505 MANDALAY AVE; 501-525 MANDALAY AVE ��a O�`�-�� �� �Q FEDERAL EMERGENCY MANAGEMENT AGENCY o.M.�3. rao. 3067-0077
i , , � NATIONAL FLOOD INSURANCE PROGRAM Expires December 31,2005
� ��oS�NIUr►d�l� ELEVATION CERTIFICATE --- -
� ��� � v�/T������'� Important: Read the instructions on a es 1-7.
P9
' SECTION A-PROPERTY OWNER INFORMATIQN Fcx Insurance Company Use:
UILDING OWNER'S NAME Policy Number
J.M.C.Design&Development Corp.
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
501-525 Mandalay Avenue(Belle Harbor)
CITY STATE ZIP CODE �
Clearvvater FL 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
Lot 1"Belle Harbor'as recorded in Plat Book 125,Page 15 of the Pubiic Records of Pinellas Couniy,Florida
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.)
Wlulti-story residen6al
LATITUDEILONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type}:
( �l#°-#�#'-##.##" or ##.�°) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other:
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
81.NFIP COMMUNITY NAME&COMMUNITY NUMBE B2.COUNTY NAME B3.STATE
Cihr of Clean,vater,Fbrida 125096 Pinellas _ FL__ �
B4.MAP AND PANEL 87.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER 85.SUFFIX B6.FIRM INDEX DATE EFFECTIVEIF2EVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depih of flooding)
1250960007 D 08119/1991 OS119/1991 AE 10&11
610.Indicate the source of the Base Flood Elevation(BFE)data a base flood depth entered in B9.
❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe):_
611.Indicate the elevation datum used fa the BFE in B9:�NGVD 1929 ❑NAVD 1988 ❑Other(Describe):_._
B12.Is he building located in a Coastal Bamer Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ❑No Designation Date_ �
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl.Building elevaUons are based on:❑Construction Drawings' ❑Building Under Construction` �Finished Construclion ��
"A new ElevaGon Certificate will be required when consUuction of the building is complete.
�.Building Diagram Number 7(Seled the building diagram most similar to the building fa which this certific;ate is being a�mpleted-see pages 6 and 7. If no diagram
aaurately represents the building,provide a sketch or photograph.)
Cc.Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AWA,AWAE,AWA1 A30,AR/AH,AWAO
Complete Items C3.-a-i below according to the building diagram spec�ed in Item C2.State the datum used.If the daturn is different frorn the datum used for the E3FE in
Section B,convert the datum to that used fa the BFE.Show field measurements and datum oonversion c;alculaGon. Use the space provided or the Comments area of
Section D or Sedion G,as appropriate,to document the datum conversion.
Dalum Conversion(Comments
ElevaUon reference mark used 5_1 Does ihe eleva6on reference mark used appear on lhe FIRM? ❑Yes �No —
\,
o a)Top of boflom floor(induding basement or enclosure) 7. 1 ft.(m) � � ����
o b)Top of next higher floor 11.1 ft.(m) �
o c)Bottom of lowest horizontal sbuctural member(V zones only) _ft.(m) �!� �
o d)Attached garage(top of slab) 7, 1 ft.(m) �� `� '� �j�
o e)Lowest elevation of machinery andlor equipment W `° \�
..� ���� \
serviang the building(Describe in a Comments area) 2.0 ft.(m) � � � � �
o f1 Lowest adjacent(finished)grade(LAG) 6.7 ft.(m) z.� ~ �� ��
o g)Highest adjacent(finished)grade(HAG) 7, 4 ft.(m) �� ` �
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 12 ; -
o i I Total area of all permanent openings(flood vents)in C3.h 108288 sq.in.(sq.cm) ' �- -
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 cerlify elevation information.�
1 certi�y that the information in Sections A,8,and C on this certificate represents my best efforts to interpret the data available.
I understand that any false stafement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTiFIER'S NAME Samuel M�k Beach LiCENSE NUMBER LS 62fi1
11TLE Professional Surveya and Mapper COMPANY NAME Florida Design Consultants,inc.
- ----------------
�DDRESS CITY STATE ZIP CODE
3�30 Staricey Boulevard New Port Richey FL 34655
�IGNl�TURE DATE TELEPHONE
� 03/10I2005 (727)849=T588
FEA1A Form 81-31,January 2003 See reverse side for continuation. �RepiacE=,s all previous editions
IMPORTANT: In these spaces,copy the corresponding information from Section A. � For Irisurance Company Use:
.- BU�DI!aG ST��EET ADDRESS(Induding Apt,UnA,Suite,and�or BkJg.No.)OR P.O.ROUTE AND BOX N0. �PoliCy Number
501-52�Mendalay Avenue(Belle Harbor)
r-�
CITY STATE ZIP CODE Company NAIC Number '
Clearvuater FL 33767
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) �
py both sides of this Eleva6on Certificate for(1)community offiaal,(2)insurance agenUcompany,and(3)building owner. �
CC MMENTS
C3 a-Elevation given is lowest garage floa elevaGon.
C3 e-Elevation given is the botom of the elevata shaft,
See atta�ed Architects plan for calculations and flood vent locations. �Check here if attachments
SECTION E-BUILDING ELEVATION INFORMATION(SURVk�Y NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
For�one�10 and Zone A(without BFE),oomplete Items E1 through E4. If the Elevation Certificate is intended fa use as supporting information fa a LOMA or LOMR-F,
Secti�n C must be completed.
E1.6uilding Diagram Number_(Select the building diagram most similar to the building for which this certificate is being completed-see pages 6 arid 7, If no diagram accurately
represents the building,provide a sketch a photograph.)
E2.The tcp of the bottom floor(including basement or enciosure)of the building is _.ft.(m)_in.(cm)❑above or ❑below(check one)the highest adjacent grade. (Use
naturai grade,if available).
E3.For Building Diagrams 6-8 with openings(see page 7),the next higher floor a elevated floor(eleva6on b)of the building is _ft.(m)^in.(cm)aFaove the highest adjacent
grade. Complete items C3.h and C3.i on iront of form.
E4.The tcp of ihe platform of machinery andlor equipment serviang the building is _.ft.(m)__in.(cm)❑above a ❑below(c;heck one)the highest adjaceni grade. (Use
natural grade,'rf available).
E5.For Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in aocordance with the community's floodplain management ortlinance?
]Yes ❑No ❑Unknown. The local offidal must certify this informaGon in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION ��
The property owner or owners authaized representative who completes Sections A,B,C(items C3.h and C3.i only),and E for Zone A(without a f=EMA-issued or communiry-
iss aed BFE)or Zone AO must sign here. The statements in Sections A,B,C,and E are correct to the best of my knowledge.
PF.OPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
��DRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL.)
The local�fliaal who is authorized by law a ordinance to administer the communiiy's floodplain management ordinance can complPte Sec,�tions�,E3,C(or E),and G of this Eleva6on
Cert�icate. Complete the applicable item(s)and sign below.
G1.]The information in Seclion C was taken from other documentation that has been signed and embossed by a licenseci surveyor,engirieer,or architect who is authorized by state
or local law to certify elevation information. (Indicate the source and date of the elevation data in the c;omments area below.)
G2. ]A community offiaal completed Section E for a building locaied in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�The following information(Items G4-G9)is provided fa community floodplain management purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF CUMPLIA,NCEJOCCUPANCY ISSUED�
G7.This permit has been issued for: ❑New Construclion ❑Substantial Improvement
G8.=levation of as-built lowest floor(including basement)of the building is: �._ft.(m) f�atum:_
G9.3FE�x(in Zone AO)depth of flooding at the building site is: `._ft.(m) Datum:__
LC�CAL OFFICIAL'S NAME TITLE
CONIMUNIIY NAME TELEPHONE ^
SIi3NATURE DATE
MMENTS —
❑Chec;k here if attachments
FEMA Form 81-31,January 2003 Repiaces all previous editions
��,��o��-�— (�� C�� FEDERAL EMERGENCY MANAGEMENT AGENCY O.M,E3. No. 3067-0077
. � NATIONAL FLOOD INSURANCE PR�GRAM Expires December 31,2005
5�5 M������i l� ELEVATION CERTIFIGATE
• ��C��` �'' �h�I j�����'/ Impo r tan t: Rea d t he instructions on pages 1-7.
SECTION A-PROPERTY OWNER INFORMATIQN Fcxlnsurance Company Use:
BUILDING OWNER'S NAME Policy Number
J.M.C.Design&Development Corp.
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bidg.N .)OR P.O.ROUTE AND O NO. Company NAIC Number
- venue e e �j�s �,�'1�-C{� .(� A ,_�'1�� _' �
CITY STATE ZIP CODE
riearwater FL 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
Lot 1"Belle Harbor'as recorded in Plat Book 125,Page 15 of the Public Records of Pinellas County,Florida
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.)
Wtuiti-story residen6al
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( ##°-##'-##.##" or ##.#t#l�##°) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other:
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME B3.STATE �
City of Clearwater,Fbrida 125096 Pinellas FL
B4.MAP AND PANEL B7.FIRM PANEI 89.BASE FLOOD ELEVATION(S)
NUMBER B5.SUFFIX B6.FIRM IND DAT EFFECTfVEIREVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depih of flooding)
1250960007 D 08119/ 1 � 08/19/1991 AE 10&11
B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in 69.
❑FIS Profile �FIRM ❑Communiry Determined ❑Other(Describe):_
611.Indicate the elevation datum used fa the BFE in B9:�NGVD 1929 ❑NAVD 1988 ❑Other(Describe):___
B12.Is he building located in a Coastal Barrier Resources System(CBRS)area or Otheiwise Protected Area(OPA)? ❑Yes ❑No Designation Date_
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) �
C1.Building elevations are based on:❑Construction Drawings' ❑Buildiny Under Construcfion* �Finished Constnirlion �
. 'A new Elevation Cer6ficate wi�l be required when consUuction of the building is complete.
_.Building Diagram Number 7(Select the building diagram most similar to the building for which this certific;ate is being completsd-see pages 6 and 7. If no dia,gram
acc urately represenis the building,provide a sketch or photograph.)
C;:.Elevations–Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AWA,AR/AE,AWA1-A30,AWAH,AWAO
Comolete Items C3.-a-i t�lrnv anx�rdinn rn tha tu�ilriinn riianram cn��a���itAm r.?,�fwtA tho rl�fi im i ic�ri If fho lio6 nn fe.�Iffo.��4 6...,,tti.,,�,r�,.,, t f,.r+ti,.�CC'
� . -__..____. ..�_' ..�_._a._..._�...,...,....
u�..vv�v���v.i�.�.i�u�i.uu�uii�iJVii��.Il.11111VI1�UIl:UCIIUIIIUJGUIVI IIIGUI L111
Section B,convert the datum to that used for the BFE.Show field measurements and datum conversion c;alcula6on. Use the space provided or the Cai iments area of
Seclion D or Section G,as appropriate,to document the datum conversion.
Da1um Conversion/Comments
Elevation reference maric used 5_1 Does the elevation reference maric used appear on Ihe FIRM? ❑Yes I�No — ��
o a)Top of bottom floor(induding basement or enclosure) 7. 1 ft.(m) � �,\ u
o b)Top of next higher floor 11.1 ft.(m) � �
� �
o c)Bottan of lowest horizontal structural member(V zones only) _ft,(m) ;� '� � .
o d)Attached garage(top of slab) 7. 1 ft.(m) �� 'y� ��`"� �
o e)Lowest elevation of machinery and/or equipment W `° "�'� �-�
� °' ���'� �/
servicing the building(Describe in a Comments area) 2.0 ft.(m) � � �
� � " � �'�
o fl Lowest adjacent(finished)grade(LAG) 6.7 fl.(m) �.� a�,,,
o g)Highest adjacent(6nished)grade(HAG) 7. 4 ft.(m) N� `�° �i�
U /
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 12 � .
o i I Total area of all permanent openings(fiood venis)in C3.h 108,288 sq.in.(sq.an) —�-
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 ceriify elevation information��
I certify that the rnformation in Sections A,8,and C on this cerfificate represents my best efforts to interpret the dafa available.
I understand fhat any false statement may be punishable by fine or imprisonment under 18 U S Code Section i001
C:ERTIFIER'S NAME Samuel Mark Beach LICENSE NUMBER LS 62Ei1
11TLE Professional Surveyor and Mapper COMPANY NAME Florida Desiyn Consultants,Inc
� PDDRESS CITY STHTE ZIP CODE
3�30 Starkey Boulevard New Port Richey FL 34655
�IGNATURE DATE TELEPHONE
�. 03/10/2005 (727)849-�588
FE�1A Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions
IMFORTANT: In these spaces,copy the corresponding information from Section A. ���� For i�s�ra�ce com��y use:
BU�D t�G STREET ADDRESS(Induding Apt,Unit,Suite,andlor Bklg.No.)OR P.O.ROUTE AND BOX N0. Policy Number
501-52�Mandalay Avenue(Belle Harbor) �
^CITY STATE ZIP CUDE Company I�AIC Number
Cle.�rwater F� 33767
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) �
„opy both sides of this Elevation Certificate for(1)community officiai,(2)insurance agenUcompany,and(3)building owner.
CCMMENTS
C3 a-Eleva6on given is lowest garage floor elevation.
C3 e-Elevation given is the botom of the elevator shaft.
See attaVhed Architects plan for calculations and flood vent locations. �Check here if attachments
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
For�one AO and Zone A(without BFE),complete Items E1 through E4. If the Elevation Certificate is intended for use as supporfing infamation for a LOMA or LOMR-F,
Secti�n C musi be completed.
E1.6uilding Diagram Number_(Select the building diagram mosi similar to the building for which this certificate is being completed—see payes 6 and 7. if no diagram accurately
represents the bui�ding,provide a sketch w photograph.)
E2.The tcp of the bottom 800r(including basement or endosure)of the building is _ft.(m)_in.(cm)❑above or ❑below(chedc one)the highesf adjacent grade. (Use
natural grade,if available).
E3.For Building Diagrams 6-8 wilh openings(see page 7),the next higher floor a elevated floa(elevaUon b)of the building is _ft.(m)_in.(an)above the highest adjacent
grade. Compleie items C3.h and C3.i on front of fam.
E4.The tcp of the platfam of machinery and/a equipment seNicing the building is _ft.(m)_in.(cm)❑above or ❑below(c;hedc one)the highest adjacent grade. (Use
natural grade,'rf available).
E5.Fa Zone AO oniy: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the cornmunity s floociplain management ordinance?
]Yes ❑No ❑Unknown. The local offidal must ceitify this informaGon in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFIGATION ���
The property owner a ownei's authaized representaGve who completes Sections A,B,C(Items C3.h and C3.i only),and E fa Zone A(wiU�out a f=EMA-issued a communiiy-
iss aed BF�or Zone AO must sign here. The statemenfs in Secfions A,B,C,and E are correcf to the best of my knowledge.
PF.OPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
• :�DRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHUNE
__ _—_ ___ _ _ _ -- _
COMMENTS __ — ------ --
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAI_)
The local��aal who is authonzed by law or ordinance to administer the community's floodplain management ordinance can complete Sec,iions�,E3,C(or E),and G of this ElevaGon
Cert�icate. Complete the applicable item(s)and sign below.
G1.]The information in Section C was taken from olher da,umentaGon that has been signed and embossE;d by a license��surveyor,enyineer,or architect�rrho is authonzed by state
or local law to certify elevation information. (Indicale the source and date of the elevation data in the Comments area below.)
G2.]A canmuniry official oompleted Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�The following informaGon(Items G4-G9)is provided for community floodplain management purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6.DATE CERTIFICATE OF COMPLIP.NCEIOCCUPANCY ISSUED
G7.This permit has been issued for. ❑New Construclion ❑Substantial Improvement
G8.=1eva6on of as�uilt lowest floor(including basement)of fhe building is: _._ft.(m) Datum:
G9.3FE or(in Zone AO)depth of Booding at the building site is: _._ft.(m) Daium: _
LUCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SI��NATURE DATE
� �MMENTS
❑Cher,k here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions
' . �
� �, .
' ������A�"� �$rj,�� r. C ITY O F C LEARWATE R
� �`��' �{ '#�
��`�' ��' DEVELOPMENT & NEIGHBORHOOD SERVICES DEPARTMENT
�,�`,;��, i`��¢ °
;���r`' �4 ' ` POST�FFICE BOX 474g� CLEA[tWATER� F�o�DA 33758-4748
���" �� ,�p���' MUNICIPAL SERVICES BUILDING, ZOO SOUTH MYRTLE AVENUE,CLF.ARWATER,FLOx�nn 33756
'° TELEPxorrE(72� 562-4567 Fnx(72'� 562-4576
MEMO OF REVIEW FOR CORRECTNESS & COMPLETION
In accordance with participation in the NFIP/CRS program, all elevation certificates are required to be reviewed for correctness and completion prior to
acceptance by the community. This complete form shall be attached to all elevation certificates maintained on file and provide with requested copies of
elevation certificates.
The attached elevation certificate requires corrections by the surveyor of section(s) prior to acceptance by the community
The attached elevation certificate is complete and correct
X Minor corrections have been made in the below marked sections by Community Official
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
A1. BUILDING OWNER'S NAME Policy Number
A2.BUILDING STREET ADDRESS(including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
505 MANDALAY AVE (BLDG 6 UNITS 61 -67)
CITY STATE ZIP CODE
A3. PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
A4. BUILDING USE(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)
A5. LATITUDE/LONGITUDE(OPTIONAL): HORIZONTAL DATUM: SOURCE:❑ GPS(Type):
(##°-##'-##.##" or ##.#####°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map 0 Other
SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION
.1. NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE
B4.MAP AND PANEL g5.SUFFIX 66.FIRM INDEX DATE B��FIRM PANEL gg.FLOOD ZONE(S) B9�BASE FLOOD ELEVATION(S)
NUMBER $�19�1992 EFFECTIVE/REVISED DATE (Zone AO,use depth of flooding)
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69.
❑ FIS Profile ❑ FIRM ❑Community Determined ❑Other(Describe)
B11. Indicate elevation datum used for BFE in B9:� NGVD 1929 ❑ NAVD 1988 ❑ Other(Describe)
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ❑No Designation Date
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. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed-see pages 6 and 7. If no
diagram accurately represents the building,provide a sketch or photograph.)
C3. 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 C3.-a-i below according to the building diagram specified in Item C2.State the datum used. If the datum is different from the datum used for the
BFE in Section B,convert the datum to that used for the BFE.Show field measurements and datum conversion calculation. Use the space provided or the Comments
area of Section D or Section G,as appropriate,to document the datum conversion.
Datum Conversion/Comments
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑Yes ❑No
e) Lowest elevation of machinery or equipment servicing the building(Describe in Comments area) ft.(m)
h) No.of permanent openings(flood vents)1ft.above adjencent grade
i) Total area of ail permanent openings(flood vents)in C3.h sq.in.(sq.cm)
C011lfilBfltS: One siqned and sealed elevation certificate submitted for Aroiect bv the survevor Raised seal attached to main certificafe for address 501-to 525 Mandalav Ave
Date of Review: Community Official:
�levation certificates shall be maintained by the community and copies with the attached memo made available by request
FRANK HBBARD,MAYOR
GEORGE N.CRE'1'EKOS,COUNCILMEMBER JOIIN DORAN,COUNCILMCMBER
PAUL F.GIBSON,COUNCILMEMRGR � CARLGN A.PE1'ERSEN,COUNCILMGMBER
��EQUAL EMPLOYMENT AND AFFIItMA"I'IVE ACTION EMNLOYEK��
FEDERALEMERGENCYMANAGEMENTAGENCY p,M,�. r�o. �os7-oo77
`� ya ��x��r���� NATIONAL FLOOD INSURANCE PRI�GRAM Expires�ecember 31,2005
�j�� ����� ELEVATION CERTIFIC:ATE ------ ---
Important: Read the instructions on pages 1-7.
• SECTION A-PROPERTY OWNER INI=ORMATION ���`For Insuranoe Company Use;
BUILDING OWNER'S NAME Policy Number
J.M.C.Design&Development Corp.
BUILDING STREET ADDRESS(Induding Apt.,Unit,Suite,and/or Bldg.No.)OFt P.O.ROUTE AND BOX NO. Company NAIC Mumber,
501-525 Mandalay Avenue(Belle Harl�or)
��ITY STATE ZIP CODE
Clearvvater FL 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
Lot 1"Belle Harbor'as recorded in Plat Book 125,Page 15 of the Public Records of Pinellas County,Floiida
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.)
Multi-story residential
LATITUDEJLONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( ##°-##'-##.##" or ##.##�#°) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑01her:
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNIIY NAME&COMMUNITY NUMBER 62.COUNTY NAME � B3.STATE
City of Clearwater,fbrida 125096 Pine�as FL
64.MAP AND PANEL B7.FIRM PANEL B9,BAS�FLOOD ELEVATION(S)
NUMBER 65.SUFFIX 86.FIRM INDEX DATE EFFECTIVF�REVISED DATE B8.FLOOD ZONE(S) (Zane F�O,use depth of flood'mg)
125096 0007 D 08/19/1991 0811911991 AE 10&11
B10.indicate the source of the Base Flood Elevation(BFE)data a base flood depth entered in 69.
❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe):_
611.Indicate the elevation datum used for the BFE in B9:�NGVD 1929 ❑NAVD 1988 ❑Other(Describe):^_
612.Is he building located in a Coastal Barrier Resouroes System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ❑No Uesignation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Building elevaGons are based on:❑Construclion Drawings" ❑Buildiny Under ConsUucfion* �Finished Construction �
'A new ElevaGon Cerfificate will be required when consUuction of the buikling is complete.
C�.Building Diagram Number 7(Select the building diagram most similar to the building fa which this cerfrficate is being completed-see pages 6 and 7. If no diagram
accurately represents the building,provide a sketch or photograph.)
C:.Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,ARIA,AR/AE,AR/A1-A30,AR/AH,ARlAO
Complete Items C3.-a-i below acxording to 1he building diagram speafied in Item C2.State the datum used.If the datum is different frorn the datum usc�i for the BFE in
Section B,convert the datum to that used for the BFE.Show field measurements and datum conversion calculaUon. Use the space provided or the Comments area of
Section D or Seclion G,as appropriate,to document the datum conversion.
Datum Conversion/Comments
Elevation reference mark used 5_1 Does�he elevalion reference mark used appear on the FIRM? ❑Yes I�No (�
o a)Top of bottom floor(induding basement or endosure) 7, 1 ft.(m) ro ��
o b)Top of ne�higher floor 11.1 ft.(m) �'
o c)BoKom of lowest horizontal strudural member(V zones only) _,_it,(m) o o ��� �
o d)Attached gar a ge(to p of slab) 7. 1 ft,(m) �� -;�
o e)Lowest elevaGon of machinery and/or equiptnent W 1° ��y�' ��;�
servicing the building(Describe in a Comments area) 2.0 ft.(m) �� ��� ��y
o fl Lowest adjacent(finished)grade(LAG) 6.7 ft.(m) z'.m �, ��
o g)Highest adjacent(finished)grade(HAG) 7. 4 ft.(m) N� '�` �
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 12 ;
o i I Total area of all permanent openings(flood vents)in C3.h 108.288 sq.in.(sq.an) �
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 cerfify that the information in Sections A,8,and C on this cerfificate represents my besf eiforts fo interpret the dafa available.
I undersfand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code Section 1001.
CERTIFIER'S NAME Samuet Mark Beach LICENSE NUMBER LS 6261
T ITLE Professionai Surveya and Mapper COMPANY NAME Florida Design Consultanls,Inc.
P DDRESS CITY STATE ZIP CODE
3D30 Starkey Boulevard New Pat Richey FL 3�655
�IGW�,TURE DATE TELEPHONE
�. 03/10/2005 (727)849=?588
FER4A Form 81-31, January 2003 See reverse side for continuation. Replaces all previous editions
IMPd2TANT: In these spaces,copy the corresponding information from Section A. Forir�s��r,�com��yu��:
BUILDING STREET ADDRESS(Induding Apt,Uni�Suite,andlor Bldg.No.)OR P.O.ROUTE AND BOX N0. ����� Pclicy Nutriber
541-525 Mandalay Avenue(Belle Harbor) ,
CITY STATE ZIP CODE Company fJAIC Number ,
Clearwater FL 33767
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(GUNTINU�D) ��� •
Copy bcth sides of this Elevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)builtling owner. �
CC MMENTS '
C3 a-Elevation given is lowest garage floor elevation.
C3 e-Elevation given is the botom of the elevator shaft.
See afla�ed Architects plan for calcula6ons and flood vent locations. �Check here if attachments
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR zONE AO AND ZONE A(WITHOUT BFE)
For�one AO and Zone A(without BFE),complete Items E1 through E4. If the Elevation Cerlificate is intended for use as supporting information for<�LOMA or LOMR-F,
Secti�n C must be completed.
E1.6uilding Diagram Number_(Select the building diagram most similar to the building for which this certificate is being completed—see pages 6 ar id 7. If no diagram aocurately
represenls the building,provide a sketch or photograph.)
E2.The tcp of the boflom fioor(induding basement or enclosure)of the building is _ft.(m)_in.(cm)❑above or ❑below(chedc one)the highest acijacent grade. (Use
natural grade,'rf available).
E3.Fa Building Diagrams 6-8 with openings(see page 7),the next higher floor a elevated floa(eleva6on b)of the building is _ft.(m)_in.(cm)ak�ove the highest adjacFnt
grade. Complete items C3.h and C3.i on front of form.
E4.The tcp of the platform of machinery ancVor equipment servicing the building is __ft.(m)_in.(an)❑above or ❑below(chedc one)the highest adjacent grade. (Use
natural grade,'rf available).
E5.For Zone AO only: If no flood depth number is available,is the top of ihe bottom flax elevated in accordance with the cornmunity's Floaiplain m<�nagement ordinance?
�Yes ❑No ❑Unknown. The local official must certify this informaGon in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION ��
The property owner a owners authorized representaUve who completes Sections A,8,C(Items C3.h and C3.i only),and E for 7_one A(witl�out a(=EMA-issued or communily-
iss aed BFE)or Zone AO must sign here. The sfatements in Secfions A,B,C,and E are correcf to the best of my knowledge.
PF.OPEfZTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAMI=
AC�DRESS CIIY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAI_)
The!ocal�ffiaal who is authorized by law or ordinance to administer the community's floodplain management ordinance c�n�mplete Seclions�,E3,C(or E),and G of this Elevation
Cert�cate. Complete the applicab�e item(s)and sign below.
G1.]The informa6on in Section C was taken from ofher documentation that has been signed and embosssc��d by a licensec.i suroeyor,engineer,or ar�hitect v��ho is authonzed by state
or local law to cerlify elevation infamaGon. (indicate the souroe and date of the elevation data in the Comments area below.)
G2.]A community offiaal completed Section E for a building located in Zone A(without a FEMA-issued or cbmmunity-issued BFE)a Zone A0.
G3.]1he following infamation(Items G4-G9)is provided for community floodplain management purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CEFtTIFiCATE OF COMPLIA.NCEIOCCIIPANCY ISSUEC�
G7.This permit has been issued for. ❑New Construction ❑Substantial Improvement
G8.=levation of as-built lowest floor(including basement)of ihe building is: __._ft.(m) I)atum:__
G9.3FE�x(in Zone AO)depih of flooding at the building site is: _._ft.(m) Datum;_
LC�CAL OFFICIAL'S NAME TITLE
COMMUNIIY NAME TELEPHONE
SIGNATURE DATE
COMMENTS
❑Cher,k here if attachments
FEMA Form 81-31,January 2003 !� � Repiac�s all previous editions