605 POINSETTIA AVE #8 ;J.S.��:`_P.4R�fMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
Expires Februarv 28. 2009
Federal tmergency Management Agency
�National Flood insurance Program Important: Read the instructions on pages 1-8. a q��__�-,�o�..y�
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 Bidg.No.)or P.O. Route and Box No. Company NAIC Number
605 Pointsetta Avenue, Unit 8 ;
City Clearwater State FL ZIP Code 33767
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)
Parcei ID No.05/29/15/66377/000/0010
A4. Buiiding 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
enciosure(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
61. NFIP Community Name&Communiry Number B2.County Name B3.State
125096 0102 G L1 Z.N�r����:-,2 Pinellas Florida
B4.Map/Panel Number B5.Suffix B6. FIRM Index B7. FIRM Panel B8.Flood 69.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
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)
�. 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/A0. 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 � f,'� �;
information. I certify that the information on this Certifiicate represents my best efforts to interpret the data available. "�,`
!understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ~ r��= ., ',�
� Check here if comments are provided on back of form. =��� �'�� `°' � ' �
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Certifier's Name Bruce A.Klein License Number PLS No.5052 • ..? ' '��--° '
� � � � _
e President Company Name Klein&Staub Surveying,Inc. . ., `""° �,.; '`v �
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Address 8016 Old County Road No.54 City New Port Richey State FL ZIP Code 34653 "- '4�
���,�;�..5"0.�,�:
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Signature Date 03/14/07 Telephone 727-834-8140 � � �� "� �
FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions
•IMP�RTANT: ,In these spaces,copy the corresponding information from Section A. For Insurance Company Use:
� Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Policy Number
� 605 Pointsetta Avenue Unit 8
City Clearwater State FL ZIP Code 33767 Company NAIC Number
SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION(CONTINUED)
Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)buiiding 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-BUILDI G ATION 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,compiete 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 enciosure)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 ❑ beiow the HAG.
E3. Attached garage(top of siab)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 locai o�ciai 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 Iaw 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 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
Signature Date
ments
❑Check here if attachments
FEMA Form 81-31, February 2006 Replaces all previous editions
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Building Photographs
See Instructions for Item A6.
For Insurance Company Use:
uilding Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number
Pointsetta Avenue,Unit 8
Clty Clearwater State FL ZI P COd2 33767 Company NAIC Number
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 Viev✓'; 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
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�tJ.S.�FP,�RrMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
Feferal Fmergency Management Agency Exoires FebruaN 28.2009
Nationai Fiood insurance Program Important: Read the instructions on pages 1-8. �,�5.,�y�,��+
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 8
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 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
61.NFIP Community Name&Community Number-r1��p� B2.County Name B3.State
125096"- - - - �1 t,��r�y ..,�� �"lr" Pinellas Florida
64.Map/Panel Number B5.Suffix B6. FIRM Index 67. FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
Date Effective/Revised Date Zone(s) AO,use base flood depth)
12103C0102� G September 03,2003 AE EL.11.0
P993-5 ��
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)
B11. 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 oniy)
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 Certificate represents my best efforts to inteipret the data availab/e.
l 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. � "� %
)
Certifier's Name Bruce A.Klein License Number PLS No.5052
President Company Name Klein&Staub Surveying, Inc.
I
ss 8016 Old County Road No.54 City New Port Richey State FL ZIP Code 34653 0£_� �'a��
1
Signature Date 03/14/07 Telephone 727-834-8140 � � �.
� .
FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions
•IMP�RTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use:
Bclildinc�Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Policy Number
� 605 Pointsetta Avenue Unit 8
City Clearwater State FL ZIP Code 33767 Company NAIC Number
SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION(CONTINUED)
y 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-BUILDI G ATION 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
ess 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 appiicable 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
i
. �
� Building Photographs
See Instructions for Item A6.
For Insurance Company Use:
lding Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number
Pointsetta Avenue,Unit 8 !
Clty Clearwater State FL ZIP COd2 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 �I�
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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
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. LatitudelLongitude: 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)wails 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 62.County Name 63.State
CLEARWATER-125096
64. Map/Panel Number B5.Suffix B6. FIRM Index B7. FIRM Panel 68.Flood B9. Base Flood Elevation(s)(Zone
Date Effective/Revised Date Zone(s) A0,use base flood depth)
12103C-0102 5/17/2005
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 B9: ❑ NGVD 1929 ❑ NAVD 1988 ❑Other(Describe)
612. Is the buiiding 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 wiil be required when construction of the buiiding 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 Vertical 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 e/evation certiBcates shall be maintained by the community and copies with the attached memo made availab/e by request
FRANK HIBAARD,MAYOR
GEORGE N.CRG7'EKOS,COUNCILMEMBER JOIIN DORAN,COUNCILMEMBER
PAUL F.GIBSON,COUNCILMEMBER � CARLEN A.PE'I'ERSEN,COUNCILNIEMBER
��EQUAL EMYLOYMENI'AND f�FFIRMATIVE AC1'ION EMYLOYER��
� . � aoo5 . a-4o�7
rtUtKAL tMtK(itNLY MANACitMtN I A(itN(:T
, - ' NAT��NAL 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. 8
BUILDING STREETADDRESS(Including Apt.,Unit,Suite,and/or Bldg.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 8,Park Place P.B.133,Pgs.30-32
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,rf necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( ##°-##'-##.##" 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 Clearwater 12103C0102G PINELLAS FLORIDA
B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER 65.SUFFIX B6.FIRM INDEX DATE EFFECTIVEIREVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depih of tiooding)
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 locatetl 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 builtling for which this ce�ificate 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,AWA1-A30,AR/AH,AR/AO
Complete Items C3.-a-i below accortling to the building diagram specified in Item C2.State the tlatum 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,lo document the datum conversion.
Datum NAVD 1988 Conversion/Comments N/A A� ' '
.,� �''icf: • ,
Elevation reference mark used LABINS EL.=4.191 Does the elevation reference mark used appear on the FIRM? ❑Yes � � ,Po=� � F '
o a)Top of bottom floor(induding basement or enclosure) 5.60 . FT ft.(m) � Wa''w �'y J�<, ;
o b)Top of next higherfloor 16.60 FT ft.(m) � .,�d 'J ,;`a �,' �,� . }
o c)Bottom of lowest horizontal structural member(V zones only) N/A . FT ft.(m) �a � ;�.,� '� ,s� , ° ; 4
o tl)attached garage(top of block) 5.60 . FT ft.(m) �-� � "-� x .
o e)Lowest elevation of machinery and/or equipment W�' ' s�-� % � " �
� °' "�+' r`'�
serviang the building(Descnbe in a Comments area) 11.00 FT ft.(m) �@ ` '�� `,r,�"' °
o fl Lowest adjacent(f nished)gratle(LAG) 5.0 . FT ft.(m) z m ' " '
o g)Highest atljacent(finished)grade(HAG) 5.1 FT ft.(m) �� "� ' f ���5��4���:.
�, �, �� �i��� �
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent gratle 3 J
o i)Total area of all permanent openings(flood vents)in C3.h 384 sq.in. .
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION �
This certification is to be signetl and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information.
I cerfify that the information 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 1001.
CERTIFIER'S NAME LICENSE NUMBER
BRUCE A.KLEIN PLS 5052
TITLE COMPANY NAME
PRESIDENT KLEIN&STAUB SURVEYING,INC.
ADDRESS CITY STATE ZIP CODE
8016 Old County R 54 New Port Richey FL 34653
SIGNATURE f DATE TELEPHONE
. 03/10I06 (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. For insurance Company Use�
BUILDING STREET ADDRESS(Induding Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX N0. ' Policy Number
605 Poinsetta Avenue Unit No.8
CITY STATE ZIP CODE Company NAIC Number
�LEARWATER FLORIDA 33767
��� SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
�opy both sides of this Elevation Certificate for(1)community official,(2)insurance agenticompany,and(3)building owner.
COMMENTS
NIA
❑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(induding basement or endosure)of the building is _ft.(m)_in.(cm)❑above or ❑below(chedc one)the highest adjacent grade. (Use
natural grade,if available).
E3.For Building Diagrams 6�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 adjacent
grade. Complete items C3.h antl 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 accortlance 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 owners authorized representative who completes Sections A,B,C(Items C3.h and C3.i only),and E for Zone A(without a FEMA�ssued or community-
issued BFE)or Zone AO must sign here. The stafements in Sections A,8,C,and E are correct to the best of my knowledge.
PROPERIY 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 cifficial who is z��thonze�by lav�.�or ortlinance to atlminister the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Certificate. Complete the applicable iter�;s;and sign below.
G1.�The info�mation in SF�tion C was taken`i om other documentation that has been signed antl embossed by a licensed surveyor,engineer,or architect who is authonzed by state
or la^a!law to certify elev�t�;n infaim�t�on. (Intlicate the source and date of the elevation data in the Comments area below.)
G2.❑A corr�muni�y offiaal completed S.�ciion E for a building locatetl in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.❑The following inforrr:ation iitair�s G4-G9)is provided for community floodplain management purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCEIOCCUPANCY ISSUED
G7.This permit has been issued for: ❑New Construction ❑Substantial Improvement
G8.Elevation of as-built lowest floor(including basement)of the building is: _._ft.(m) Datum:_
G9.BFE or(in Zone AO)depth of flooding at the builtling 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