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420 PALM ISLAND SE U.S.DEPQRTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB NO. 1660-0008 F�e�+eral Emergency Management Agency Expires March 31,2012 National Fiood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION ��br�X�yrance,�(;ompany;,,f�se:. `, A1. Building Owner's Name ° ' ��`' ' " '' Jeffre W.Garland&Fezi'e R.Garland �t�� : � ... .' r , '�� . ,.�:� ""`� ` A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. � °��,8 , �U►l(� ;urh�* z';;K' ; `�' 420 Palm island SE re���•�.�.' , � City Clearvvater State FL ZIP Code 33�6� JUN 2 5 ���� A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) ��--� - Lot 28, Island Estates of Clearwater Unit 6-A � . ' �"•> a� �w ✓ ,� A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential ��;��'y� ,�� � r; ., " A5. Latitude/Longitude:Lat.27.9841964 Long.-82.815358 ' Horizontal Da um:"°""�°?� -{�•�'M9$3 ; A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 16 AS. 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 462 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 0 c) Total net area of flood openings in AB.b N/A 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 Clearvvater 125096 Pinellas FL 64.Map/Panel Num r ' 65.Suffix 66.FIRM Index 67.FIRM Panel B8.Flood 69.Base Flood Elevation(s)(Zone 12103C0102 � G Date Effective/Revised Date Zone(s) AO,use base flood depth) 8-18-09 9-3-03 AE 11' 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 Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other(Describe) B12. 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 Q below according to the building diagram specified in Item A7. Use the same datum as the BFE. Z Benchmark Utilized CWBM"H-40"ATLAS PG 2676Verticai Datum ELEV=4.4997'(N.A.V.D.I � Conversion/Comments N/A Check the measurement used. "'� � a) Top of bottom floor(inGuding basement,crawlspace,or enclosure floor)7.12 �feet ❑meters(Puerto Rico only) � � b) Top of the next higher floor N.A �feet ❑meters(Puerto Rico only) 5 � c) Bottom of the lowest horizontal structural member(V Zones only) N.A �feet ❑meters(Puerto Rico only) J O d) Attached garage(top of slab) 6.42 �feet ❑meters(Puerto Rico only) � � e) Lowest elevation of machinery or equipment servicing the building 6.55 �feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) (L � N � Lowest adjacent(finished)grade next to building(lAG) F.3 �feet ❑meters(Puerto Rico only) a g) Highest adjacent(finished)grade next to building(HAG) 6.� �feet ❑meters(Puerto Rico only) (V (� h) Lowest adjacent grade at lowest elevation of deck or stairs,including N.A �feet ❑meters(Puerto Rico only) �' m 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 certi(y fhat the information on this Certifrcate represents my best efforts to interpret the data available. � ,f �';��{ z I understand that any fa/se statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. ^�� �-�p��•;,�, •,,�,:�-•.� � ,;rr�-" � Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ��.•f,,�. , licensed land surveyor? � Yes ❑ No ''= = : ��'9�� ., �� Certifier's Name Philip C.Stock License Number RLS#3035 _ _ '• J�. ; Title President Company Name Target Land Sunreying,Ina �r`�J4,rD�,�',��'." .,�.��� Address 516 Lakeside Place City Largo State FL ZIP Code 33771 �"'" �' �` - , =;; ...�,4 ,.,.. �_ : Signature �- Date 6-24-10 Telephone (727)784-0573 `� ? .� � �'`- '�"'�� i - �-�.��°_-�� { .--� FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. ;nFor'Ipsurance Company,Use;. �uilding Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O.Route and Box Na Poll�y,`Number' 420 Palm Island SE City Clearwater State FL ZIP Code 33767 'Compeny;NAIC Number ' SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments Job#100621.04 C2.e)=A/C Unit According to the Pinellas County Property Appraiser,this house was built in 1968. At that time,FEMA flood maps did not exist. /�'���_._ Signatu e �' Date 6-24-10 ❑ Check here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT RE�UIRED)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 oniy,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 enGosure)is ❑feet ❑meters ❑above or❑ below the HAG. b)Top of bottom floor(including basement,crawispace,or enGosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Buiiding 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 buiiding 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 informaGon in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who compietes 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 buiiding: ❑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 U.S.DEPAE3TMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency Expires March 31,2012 National F�ood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION A1. Building Owner's Name BRADLEY CONSTRUCTION A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. 420 PALM ISLAND SOUTHEAST Ciry CLEARWATER State FL ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) LOT 28,UNIT 6A ISLAND ESTATES OF CLEARWATER,PLAT BOOK 60,PAGE 90 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)RESIDENTIAL A5. Latitude/Longitude:Lat.27°59'04"N Long.82°48'54"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 1 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 462 sq ft b) No.of permanent flood openings in the crawispace or b) No.of pennanent 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 AS.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 62.Counry Name 63.State CITY OF CLEARWATER 125096 PINELLAS COUNTY FLORIDA B4.Map/Panel Number B5.Suffix 66.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) 9-3-2003 9-3-2003 AE 11.0' 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)N/A 611. 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 Othenvise 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 ConsVuction '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. Benchmaric Utilized PINELLAS COUNTYVertical Datum NAVD 1988 Conversion/Comments N/A Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enGosure floor)7.3 �feet ❑meters(Puerto Rico only) b) Top of the next higher floor N/A. ❑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) 6.8 �feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building N/A. ❑feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) � Lowest adjacent(finished)grade next to building(LAG) 5.8 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 6.1 �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. I certify that the information on this Certificate represents my best efforts to interpret the data available. � ' ``` `°�"f f� l understand that any false statement may be punishable by�ne or imprisonment under 18 U.S. Code,Section 1001. *'��A , �-� i������,i1f�,i � Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ''�- '*�' ,�? �p �'. licensed land surve or? � Yes ❑ No ° �"� ;��:Q��� ���'�" .. c''' y � � .r F r'.. �7t;��?r� �.. Certifier's Name DONALD L.WILLIAMSON License Number PSM#5649 A -,;, ; f t! �'� a Title PROFESSIONSL LAND SURVEYOR Company Name WILLIAMSON&ASSOCIATES INC. � ��'�`�=�° �'; `� i�� �.� �.t"�����,,�'�. '•'-� •r '' . ''�o. ._. Address 5020 GU N HWY S E 220A City TAM State FL ZIP Code 33624 �,. ��, .. ....�'' �. `' ���\'/ r fV,:�3� ���:�� Signature � Date 11-17-2010 Telephone 813-265-4795 - f , s c��� FEMA Form 1-31, Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. Building Street Address(including Apt.,Unit,Suite,and/or Bidg.No.)or P.O. Route and Box No. 420 PALM ISLAND SOUTHEAST City CLEARWATER State FL ZIP Code 33767 �,�: 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 JOB#10-762 Signature Date 11-17-2010 ❑ Check here if attachments SECTION E-BUI�DING 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 foilowing 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(inGuding basement,crawlspace,or enGosure)is N/A. ❑feet ❑meters ❑above or❑below the HAG. b)Top of bottom floor(inGuding basement,crawlspace,or enGosure)is N/A. ❑feet ❑meters ❑above or❑ below the LAG. E2. For Buiiding Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the ne�ct higher floor (elevation C2.b in the diagrams)of the building is N/A. ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is N/A. ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is WA. ❑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 o�cial completed Section E for a building located in 2one 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(inGuding 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�Vame Title Community Name Telephone Signature Date Comments --- ❑Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions