815 HOWARD ST � U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
Federal ErYiergency Management Agency Expires 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 Owner's Name HABITAT FOR HUMANITY OF PINELLAS COUNTY Policy Number
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number
815 HOWARD STREET
City CLEARWATER State FL ZIP Code 33756 -
A3. Property Description (Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) 815 H OWA R D S T
LOTS 6,7 8�8,BLOCK J OF 2ND ADDITION TO BELMONT(22-29-15-07938-010-0060) BCPZOOH-11164 -
A4. Building Use(e.g., Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL
A5. Latitude/Longftude:Lat.N 27. ° Long.W 2.8 7945�' Horizontal Datum: ❑NAD 1927 � NAD 1983
A6. Attach at least 2 photographs of the building if the Cert'rficate is being used to obtain flood insurance.
A7. Building Diagram Number 1
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) IVA sq ft a) Square footage of attached garage 363.5 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 NA walls within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b NA sq in c) Total net area of flood openings in A9.b Q sq in
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
61.NFIP Community Name&Community Number B2.County Name 83.State
CITY OF CLEARWATER 125096 PINELLAS FL
64.Map/Panel Number 65.Suffix 66.FIRM Index 67.FIRM Panel BS.Flood 69.Base Flood Elevation(s)(Zone
Date Effective/Revised Date Zone(s) AO,use base flood depth)
12103C-0108 H 5-17-2005 5-17-2005 X N/A
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)
811. 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 Othervvise Protected Area(OPA)? ❑Yes �No
Designation Date N/A ❑CBRS ❑OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REGIUIRED)
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,V7-V30,V(with BFE),AR,AR/A,AR/AE,AR/Ai-A30,AR/AH,AR/AO. Complete Items C2.a-g
below according to the building diagram specified in Item A7. ;�'�""��I
Benchmark Utilized CLEARWATER B.M.B-06 Vertical Datum NAVD 88 f�TC1 �-� =� �
Conversion/Comments WA n m
Check the measurement used. �Q ` �
a) To p of bottom floor(includin g basement,crawl s pace,or enclosure Hoor)_ 55.�8 �feet ❑meters(Puerto Rico only) C7 � � ��
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b) Top of the next higher floor N.A �feet ❑meters(Puerto Rico only) � .,� � b ---.,k
c) Bottom of the lowest horizontal structural member V Zones onl N.A �feet ❑meters(Puerto Rico onl � �€�r;
( Y) Y) , t/; co � .�._,-�
d) Attached garage(top of slab) �.09 �feet ❑meters(Puerto Rico only) � � N `�
,..--��
e) Lowest elevation of machinery or equipment servicing the building N.A �feet ❑meters(Puerto Rico only) D � $ ���
(Describe rype of equipment in Comments) -i rTy �� t
f) Lowest adjacent(finished)grade(LAG) �4.� �feet ❑meters(Puerto Rico only) ��/3 ��U
g) Highest adjacent(finished)grade(HAG) �4.�7 �feet ❑meters(Puerto Rico only) � r-------.-�--
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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 certrfy elevation
infortnation. I certily that the infom►ation on this Cerdficate represents my best efforts to interpret the data available.
1 understand that any false statement may be punishable by fine or imprisonmeni under 18 U.S.Code,Section 1001.
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� Check here if comments are provided on back of form. �,,�-, ..
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Certifier's Name GEORGE A.SHIMP III Job No. 080184-C License Number 6137 . �.,�y��t��' "��` � .�`
<:c � ;:3dt7. �1:�7� :,.r
Title VICE PRESIDENT Company Name GEORGE A.SHIMP II&ASSOCIATES,INC. � �' „� �,� �3��`.�}.�~
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Address 3301 DESOTO BLVD.,SUITE D City PALM HARBOR State FL ZIP Code 34683 � �, . (�����. "� ' �`
ture �,_,,, Date 1-28-2009 Telephone 727-784-5496 ������!� ��
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FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previo�s editions
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 �
815 HOWARD STREET ' ,
City CLEARWATER State FL ZIP Code 33756 Company NAIC Number
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 C2.e)AIR CONDITIONER HAS NOT BEEN INSTALLED
�9 �
Sig 'ature Date 1-28-2009
� Check here'rf attachments
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT RE�UIRED)FOR 20NE AO AND 20NE 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 oniy,enter meters.
E1. Provide elevation information for the foilowing 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 Inst�uctions),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 0 below the HAG.
E5. Zone AO only: If no fiood 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 REPRESENTATIV�CERTIFICATION
The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE)
or Zone AO must sign here. The statements in Sections A,8,and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local offiaal who is authonzed 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 Certficate. 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 communit}r floodplain management purposes.
G4.Permit Number G5. Date Permit Issued G6. Date Cert'rficate 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 Official's Name Title
Community Name Telephone
Signature Date
Comments
❑Check here if attachments
FEMA Form 81-31, February 2006 Replaces all previous editions
i
� Building Photographs
� � Continuation Page I
For Insurance Company Use:
Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number
815 HOWARD STREET
City CLEARWATER State FL ZIP Code 33756 CompanyNAlCNtmber
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."
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REAR VIEW
PICTURE TAKEN ON 1-28-2009
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
815 HOWARD STREET
City CLEARWATER State FL ZIP Code 33756 CompanyNAlCN�nber
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.
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