1401 GULF BLVD #105 � ����_I5U�-� I�� II' I __ _ _ _
� � FEDERAL EMERGENCY MANAGEMENT AGENCY
� il C��" � R 2004 ��+ �I NAl10NAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
� l.-� Ex ires December 31,2005
� �� S�; p.
�
, * � � ELEVATION CERTIFICATE
UE�Ei_��'�EN���A WpTE F"�£ .:__ . Readtheinstrucfionson 1-7.
-""�""~+���� SEC110N A-PROPERTY QWNER INFORMATION Fa Nsuanoecarpeny use:
BUILDING OWNER'S NAME p�y N�
LOUISE ALVERSON
BUILDING STREET ADDRESS(Induciig Apt,Urit,Su6e,anci/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
1401 GULF BLVD,UNIT 105
Cm' STATE ZJP CODE �
CLEARWATER FL 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Desqiption,etc.)
TAX PARCEL ID 19C29/15/78633/001/1050 PINELLAS COUNTY,FLORIDA
BUILDING USE(e.g.,Resider�Ual,Non-residential,Add�on,Ac�ory,etc. Use a CommeMs area,'rf necessary.)
RESIDENTIAL
LATITUDEJLONGfTUDE(OPTIONAL)HORIZONTAL DATUM: SOURCE: GPS(Type):
(#►�-�-�a#.�a ##.�i ❑ww 1 sz� ❑ruw�sss ❑uscs Q�a Maa ❑ou,�:
SECIION B-FLOOD INSURANCE RATE MAP(FlRIII�INFORMATION
61.NFlP COMMUNf1Y NANE&COMuIUNITY NUh�BER 62.COUMY NAIuE 63.STqTE
PINEIlAS COUMY 125096 �L i��t w Ar6 R PlNg1qg�pUMy F�
B4.MAP AND PANEL B7.RRM PANEL B9.BASE FLOOD EIEVATION(S)
NUI�8Ef2 B5.SUFFU( B6.FlRM INDDC DATE EFFECTNE�RE1/ISED DATE B8.ROOD ZONE(S) (ZoneAO,usedep�aFlbod��g)
125(%�60104 G 09�03 09�03 AE 11.00&12.00
610.Indicate the sour�e of the Base Fbod Elevation(BFE)data or base flood depth entered in 69.
❑FIS Profle �FIRM ❑Communihr De�ermined ❑Ofher(Desai�e):
B11.Indicate the elevation datum used forthe BFE in B9:�NGVD 1929 �NAVD 1988 ❑OUier(Descxbe):
612.Is the buiding bcated in a Coastal Bartier Resouroes System(CBRS)area w Otliervu'se Proteded Area(OPA)? ❑Yes X No Designation Date
SEC110N C-BUILDIN6 ELEVA710N INFORMATION(SURVEY REQUIRED)
C1.Buiding elevations are based on:�Construction Drawings"' ❑Buiding Under ConstnKtion" �Fini�hed Conshix�on
� "A new Elevation Certificate wil be required when constnKtion of the buiding s complete.
.Bokiirg Diagram Number 1(Seled the buiding diagram rrio�simiar to the buiding iw which this certificate is being oompleted-see pages 6 and 7. If no diaqram aocur�ely
represents the buiding,provide a sketch or photograph.)
C3.Elevations-ZonesA1,A30,AE,AH,A(w�h BFE',VE,V1-V30,V(w�h BF�,AR,AWA,AR/AE,AR/A1-�130,AR/AH,AR/AO
Complete items C3.-a�i bebw aocortiirg to the bukling diagram speafied'm Item C2.Stahe the datum used.if the datum is different from the dalum used for the BFE in
Section B,cornert the datum to that used for the BFE.Stmw field measuremertls and datum cornrersan r,alailation. Use the spaoe provided or the Comments area of
Sedion D or Sedion G,as appropriate,to document the datum cornersion.
Dahim NAVD CornrersioNComments 1988 DATUM
Ele�vation referenoe ma�k used uDces the elevation refererxe mark used appear on the FIRM? ❑Yes �No
o a)Top of bottom floor(induding basement or endosure) 6_34 ft(m) �;
o b)Top of next higherfloor WA ft(m) �' '�"�r �": " ,�-
o c)Bot6�m of bwest horiaontal strudural member(V mnes ony) I�UA ft(m) �� �;,� � � _ ~•
o d)AVad�ed 9arage(bp of slab) WA ft(m) $a s:' :=�� �,r `': ,. �"��
o e)Lorr�est e,levation of machinery andlor equipment `�m �� :�„ ��'�r *�:
�� �'• � t . � �1 .. R.''�
servicing the buiding(Des�be in a Comments area) 628 ft(m)(2) � � �`
o fl Lowest adjaoent(finist�ed)9rade(LAG) 5.71 ft(m) z w" , ' "s�'���� `' , ., � � . �
o g)Hghest adjaoent(finish�grade(HAG) 5.97 ft(m) �� b�' ;�, r . `,�F
o h No.of rmanent n � :- i `�`+J `��
) Pe ope irgs(flood vents)vwtliin 1 ft abrnie adjacent grade IVIA �, �
o )Total area of all permanent openings(flood veMs)in C3.h 0 sq.in.(0 sq.an)
SECTION D•SURVEYO R,ENGINEE R,ORARCHtTECTCERTIFl C ATI ON 1�
,
This cert�cation is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certif}+elevation information. ''��
f cerfify that the informafion in Sections A,8,and C on this ce►tificate represents my best efforfs to inferpref the data available.
1 undersfand fhaf any false sfatement may be punishable by fine or imprisonment under 18 U.S.Code Section 1001
CERTIFIER'S NAME JOHN STRACHAN LICENSE NUMBER 6312
TITLF PRESIDENT COMPANY NAME CROSSTOWN SURVEYORS,INC
�
ADDRESS CIN STATE ZIP CODE
5030 78�"AVENUE ORTH-SUITE 8 PINELLAS PARK FL 33781
SIGNATURE DATE TELEPHONE JOB NUMBER
10NSiC)4 (12�647-7984 04621�
IMPORTANT: In these spaces,copy tl�e oorresponc�n ir�forma6on finm Sec6on A. Fa in�aance carpeny use:
,
BUILDING STREET ADDRESS(Induc�irg Apt,Ur�,Sui�,ardlar Bldq.No.)OR P.O.ROUfE AND BOX N0. Poio�r Number ,
1401 GULF BLVD,UNIT 105 �
CffY STATE ZIP CODE Carperry NAIC Nurber " �
CLEARWATER R 33767
SEC110N D-SURVEYOR,ENGINEER,OR ARCHtTECT CERTIFlCATION(CONIINUED) •
Copy both sides of this Elevation Certificate for(1)oommunity offidal,(2)insuranoe agent/oompany,and(3)bu8ding owner.
COMMENTS
(1)BM USED: FLORIDA DEPARTMENT OF NATURAL RESOURCES°R�57",ELEVATION 5.91 NAVD 1988 DATUM.
(2)LOWEST AC UNIT.
❑Check here if a�achmertls
SECTION E•BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A NNTHOUT BFE)
For Zone AO and Zone A(wrthout BF�,complete 16ems E1 through E4. If the E�.wation Certficate is interxied for use as supporting i�orm�on for a LOMA or LOMRf,
Section C must be aompleted.
E1.Buiding Diagram Number_(Seled the buiding diagram most simiar Uo the bu�Jing forwhich ihis cerUficate is being oompleted—see pages 6 and 7. If no diagram aa;urately
represents the buiding,provide a skeUch or photograph.)
E2.The top of the bottom floor(induding basement or endosure)of the buiding is _it(m)_in.(an)�above or ❑below(d�ck one)the highest adjaoent grdde. (Use
natural grade,if avaiable).
E3.For Buiding Diagrams 6-8 wrth openings(see page�,the next higherflooror elevated floor(elevation b)of the buiding is _ft(m)_in.(an)above the highest adjacent
gr�de. Complete items C3.h and C3.i on frontof form.
E4.The top of the pl�aif�ortn af machinery aridlor equipment senriang the building is _ft.{m)_in.(an)�above or ❑bebw(chedc one)the highest adjaoent grade. (Use
natural grade,if avaiable).
E5.For Zorie AO only. If no flood depth number is avai�le,is the top of the bottom floor elevated in a000rdar�ce with the communil�s floodplain management orclinanoe7
❑Yes ❑No ❑Unknovm. The br,al offiaai must oertify this ir�fortnation in Section G.
SEC110N F-PROPERTY OWNER(OR OWNER'S REPRESENTATNE)CERTIFlCATION
The properiy ownerorowners author¢ed repre.sentativve who completes SedionsA,B,C(Ifiems C3.h arid C3.i only),and E forZone A(without a FEMA-issued orcommunihr-
�BF�or Zone AO must sign here. The st�emerrts in Sedions A,B,C,and E are oarect to the besf of my Imowledc�e.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE •
SIGNATURE DATE TELEPHONE
COMMENTS
❑Check here if a�achmerds
SECTION G•COMMUNITY INFORMATION(OPTIONAL)
The bcal offiaal who's authorQed by law or ordinanoe to administer the communihls floodpl�n management ordinanoe can oomplete Seations A,B,C(or�,and G of this Elevation
Certificate. Complete the applicable iEem(s)and sign bebw.
G1.�The informatan in Section C was taken from other documentation that has been signed and embossed by a lioensed surveyor,engineer,or arohited who is author¢ed by state
or bcal law Uo cerfAy elevation information. Qndicate ihe source and da�of the elevation dafa in the Commer�ts area bebw.)
GL.0 A commundy offiaal oompleted Section E for a buiding bcated in Zone A(without a FEMA�.ss��ed orcommunily-iss�d BFE�or Zone A0.
G3.❑The fdbwing ir�formation(Items G4�G9)is provided for oommunily floodplain management purposes.
G4.PERIuAT'NUN6ER C�. DATE PERMff ISSUED G6.DATE CERTIFICATE OF CONPLIANCFJOCCUPANCY ISSUED
G7.This permit has been is�ed for. ❑New Construdion ❑Substantial Improvement
G8.Elevation of as�buit lowestfloor(induding basement)of the buiding is: __ft(m) Datum:
G9.BFE or(in Zone AO)depth of flooding at the buiding site is: __ft(m) Datum:
LOCAL OFFICIAL'S NAME �1�
COMMUNIIY NAME TELEPHONE
SIGNATURE DATE
COMMENTS •
❑Ct�cfc nere iF attacnmerns
� U � � � FEDERALEMERGENCY MANAGEMENTAGENCY
� �� �(;� ,`G � 20�4 NAl10NALFLOODINSURANCEPROGRAM O.M.B. No. 3067-0077
� Expires December 31,2005
� � ELEVATION CERTIFICATE
r�EvEtOPMEF���Q WATE R EPT
I � Read the instructions on 1-7.
• _�"`�"` SECTION A•PROPERTY OWNER INFORMATION ��+��H�=
BUILDING OWNER'S NAME PoicyNumber
LOUISE ALVERSON
BUILDING STREET ADDRESS(Indudng Apt,Urit,Suite,andlor Bldg.No.)OR P.O.ROUTE AND BOX NO. Cott�any NAIC Number
1401 GULF BWD,UNIT 105
CITY STATE ZJP CODE
CLEARWATER FL 33767
PROPERTY DESCRIPTION(Lot and Bbdc Numbers,Tax Parcel Number,Legal Descripbon,etc.)
TAX PARCEL ID 19C29/15/78Ci3/001/1050 PINELLAS CAUNTY,FLORIDA
BUILDING USE(e.g.,R�,Norxesicier�al,AddUon,AccessorY,etc. Use a CommeMs area,if neces�y.)
RESIDENTIAL
LATfTUDEILONGITUDE(OPTIONAL)HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
(�-#�-#�.#rr or �#.#raat�j ❑nu��s2� ❑r��sas ❑uscs Quad nnap ❑ou,er:
SEC�WN B-FLOOD INSURANCE RATE MAP(FlRIII�INFORMATION
B1.NFlP COMu�JNf1Y NAME 8�COMu�1Nf TY NUA�BEft �.COUNTY NAWE 63.STATE
PI�O�'1250A6 �t i�R u�rd R PINBIAS COUMY FL
84.MAP AND PANEL B7.F�2M PANEL B9.B�ASE ROOD EIFVATION(S)
NUMBER B5.SUFFD( B6.FlRM INDDC DATE EFFECENE�VISED DATE B6.FLOOD ZOt�(S) (Laie A�.u�e de�ri d�oodrl9)
1250960104 G OAAl3�7Ci 09�03p3 AE 11.00&12.00
B10.Indicate the sour�e af fhe Base Flood Elevation(BFE)data or base flood depth entered'm B9.
❑FIS Profle �FIRM ❑Commun�y De�mir�ed ❑Ofher(Desai�e�_
811.Indicate the devation dafum used kxthe BFE�B�0 NGVD 1929 �NAVD 1988 ❑Otl�er(Desai�e):—
612.Is the buiding lop�in a Coastal B�rier Resouroes S�em(CBRS)�ea or Ofhervrise Prot�d Area(OPA)? ❑Yes X No Designation Da�
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Buiding elevations are based on:�Constr�tion Drawings" ❑Buiding Urxier Constri�on' �Finist�ed Constn�tion
*A new 8evation Certifi�w�be requwed when oonstnxiion of the buiding is oom�lete.
• 2.Buki'rg Diagram Number 1(Seled the buidrc�g diagram most simiar b the buiding forwhich th's ' is being oompleted-see pages 6 and 7. If no diagr�n aoaua�ely
represents the buiding,provide a skeich or pl�9raph.)
C3.Elevations–Zones A1-A30,AE,AH,A(wrth BFE),VE,V1-V30,V(w�h BF�,AR,AR/A,AWAE,AR/A1-A30,AWAH,AWAO
Complete t�ms C3.-�i belaw a000rd�g�the buiding diagr�n s�ified�I�m C2 Sta�e the dalum used,If the da�um is di�rent irom the da�m used k�r the BFE n
Section B,cornert the dabum ho tl�used for the BFE Shaw field measuremeMs and datum oarversion c�CUlation. Use the space pravided orthe Comments area of
Section D or Section G,as appropriate,�doaiment the dahim conversion.
Dah�m NAVD Corn�ersionlComments 1988 DATUM
Elevation referenoe mark used 11Dces the elevation referenoe mark used appear on the FIRM? ❑Yes �No
o a)Top of botbm floor(uiduding baqernent orer�dOSUre) 6.34 ft(m) �;
o b)Top of ne�d hgherfloor WA ft(m) �Y � , �
o c)Botbm of bwest hor¢ontal strtxluurdl member(V mnes only) WA ft(m) �
o d)Attact�ed 9arage(ioP ofislab)x NIA it(m) ��' � � ` �"
w�o
o e)Lowest elevaati�on of machinery�dlor equipment -m ° . �,<-� ',��
sennang the buiding(Desabe�a Commer�s�ea) 628 ft(m)(2) �� - -�.°
o f�Low�est adjacent(finisf�ed)9rade(LAG) 5.71 ft(m) z� ,O � ' ��
o g)Hig h e s t a djaoen t(fi n i s h�g r a d e(H A G) 5.9 7 ft(m) �
� , � �;
o h)No.of permaneM openings(floal vents)w�hin 1 ft above adjaoent grade WA J �
r�
o)rotal area of a�permane�topen�s(flood vents)�can o sq.in.(o sq.an) �� �r �
SECiION D-SURVEYOR,ENGINEER,ORARCHITECTCFRTIFICA710N ;�
�
This certfication is to be signed and sealed by a land surveyor,engineer,or architec�authorized by law to ceRih+elevation information.
I certify that the information in Sections A,B,and C on this certificate represents my best efforts to interpret the data available.
1 undersfand that any false sfatement may be punishable by fine or imprisonment under 18 U.S.Code,Secfion 1001.
CERTIFlER'S NAME JOHN STRACHAN LICENSE NUMBER 6312
TITLE PRESIDENT COMPANY NAME CROSSTOWN SURVEYORS,INC
ADDRESS CITY'�-, STATE ZJP CODE
5030 78�"AVENUE ORTH�SUITE 8 PINELLAS FL 33781
SIGNATURE DATE �, TELEPHONE JOB NUMBER
1Q118+04 } (72'7)647-7984 046213
IMPORTANT: In these spaces,copy the cbrresponc6ng information from Secfion A r-or.tr,s�,ce carp�,use_
BUILDWG STREET ADDRESS(Ind�g Apti,Uri�Sui4�,arxi�or Bkig.No.)OR P.O.ROUTE AND BOX N0. p�,N��
1401 GULF BLVD,UNfT 105
CffY STATE ZIP CODE Cat�arry NAIC Nunber • ' •
CLEARWATER R 33767
SECf10N D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFlCATION(CONTINUED) r
both sides of this Elevation Cerfificate for 1 oommun of6aal, 2 insurance � •
�PY ( ) ilY ( ) agentloompany,and(3)buidmg ov�ner.
COMMENTS
(1)BM USED: FLORIDA DEPARTMENT OF NATURAL RESOURCES°R�57°,ELEVATION 5.91 NAVD 1988 DATUM.
(2)LOWEST AC UNIT.
❑Cnedc trae if attaci,merns
SECiION E•BUILDING ELEVATION INFORMATfON(SURVEY NOT REQUIRED)FORZONE AO AND ZONE A NNTHOUT BFE)
For Zone AO�d Zone A(w�hout BFE),comple�193ms E1 thrcwgh E4. IFthe Elevation Cer6�is in�erxied for use�suppoiting irrfortnaation for a LOMA or LOMRf,
Section C must be aompleted.
E1.Buiding Diagram Number_(Select the buiding diagr�n most simiar to the buiding forwhich th's certificate is be�g complded—see pages 6 and 7. If no diagram aocur�ly
represents the buid'ag,piovide a sketch or phobgraph.)
E2.The�p of the bot�m floor Qnduding basement or endosure)of the buidin9 is _ft(m)_in•(cm)0 abaue or ❑bebw(chedc one)the highest adjaoent grade. (Use
n�ural grade,�av�lat�le).
E3.For Buiding Diagr�6-8 wdh openings(see Pa9e�,the rie�Q higherfloor orelevated floor(elev�atiai b)of ihe bukJir�g is _ft(m)_�.(an)above the highest adjaceM
grade. Complete i�ms C3.h�d C3.i on ftontofiorm.
E4.The top of the pl�rrn ofi madi�ery andlorequpment serviang the buidin9 is _ft(m)_indcm)�above or ❑bebw(chedc one)the hghest adjacent grade. (Use
na�ural grade,�avaiable).
E5.ForZone AO ordy: If no flood depth number's avaiable,'s the�p of the bottom fborelevated in aocordanoe wdt�ihe oommun' s
dy floodplain managementordinarae?
❑Yes ❑No ❑Unkra�m.The bcal offCial mu�cert�y this ir�formation in Section G.
SEC110N F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFlCATION
The P►opedY ownerorowners autlia¢ed represent�ve who oompletes Sedions A,B,C Q�ms C3.h and Ci.i onlY),and E itx Zone A(w�twut a FEMA��ed orcommunAy-
�BF�orZorie AO must sign here. The sh�emerrts�Sec4ons A,B,C,and E are carectto the best ofmylo�owlec�je.
PROPERIY OWNER'S OR OWNER'S AUTNORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIPCODE �
SIGNATURE DATE TELEPHONE �
u�iuiiui�iv i 5
❑Check here if�fachmer�s
SEC110N G-COMMUNITY INFORMATION(OPTIONAL)
The bcal dfiaal who is autho�ed by law orord�anoe�adminis�r the commundys floodpla�management ordin�noe can oomplete Sec�wis A,B,C(or�,and G ofith's Elevation
Certificahe.Comple�e the applicable i�em(s)and sign bebw.
G1.�The irdorm�ion�Section C wras taken from otherdocumentation that has been signed�d embossed by a I'aensed surveyor,engineer,or arr��ct who is author¢ed by st�e
or bcal law to oert�y elevation ir�formation.(Indicate ihe souroe and dake of fhe eleva6on data in ihe Comments area below.)
G2.0 A commundy offidal oompleted Sedion E for a buiding bcated in 7_one A(�n�hout a FEMA-�woommunity-issued BF�or Zone A0.
G3.❑The fnNawing ir�oRnation Qtems G4G9)s provided forcommundy floodplain management Wrposes.
G4.PERMT NUMIBEF2 C�.DATE PERN�ISSUED G6.DATE CERTIFlCA7E OF CANPIJANCE/OCCUPANCY ISSUED
G7.This perm�has been iss�d fa: ❑New Constnx�on ❑Substantial Imprwement
G8.ElevaUon ofias-buit lowestfloor(mduding basemer�)ofthe buidirg is: _._ft(m) Da6um:_
(x9.BFE or(n Zone AO)depth offloodirg a�the buidirg site is: __ft(m) Datum:_
LOCAL OFFICIAL'S NAME �
COMMUNITY NAME TELEpHpNE
���� DATE
COMMENTS
�
❑CheCk her2 if attaCMTlentS •
.
- C ITY OF C LEARWATER
• DEVELOPMENT & NEIGHBORHOGD SERVICES DEPARTMENT
POST�FFICE BOX 474g� CLEARWATER� F�o�DA 33758-4748
MUNICIPAL SERVICES BUILDING, IOO SOUTH MYRTLE AVENUE,CLEARWATER,FLO�unA 33756
TELEPxoNE(72� 562-4567 Fnx(72� 562-4576
MEMO OF REVIEW FOR CORRECTNESS & COMPLETION
In accordance with participation in the NFIP/CRS program,all elevation certificates are required to be reviewed for correctness and completion prior to
acceptance by the community. This complete form shall be attached to all elevation certificates maintained on file and provide with requested copies of
elevation certificates.
The attached elevation certificate requires corrections by the surveyor of section(s) prior to acceptance by the community
The attached elevation certificate is complete and correct
X Minor corrections have been made in the below marked sections by Community Official
SECTION A-PROPERTY INFORMATION For insurance Company Use:
A1. BUILDING OWNER'S NAME Policy Number
A2.BUILDING STREET ADDRESS(including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
CITY STATE ZIP CODE
A3. PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
A4. BUILDING USE(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)
A5. LATITUDE/LONGITUDE(OPTIONAL): HORIZONTAL DATUM: SOURCE:❑GPS(Type):
���_��_�,��� or �.�°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map�Other
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
1.NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME 63.STATE
City of Clearwater-125096
64.MAP AND PANEL g5.SUFFIX B6.FIRM INDEX DATE B�•FIRM PANEL gg,FLOOD ZONE(S) B9•BASE FLOOD ELEVATION(S)
NUMBER EFFECTIVE/REVISED DATE (Zone AO,use depth of flooding)
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 69:❑ NGVD 1929 ❑NAVD 1988 ❑Other(Describe)
612. Is the buildin located in a Coastal Barrier Resources S stem(CBRS)area or Othervvise Protected Area(OPA)? ❑Yes ❑No Designation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. Building elevations are based on: ❑Construction Drawings" ❑ Building Under Construction" ❑ Finished Construction
"A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number (Select the building diagram most similar to the building for which this ceRificate is being completed-see pages 6 and 7. If no
diagram accurately represents the building,provide a sketch or photograph.)
C3. Elevations—Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO.
Complete Items C3.-a-i below according to the building diagram specified in Item C2.State the datum used.If the datum is different from the datum used for the
BFE in Section B,conveR the datum to that used for the BFE.Show field measurements and datum conversion calculation. Use the space provided or the Comments
area of Section D or Section G,as appropriate,to document the datum conversion.
Datum Conversion/Comments
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑Yes ❑No
e) Lowest elevation of machinery or equipment servicing the building(Describe in Comments area) ft.(m)
h) No.of permanent openings(flood vents)1 ft.above adjencent grade
i) Totai area of all permanent openings(flood vents)in C3.h sq.in.(sq.cm)
Comments
Date of Review: Community Official:
�levation certificates sha//be maintained by the community and copies with the attached memo made availab/e by requesf
FRANK HIRBARD,MAYOR
GEORGE N.CRE7'EKOS,COUNCILMEMBER JOIIN DORAN,COUNCILMEMBER
PAUL F.GBSON,COUNCILMEMBGR � CARLEN A.PE7'ERSGN,COUNCIL�IEMBER
��EQUAL EMYLOYMENT AND AFFIRMA'I'IVE AC1'ION EMYLOYER�