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605 POINSETTIA AVE #6 U.S. DEP,��MEN7'OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 F�deral Emergency Management Agency Ex�ires Februarv 28.2009 National Fiood Insurance Program Important: Read the instructions on pages 1-8. ��p5--.��.{py 5 SECTION A-PROPERTY INFORMATION For Insurance Company Use: . Buiiding Owner's Name Florence Enterprise,LLC Policy Number . Building Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number 605 Pointsetta Avenue, Unit 6 aa;ns`}.�; City Clearwater State FL ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcei Number,Legal Description,etc.) Parcel ID No.05/29/15/66377/000/0010 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) Residentival A5. Latitude/Longitude:Lat.82^49'32" Long.27^59'09" 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 7 A8. For a building with a crawl space or enclosure(s), provide A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s) N/A sq ft a) Square footage of attached garage 509 sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade N/A walls within 1.0 foot above adjacent grade 8 c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b 912 sq in SECTION B -FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1. NFIP Community Name&Community Number B2.County Name B3.State 125096 0102 G ��g.2��T�� Pineilas Florida 64. Map/Panel Number 65.Suffix B6. FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 12103C0102G G September 03, September 03,2003 AE EL.11.0 2003 610. 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 B9: ❑ NGVD 1929 � NAVD 1988 ❑Other(Describe) �. Is the building located in a Coastai Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes �No Designation Date ❑ 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-g below according to the building diagram specified in Item A7. Benchmark Utilized Labins EI.4.191 Vertical Datum NAVD 1988 Conversion/Comments N/A Check the measurement used. a) Top of bottom floor(including basement,crawl space,or enclosure floor)_ 6.60 �feet ❑ meters(Puerto Rico only) b) Top of the next higher floor 16.60 �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) 6.00 �feet ❑ meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 11.00 �feet ❑ meters(Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent(finished)grade(LAG) 5.0 �feet ❑ meters(Puerto Rico only) g) Highest adjacent(finished)grade(HAG) 5.8 �feet ❑ meters(Puerto Rico only) 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 Certi�cate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. � Check here if comments are provided on back of form. ` r f v ✓ :, . . , . �.� ° r rv Certifier's Name Bruce A.Klein License Number PLS No.5052 _f •"t``' 4�� p „�.� �� President Company Name Klein&Staub Surveying, Inc. E, ~ ' � � ,-- �J � G e 3 ' ,_ Address 8016 d Coun oad No.54 City New Port Richey State FL ZIP Code 34653 '" ,f � ��:Z �k Signature Date 03/14/07 Telephone 727-834-8140 ° ?.� ':'�� ,� f ,,�� J . .e'•• . FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions 1 � IMPOR i ANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: � uilding Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number , 605 Pointsetta Avenue Unit 6 City Clearwater State FL ZIP Code 33767 Company NAIC Number SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) opy both sides of this Elevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)building owner. Comments All A/C Units are on the roof Elevator equipment is on or above EI. 11.00 Signature , Date 03/14/07 . ❑ Check here if attachments SECTION E -BUILDING N 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,crawl space,or enclosure)is ❑feet ❑ meters ❑above or 0 below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑ meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9(see page 8 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 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. perty 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 comp�ete 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 Compiiance/Occupancy Issued G7.This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8.Elevation of as-built lowest floor(inciuding 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 Local Official's Name Title Community Name Telephone Signature Date �mments ❑ Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions U.S.DE�.�^-aRTMENT�OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660=0008 Federal Emergency Management Agency Expires Februarv 28. 2009 fvdtional Fiood Insurance Program Important: Read the instructions on pages 1-8. ��„�pS,..n�p�S SECTION A-PROPERTY INFORMATION For Insurance Company Use: Building Owner's Name Florence Enterprise,LLC Policy Number Building Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number 605 Pointsetta Avenue, Unit 6 City Clearwater State FL ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Parcel ID No.05/29/15/66377/000/0010 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) Residentival A5. Latitude/Longitude:Lat.82^49'32" Long.27"59'09" 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 7 A8. For a building with a crawl space or enclosure(s),provide A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s) N/A sq ft a) Square footage of attached garage 509 sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade N/A walis within 1.0 foot above adjacent grade 8 c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b 912 sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 61.NFIP Community _' Number B2.County Name 63.State 125096-03�' q,2� T= Pinellas Florida 64.Map/Panel Number B5. u ix 66.FIRM Index 67.FIRM Panel B8.Flood 69.Base Flood Elevation(s)(Zone 5 �ffective/Revised Date Zone(s) AO,use base flood depth) 12103C0102� G Septe�m=bee 03, ' � September 03,2003 AE EL.11.0 20A3-- 610. 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) 611. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 ❑Other(Describe) B 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. 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-g below according to the building diagram specified in Item A7. Benchmark Utilized Labins EI.4.191 Vertical Datum NAVD 1988 Conversion/Comments N/A Check the measurement used. a) Top of bottom floor(including basement,crawl space,or enclosure floor)_ 6.60 �feet ❑ meters(Puerto Rico only) b) Top of the next higher floor 16.60 �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) 6.00 �feet ❑ meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 11.00 �feet ❑ meters(Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent(finished)grade(LAG) 5.0 �feet ❑ meters(Puerto Rico only) g) Highest adjacent(finished)grade(HAG) 5.8 �feet ❑ meters(Puerto Rico only) 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 Cerfi�cate represents my best efforts to interpret the data available. I understand that any false statement may be punrshable by fiine or imprisonment under 18 U.S. Code, Section 1001. � Check here if comments are provided on back of form. I - Certifier's Name Bruce A.Klein License Number PLS No.5052 f i 'resident Company Name Klein&Staub Surveying, Inc. � � A ss 8016 d Coun oad No. 54 City New Port Richey State FL ZIP Code 34653 ��' ��-Z Signature � Date 03/14/07 Telephone 727-834-8140 _ � j �� FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions IMPO,^"i ANT: 1�1 these spaces,copy the corresponding information from Section A. For Insurance Company Use: Eiuilding Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Policy Number 605 Pointsetta Avenue Unit 6 City Clearwater State FL ZIP Code 33767 Company NAIC Number SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION(CONTINUED) py both sides of this Elevation Certificate for(1)community o�cial,(2)insurance agenUcompany,and(3)building owner. Comments All A/C Units are on the roof Elevator equipment is on or above EI. 11.00 Signature _ Date 03/14/07 ❑ Check here if attachments SECTION E-BUILDING N 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,crawl space,or enclosure)is ❑feet ❑meters ❑above or�below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑ meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9(see page 8 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 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. .� erty Owner's or Owner's Authorized Representative's Name ress City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local offcial 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 building: _❑feet ❑ meters(PR)Datum G9. BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑ meters(PR)Datum Local Official's Name Title Community Name Telephone Si nature Date ents ❑Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions , y � I � Building Photographs See Instructions for Item A6. n Use: For Insurance Compa y ilding Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number Pointsetta Avenue,Unit 6 Clty Clearwater State FL ZIP COd@ 33767 CompanyNAlCNumber 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, following. Front View Rear View � t 1 °s �„� — ._ �� v� ' � � \ `<_ .\ �� , , � 4 �D��A`F%i y _.-- a � .�.r,5'"� �o a ■ � � � c:; � ■ ��s�' � � �� "+�r ;: .:��-`��'�s� x: A 4 � ? ��.�� a,a�{��.�i f � .t..�.�...�.�"�,,,1 r �.„ . � "'"St,�' '. �. ?�a�` '�,'�_�w�' : � x � �� . ��e . �r �s -.' i . � � ¢� �� j;. rn � r°'' + -.4 t � � '"�,.�,^ ..� � .g IY�''.� . 3 ;.,s ...�9- ��.� . � �'� '�; ' C � .�i�� ' � .. ��j �i� . � ��'9•w�, y#v°�� ` �'. : � .' ,r.^ T � �� . : � � : . � u g �.��` � . , . , . , 4 �� . � .' � ' , � . &, � �.. _ . �. s,`F. ,Y��. g �� x � � ` �� k t�a � 6 �..y � . ._. y � � � �r . ,:.+� ��' i� ,�+. 4 F F ,s , y � , � . �� `,�' ,� �� • `r�°-.-�1a. �f<i�,. . r, ,�,�, , . _ _ _ . � .. _ „� r 1 ' �� ''��.�'+�IA� , C -� �� -�.�-_ � � # � �J��` s°� . �� - �� t -� - " �`� � �� , �. �°i�:��..-;=.,. � � . \. �.r.X" s.�. . . 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"_ +E,_.:.�-- Ei.i 'fi . �.e�� - �F • � �� , r�'��„,�"��'�,�rr,�� @��r�� :'Ex'�X ��`��" CITY OF CLEARWATER b �� ,r�*si�1h� �1�. � : � us. �� ;.�Y'c � ��`�"� '� DEVELOPMENT & NEIGHBORHOOD SERVICES DEPARTMENT �� 4� $ '°��+ �gre�+��"' ° POST OFFICE BOX 4748� CLFARWATER� FLOx,DA 33758-4748 ��f�.��$wa�,.�,, �E. #�� '. ,�r ,�, , � MUNICIPAL SERVICES BUILDING, IOO SOUTH MYRTLE AVENUE,CLEARWATER,FLO�uDA 33756 `�'�`y`"' ' TELEexoNE(72� 562-4567 Fnx(72� 562-4576 MEMO OF REVIEW FOR CORRECTNESS 8� 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 City State ZIP Code A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) A4. Buiiding Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) A5. Latitude/Longitude: Lat. Long. 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 A8. For a building with a crawl space or enclosure(s), provide A9. For a building with an attached garage,provide: � a) Square footage of crawl space or enclosure(s) sq ft a) Square footage of attached garage sq ft b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage enclosure(s)walis within 1.0 foot above adjacent grade walls within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION 61. NFIP Community Name&Community Number B2. County Name 63.State CLEARWATER-125096 B4. Map/Panel Number 65.Suffix B6. FIRM Index 67. FIRM Panel B8. Flood B9. Base Flood Efevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 12103C-0102 5/17/2005 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) 611. Indicate elevation datum used for BFE in Item B9: ❑ 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. 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-g below according to the building diagram specified in Item A7. Benchmark Utilized Ve�tical Datum Conversion/Comments Check the measurement used. e) Lowest elevation of machinery or equipment servicing the building ❑feet ❑meters(Puerto Rico only) (Describe type of equipment in Comments) Comments: �of Review: Community Official: All elevation ceRificates shall be maintained by the community and copies with the attached memo made available by request FRANK HIBAARI),MAYOR GEORGE N.CRE7'EKOS,COUNCILMEMBER JOI W DORAN,COUNCILMEMBER Pnu�F.Gissorr,COUNCILMEMBER � CARI.GN A.PE'I'ERSEN,COUNCILMEMBER ��EQUAL EMYLOYMENT AND E�FFIRMA'fIVE AC1'lON EMPLOYEK� � "a00�' -C74o4 � F-tUtKAL tIVItKCitNI:T MANAIitMtN I A(itNl:T ' NaTIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077 Expires December 31, 2005 • ELEVATION CERTIFICATE Important: Read the instructions on pages 1-7. JOB No.050132.2 SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Policy Number Park Place Townhomes, LLC Unit No. 6 BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number 605 Poinsettia Avenue CITY STATE ZIP CODE CLEARWATER FLORIDA 33767 PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Lot 6,Park Place P.B.133,Pgs.30-32 BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.) RESIDENTIAL LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type): ( ##°-##'-##.##" or ##.###if#°) ❑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 12103C0102G PINELLAS FLORIDA B4.MAP AND PANEL 67.FIRM PANEL 69.BASE FLOOD ELEVATION(S) NUMBER 65.SUFFIX B6.F�RM INDEX DATE EFFECTIVEIREVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depih of Booding) 125096-0102 G SEPTEMBER 03,2003 SEPTEMBER 03,2003 AE EL.11.0 B10.Indicate the source of the Base Flood Elevation(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 B9:❑NGVD 1929 �NAVD 1988 ❑Other(Describe): B12.Is the 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) 1.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. 2.Building Diagram Number 7 (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,AWAE,AWA1-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 appropnate,to document the datum conversion. Datum NAVD 1988 Conversion/Comments N/A � �'� ;;°�f , Elevation reference mark used IABINS EL.=4.191 Does the elevation reference mark used appear on the FIRM? ❑Yes��'t ' ;�. o a)Top of bottom floor(including basement or enclosure) 5.60 . FT ft.(m) -�• �, '�y o b)Top of ne�higher floor 16.60 FT ft.(m) `� „ �' G=� � _� �` o c)Bottom of lowest horizontal structural member(V zones only) NIA . FT ft.(m) "� �s.- �� o d attached ara e to of block 5.60 FT ft.m �� " � ) 9 9 � P ) � ) � ��` �`" �' � o e)Lowest elevation of machine ry and/or e qui pment -�,a � �v,-' �, � servicing the builtling(Descnbe in a Comments area) 11.00 Ff ft.(m) ,. @� �,��,,"� ��."�• o fl Lowest adjacent(finished)grade(LAG) 5.0 . FT ft.(m) ��' �•.,�.��$'��;�5052 o g)Highest adjacent(finished)grade(HAG) 5.1 FT ft.(m) �;, �, �'f�`' �`< s,R pp3%10/06 o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 3 J o i)Total area of all permanent openings(flootl vents)in C3.h 384 sq.in. 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 in Sections A,B,and C on this cerfificate represents my best efforts to interpret the data available. I undersfand that any false sfafemenf may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. CERTIFIER'S NAME LICENSE NUMBER BRUCE A.KLEIN PL5 5052 TITLE COMPANY NAME PRESIDENT KLEIN&STAUB SURVEYING,INC. ADDRESS CITY STATE ZIP CODE 8016 Old County Roa New Port Richey FL 34653 SIGNATURE � r DATE TELEPHONE ' 03/10/06 (727)834�140 FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. Forinsurance company�ise: BUILDING STREET ADDRESS(Induding Apt,Unfl,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX N0. ' Policy Number 605 Poinsetta Avenue Unit No.6 CITY STATE ZIP CODE Company NAIC Number � CLEARWATER FLORI�A 33767 SECTION D•;;U_��_.`��:1',F.M�INk'cR_CR ARCHIT'�CT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)commu�,t, .,ifcial,(2)ir,,urance agenUci:mpany,and(3)builtling owner. COMMENTS N/A ❑Check here if attachments SECTION 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 Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. E1.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.) E2.The top of the bottom floor(including basement or enclosure)of the building is _ft.(m)_in.(cm)❑above or ❑below(check one)the highest atljacent grade. (Use natural gratle,if available). E3.For Builtling Diagrams 6-8 with openings(see page 7),the ne�higher floor or elevated floor(elevation b)of the builtling is _ft.(m)_in.(cm)above the highest adjacent grade. Complete items C3.h and C3.i on front of form. E4.The top of the platform of machinery and/or equipment servicing the building is _ft.(m)_in.(cm)❑above or ❑below(check one)the highest adjacent grade. (Use natural grade,if 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 community's floodplain management ordinance? ❑Yes ❑No ❑Unknown. The local official must certiiy this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owners authorized representative who completes Sections A,B,C(Items C3.h antl 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 SIGNATURE DATE TELEPHONE COMMENTS ❑Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official�rho is authorized by law or ordir�ance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation Certificate. Complete th°applicable item(s)an�sign below. G1.�The information��Sec;tion C e:as taken from other documentation that has been signetl antl embossed by a licensed surveyor,engineer,or architect who is authorized by state or local law to certify elevation ir�(orroation. (!ndicate the source antl date of the elevation data in the Comments area below.) G2.�A community oificial a�mpleted Sectio^E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0. G3.❑The following informatic�(Items G4-�9)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 issuetl for: ❑New Construction ❑Substantial Improvement G8.Eleva6on of as-built lowest floor(indutling basement)of the building is: _._ft.(m) Datum: G9.BFE or(in Zone AO)depth of flooding 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 81-31,January 2003 Replaces all previous editions _ - . �t , , � Building Photographs See Instructions for Item A6. . For Insurance Company Use. ilding Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number Pointsetta Avenue,Unit 6 Clty Clearwater State FL ZIP COd6 33767 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least finro 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, following. 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