10 PAPAYA ST SOUTH TOWER �
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htUtKALtMtKC�tN(;1(MANAC�tMtNIA(itNl:Y O.M.B. No. 3067-0077
� � NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002
�. ELEVATION CERTIFICATE
Im ortant: Read the instructions on pa es 1-7.
SECTION A-PROPERi'Y OWNER INFORMATION For Insurance CompanyUse;
BUILDWG OWNER'S NAME Policy Number
JMC Communities
BUILDING STREETADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company.NAIC Number
10 Papaya Street South 7ower
CITY STATE ZIP CODE
Clearwater FL 33767
PROPE TY DESCRIPTION(Lot and Blodc Numbers,Tax Parcel Number,Legal Description,etc.)
Tax Parcel#08/29/15/54670/000/0010
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if neczssary.) .
Residential
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( ##°-##'-#1#.##" or ##.�� ❑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 Cleaiwater 125096 Independent City FL
64.MAP AND PANEL 85.SUFFIX 67.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER B6.FIRM INDEX DATE EFFECTIVEIREVISED DATE 68.FLOOD ZONE(S) (Zone A0,use depth of flooding)
125G96-0007 D 08118192 08119/91 AE,VE 11,12,13
810,Indicate the source of the Base Flood Elevabon(BFE)data or base flood depth enteretl in B9.
❑FIS Profile (�FIRM ❑Community Determined ❑Other(Describe):
B11.Indicate the elevation datum usetl for the BFE in B9:�NGVD 1929 ❑NAVD 1988 ❑Other(Describe):
B12.Is the building located in a Coastal Barrier Resources System(CBRS)area or Othen�vise Protected Area(OPA)? ❑Yes �No Designation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIREDj
C1.Builtling elevations are based on;�Constructlon Drawings' ❑Building Under Construcllon* �Finished Construction
"A new Elevation Certificate wili be required when construction of the building is complete.
C2.Builtling Diagram Number 6(Select the building tliagram most similar to the building for which this certificate is being compieted-see pages 6 and 7. If no tliagram
accurately represents the builtling,provide a sketch or photograph.)
C3.Eleva�ons—Zones A1 A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AWA,AWAE,AWA1-A30,AWAH,AWAO
Complete Items C3:a-i below according to the building diagram specified in Item C2,State the datum used.If the datum is tlifferent from the tlatum used for the BFE in
Sec6on B,convert the datum to that used for the BFE.Show fleld measurements and tlatum conversion calculation, Use the space provitled or the Comments area of
SecGon D or Sedion G,as appropriate,to document the datum conversion.
Datum 1929 ConversionlComments
Elevation reference mark used 5.624 Does the elevation reference mark used appear on the FIRM? ❑Yes �No
o a)Top of boflom floor(induding basement or endosure) 6. 7'ft,(m) �
�
o b)Top of next higher floor 17.0'ft.(m) �
o c)Boflom of lowest horizontal structural member(V zones only) 16.3'ft.(m) o 0
o tl)Aflached garage(top of slab) 6. 7'ft.(m) ��
o e)Lowest elevation of machinery andlor equipment W�
seroicing the building(Describe in a Comments area) 2.0'ft.(m) �@
o fl Lowest atljacent(finished)gratle(LAG) 5.5'ft.(m) z'�
o g)Highest adjacent(finished)grade(HAG) 6. 0'ft.(m) ��
o hj No,of permanent openings(flood v�ts)within 1 ft.above adjacent grade 0 �
o i)Total area of all permanent openings(flood venGs)in C3.h 0 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 authorizetl by law to certify elevation information.
!certify thaf the information in Sections A,B,and C on this certificate represents my best efforfs to interpret the data available.
!understand that any false stafement may be punishable by�ne or imprisonmenf under 18 U.S. Code,Section 9001.
CERTIFIER'S NAME Samuel Mark Beach LICENSE NUMBER LS0006261
TITLE Professional Surveyor antl Mapper COMPANY NAME Floritla Design Consultants,Inc.
ADDRESS CITY STATE ZIP CODE
2639 McCom�idc Drive Clearwater FL 33759
SIGNATURE DATE 7ELEPNONE
G �(A`��".,�-O'Z. (727)724-8422
FEMA Form 81-31,JUL 00 SEE REVERSE SIDE FOf2 CONTINUATION REPLACES ALL PREVIOUS EDITIONS
_ _
IMPORT�#NT: In these spaces,copy the corresponding information from Section A. Fo�in5�r��ce comPany use:
� 6UILDING STREET ADDRESS(Induding Apt,Uni�Suite,andlor Bidg.No.)OR P.O.ROUTE AND BOX N0. : Policy Number
' Papaya Street
CITY STATE ZIP CODE Campany NAIC Number
Clearwater FL 33767
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
Copy both:�ides of this Elevation Certificate for(1)community offiaal,(2)insurance agenUcompany,and(3)building owner.
COMMENI'S
C3e:Lowe.S�t machinery servicing the building is elevator equipment in parking garage.
❑Check here if attachments
SEC710N E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zone AO and Zone A(without BFE),complete Items E1 through E4. If the ElevaGon Certificate is inlended for use as supporting information for a LOMA or LOMR-F,
Section C must be completed.
E1.Building C)iagram Number_(Select the building diagram most similar to the building for which this certificate is being completetl—see pages 6 antl 7. If no diagram accurately
represenls the building,provide a sketch or photograph.)
E2.The top of the bottom Boor(induding basement or endosure)of the builtling is _ft.(m)_in.(cm)�above or ❑below(check one)the highest adjacent grade. (Use
natural grade,if available).
E3.For Building Diagrams 6-8 with openings(see page 7),the ne�higher floor or elevated floor(elevation b)of the building is _ft.(m)_in.(cm)above the highest atljacent
grade. Complete items C3.h and C3,i on front of forrn.
E4.For Zone AO oniy: If no floai depth number is available,is the top of the bottom floor elevated in accordance with the community's flootlplain management ordinance?
❑Yes ❑No ❑Unknown. The local official must ce�ify this informa6on in Section�,
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owne�'s authorized representative who completes Sections A,B,C(Items C3.h and C3.i only),and E for Zone A(without a FEMA-issued or community-
issued BFE}or Zone AO must sign here. The statements in Sections A,B,C,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
SIGNATUR,E DATE TELEPNONE
COMMENTS
❑Check here if attachments
SECTION G•COMMUNITY INFORMATION(OPTIONAL)
The local offic�al who is authorized by law or ordinance to administer the community's floodplain management ortlinance can complete Sections A,B,C(or E),and G of this Elevation
Certificate, Cc�mpiete the applicable item(s)and sign below.
G1.�The ir�formaUon in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor,engineer,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 Comments area below.)
G2.0 A corrimunity offiaal completed Section E for a building located in Zone A(without a FEMA-issued or community-issuetl BFE)or Zone A0.
G3.�The fc�llowing information(Items G4-G9)is provided for community floodplain management purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED - — G6.DATE CERTIFICATE OF COMPLIANCEIOCCUPANCY ISSUED
G7.This perm�t has been issued for.0 New Construction ❑Substantial Improvement
G8.Elevafion nf as-built lowest floor(induding basement)of the building is: _.�ft.(m) Datum:_
G9,BFE or(in Zone AO)tlepth of flootling at the building site is: _._ft.(m) Datum:_
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE: DATE
COMMENT:i
❑Check here if attachments
FEMA Form 81-31,JUL 00 REPLACES ALL PREVIOUS EDITIONS
• h�tJtKALGMtKC�tNLY MANACitMtNl AtitNLY O.M.B. No. 3067-0077
���, NATIONAL FLOOD INSURANCE PROGRAM Expires Jufy 31, 2002
`��� ELEVATION CERTIFICATE
Im ortant: Read the instructions on pages 1-7.
_ ._ __ _
SECTION A-PRQPERTY OWNER INFORMATION Forinsuranc�CanpanyUse:
BUILDING OWNER'S NAME Policy t�umber
JMC Cammunities �
BUILDING STREET ADDFtESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Corrapany.NAIC Number
10 Papaya Street South Tower
CITY STA7E ZIP CODE
Clearwater FL 33767
PROPE TY DESCRIPTION(Lot and 61ock Numbers,Tax Parcel Number,Legal Description,etc.)
Tax Parcel#08/29/15/54670/000/0010 •
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,ff necessary.) .
Residential
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DAn1M: SOURCE: ❑GPS(Type):
(##°-##'-#t#.##" or ##.�) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.
SECTION B-FLOOD INSUf2ANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3,STATE
City of Clearwater 125096 Independent Cihr FL
84.MAP AND PANEL 85.SUFFIX B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER B6.FIRM INDEX DATE EFFECTIVEIREVISED DATE B8.FLOOD ZONE(S) (Zone A0,use deplh of flooding)
125696-0007 D 08118192 08119KJ1 AE,VE 11,12,13
610.Indicate the source of the Base Flootl Eleva6on(BFE)data or base flood depth entered in B9. .
❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe);
B11.Indicate the elevation datum used for the BFE in 69:�NGVD 1929 ❑NAVD 1988 ❑Other(Describe):
B12.Is the building located in a Coastal Barrier Resouroes 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:[]Constructla�Drawings' ❑Building Under Construction" �Fnished Construction
"A new Elevafion Certificate will be require�when consGuction of the building is eomplete.
C2.Building Diagram Number 6(Select the buiiding diagram most similar to the building for which this oeriificaie 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,ARIA1-A30,AR/AH,ARIAO
Complete Items C3,-a-i below aocording 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
SecGon 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
SecGon D or Sedion G,as appropriate,to document the datum conversion.
Datum 1929 ConversionlComments
Elevation reference mark used 5.624 Does the elevation reference ma�C used appear on the FIRM? ❑Yes �No
o a)Top of bottom floor(induding basement or endosure) 6. 7'ft.(m) �
o b)Top of next higherfloor 17.0'ft.(m) �
o c)Boflom of lowest horizontal structural member(V zones only) 16.3'ft.(m) o 0
o �Attached garage(top of slab) 6. 7'ft.{m) E�
o e)Lowest elevation of machinery and/or equipment W�
senriang the building(Describe in a Comments area) ?,p'ft,(m) E�
o fl Lowest adjacent(finished)gratle(LAG) 5,5'ft.(m) z'm
o g)Highest atljacent(finished)grade(HAG) 6. 0'ft.(m) y�
�
o h)No.of permanent openings(800d v�ts)within 1 ft.above adjacent grade 0 �
o i)Total area of ail permanent openings(flood vents)in C3.h 0 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 certify elevation information,
I certify that the information in Sections A,B,and C on this certificate represents my best efforts to lnferpret fhe data available.
1 understand that any false statement may be punishable by�ne or imprisonment under 18 U S Code,Section 1001
CERTIFIER'S NAME Samuei Mark Bead� LICENSE NUMBER LS0006261
TITLE Professional Surveyor and Mapper COMPANY NAME Florida Design Consultants,Inc.
ADbRESS CITY STATE ZIP CODE
2639 McCormidc Drive Clearwater FL 33759
SIGNATURE DA7E TELEPHONE
G �(p`',���O'Z, (727)724-8422
FEMA Form 81-31,JUL 00 SEE REVERSE SIDE FOR CbN71NUATION REPLACES ALL PREVIOUS EDITIONS
a
, . � �RTANT; In these space,,cr�py the corresponding information fram Section A. 'For Insurance Company Use:
' �UILDING STREET ADDRESS(Induding Apt,Unit,Suite,andlor Bkig.No.)OR P,O.ROUTE AND BOX N0. ' Rolicy Number
' Papaya Street
CIIY STATE ZIP CODE Company NAIC Number
Cleanvater FL 33767
SEC710N D-SURVEYOR,ENGINEER,OR ARCHITEC?CERTIFICATION(CONTINUED)
Copy both sides of this Elevation Certificate for(1)community offiaal,(2)insurance agenUcompany,and(3)buiiding owner.
COMMENI'S ,
C3e:Lowest machinery seroicing the building is elevator equipment in paricing garage.
❑Check here if attachments
SEC710N E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIREDj FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zone AO and Zone A(without BFE),complete Items E1 through E4. If the EJevation Certificate is inlended for use as supporting information for a LOMA or LOMR-F,
Section C must be compieted.
E1.Building C)iagram Number_(Select the building diagram most similar to the building for which this cerfificate is being completed—see pages 6 and 7. If no diagram accurately
represents the building,provide a sketch or photograph.)
E2.The top af the bottom floor(induding basement or endosure)of the building is _ft.(m)_in.(cm)�above or ❑below(check one)the highest adjacent grade. (Use
natural grade,if available).
E3.For Buiiding Diagrams 6-8 with openings(see page 7),the ne�higher floor or elevated floor(elevation b)of the building is _ft.(m)_in.(an)above the highest adjacent
grade. Complete items C3.h and C3.i on front of forrn.
E4.For Zone AO only: if noflood depth number is available,is the top of the bottom floor elevated in acoordance with the community's flootlplain management ordinance?
❑Yes ❑No ❑Unknown. The bcal official must oer�fy this informaGon in Section�,
SECTIQN F•pROPERTY OWNER(OR OWNER'S REPRESENTA7IVE)CERTIFICATION
The property owner or owner's authorized representaGve who completes Sections A,B,C(Items C3.h and C3:i only),and E for Zone A(wilhout a FEMA-issued or community-
issuetl BFEp or Zone AO must sign here. The statements in Sections A,B,C,and E are correct to the best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENI'ATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑Check here if attachments
5ECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local offiaal who is authorized by law or ordinance to administerthe community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Ce�ificate. Complete the appiicable item(s)and sign bebw.
G1.�The i�forrna6on in Section C was taken fran other documentation that has been signed and embassed by a licensed surveyor,engineer,or architect who is authorized by
state or local law to cerhfy elevation infom�ation. (Indicate the source and date of the eleva�on data in the Comments area below.)
G2.�A conimunity official oompleted Sedion E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�The fallowing information(Items G4-G9)is provided for communiiy floodpiain management purposes.
G4,PERMIT NUMBER G5. DATE PERMIT ISSUED G6.DATE CERTIFICATE OF COMPLIANCEIOCCUPANCY ISSUED
G7.This permit has been issued for.�New ConsVudion ❑Substantial Improvement
G8,ElevaUon of as-built lowest floor(induding basement)of the building is: _._it.(m) Datum:_
G9,BFE or(in Zone AO)depth of fboding at the building site is: _._ft.(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE: DATE
COMMENTS
❑Check here if attachments
FEMA Form f11-31,JUL 00 REPLACES ALL PREVIOUS EDITIONS