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483 MANDALAY AVEr � U.S.D�PARTMENTOFMOMELANDSECURITY ELEVATION CERTIFICATE Federal Eme�gency ManagementAgency Nationaf Flood Inaurance Propram Importar�t: Read the ir�tructions on pages 1-9. SEC'i'iON A - PiZOPERTY INFOi�fNATt0�1 Ai, Building Ownets NameEQUI'CY MANAGEMENT PARTNERS, INC —"—""'��••�� A2. 8uilding Street Addresa {indudirg Api., UNt, 3uite, atxUar Bldg. tVo.) or P.O. Ro�e and Box No. 483-487 MAhlDALAYAVENUE (PELICAN WA�K� CityCLEARWATER BEACH SfateFLZIp Code33787 A3. Property Descriptlon (Lot and Block Numbers, Tsx Parcel Number, LATS 32-43, BLOCK B, FIR3T ADDRION TO CLEAftWATER BEACH, OMB iVo. 1660-0008 Expires March 31, 20'f2 u uescnpnon, etc.) 15, !�G 8D, PCR) PCPA FOL10 NO. OS-2&15-16418-00�-0320 A4. euilding Use (e.g., Residential; i�on-Residential, Addition, Accsssory, elc.) NoN-RE8IDENTIAL A5. LatitudelLortgitude: Lat. 813Long. 8267 Horizontai Datum: ❑NAD 1927 �NAD 1983 A6. Attech at least 2 photopraphs of the building if the Certificate is bei� used to obtain flaod tnsurance. A7. Bullding Dlapram Number� A8. For a twifdin9 w�h a crawlspace or en�los�ae(s): A3. For a Building with an attsched yaraye: a) Square footage ot crawl:pace or enclosure(s) 0 sq ft a) 3quare foolage of attached garage Q sq ft b) No. of permaner�t flood openfnga in the cratMapace a bj Na of permanent flood opehings in the attached garage encEosure(s) wiiHiin 1.0 foot ahove adjecerrt prade g within 1.0 foot abcve adjacerd grade Q c) Total net area of ffood openinys in A8.b 4 sq in c) Totat net area of flood openings in A9.b Q aq in d) Engineered flood openfngs? ❑Yes �No d) Engneered flood openinga? �Yea �No SEC]lON B- FLOOD INSURANCE RA'T� MAP (FIRM) INFORMATION B1. NFIP Community Name 8, CommunHy Numb� B2. County Name B3. State CLEARWATER 125D98 pINELLAS FLORIDA 92903C01Q2 I G I 0� 8f2U09 I Effective/0&2003 Date I 7A E(s) I-- AO� use b�0.5ood depth) ' B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood de�th errtered in Ifem B9. �FES Proflle p�iRna pCommwiity.qet�rnined ❑om� �o�cr;be� 811. Indicate elevation dattan used for BFE in Item 89:0 NGVD 1929 �NAV� 1888 ❑Other (Describ�) B12. ts the buikiing located in a Coestel Bartier Resources Syatem (CBRS) area or Othervulse Protected Area (OPA)? ❑Yes �No Designation Date �CBRS DOPA SECTION C- BUfLD1111G ELEVAl10N INFORMATION (SURVEY REQUIR�D) C1. Building elevatbns are based on: QConstruction Draw'v�ga' ❑Building Under Conetruction` �Rnlshed Conetructlon 'A new Elevation Certirtcate wlll be required when construction of the buitdtng ia complete. C2. ElevaHore — Zones A1�430, AE, AFf, A(with 8�), VE, V1:1I3U, V(wiHi BFE), AR, AR/A, ARlAE, AR/A9-A30, AR/AH, AR/AQ. Compiete Items C2.a-h befow aacardinp to the 6uldtn9 diegram specif��! in ftem A7. Uselhe same dahim ae the BFE. BEIICht718�k Ut111Z@dCITY OF .1 FARW4TFR H1b Vertical DatumNAVD 88 - ConversioNComments � a) Top of bottam iloor (InGuding basemeM, crawlspace, or enclos�e fioor)$.,� b} Top ofthe nexk higher floor 19.8 c) Bottom of the lowest horizo�al strucEurai member (V Zones only) � d) Attached yarage (top of siab) �. e) toweet elevatton of machinery a equipment servicing the buikJir�g �.$ (Describe type of equipment and locatfon in Commerrts) f� Lowest adjacent (finished} grade next to building (LAG) �.� g) Highest adjacent (finiahed} grade next to building (HAG) �.5 h) Lowest adjaceM grade at Iowest elevation of deck or statrs, including �,� Checkthe measurement used. Q�fE+et �feet ❑feet ❑feet �Feet �metera (Puerto Rico only) ❑meters (Puerto R3co only) �mefers (Puerto Rico oniy) ❑meters (Puerto Rico only) ❑met�s (Puerto Rico orAY) �feet Orteeters (PuerFo Rico only} �teeE ❑rneters (Puerin Rko oNy) �feet ❑met�s (Puerto Rico oNY) OR ARCHITEC7 CERT! FICATION This certiflcation Is to be signeci and sealed by a tand sirveyor, engineer, or architect author¢ed by law to cerii[y elevation ireformffilon. ! cerily fhat tha iMormatkrt on fhis CeRI%caf� represerrts my beat efforts to !r�l�evp�ref fhe dats eveHable ! understand that any fa1[se statemetrt inay be punishaobls by frna or imprisomneen# urnier f 8 U.S. Coda, Section 1001, � Check here if comments ere provided on back ot fortn. Were latitude and longitude in Sectlon A provided by a licensed land surveyoR � Yea ❑ No Certifier'sName JEFFRYH. HILLIG055 LloenseNumber LS 4488 Title �20F_ SURVEYORl� MAPpER Coropany Name FLROIDA FLOODZONE SERVICES Address B01 PADUA COURT Clty PlOKOMI3 StateFL ZIP Code 34275 ��Y ,: Signature /J Date 04-03-2012 Telephone 954-290-742EJ �,/ FEMA Form 81-39, Mar Q8 � See reverse side for coMinuaiion. Replaces all previous editions l ' : In these spaoes, oopy tf� cvResponding informatlon from Section A Bulidfng 8treet Addrese (ir�cludi�g Apt., Unit, Sulte, and/or �ldg. NoJ or P.O. Route 463487MAkDAL/4YAyENUE (PELECAN WAL10 CLEARWATER BEACHState FLZiP SECTIOfd D- SURVEI(OR, ENGINEER, OR ARCHITECT GEi2TIFlCATION (CONTIIdUED) Copy both sides of thls ElevaUon Certificate far (1) aommunity �cial, (2) fnsirance agent/company, and (3) bu'[dir� onmer. . Commerrts LdWEST EQUlPMENT IS BOTTOM OF ELECTRICA� METER PANELS; AIR CONDITI�NER UNfTS ON RQOF slgnature � DateU4-0�2012 Ct�edc here if attachments SECiION E- BUIL.DING �LEVA710N INFORMA710N (SURVEY 11fOi ftEQUlRED) FORZONE AO AND ZO�EE A(iMTHOUT BFEj For Zonas AO and A(without BFE), comple#e fteme E1-E5. ff the Certificate is Mtended tn support a LOMA or LOMR-F req�est, corrq�lete Sections A, B, and C. For Items E1-E4, use nat�aal grade, if avai[able. Chedc the measurement �ed. In Puerto Rico on1y, enter meters. E1. Provide elevation irNortnation for the fdlowing end check the approprtate boxes to show whether the elevation is above or be1 ow the highest adJacerrt grade (HAG) and the loweat adJacerrt grade (LAG). a) 7op of bottom 11oor (including basemerrt, crawlspace, or enclostRe} is .�]feet[] meters ❑ above or[J below the HAG. b) Top of bottom floor (Including basem�f, crawlspace, or enclosure) is ._J.7feet[] metars ❑ above or� belaw the LAG. E2. For B�IdInB Diaprams 6-9 with permanerrt flood openings provided in Sectlon A Items B and/or 9(see pages 8-9 of Instruc�ions), the ne�ct higher fioor (etevation C2.b in the diagrams) of the buAding Is ._pfeet0 meters(� above er � below the HAG. E3. Attached garage (top of siab) is .��feetOmefers ❑ above or ❑ below the HAG. EA. Top of plaEform of machinery end/or eq uEpment aervicing the building is ._�teet[]metere ❑ above or❑ below U�e MAG. E5. Zone AO only. H no flood depth number is availsble, ia the top ai the baltom floor elevaEed tn accordance wiih tha community's floodplain management ordlr�ncM. �Yes 0 Mo ❑ Unlaiown. The local official must certify this information m Section G. SEC'iiON F- PROPEit7Y OWNER (OFt OWNEFt'S REPRESENTA7IVE) CERTIFICATION The property ownet or owners authorized representative who compleies Sections A, B, and E for Zone A(witimut a F�MA-iasued or community-issued BFE) or Zone qQ must sign here. The statemeMs lrr 5ectfons A, 8, and E are cortect to dire treat W my knowledQa Property Owr�s or Owner's Aufhorized Represenfative's Name JEFF H NilL1C�05S, PSM, CFM Address601 PADUA COURT CItyNOKOMIS StateFL ZIP Code34275 Sigr�ature Dake04-02-2012 Teiephone85429Q7420 Cotrunerrts SECTtON G - i ne iocai omc�ei wno ie aumarizea t�y iaw or ortlinance to adm�r�ster the commim�s flaodplain mansgemeni ordinanee can complBte 5ections A, B, C{or �), end G of this Elevebion Certfficete. Complele the applkabie kem(s) and sfgn below. Check the measurement used 'm Rems 08 and G9. C31.0 The i�orma�ion in Sec#ion C wae taken from other dxumer�tation that tias been sbned and sealed by a I�e�sed aweyor, engineer, o r architect who Is authorized by law to certify elevation infortnation. (IrxNcate tFle source and date ot the elevation data in the Commerrts area below.} G2. ❑ A commindy oPfic€af compl�ed 3ectian E for a buildirg located in Zone A(witltout a FEMA-issued or communily-iseued BFE} or Zone AO. G3. ❑. The following Infortnatlon (Items G4-G9) is providetf for commurtify flvvdplairt managemerR purposes. G4. Permit Number G5. Date PermR Issued GB. Date Certificate Of CompfiancelOccupancy Issued G7. Thls permR has been lasued for: ❑NewCanstructiort �Substandai Imp�avement G8. Elevation of as�u}� lowest floor (including basement) of the building: .�[]feet❑meters(PRj Datum G9. BFE or Qn Zone AO) depth of flooding at the budding site: �feet[]meters(PR) Datum G10. Communfty's deslgn fload elevation ._OfeetC7meters(PR) Datum � �o�ai amc�rs �ame r�ne Community Wame Telephone Signahue Date Comr►terts , „ f^1Check here if attachments FEMA �orm 81-3'{, Mar 09 f�eplaces a� previous editions a q ' Building Photographs See (nstructions for Item Afi. or P.O. Raute and Brnc fVo. 483-487 MANbALAYAVENUE {PELICAPf WALF� Cl1.y CLEARWATER BEACN $t�@ FL Z�P COd9 33767 !f using the Efevatinn Certificate to obtain NFIP flood insurance, affix at least two building photographs below acaording to #he instructions far liem A6. Identify all photographs with: date taken; "Frord Vem!' and "Rear Vievd'; and, if required, "Right Side Ueui' and "Left Side Vew." If submitting more photographs than will fit on this page, use the Continuabion Pags on the reverse. ' FROM` (SOUiH) 0�4-03 �012 FRONT (NORT!-� 0403-2012 . � .� , , , . i , • Building Pho#,ographs Continuation Page ,�o[ 1��'a�ice Cq�iip�r��r �J,sa:-� Buildng Strcet Address (ind�kng Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Ba�c No. �,Poltcr Ny,� ':, ; A83A87 MANDALAYAVENUE (PELICAN WALiQ ° - :`�e f � �� ` a,' CI�}I CLEARWATER BEACH SiatL FL ZIP COCf@ 33767 �ar�y�� Nsir�b�� ' � `�:: x' -;,�. ` '1 .� j If submitting more photographs. than will fit on the preceding page, aifix the adc�tional photographs below. Identify all photographs with: date taken; "�font Vieu�' and "Rear Viev�; and, if required, "Right Side VetiN' and "Left Side View." REAR (SqUTH} 0�4-03-2012 REAR (NORTH} 04-03-2012 U.S.�EPARTMENT 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 A1. Building Owner's Name BROWN BOXER BAR AND GRILL A2. Building Street Address(including Apt.,Unit,Suite,and/or Bidg. No.)or P.O. Route and Box No. 483 MANDALAY AVENUE City CLEARWATER State FL ZIP Code 33767 A3. Property Description(�Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) LOTS 32-43,BLOCK B, 1 T ADDITION TO CLEARWATER BEACH PARK,P.B. 15,PG.80 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)NON-RESIDENTIAL A5. Latitude/Longitude:Lat.N-27-58-54 Long.W-82-49-35 Horizontal Datum: ❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the buiiding if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1A A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enciosure(s) 0 sq ft a) Square footage of attached garage 0 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 0 within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b 0 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 63.State CITY OF CLEARWATER 125096 PINELLAS FLORIDA B4.Map/Panel Number 65.Suffix B6.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) 8-18-2009 93-2003 AE 11' 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) 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. Buiiding 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 PIN CO DISK AURAL A Vertical Datum ELEV.=11.82 NAVD 1988 Conversion/Comments Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor)5.7 �feet ❑meters(Puerto Rico only) b) Top of the next higher floor 19.6 �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) N/A. ❑feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 6.2 �I feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) fl Lowest adjacent(finished)grade neut to building(LAG) 4.2 �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 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 availab/e. �� !understand that any fa/se statement may be punishab/e by fine or impnsonment under 18 U.S. Code, Section 1001. v�"`,`'"E�"��,� '� � Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a �►`S!��`p�� licensed land surveyor? � Yes ❑ No ;.�+K-,�� , t Certifier's Name LAUREN R.PENNY License Number #4931 �tH�'��`. � ' Title LAND SURVEYOR Company Name L.R.PENNY AND ASSOCIATES, INC. � � -� ;�;°'� w ; � . . . ;y, � - Address 10730 102 AVENUE NORTH City SEMINOLE State FL ZIP Code 33778 ' Signature �J Date 5/18/2011 Telephone 727-398-4360 � tr�';�;�� FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces al�previous editions IMPORTS4NT: 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. 483 MANDALAY AVENUE City �LEARWATER State FL ZIP Code 33767 SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community o�cial,(2)insurance agent/company,and(3)building owner. Comments LOWEST MACHINERY IS AN ELECTRIC METER ��-�' � - Signature Date 5/18/2011 � 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,crawispace,or enclosure)is ❑feet ❑meters ❑above or Q 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 o�cial 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 GS 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 ' . � _. Buiiding Photographs ' See Instructions for Item A6. Building StreetAddress(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. 483 MANDALAY AVENUE Clty CLEARWATER State FL ZIP COd@ 33767 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 on the reverse. 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