854 ISLAND WAY ._. . . _ .�i �__ . .__ . ......_.
U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB NO. 1660-0008
Federal Emergency Management Agency Expires Februarv 28.2009
National Flood Insurance Program Important: Read the instructions on pages 1-8.
SECTtON A-PROPERTY iNFORMATION For Insura�ce Company Use:
. Building Owner's Name RODNEY L.ANTHONY Policy Number
A2. Buiiding Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Gompany NAIC Number
854 ISLAND WAY
City CLEARAWATER, State FLORIDA ZiP Code 33767
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legaf Description,etc.) ��������a �
LOT 56,UNIT 8,ISLAND ESTATES of CLEARWATER
�
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL
A5. Latitude/Longitude:Lat. 27°59J24' Long. 82°49.224' Horizontal Da1um: ❑NAD 1527 X❑ NAD 1883
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 01
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) N/A sq ft a) Square footage of attached garage 834 sq ft
b) No.of pertnanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage
enclosure(s)walls within 1.0 foot above adjacent grade N/A walls within 1.0 foot above adjacent grade 4
c) Total net area of flood openings in AB.b N!A sq in c) Total net area of flood openings in A9.b 1024 sq in
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name&Community Number B2.County Name B3.State
CLEARWATER ! 125096 PINELLAS FLORIDA
64.Map/Panel Number 65.Suffuc B6.FIRM Index B7.FIRM Panel 68.Flood B9.Base Flood Elevation(s)(Zone
Date Effective/Revised Date Zone(s) AO,use base flood depth)
12103 C 0102 G 5-17-05 9-03-03 AE 12' ,
B10. 4ndicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69.
❑FIS Profile X❑FIRM ❑Community Determined ❑Other(Describe)
B1 t. fndicate elevation datum ased forBFE in Item B9: ❑hIGWD t929 Xa NAVD 1988 ❑Other(Describe)
� Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes X❑No
Designation Date �CBRS 0 OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. Building eievations are based on: ❑Construction Drawings* []Building Under Construction" XD Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Efevations-Zones A1-A30,AE,AH,A(with 8FE),VE,W-V30,V(with BFE),AR,AR/A,RR/AE,ARJA7-A30,AR/AH,AR/AO. Comp(
below according to the building diagram specified in Item A7. . �� �
Benchmark Utilized HARR{S"A" Vertical Datum NGS PUBLISHED EI.EVAT{OP1=7.66'(PIAWD 1988> p Ct
Conversion/Comments (-0.78')NGVD 1929 to NAVD 1988 J11 W ��..
Check the measurement used. � � C,� �
9 �
a) �op of bottom floor(inctuding basement,crawf space,or enclosure floor)_ 12.4 XO feet[]meters(Puerto Rico onlyJ 0 � � �
b) Top of the next higher floor 24.4 X�feet❑meters(Puerto Rico only) � ^, U
c) Bottom of the lowest horizontal structural member(V Zanes anly) NfA. ❑feet ❑meters(Puerto Rico onlyJ �
d) Attached garage(top of slab) 9.4 X❑feet❑meters(Puerto Rico only) � _ »� ��"
e) Lowest elevation of machinery or equipment servicing the building 12.5 X�feet 0 meters(Puerto Rico only) �n � � }
(Describe type of equipment in Comments) t�.=! � !��
� Lowest adjacent(finished)grade(LAG) 8.2 XD feet 0 meters(Puerto Rico only) . � --� � '�
l.0
g) Highest adjacent(finished)grade(HAG) 9.5 XD 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 infonr►ation on this Certificafe reprtssents my best efforts to interpret the data available. ,�r,
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ° '��`�„
X❑ Check here if comments are provided on back of form. �,� °�e."=`�}yi,'���
_�d.,`�
Certifier's Name ,tiy;
Lar L.Evans License Number PLS#2937 �- �
.;c;; � .:
Land Survevor Comoanv Name Evans Land Survevinq Inc � ��i�"��� � ��
Address �^„ �� ��,, .
1460 Beltrees Street Ste.9 Cit Dunedin State FI. ZIP Code 34698 ,r; , °
Signature Date ` �.,��{`s�
�'d "�� Tele hone 727 734-3821 �� >:
FEMA Form 81-31, ebruary 2006 See reverse side for continuation. Replaces all previous editions
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IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use:
Buiiding Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number
854 ISLAND WAY
City CLEARWATER, State FLORIDA ZIP Code 33767 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
Item C2.e): is an exterior A/C compressor.
(.t, (�-v -vj3
Signature Date
X❑ Check here if attachments
SECTION E-BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO and A(without BFE),complete items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B,
and C. For Items E1-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade(HAG)and the lowest adjacent grade(LAG).
a)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑meters ❑above or�below the HAG.
b)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG.
E2. For Buifding Diagrams 6-8 with permanent flood opertings provided in Section A Items 8 andbr 9(see page 8 of Instruc[ions),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 pfatform 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 availab{e,is the top of the bottom ffoor elevated in accordance with the comm�nity's ffoodplain management
ordinance? ❑Yes ❑ No ❑ Unknown. The local official must certify this information in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE)
or Zone AO must sign here. The statements in Sections A,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
..Comhsents':-::__..;.W ?
' . � �
t ❑Check here if attachments
' r` SECTION G -COMMUNITY INFORMATION(OPTIONAL)
j '�he,: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),
��nd G of this Elev�tion C.ertificate. Complete the applicable ftem(s)and sign below. Check the measurement used in Items G8.and G9.
G1.Q The informatibn 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 twithout a FEMA-issued or community-issued BFE)or Zone AO.
G3. [] The following,i�formation(Items G4.-G9.)is provided for community floodplain management purposes.
G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliancel0ccupancy Issued
G7.This permit has been issued for: ❑New Construction ❑Substantial Improvement
G8.Elevation of as-built lowest floor(including basement)of the buildi�g: �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