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) IV.A �feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including N.A �feet ❑meters(Puerto Riw 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. I certify that the information on this Certificate represents my best efforts to inte�pret the data available.l understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.❑ ��ri►r�,�, Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a .�;s�4 r.� �f� licensed land surveyor? � Yes ❑ No �°`'�.�:�r . ` ��'"r ,�ti,�,,,� , ��o .r .• Certifier's Name Edward D.Murphy License Number 5333 � �, � .,� y Title Professional Land Surveyor Company Name Murphy's Land Surveying, Inc. _',��T ,'�"`n�Qf . � � � ° - : ;-a` Address 5750 11 Avenue N. City St.Petersburg State FL ZIP Code 33710 ^�'.�'..� � ' ''`� ' �i'�i;"�ti(�E�1�7%';ti^�``•. Signature Date 8l20/10 Telephone 727/347-8740 `•,�f!`��1kk��✓�'�b��° � €r�:��. FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions IMP,ORTANT: In these spaces,copy the corresponding information from Section A. �� '��"��r�i��=��y Building Street Address(including Apt.;Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. �� ,.��`�� 672 Harbor Island �� ' '�g�e�i.��a,>�,•�'i��a .:�'�: 3� �:., City Clearwater State FL ZIP Code 33767 � �� . . a��,�,�k�... 3°is;,n r,�;�� . SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)building owner. Comments Signature Date 8/20/10 ❑ Check here if attachments SECTION E-BUILDING ELEVATI NFOR tON (SURVEY NOT REQUIRED)FOR ZONE AO AND 20NE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Item 1-E5. If t 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 av lable. Check th measurement used. In Puerto Rico only,enter meters. E1. Provide elevation information for the followi g and check the propriate 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,c wlspace,or closure)is ❑feet ❑meters ❑above or 0 below the HAG. b)Top of bottom floor(including basement,craw s ,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 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 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�ections 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 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. ❑ 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/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 ff attachments FEMA Form 81-31, Mar 09 Replaces all previous editions � , . Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(induding Apt,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Poucy Number 672 Harbor Island Clty Cleannater State FL ZIP Code 33767 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least finro building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front Viev�' and "Rear Viev�'; and, if required, "Right Side View" and "Left Side Vew." If submitting more photographs than will fit on this page, use the Continuation Page, following. �� .�' »., DATE: 8/17/10 � '�° �• � . . �_. �4. � �� ' . . ' ',i � � � �� s.._ i �} I , 3 • e. +i , J ��g , 7 � s v ."' °"'.�„ -.# .:� ,R��lt I�� i � }� S��"� _ � . �1Nf . �' �1[:�. ree � .� �,,, �,._ � � ��. _ � . �:"!"� .- - _ _ � . � " .,,. ��._ � FRONTVIEW: _ � .� 4�:��l ,.��._ _ �-� - . , _ _ , _ .. _ . -_ . m-_� _ e ,-_ � - - � _- -�-- ,:� _ . ,. _ _ ,,. ` ., , �_,_.,_,. _ �_ �r; ;; , ;, .,.;. . � . y.. �� .� ��` � -� - - __ � � __°___ a..il '� . .. . t �++Y,�!��':,w= �~ Y � . /�, i � . ! C- :� . eL �� ' yyp['.:_ � i .. � �a - � . � REAR VIEW: ' � . � . _ --�-t----- r : r�� ,. ; .;ie , . . �� e � �_� I� �,tiri � � , .�...� �} �.� ...-. ;.. < . — - --- ..,.:. �_ _._.�,�..a.��.ir„°"�.__ . ._ . -:,.� ;,� � �,� � ��, � -�i ~'�� .,�. � � —�y.r - - '�,'� � ^_" i, � � �. ,.v �„..^ _ '�4-'+�.� t _ . �:.> ��. � ' . -- . .. . . . 4 K � �'�.T ��SYC` ��L. .-. .. :. �+ � ��. A�^`. .. °aV°'..N'- .a� . .�.�.,: ?� y �'4 ✓f'�. : 4'�� .. -� . - i�.. � '~�' ��i��J t �{.y*r# y.A '1 .�. . . . . ' � ..... . ._ � . _ . .. e. ....'s^.. .. ._. . ...'.3y• �� ....� U�°..�EPA�tTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Fed�ral Emergency Management Agency Expires March 31,2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION �` ��"� q r� ��,;�, A1. Building Owner's Name David Peters&Jenee Peters A2. Building Street Address(including Apt.,Unit,Suite,andlor Bldg.No.)or P.O.Route and Box No. 672 Harbor Island p �,y �� ,h City Ciearwater State FL ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Lot 87,UNITS 6D,7A,7C ISLAND ESTATES OF CLEARWATER A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential A5. Latitude/Longitude:Lat.27d 59'21.19"N. Long.82d 49'00.60"W. 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. Buitding Diagram Number 16 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) NA sq ft a) Square footage of attached garage 869.5 sq ft b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage enctosure(s)within 1.0 foot above adjacent grade IVA within 1.0 foot above adjacent grade 8 c) Total net area of flood openings in A8.b NA sq in c) Total net area of flood openings in A9.b 1244.2 sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 61.NFIP Community Name&Community Number 62.County Name B3.State Clearwater 125096 Pinellas Florida B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone 12103C 0102 G Date Effective/Revised Date Zone(s) AO,use base flood depth) 9/3/03 9/3/03 AE 11.0' B10. 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 69: ❑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 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 Citv of Clearvvater Vertical Datum NAVD 1988 Conversion/Comments Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor)11.0 �feet ❑meters(Puerto Rico only) b) Top of the next higher floor N.A �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) 7.0 �feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 11.0 �feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) fl Lowest adjacent(finished)grade next to building(LAG) 7.0 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 6.7 �feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including N.A �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 efforts to interpret the data available.l understand 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 �� ttt�f� licensed land surveyor? � Yes ❑ No e� �'` f�� ' ; �i�` , Certifier's Name Edward D.Murphy License Number 5333 ' v ,•' . ��:-, . •�-, Title Professional Land Surveyor Company Name Murphy's Land Surveying,Inc. � � � t;�,[�r,.��; . Address 5750 11 Avenue N. City St.Petersburg State FL ZIP Code 33710 �1`-��: �7�'��w `�' ' � , �. . ,� � Signature _ Date 12/29/10 Tele hone 727/347-8740 �;' �'��R 1�`-'��-�° p .;t� ... ,�� `w� � ',r��f Y, `,�b FEMA Form 81-31, Mar 09 � See reverse side for continuation. Replaces all previous editions - --.� __ ,�� • � I l� � , ^ � � \ ��--� � , _ _ U.S.DEP„��,MENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Fedural E?�f€igency Management Agency Expires March 31,2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION "�" ""' ��: �a� A1. Building Owner's Name David Peters&Jenee Peters v; ` �.s.�� A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. `��_ 672 Harbor Island � City Clearwater State FL ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Lot 87,UNITS 6D,7A,7C ISLAND ESTATES OF CLEARWATER A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential A5. Latitude/Longitude:Lat.27d 59'21.19"N. Long.82d 49'00.60"W. 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 16 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) NA sq ft a) Square footage of attached garage 869.5 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 NA within 1.0 foot above adjacent grade 8 c) Total net area of flood openings in A8.b NA sq in c) Total net area of flood openings in A9.b 1244.2 sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Communiry Name&Community Number 62.Counry Name B3.State Clearwater 125096 Pinellas Florida 64.Map/Panel Number B5.Suffix 66.FIRM Index B7.FIRM Panel 68.Flood B9.Base Flood Elevation(s)(Zone 12103C 0102 G Date Effective/Revised Date Zone(s) AO,use base flood depth) 9/3/03 9/3/03 AE 11.0' 810. 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) 611. Indicate elevation datum used for BFE in Item B9: ❑NGVD 1929 � NAVD 1988 ❑ Other(Describe) 612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Othervvise 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 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 befow according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized City of Clearwater Vertical Datum NAVD 1988 Conversion/Comments Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor)11.4 �feet ❑meters(Puerto Rico only) b) Top of the next higher floor N.A �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) 7.0 �feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 11.0 �feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) fl Lowest adjacent(finished)grade next to building(LAG) 7.0 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 6.7 �feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including IV.A �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. I certify that the information on this Certificate represents my best efforts to interpret the data available.l understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.❑ `�� i�� Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a �ti�.'',�. . � �'�i, •.�p� licensed land surve or? �� `` " ' -°` Y � Yes ❑ No ,,.. �, �.� / Certifier's Name Edward D.Murphy License Number 5333 '°�� . �-��_.. Title Professional Land Surveyor Company Name Murphy's Land Surveying,Inc. �. � .� 4' -, l,��;r' C � Address 5750 11 Avenue N. City St.Petersburg State FL ZIP Code 33710 ''." � •� r1✓ : � '-' '..1Q��'r•'`�,�p\,�` Signature . Date 12/29/10 Telephone 727/347-8740 ��j��,��'�� ; � tt: FEMA Form 81-31, Mar 09 � See reverse side for continuation. Replaces all previous editions IMPQRTANT: In these s aces co the corres ondin information from Section A. �� " � ` ' � p � pY P 9 �. : � ' ��"�,Jt��'.��:�� Building Str�et Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. � � � 672 H�arbor Island �? >a ,.. ,: . .. , .. a��,�,,� City Clearwater State FL ZIP Code 33767 � a�nnm`': x A.Z:.�� 4y\^ �'s SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)building owner. Comments C2e=A/C Signature Date 12/29/10 ❑ Check here if attachments SECTION E-BUILDING ELEV N INF ATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete It s 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 vailable. Ch k the measurement used. In Puerto Rico only,enter meters. E1. Provide elevation information for the f lowing and chec the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacen grade(LAG). a)Top of bottom floor(including bas ment,crawlspa ,or enclosure)is ❑feet ❑meters ❑above or�below the HAG. b)Top of bottom floor(including base ,.�[awls ace,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 the building is ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of siab)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 o�cial must certiry 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 tor 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 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.❑ 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/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 FEMA Form 81-31, Mar 09 Replaces all previous editions � . . . � I Building Photographs See Instructions for Item A6. For Insurance Company Use: Building StreetAddress(including Apt,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Poiicy Numbe� 672 Harbor Island Clty Clearwater State F� ZIP Code 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 Viev►r' 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. =•� '��'r"'r ' `�,-, k �`-----_ DATE: 12/29/10 r: � �;.� _�_ __ _ ., . ��`�,�'z S y�„`S..'�3'"^ t �:J y�iAt� .': .. .... _ -,.. �.. �.ti.� ... h� �� ` 4 w � �' , �c„� . .---- � . �i �"'`'x' ; .. 4n. �. r . .?�.-�-,-...... .. .�; ., . y� �, '-� ... � ��KF .. - � 2 �r.�t v. � y't � �� - .� � �f ..... � - �� r � � ; ... �'1°' r -.. — �.- ,. �a � � ,�� -. �� ,�, ` �� I :'.. !''_ --------— ' ..: -=1 - �:. . .�- a�` _ - FRONT VIEW: ��. . �.� �y . ;�� ,� _��" _ ��7 . .�.' a'..�'.+e`Nl.'�.'' ' . . � �pi�q.-,..� . . . � . �^'"'.y�riw�,:.... . . `� . � . `�� dd F �!F�+ '�q,' "a'+t�� w�+ �:` -_. - `-y, .� � . � - � � ,- m � '4 �,��PU ,� , ,,. , '�+. ,��,q . '� y "y� "'"' �`" �� 'r�^��`.' � '� � � v v' �'�. 4 ^ " w , , '_ - � �- . � ,r .. »�.r�,:� . "1 � a* e �-. . .....� .��.• . i' �r � � _ °I � I , ..... .. � � 1. �.�+.� . .�.-g .[V �' �,.....o""' �._ . REAR VIEW: �' '£��ai � Yy 4ai � �y .�: �� ,� . �.� P �� Ir r. :� -�R�y�.�or✓�.; ,� ..� � _ ' ` k �. 4� � M "" - y.. 4 ; ��q' � �� ,� � _ , . . :::. -'�:, t�� ..sgai�� . . �_ : , .�:, • . , . ' . . �� .: ...;"+�- _ ., . ,. ,. . � �- ::� -°� � � .. w »,y.,,, �. . � ''+��54!kAt��9'""� R 1 ._ y r��, . � .:rti '��+%1` � i ., _ +.. . . _ __ , .:'h—. IIyIPORTANT: In these spaces,copy the corresponding information from Section A. ��f�_ � ''��r�$�� _. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. �3 672 hrarbor Island ` ' �€„n,, „�� .x,b�-,.�..�.a; City Clearwater State FL ZIP Code 33767 �� _ ��,��,,.,;��, _�,;�,, �., .-a��? 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 C2e=A/C Signature Date 12/29/10 ❑ Check here if attachments SECTION E-BUILDING ELEV N INF ATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete It s 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 vailable. Ch k the measurement used. In Puerto Rico only,enter meters. E1. Provide eievation information for the f lowing and chec the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacen grade(LAG). a)Top of bottom floor(including bas ment,crawlspa ,or enclosure)is ❑feet ❑meters ❑above or❑below the HAG. b)Top of bottom floor(inciuding base ,.r,r.awJs ace,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 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 local o�cial must certify this information 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,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 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.❑ A community official completed Section E for a buiiding 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/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 FEMA Form 81-31, Mar 09 Replaces all previous editions ., . , Building Photographs See Instructions for Item A6. For insurance Company Use: Building Street Address(including Apt,Uni�Suite,and/or Bldg. No.)or P.O.Route and Box No. Poi�cy N�mner 672 Harbor Island Clty Clearwater StBte FL ZIP COde 33767 Company NAIC Number 1f 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. .. �.,�e,�fi�— � y v .._�� a �k s' DATE: 12/29/10 �� _______ Y �,� � '�-� :^r 4 4,k' �:�� _'a.� �-, � � p �.. .#x3,y �._._ � �� ,. — '�" ..�;� �.1 � ..� � �.... i°. .� � � �� ,.� - �:.{ �`�a h � � . V.�:r �'�� A �'�° `.,_ r ..;»,sk, , ' �� '"v �_ �� °',-'��E;u- r__. ,_ �� ,„. ,�,-�•:��.��;:.. �... _ �� .-� - FRONT VIEW: ^�'° - ' _ � .�r�w�� `7``� �rw � `_. „� �.�, �+,� `�`. \ ; �,��Y� �. �": � i �� ;� � � .� r _ ,. . ; . ,. � � _' r� �` �. � x ��«�- �� a . w, �, _ >, � T� r„� �v �_� ... .. _��:�"` F - ; _. � . ..— �-�" � � _,�,,�,� � ��,,,� """'— ts I .�..�..-+-�" ;� �- : �9 REAR VIEW: , t �` ' j: a3�a:��:J� �� 'o�, # + ; j �s� ` ,r,,, �l �� [1 ..�r��-Y*-rtrwrs�c+i,4� r� ' e � . . �� ,� �_,� - " � � ' ��°�?TM"�' .�.�: �s � --�:4;.,=`- W: �:_.� ' ,i � ' �� :--.,. . r __ � `.� � a�-; '"".....+�,,,� . X_ � R . -_ a i � � < - "'e-- - - - - � " �':-�=,�