505 MANDALAY BLDG 7 #71-75 �jr �a�C�4—(� � l,(�� FEDERAL EMERGENCY MANAGEMENT AGENCY o.M.E�. rJo. 3os�-oo�7
�. .�l� NATIONAL FLOOD INSURANCE PROGRAM Expires December 31,2005
• �D�' ��'n���lG`y / ELEVATION CERTIFIGATE ------ —
�l�fa� �7 Unr # ,
✓ , �5 7i r 7� Important: Read the instructions on pages 1-7,
� SECTION A-PROPERTY OWNER INFORMATION M Fw Insuranoe Company Use: `
�UILDING OWNER'S NAME Policy Numbe� '
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(Beile Harbor)
����' STATE ZIP CODE
Clearvvater FL 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Desaiption,etc.)
Lot 1"Belle Harbor'as recorded in Plat Book 125,Page 15 of the Public Records of Pinellas Couniy,Florida
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.}
I�lulti-story residential
LATITUDElLONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):__
( �f#°-##'-##.##" or ##.�°) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other:
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME 63,STATE
City of Clearwater,Fbrida 125096 Pinelias FL
84.MAP AND PANEL B7.FIRM PANEL B9.BASL=FLOOD ELEVATION(S)
NUMBER 65.SUFFIX B6.FIRM INDEX DATE EFFECTIVBREVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depih of floodirg)
1250960007 D 08I19/1991 0811911991 AE 10&11
810.Indicate the source of the Base Flood Elevation(BFE)data a base flood depth entered in B9.
❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe):_
B11.Indicate the elevation datum used fa the BFE in 89:�NGVD 1929 ❑NAVD 1988 ❑Other(Describe):___
B12.Is he building located in a Coastal Barrier Resources System(CBRS)area or Otheivuise 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 ElevaGon Certificate will be required when construction 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 completed-see pages 6 and 7. If no diagram
acc�rately represents the building,provide a sketch a photograph,)
C�.Elevations–Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AWAH,AWAO
Compiete Items C3.-a-i below acoording 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 fa the BFE.Show field measurements and datum conversion calculation, Use the space provitled or the Coniments area of
Section D or Section G,as appropriate,to document the datum conversion.
Datum ConversionlComments
ElevaGon reference mark used 5_1 Does lhe elevation reference maric used appear on the FIRM? ❑Yes �No — t1
v a)Top of boflom floa(induding basement or endosure) 7. 1 ft.(m) -� `� �
o b)Top of next higher floor 11.1$.(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) �° "� �j�
o e)Lowest elevation of machinery and/or equipment W� �
o= ti.�� �
servicing the building(Desaibe in a Comments area) 2.0 ft.(m) �� `�,
o fl Lowest adjacent(finished)grade(LAG) 6.7 ft.(m) z'� ��
o g)Highest adjaoent(finished)grade(HAG) 7. 4 ft.(m) �� `� �
o h)No.of permanent openings(flood vents)within 1 ft.above atljacent grade 12 J ``.
o i I Totai 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 ceriify elevafion information.
I certify that the in(ormation in Sections A,B,and C on fhis cerfi�cate represents my best efforts fo interpret fhe data avai(able.
I understand that any false sfatement may be punishable by fine or imprisonment under 18 U S Code,Section 10U1
C:ERTIFIER'S NAME Samuel Mark Beach LICENSE NUMBER LS 62Ei1
TITLE Professional Surveyorand Mapper COMPANY NAME Florida Design Consultants,Inc.
�DDRESS CITY STATE ZIPCODE
3�30 Starlcey Boulevard New Pat Richey FL 34655
�IGNl�TURE DATE TELEPHONE
� 03/10I2005 (727)849-7588
FEA4A Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions
�' C��U(��- - � �`�a�l
IMPORTANT: In these spaces,copy the corresponding information from Section A. �� For Insurance Company Us�r. '
'FUILDING.:TREET ADDRESS(Induding Apt,Uni�Suite,andfor BkJg.No.)OR P.O.ROUTE AND BOX N0. Pol'�,y NUmber
501-525 Mandalay Av�;nue(Belle Har�or)
CITY, STATE ZIP CODE Company NAIC Number
Clearwater , FL 33767
SECTION D•SURVEYOR,ENGINEER,OR ARGHITECT CERTIFICATION(GONTINUED� ��
�py both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. ��
CC MMENTS
C3 a-Elevation given is lauvest garage floor elevation. _ _
C3 e-Elevation given is the botom of the elevator shaft.
See atta�hed Am,hitects 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(WffHOUT BFE)
For�one AO and Zone A(without BFE),complete Items E1 through E4. If the ElevaGon Certificate is intended for use as supporting infamation for<�LOMA or LOMR-F,
Secti�n C must be canpleted.
E1.Building Diagram Number_(Select the building diagram most similar to the building for which this cert'rficaie is being completed—see payes 6 ar�d 7. If no diagram accurately
represents the building,provide a sketch or photograph.)
E2.The tcp of the bottom floor(induding basement or enclosure)of the building is �ft.(m)_in.(an)❑above or ❑below(c:heck one)the highest adjacent grade. (Use
natural grade,'rf available).
E3.Fa Building Diagrams 6-8 with o�enings(see page�,lhe ne�higher floor a elevated floa(elevation b)of the building is _ft.(m)_in.(cm)ak�ove the highest acijacent
grade. Complete items C3.h and C3.i on iront of form.
E4.The tcp of the platform of machinery ancUa equipment serviang the building is __ft.(m)_in.(cm)�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 the bottom floor elevated in accordance with the cornmunity's floodplain managemen(ordinance?
]Yes ❑No ❑Unknown. The local offiaal must cerfify this infamaGon in Sec6on G. ��
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owners authorized representa6ve who completes Sections A,B,C(Items C3.h and C3.i only),and E for Zone A(witl�out a f=EMA-issued or community-
iss aed BFE)or Zone AO must sign here. The statemenfs in Secfions A,B,C,and E are conect to the besf af my knowledge.
PF.OPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
�DRESS CITY STATE ZIP CODE
SIGNATURE DATE 1�ELEPHONE
COMMENTS
❑Chec;k here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAI.)
The local�ffiaal who is authorized by law or ordinance to administer the communiry's floodpiain management ordinance can complete Sections A,E3,C(or E),and G of this Elevation
Cert�icate. Complete the applicable item(s)and sign below.
G1.�The information in Section C was taken from other da,umentation that has been signed and embossed by a licenseci surveyor,engineer,or architect v�ho is authonzed by slate
or local law to certify elevation infamaGon. (Indicate the source and date of the elevation data in the�omments area below.)
G2.]A community o�cial completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�The following information(Items G4-G9)is provided for community floodplain managerrient purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6.DATE CERTIfICATE OF COMPLIANCEIOCCUPANCY ISSUED
G7.This permit has been issued for. ❑New ConsUuction ❑Substantial Improvement
G8.-levalion af as�uilt lowest floor(including basement)of the building is: _._ft.(m) Datum:__
G9.3FE��r(in Zone AO)depth of flooding at the building site is: �._ft.(m) Datum:_
LC�CAL OFFICIAL'S NAME TITLE
COMMI)NITY NAME TELEPHONE
SU�NATURE DATE �
MMENTS
❑Chec;k here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions
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� � i��`��'�� DEVELOPMENT & NEIGHBORHOOD SERVICES DEPARTMENT
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����, _ , .,�'� ,e PosT OFFicE Box 4748, Cr.�wn�a, Fco�u�n 33758-4748
�.sQ��'�p�� � � �f MUNICIPAL SERVICES BUILDING, lOO SOUTH MYRTLE AVENUE,CI.EARWATER,FLO�uDn 33756
'�at.sr�r;r?, ,;,
TELEPHONE �7Z� S6Z-4S67 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
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 ##.##�t#°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map❑Other
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME B3.STATE
64.MAP AND PANEL g5.SUFFIX B6.FIRM INDEX DATE B�•FIRM PANEL gg.FLOOD ZONE(S) B9•BASE FLOOD ELEVATION(S)
NUMBER 8�19�1992 EFFECTIVE/REVISED DATE (Zone AO,use depth offlooding)
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)
611. Indicate elevation datum used for BFE in 69:� NGVD 1929 ❑ NAVD 1988 ❑Other(Describe)
B12. Is the buiiding located in a Coastal Barrier Resources S stem(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ❑No Designation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. Buiiding elevations are based on: ❑Construction Drawings* ❑ Building Under Construction* ❑ Finished Construction
"A new Elevation Certificate wiil 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)1 ft.above adjencent grade
i) Total area of all permanent openings(flood vents)in C3.h sq.in.(sq.cm)
COfTl�lBfltS:_One signed and se d evation ertificat O6mitted for pioject by the surveyor. Raised seal attached to main i for address 0 to 525 Ma�dalay A e._
Date of Review: Community Official:
Al�vation certi6cates shall be maintained the community and copies with the attached memo made availab/e by request
FRANK HIBBARD,MAYOR
GEORGE N.CRE7'EKOS,COUNCILMEMRER JOI1N DORAN,COUNC[LMEMRER
PAUL F.GIBSON,COUNCILMEMBER � CARI.EN A.PE7'BRSEN,COUNCILMEMBER
��EQUAL EMYLOYMENT AND AFFIRMA'IIVE ACTION EMPLOYEK�