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377 MANDALAY AVE; STICKERED FOR 385 MANDALAY AVEU..i. DEPARTMENT OF HOMElANO SECUF2ITY ELEVATI4N CERTIFICATE OMB NO. 1660-000$ Federai Emergency Management Agency Expires March 31, 2012 National Flaod lnsurance Program Important: Read the instructions an pages 1-9. SECTION A- PR{JPER7Y INFG►f2MATiOIV For tnsurat�ce Company Use: A1. Building Owner's Name 387-391 Mandalay Ave LLC rPblicy Nutttber : A2. Bui#ding Street Address (including Apt., Unit, Suite, and(or Bldg. No.) or P.O. Route and Box Na Comp�ny NAtC Number 377 Mandalay Ave City Ciearwaier State FI ZIP Code 33767 A3. Praperty Descripkioo (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) P i N: 08-29-15-02592-001-0260 A4. Building Use (e.g., Residential, Nan-Residential, Addition, Accessory, etc.} Non-Residental A5. Latitutle/Longitude: Lak, 27° 35' 12.156"N Long. Q82° 29' 48.572"W Horizontal Qatum: ❑ NAD 1927 � NAD 1983 A6. Attach at ieast 2 photographs of the building if the Certificate is being used io abtain flood insurance. A7. Building Diagram Number 1B A8. For a building wilh a crawispace or enclos�re(s): A9. For a building with an attached garage: aj Squa�e footage of crawispace or enclosure(s) tdlA sq ft a) 5quare footage of attached garage 516 sq ft bj No. of permanent flood openings in the crawispace or b} No. of permanent flood apenings in the attached garege enclosure(s) within 1.0 foot above adjacent grade N1A within 1.0 foot above adjacent grade N/A c) Totat net area oP flaod openings in AB.b NiA sq in c) Total net area of flood apenings in A9.b N/A sq in d} Engineered tiood openings? ❑ Yes � No d} Engineered flood apenings? ❑ Yes � No SECTION B- FLOOD INSURANCE RATE MAP {FIRMj INFORMATION 81. NFIP Cammunity Name & Cammunity Number B2. County Name 83. State Clearwater, City of 125p96 Pinellas Florida B4. MaplPanel Number 85. Suffix 86. FIRM Index 87. FIRM Panei B8. Flood B9. 8ase Flood Elevation(s) (Zone i21d3C0102 G Date EffectivelRevised Date Zone(sj AO, use base flaod depth) OSli8l2009 09(43/2003 AE 12 feet Bid. Indicate the source af the Base Flood Elevation (BFE) data or base flood depih entered in Item BB. ❑ FIS Profile � FIRM ❑ Cammuniry Determined ❑ Other (Describe} N/A B11. indieake efeuation datum used for BFE in Item 89: ❑ NGVD 1929 � NAVD 1988 ❑ Other {Describe) N1A 812. Is the building located in a Goastal Barrier Resources System {CBRS) area or Othervvise Protected Area (OPA}? ❑ Yes � No Designation Date N!A ❑ CBRS ❑ OPA SEGTIQN �- BUI�DING ELEVATION INFORMATION (SURVEY REQUIRED) C1. 6uiiding elevations are based on: ❑ Constructian Orawings' ❑ Building Under Construction' � Finished Construction *A new Elevation Certificate wili be required when consUuctio� of ihe 6uiiding is complete. C2. Elevalions - Zanes A1-A30, AE, AH, A(with BFEj, VE, V1-V30, V(with BFE}, AR, AR/A, AR/AE, AWA1-A30, ARiAH, AR/AO. Complete Items C2.a-h belaw according to the building diagram specified in item A�. Use the same datum as the BFE. Benchmarlc lltilized Gity of Clearvuater G-03 Vertical Datum NAVD 88 ConversioNGomments Elevation = 4.75 Feet. NAVD 1988 Check the measurement used. aj Top of bottom floar {including basement, crawlspace, or enclosure floor) 6.38 � feet ❑ meters {Puetio Rica oniy) b) Top oF the next higher floor 19.05 � feet ❑ rneters (Puerto Rico anly) c) Bottom of the lowest hori2ontal structural member (V Zones only) NIA. ❑ feet ❑ meters (Puerto Rico only) d) Attachad garage (top of slab) 5.33 � feet ❑ meters (Puerto Rico only} e) Lowest elevation ofi machinery or equipment servicing the building 1.38 � feet ❑ meters (Puerto Rico only} (Describe type of equipment and iocatian in Comments) f) Lowest adjace�t jfinished) grade next to building (LAG) 5.0 � feet ❑ mete�s (Puerto Rico oniy) gj Highest adjace�t (finished) grade next to building (HAG) 5.4 � feet ❑ meters (Pueria Rico aniy) h) l.awest adjacent grade at lowest elevation of deck or stairs, including 4.9 � feet ❑ meters (Puefto Rico only) structurai 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 elevetion information. ! cerfify lhat the information an ttris Certiticate represents my best efforts to interpret the data availabieJ undersiand that any fatse statement may be punishabte by fine ar imprisonment under 18 U.S. Cade, Seotior7 100i.� Check here if comments are provided on back of farm. Were latitude and longitude in Section A provided by a ��-�3 � licensed land surveyor? � Yes ❑ No +��r�_,,�-,,--�"* �.,M�a;,,.^., ni.,..,� rcoov n �cor_� �enn� �:.....,..,, ni.....M... i e.u�coc �.1'a �-��'f..t Titte Professional Survayor and Mapper Company Name COMPASS POINT SURVEYORS, Pl Address 806 FrankBn Strest City GI.EARWATER State FL FEMA Form 81-31. Mar Date 05f2A12012 Telephone 727-230-9606 See reverse side for continuation. � � Replaces all previous editions IMPORTANT: In these spaces, copy the carrespanding infarmation from Section A. For insurance Campany Use: Buiidin� Street Address (including Api., Unit, Suike, andlor Bldg. No.} or P,O. Route and 8ox No. Policy Nutn6er 377 Mandalay Ave City ClearwaterSiate FL ZfP Code 33767 Gomparry NA1C Number� SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATIOM1I (CONTINUEDj Copy both sides of this Elevatio� Certificate for (1} communiry o(ficial, (2) insurance agenUcompany, and (3) building owner. Comme�ts A9.a) Adached enclosed dumpster area. C2.d} Attached enclosed dumpster area. C2.e) bottom of elevator shafL Fieid date: 05/23112 shawing substanially finished canstruction Signature Date Q5/24l1� � Check here ii attachments SECTION E- BUILDING ELEVATtCEN INFORMA710N (SURVEY NOT REQUIRED) FOi2 ZC1NE AO AND ZQNE A{WITHOUT BFE) For Zones AO and A(without BFE), complete Ikems E1-E5. If the Certificate is intended to suppart a LOMA or LOMR-F request, complete 5ections A, B, and C. For Items E1-E4, use natural grade, if availabie. Check the measurement used. In Puerto Rico oniy, enter meters. E1. Provide eleva#ion inforrnation for the follawing and check ihe appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG} and the lowest adjacent grade {LAG). aj Top of bottom floor {including basement, crawispace, or enclosure) is ❑ feet ❑ mekers ❑ above or 0 belaw the HAG. b} Top of bottom floor (inciuding basement, crawlspace, or enciosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permane�t flood openings p�ovided in Seckion A Items 8 and/or 9(see pages 8-9 of Instructions), the next higher floor {elevation G2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of siabj is ❑ feet ❑ meters ❑ above or ❑ below the NAG. E4, Top of platfarm af machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or 0 below the HAG. E5. Zone AO only: If no flood depth numtaer is availabie, is the top of the bottom floor elevated in accnrdance with the community's floadplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local o�ciai must certify this information in Section G. SECTION F- PFtOPERTY t?WNER (OR OWNER'S REPRESENTATIVE) CERTIFICATIDN The property owner or owner's authatized representative who completes Sections A, B, and E for Zone A(withoui a FEMA-issued or community-issued BFE) or 2one 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 Signature Comments Gity Date State ZIP Code Telephone ❑ Check here if attachments SECTION G - COMMUNITY INFORMATIQN (OPTlONAL) The local o�ciai who is authorized by law or ordinance to administer the community's floodpiain management ordinance can complete Sections A, B, G{or Ej, and G af this Eleuaiion Certificate. Complete the applicable item{s) and sign below. Check the measurement used in Ikems G8 and �9. G'1. ❑ The inFormation in Section C was taken from other documentation thai has been signed and sealed by a licensed surveyor, engineer, or architect wha is authorized by law to certity elevation infa�mation. (Indicate the source and date of the e�evation data in the Commenis area below.} G2. � A community official campleted Section E for a building locaked in Zone A(without a FEMA-issued or community-issued BFE) or Zone AO. G3. � The following infarmation (Items G4-G9} is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate OP ComplianceJOccupancy Issued G7. This permit has been issued for. ❑ New ConsUuction ❑ Substantial Improvement GS. Elevation of as-built lowest Floor (inciuding basement) ot the buiiding: ❑ feet ❑ meters {PR) Datum G9. BFE ar (in Zone AO} depih of ilooding at the buiiding site: ❑ feet ❑ meters {PR) Oatum G10. Gommunity's design flood elevation ❑ feet ❑ meters (PR) Datum Locai O�ciafs Name Cammunity Name Signature Comments Title Telephone Date ❑ Check here if atiachments FEMA Fo�m 81-31, Mar 09 Repiaces all previous edifions �uilding Photographs See Instructions for Item A6. Building Sireet Adciress (including Apt., Unit, Suite, and/or Bldg. No.) ar P.O. Route and Box No. 377 Mandalay Ave City Clearwater State FL ZIP Code 33767 For Insurance Company If usiny the Elevation Certificate ta obtain NFIP flood insurance, affix ak least twa building photagraphs 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 "l.eft Side View." If submitting mare photographs than will fit on this page, use the Continuation Page, fo{lowing. "Frant Uiew" of building looking east an 05f23/2012 � � •� �s-a��. � ��4 �> � � � i ;° . . � �`�'� �'°< y �_ �� .n �� -� , �a:� v �.. �� ...._ "Right Side View" of building laoking north on 05/23/2Q12 ') �� .�� .,�.� y ., _a,'rd."•. . a .�r� w _..�,__. � v9G �i � � „4 �" � �' ��u � , ' �. ,- I �^ �" �� s, �� »_ �� t��,,, � �� . ;.. � _� � � k � . �� r� � � � � � � � U�.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federar Emergency ManagementAgency Expires March 31, 2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION For Ir�surance Company Use: A1. Building Owner's Name 387-391 Mandalay Ave LLC Policy Number A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number 377 Mandalay Ave City Clearwater State FI ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) PIN:08-29-15-02592-001-0260 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Non-Residental A5. Latitude/Longitude: Lat.27°35'12.156"N Long.082°29'46.572"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) N/A sq ft a) Square footage of attached garage 516 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 N/A within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A 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 B2.County Name B3.State Clearwater,City of 125096 Pinellas Florida B4. Map/Panel Number B5.Suffix 66. FIRM Index B7. FIRM Panel B8. Flood B9.Base Flood Elevation(s)(Zone 12103C0102 G Date Effective/Revised Date Zone(s) AO,use base flood depth) 08/18/2009 09/03/2003 AE 12 feet 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)N/A B11. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 ❑ Other(Describe)N/A 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 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 Clearwater G-03 Vertical Datum NAVD 88 Conversion/Comments Elevation=4.75 Feet.NAVD 1988 Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor)5.38 �feet ❑meters(Puerto Rico only) b) Top of the next higher floor 19.05 �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) 5.33 �feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 1.38 �feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 4.3 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 5.3 �feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including 4.9 �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 ,e r�s s ' understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.� ��`q8e ��`,Df Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ., �i � licensed land surveyor? � Yes ❑ No �,�`�� , :�� ;� � � s ,�•. � Certifier's Name TERRY D. FERGUSON License Number LS#4535 ` ' ��'".',:`�5�5 _.;�� Title Professional Surveyor and Mapper Company Name COMPASS POINT SURVEYORS,PL , �`� : �';q � '�`''-� Address 806 Franklin Street City CLEARWATER State FL ZIP Code 33765 Yl�,�4�.,,'•, ��,.��r•�ti` JJ�,/��•.....• �:'�: Sig T Date 04/11/2012 Telephone 727-230-9606 -, ��u/y�Z��t`a�b�` cL FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions _ � � � � � � � � � � � r �� ;r ts � P�1vFv�{�G&�EVELCs�tiP�P�9T DEP`I' C!iY C?F t�i_�A�Ef�'AT'�R 385 MAN DALAY BCP2011-09261 elevi cert finished const 385 MANDALAY Zoning: Tourist , ' 111APORTANT: 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 377 Mandalay Ave City ClearvvaterState FL 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 A9.a)Attached enclosed dumpster area. C2.d)Attached enclosed dumpster area. C2.e)bottom of elevator shaft. Building was substancially complete on field date of 04/05/2012. Signa , Date 04/11/2012 � Check here if attachments SECTION E-BUILDING EL T 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,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 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 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 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 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 tvumber 377 Mandalay Ave Clty Clearwater StBt@ FL ZIP COde 33767 CompanyNAlCNumber 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. "Front View" of building looking northeast on 04/05/2012 � �. �Ir:6: �, ,`, " `?�� 'R�..- �;.. «� "�` �0� � �.., �� '� �� i�d�..` ` 3�'�` 3 `'"`� '!� ��,`.';. _ � - ,� ,��y.�, ' ,,;�r, n��*� � -�� r,. � '�,., ��' ,-+� "' � � � �� f - }� � �a 4 C ' , �1�,,, 7ip: �a�t�.,�,� 5�n �+1 ,'_�,- � �=f.. �=~ P jy'�y.�r�,�� r"'a' ��'�''«�,'=�� "sa�.�.. ��fi�'i ,;_, _: ,��.�.�,,.;�ar�s:,w, -... .�ya�M�;. .�,. ^�g. �+;;:wi7'ar ' ' ,,,.. .<.,..��,76d'��i� �+ .,:�s��:�i�� . ��'- ,� ,� _ 3 � � Aat, "Left side view" of building looking east on 04/05/2012 , ; . ,,�w '` Z�,iM� .. .., > a ` i , � - � � � ��w '� �� ,�, — �� E;;, �WW�� `<. , f ,p� jc �; � � .: �'��g..."., � .t��`� S �F ,'�� s ,��` �- � � - �. � � ��,�. � ��.i.. .�r� � i��;} � � ��„'% �, Qj ' _,¢ "! ,.i ..�• �$. NG '�4 1 �n �:�� '!g :�;, � ��.�M �0 ,( � � .,..� 3 � ��y�. i a ��._. .. -.. ' '_. �.t y � - ......_r.uw....�+�-....___•� - �_ _,�� 3�1R`J.+� . . O `�.y�,,�.,y . . .. . .. . .. ..... ." > .�:'y��..,"�:E . . ...� ..... ��'�r?C.�li�µ �;� '"� -!1-.yF . • Building Photographs 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 rvumber 377 Mandalay Ave Clty Clearwater State FL ZIP COd2 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." "Right side View"of building looking northwest on 04/05/2012 . ��' �� . � n .� � �a , . , � �. .,x � �b � �� a� � � � .,, .> � _�. � ✓ ` �� ~ 'f � � � • �,c t � � -, - �-� M � ' r > � /� � ; ,�� '��: � , y '� `��w�d, � T� �s �. �� ' F ..��•"""� '� 1� _... 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' --,.....—° � � �,"�" . -< ��►„�a � s M . . . . . . .. .a....► ' U.S.DE,PARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency ManagementAgency Expires March 31,2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION For Insurance Gompany Use: A1. Building Owner's Name 387-391 Mandalay Ave LLC PoliCy Number A2. Building Street Address(including Apt.,Unit,Suite,and/or Bidg.No.)or P.O.Route and Box No. Comp2iny NA1C Number 377 Mandalay Ave City Clearwater State FI ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) PIN:08-29-15-02592-001-0260 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Non-Residental A5. Latitude/Longitude:Lat.27°35'12.156"N Long.082°29'46.572"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) N/A sq ft a) Square footage of attached garage 516 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 N/A within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A 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 B2.County Name B3.State Clearwater,City of 125096 Pinellas Florida B4.Map/Panel Number B5.Su�x B6. FIRM Index 67.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone 12103C0102 G Date Effective/Revised Date Zone(s) AO,use base flood depth) 08/18/2009 09/03/2003 AE 12 feet B10. 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)N/A B11. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 ❑ Other(Describe)N/A 612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes � No Designation Date N/A ❑ 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 Clearwater G-03 Vertical Datum NAVD 88 Conversion/Comments Elevation=4.75 Feet,NAVD 1988 Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor)5.38 �feet ❑meters(Puerto Rico only) b) Top of the next higher floor 19.05 �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) 5.33 �feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 1.38 �feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 4.3 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 5.3 �feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including 4.9 �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.� <��' '�s`'�� Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a <.� ' .� e licensed land surveyor? � Yes ❑ No �� 1`d '. ` w F�:, � v t,�� ' � . Certifier's Name TERRY D.FERGUSON License Number LS#4535 `" ��< .r Title Professional Surveyor and Mapper Company Name COMPASS POINT SURVEYORS,PL • `l~.£ `'� � "� A�C ,'� �i`-�`: Address 806 Franklin Street Cit CLEARWATER State FL ZIP Code 337fi5 ' '�' '' � ,/ A� `s . �C(7� •�.~`�+� Signa � . Date 04/11/2012 Telephone 727-230-9606 � �'�'�� Ur��,� q10,t'e !f �. FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions t c � C� C� � �� h �� _ � r�=':°t� � � y�"�� `� t I l `� � t �� '< . � ��a��r��:��_v��o��,��r��P-r c�;�Y a�'_c,�_�F�� `l� � e M�l. -�-�, � s � 385 MANDALAY q �d ��c�, � BCP2011-09261 1 � t S ` elev csrt finished const �� d�� 385 MANDALAY Zoning: Tourist � � C Atlar � �- � ► � 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 377 Mandalay Ave City ClearwaterState FL 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 A9.a)Attached enclosed dumpster area. C2.d)Attached enclosed dumpster area. C2.e)bottom of elevator shaft. Building was substancially complete on field date of 04/05/2012. Sign e . Date 04/11/2012 � Check here if attachments SECTION E-BUILDING EVAT N 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,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 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 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 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 Street Address(including Apt., Unit,Suite, and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number 377 Mandalay Ave City Clearwater StBte 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. "Front View" of building looking northeast on 04/05/2012 � �� , }I�It:4 a�, �� a�r i a�,� .�...� `�,. � ' '�',� r.. � �� * ;;� '. ��F'; � �± �A�. � ��A�1 '�., `+�� * ��` �� L'�� , ��j ,. ` � � � �a.� u,�.. °��' . � _ — `,�t, �c . . �.�l . .�` , .�. {+ .. �1�_: � ��_� �'� Y��t� � ..,._ `*�, w � x �,;�.� � �r....�tl�rr�n�r r � s#.3:,� � �-;�. . � ' „c .- � >,„:: . .. �, .�:. „ ..,. �_ .. ..,a, � ""``��''��`�vc' "` ur�h�.e�.. ��i�. ,t�',�,r,..-,y�,,,,.,.��. �' z.�� ..3 R}+� T Ak . . ...X . " F.:.'.; `t.� .:...:.. . ...:.�.. ... .., .. . . . . "Left side view" of building looking east on 04/05/2012 � �o. ' �;:•r ,,� �r � , � i l� �,� ,i �-u'� � ��> �; ' s� � . . , x� � y � � �� : ,, . � 'y �a� '�i �� * 4 .��a,r� '� �� I��1�w�,� ;��. � '{ —0 �_ tg � !. # Y� � ��'�� 0 � et 'iq;S -� � t ��;; � �.. _ _��__ _. ��. , �. . _ . ; .. : _ _ �..__ ��...�::�; ��.�� ' Building Photographs 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 rvumber 377 Mandalay Ave Clty Clearvvater StBte FL ZIP COde 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." "Right side View" of building looking northwest on 04/05/2012 �� . - ��; .� � � � �� , � . �, e _� ��- _ '' �. %� �-�� ._ . ° - � i , ��+A'� ' , T � -. , . . .,,,�` : . . ' �� ``r"ap�: �� ` `� . ; , �� - �y ,4� m �";'�y e� 1,.... , � , _ � _ ,., �--_,_ • _--- � � _ �� ` ��. �� i�� i _ . , �. � � a ,r� � ,�..., �` "� I� . � ,,� a. _— ___— . ' . , �* � , i�ii , ,�� " � � �� i!� �� _.. r _ . - �� -� "� �'�' ' �, . �� _�".' � ,,,,.q. . �� iZ� a � �J �� ',� z ' � D'�� " �.,� � !,.;>, 4'. ;�� ; ► �:��.�"«*', �� + � '.. 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