454 MANDALAY AVE < � +
u.s.DEPARTMENT�F HOMELAND SECUR{TY ELEVATION GERTiFICATE
Federal Emergen"cy Management Agency
t�a�na��vod i�anos�roqr�n Important Read the instructions on pa�1 9. -
�ECTION A-PROPERTY tNFORMATfON ;�t11i�r��iF��
A1. Buitding Ow�rer's Name Devcxir N.Y.Developments,Inc. �'�� �
AZ. Building Street Address{indud'+ng Apt.,Un�,Suibe,and/or Bidg.NoJ or P.O.Route a�d Box No. C�ip(ar�;1�41'�`N�th�� ,
454 Mandalay Avenue
City Cleanwater State FL ZIP Code 337B7
A3. PropertY Oescript+cn(LM and Biodc N�nbers,7�c Paroel IVtxr�ber,Logaf De�on,ebc�.3
Lots 78 and 78 Clearwater Beach Park On Ci�rtirater�la�nd
A4. Building Use(e.g.,Residerrtiai,Non-Residentiai,Add�ion,Ac�ce�orY,eEc.)�!
A5. LatitudelLongitude:Lat.2T.9804g$ Lon9•��.7.� Horixort�Datwn: ❑ NAQ 1827 � NAD 1983
A6. Attach et leasf 2 photograptts afthe bul�d'n�g�the Cerl�be is beir�g t�ad M obtant flood�.
A7. Buiiding Diagram Mumbor �
A8. For a building with a crewlspace or encloswe(s): A9. For a bui�g ai�an atteud�ed garag�e:
a) Squane footage of crawtspace or enci�ure(s) j�19 sQ 1t a) Squars footage o#�9ac�ge 11F8 �i�
bJ No.of pemtanent flood a�enings�the cxs�wispaoe or b) No,of pent�u�er►t flood openi�s in tl�e attad�ed qar�age
enGosure(s)withi�1.Q#oo#above ad)ac�ent gra�e within 1.0 toat abo�ve adja�grade
c) Totai net area of flood openings in A8.b aq in c} Totat net ar�of fbod openings in A9b aq in
c� Engin�reci floact openings? ❑ Yes ❑ No d) Er�inee�t fiood openirgs? [] Y� ❑ No
SECTlON B-FLOOD INSURANCE RAtE MAP(FIRIYI�INfORiY1p►TIQN
B1.NFlP Community IVame&C�nmunity Number 82.Courity Name �•�
City Of Clestv+rater 125096 Pine{las F[
84.Map/Pane[Number B5.Suffa B8.FlRM l�ex 87.FiRM Panei 88.Flood 89.6ffie Flood Eleva�on(a)(Zor�e
121 Q3C 4102 G Date Effective/Ravised Date Zone(s) AO,t�e bese fiood deplh)
June 30,t�J9 September 03,2003 AE i2.0'
B40. lndicate the source of the Base Ftood Elevation(BFE)data or base flood depth errtered in Mem 89.
❑ fiS Profile � FiRM ❑ Canmunlly Determir�ed ❑ Other'(E�S)
B11. Indicate etevation dc�lum used for BFE in Ftem 69: � NGW 1928 � Haw�a8a C� aner taes�roe)
812. Is the bwilding located in a Coastal Barrier Resovroes 3Ysbsm(CBRS)ar�or Otheiwise Proeec�ed Nea(Qi'A)? ❑ Y� ❑ No
Desfgnation Data ❑ CBR3 ❑ OPA
8ECTION C-BUILDINCs ELEVATION INFORMATION(SURVEY REC.ttIIRED)
C1. Buiiding elevations are based on: Q Construcdon Drawings' ❑ Building Under Goc►struction" � Fnist�d Co�cdon
'A new Efevatkon CerUflcate wfll be required when construdfon of the buitd(ng is complete.
C2. Etevations-ZotNes A1-�A30,AE,AH,A(with BFEa,VE,V1-V30,d Cwith BFE),AR,AR/A,AR/AE,AR/A1,A30,•/�WRH,AR/AO. Campleba Ifiems C2a-h
below accoreiing to Ehe buikl'mg diagram specified'm FtemA�. Use the same dattxr►as the BFE.
Benchmarlc Utiiized Clearwater Benchm�r�_VeFtic�d Datum NAW1�$$
ConversionlGomments f�
Chedt the me�ur�nt used.
a� Tap of bottom floor(inGuding basement,crawispace,or enclosure floorj;�.� �feet ❑rrreteRa(Pt�rto Rk:o only)
b� Top ot the ne�d higher floor �. C7 teet ❑meters EPuerto Rico onN1
c) Bott�n aF the lowest horizcntal strud�ral member(V Zones oniy) NlA. �feet �meters(PueRo Rf�o only)
d) Attached gsrage(top of slab) �• ❑feet ❑meters(Puerto Rico onlY)
e) Lowest eleva�on of machinery or equipment senrtcing the building N�. ❑feet ❑mete+'s tPuerto Rico oniy}
(Descxibe type of equipmerit and toc�tiort in Cornments)
� Lawest adjacent(flnishet�grade next to building{LAG) 4.� �feet ❑metars(Puerto Rico only)
9j Hi�hest adjaceM(finished)grade r�ext to buikiing f HAG? 4_.� �fi9et ❑meters{Puerto Rit�o only) y 6,�o n o 9 Q 9 0 0
h) Lowest adjacerrt grade at lowest elevatlor►of dedc or stairs,induding �/A. ❑feet ❑meters(Puerto R�o or�'' o,,
StfUCt4lPfll SUPp01� - �� t' t i �.'
,° .-�k%x•_ • ,�F''. �'�
SECTIBN D-$URVEYOR,ENGINEER�OR ARCHlTECT CERTIFICAT{ON: ,�„� ..•'.�e:t t�s'_••_`�'���F_ `
This certificatlon is to be s�ned and seated by s�r�d surveyor,engineer,or arch�ed sutho�ized by iaw M certdy elevat��In r~� '�' `
infarmabon. I cerfify that the i»fomtation an this CeM�te represerrts my bast afrorfs to inio�prst the data aveilab/e ; �' ����" �1�+ :
l nnderstand that any fa/se statement may t�punishable by fine or imprisonment under?8 U.S.Code,SecHon 100l. ' � • � m
� Check here if commenb aro provided on badc of form. Were taUiude and longitude in Section A prov&ied by a �� � .�0�� ���>.
ficertsed land sut'veyor? � Yes ❑ No ���jsa'E��'.�� • `� ^
,��''"`�ti'f.(��R�'+K . .�, �c,`� "
Certffier's Name Christopher C.Chittum U�Number 5167 . �
r� .. ..
Title Rrofessional Surveyor and Mapper Ccmpany Name CCI SUtV@)lifl�811d M�A�[nQ,fnc ` a' �''��# ;;j,e�Q �'
Ackfress 5830 Nebraska Avenue Cigt New Port Richey S'tafe k1 ZIP Code 34652 ``"°,.�,><�`,.
Signafiare Da� 05�Ort-f2 Teleplione 727-232-3800
FEMA�cKm 8t-3t_Msr� See reverse side tor c�rtinuation. Repiaces a8 previous editions
� \
IMPORTANT: !n these spaces,copy the corresponding information from Section A. For insurance Cor�npany Use:
Building Street Address(inciuding Apt.,Unit,Suite,andlor Bidg.No.)or P.O.Route and Box Na Policy Number
454 Mandalay Avenue ' ,
City Clearwater State Fl ZIP Code 33767 Company NA1C Number
SECTIOM D-SURVEYOR, ENGtNEER,OR ARCHITECT CERTIFiCATION(CONTINUED)
Copy both sides of this ElevaEion Certificate for(1)community off►cial,(2)insurance ageM/company,and(3}bui�ing owner.
Comments CCI Projed#12Q83
Signature , Date 05-0�4-12
� ❑ Chectc here if attachments
SECTION -BUILDING ELEVATION INFORMATION(SURVEY NOT REQUiRED)Ft?R ZONE AO AND ZONE A(WITHOUT BfE)
For Zones AO and A(without BFEj,comptete 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 gracle,if ava�able. Chedc the measurement used. In Puerto 12ico ony,ertter meters.
E1. Provide elevation information for the toilowing and chedc the appropriate boxes to show whether the etevation is above a�below the highest adjacent
grade(HAG)and the lowest ad�acerrt grade(l.AG).
a)Top of bottom floor(including basement,cxawispace,or enGosure)is ❑feet ❑meters ❑above or�below the HAG.
bj Top of bottom floor(including basemeM,aarrispace,or enclosure)is �feet ❑meters ❑above or[] belovor the LAG.
E2. For Building Diagrams 6-9 with permane�t flood openings provided in Section A Items 8 and/or 9(&ee pages 8-8 of Instruc�ions),the next higher floor
(elevation C2.b in the diagrams}of the buiWing ia ❑feet ❑meters ❑above or ❑below the HAG.
E3. Attached garage(top of slab)is Q feet ❑meters Q above or ❑below the HAG.
E4. Top of platform of machinery and/or equipmerrt serviang the building is ❑feet ❑meters ❑above or 0 below the WhG.
E5. Zone AO only: if no flood depth numtser i�available,is the top of the bottom floor elevated in accordance with the commurtity's floodpiain management
ordinancs? ❑Yes ❑ No ❑ Unknown. The loca!official must certify this information in Sectian G.
SECTtON F-PROPEIZiY OWNER(OR OWNER'S REPRESENTATIVE)CERIIFICATION
The property owner or owner's authorized representative who completes Sedions A,B,and E for Zone A(without a FEMA-issued or community-issued BFEj
or Zone AO must sign here. The stafements in Sections R,8,snd E am co►rect to th�best of my knowledge.
Property Owne�'s or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
❑Check here'rf attachments
SECTION G-COMMUNITY INFORMATION(OPTtOMAL)
The focal official who is authorized by law or ordinance to administer the c�mmunity's ftoa(plain martagement oNinance can compYete Sections A,B,G(or�,
and G of this Elevation Certificate. Complete the applicable item(s)and sfgn be(ow. 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 sunreyor,enyineer,or architect who
is authorized by law to certity elevation information. (Indicate the source and date of the elevation data in the GommeMS area belaw_)
G2.❑ A community officia{completed Secc;tion E for a buitding located in Zone A(without a FEMA-issued or community-�sued BFE)or Zone AO.
G3.❑ The folfowing infom►ation(items G4-G9)is provided for community floodplain management purposes.
G4.Permit Number G5. date Pe�m�issued G6. Date Certifkate Of CompfianceiOccupancy Issued
G7. This pertnit has been issued for: �New Construction ❑Substantial improvement
G8. Elevation of as-buiR lawest floor(induding basement)of ihe building: ❑feet ❑ma�rs(PR)Datum
G9. BFE or{in Zone AO)depth of flooding at the building site: ❑feet ❑rr�eters(PR}Datum
G10.Community's design flood elevation ❑feet ❑meters(PR)Datum
Local Officiaf's Name Tide
Community Name Telephone
Signature Date
Comments
❑Check hete if attachments
FEMA Form 81-31, Mar 09 Replaces all previous editions
r .
w
� Building Photographs
See Instructions for Item A6.
For insurance Company Use:
Building SVeet Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poucy Number
454 Mandalay Avenue
Clty Clearwater State F�, ZIP Code 33767 Canpany NPJC Number I
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 afl 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 on the
reverse.
Front View
,,, � i� s ����'� .�s�� =�;� �, �°'.� - ,'�f,a,� � _.
�
- � �� :* �, " ���� -°q� � i � ,# # 't
� � � — —
-°-- �
..�
�r ��„'�Nji��y i� � . n. iw- � :
�
� d � \��� � +*'�' � � � �!
L '� �'� �3�
i W
:n. . ,A''. . . �f .�."' ,
. '��LJSti� ix, .��� � .,,, � �. � .� ��1
J � �
i Y
_ �' �
.� _ � : : : _ ��.�,�,,,�:, � �1 Y� � -
', ., ....,�
'�.
�,..
�. �
. ,
, ,
� , c. � � :�ii� .
_ ° �
1:� �, �`
2i � - '; �.x,
�tG 3..�a��3,. . .
`' m=�,r. �� `•���.�.k.. .
�., s la
-� _ :,- a,r . - i
. �
, �.:, , ... -, .,-,..0 .v --- _ .
,
:a:.. 1��,11
� «W
� �. � �� � ., .'�,;" .
�y s: , ,... �-� �.
" „xm.. �-�m
<
�, � „, .t
_ �
; _: . ,, . :
�,..: �r '�";�s_...�...,.. _..,�.._. . .. ' -�• . ... ��' .
..�»� � .,..� ..... �� ,'.
-,..,a,�«�,W,. - —�
;;_-. ..a^� � : ��. �.._ ._�
� �':�
�
�_ �'a.-. .- � � � � --�.
,
.z�� ..
��� �r-- ��r�w�,,,,„.,... +Ir �r�
�� ^ _
■►• �
.e A��,... _,_. . �. _
�� ,...,:,:.,..., .�e._�_�_. ...,_,. . .
Rear View
� ��,R �
� �
� �..
� i �,� �, w
� �
.�,,
� .
.�.
' �N rf
'i�,�^u i`
�;� ���. '��R�k � 1�� ,� :' p.... y
' 4 t� ,y��x i.�� f��3�.,�5 .. . ,, � ::.... y�r. � ..@ � ' ~
i
r ' � '�7� � r � �a t, T ..
�� �� � �, s �, ; "�'���� �� � "' t,u�`R'J� �e"�`'*' I
.,t a '�` � �'
i �t� W :�� da�•4 ».� 3 i� �::y,' #. ag`�:
� A—�
R v( '� � �' � g �
4 y ^;.�S,J�4-'�' C�, d'�-�"�'�� �
�" �i
..�,,. �. m� . ..�;
,� � _, . .. e. ... .
^}• � ..,y� . �
�ae�v�°� '1�" . , .
. . . rp`... . . � � �� � r � ii�e
. �
l�l�t� [I��CJpapa��
� � � � � � �A � � �
; �
� MaY o 5 zoiz
�
� PLA�lNI�JG& DEVELOPIUIEiVT DEPT
a CfTY l7F C�.EARViIATER
�
��