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332 GULFVIEW BLVD �l.S.DEI�RTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Ex�ires Februarv 28.2009 Federal Emergency Management Agency n�at�nai Fiood insurance Proyram Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1. Building Owners Name MAINSTREAM PARTNERS VIII Policy Number A2. Building Street Address(including Apt.,Unit,Suite,andlor Bldg.No.)or P.O.Route and Box No. Company NAIC Number 325 S.GULFVIEW BLVD. City CLEARWATER State FL ZIP Code 33767 A3. Property Description(Lot and Blodc Numbers,Tax Parcel Number,Legal Description,etc.) PINELLAS COUNI'Y PARCEL ID No.07l29/15/52380/000/0630 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) HoteUMotel A5. LatitudelLongitude:Lat.N.27°58'20.6" Long.W.82°49'45.2" Horizontal Datum: ❑NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building if the Cert�cate is being used to obtain flood insurance. A7. Building Diagram Number 1 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 n/a sq ft b) No.of pertnanent 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 n/a c) Total net area of flood openings in A8.b n/a sq in c) Total net area of flood openings in A9.b Na sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Commun'ity Name 8�Community Number 62.County Name B3.State City of Clearwater i25096 Pinellas FLORIDA B4.Map/Panel Number B5.Suffix 66.FIRM Index 67.FIRM Panel B8.Flood 69.Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 12103C 0102 G 5/17/05 9/3/03 VE 14'and 13' 610. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69. ❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe) B11. Indicate elevation datum used for BFE in Item B9: ❑NGVD 1929 �NAVD 1988 ❑Other(Describe) B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes �No Designation Date n/a ❑CBRS ❑OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑Construction Drawings` ❑Building Under Construction" �Finished Construction *A new Elevation Cert�cate 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 specfied in Item A7. Benchmark Utilized see comments Vertical Datum NAVD 1988 Conversion/Comments none Check the measurement used. a) Top of bottom floor(including basement,crawl space,or enclosure floor)_ 7.22 �feet ❑meters(Puerto Rico only) b) Top of the next higher floor 18.69 �feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) 6.89. �feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) n/a. ❑feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 7.30 �feet ❑meters(Puerto Rico only) (Describe type of equipment in Comments) fl Lowest adjacent(finished)grade(LAG) 5.9 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade(HAG) 7.2 �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 archRed authorized by law to certiTy elevation o��f;�;a a;^,,a information. I ce►fify that the infom►ation on this Certificate represents my best efl`oRs to interp�t the data availabJe. �- ;;L, I understand that any false statement may be punishable by fine or imp►isonment under 18 U.S. Code, Section 1001. ��c��`�'"y ��"'�a e�0 6 L,�f ��''� epO „� w, . � �4re'°" �l�'r� , ,��, o � Check here'rf comments are provided on badc of form. -�_ � ,o�;-ev�� r.�`, � ��•. uz ; � p,b.:C:_ k �\.'�4 ry �✓'u ..,. 'ii! � �Q o r+ Certifiers Name KELLY O.MCCLUNG License Number 4032 � ,_ ���.,Y. : � _° ��:� :. Title FLORIDA REGISTERED LAND SURVEYOR Company Name Suncoast Land Surveying -' �°�"� � � ^ � + ° �°o�,,;,;` �T i�3'I�.. �� `, Address 111 F REST LAKES BLVD. City OLDSMAR State FL ZIP Code 34677 ' i n °� �^ ' k., a,"aF..� ,, f �`�,'� +�^9��e� e��=�,��ti Signature te 6-21- Telephone 813-854-1342 , ,f,�, >r, , , lert,��§�M'�-+3���'9 FEMA Form 81-31, Febn�ary 2006 See reverse side for continuation. Replaces all previous editions 'IMPOI�$ANT: 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. Poiicy Number 825 S.GULFVIEW BOULEVARD 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 agent/company,and(3)building owner. Comments C2.Benchmark utilized:Ciry of Clearwater Benchmark No.G-03,Elevation=4.7495'(N.A.V.D. 1988) C2c.Estimated elevation bottom of slab assuming 4"slab thidcness. C2e.Air conditioner pad elevation. 6 Signature Date 6/21/11 ❑ Check here if attachments SECTION E-BUILDING ELEVATION ORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5. If the Certficate 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. Chedc the measurement used. In Puerto Rico only,enter meters. E1. Provide elevation information for the following and chedc 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 Q 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. Property Owner's or Owner's Authorized Representative's Name Address Ciry State ZIP Code Signature Date Telephone Comments ❑Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8.and G9. G1.❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2.❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.❑ The following information(Items G4.-G9.)is provided for community floodplain management purposes. G4.Permit Number G5. Date Permit Issued G6. Date Certficate 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 Comments ❑Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions . � � � , Buiiding Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number 325 S.GULFVIEW BLVD. Clty CLEARWATER State FL Z)P COd@ 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. FRONT VIEW � ' ��� v �_ � � d ..�.� ..k}crc �_. . ��� � . ��� � � � y! ��� � 11 .,, i=;�t tl��s . pi��I�II1�M;.: ��� �� �` � .. �� # J �{._ , f' �-�± Y� ��F "� _.., _ "��d{�-. �� x. �,�� .,� ' ..� e i �����. � °,� .�. �.,�. ..,.�„�,�,.: ,F � �..a...,K— ,�.,_ ,. , �, ;.,� F �` � � , .�4ir . v � ��� � .:�. i n�es�> I � ` , (��ll�" ' __. ,�� .„,x-,.... ...__. .. ._s. . . ".�A,^'.e.. � , ' :,,� _ . � �,�� �� ,. ��-� � � � '� �� �. _ � � � . __r ,, ��,',' ��, , _,.,, � � �. �., _a�... •- �__� _ _ ;. �„�_ �. .....—.�_.,;"�+..,,a�.... REAR VIEW - :�� f � - a'i�-.: � : ' r a.. � �i: y�� p ,— � - — . ,..,,....� 1 ,� �;r�� ,�r � �a+�� ���� :. n� � ��� x "' �,��' ��� , ,� d�lll �`� r � -a.: �t ,�, s - cm��� � �' �� '�' � �or,�1� � � � ,, ����� .� � � , , � a, s� , ` _..� ;�,�; °� , ,� � , � " , �. '�' ;tMU� :t� �;. s ' 1' f '��� �� ;, f � :�;„ ��f'�<:a �'' ;,�"' �,. �A i �� �'����5�Il�lt� � �P �" � �f �q�'`�,���'. � � ��` -. ' � � �3�� '`� � .,... �i' �� ` � �``'�� � �_ � ' - . _ .. �-�r. ,��� „ � _. Y� � ..._� �._. .— . . ����aa"`�� ��. . �� ��'. � r,F -s�;, j, ,:�a.�— , �a .� ' ' � �' �.�_ _ � ,r, _�.�---, ��,; ` � "'.�,. � . , � Building Photographs Continuation Page For Insurance Company Use: Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number 325 S.GULFVIEW BLVD Clty CLEARWATER State FL ZI P COd@ 33767 Company NAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View"and"Rear View"; and, if required, "Right Side View" and"Left Side View." Southwest Corner � �� �� � � � � � . c . _ i�� � _ __ � fi K , . . �u. � �; �x�.. �, � �,� �, �— �� � �,�-. a �' � ��� �r� ��4 �I� �f � 1 , � � � . f;� : , `� � E. ` � - �� ° � :?_,- � _ . , t � � �� . +P� , � �-' �� ��� ,�.�ir':�!lf�..�;��� I... � ��• _��� - . -���r E ��y„ �� � I � � �� �,�.; ��..I �a � :� .��,�:�� _ :�� _ - �: �t . - _ - �_A _ f " � . '�` .:� ,�.Wet�kA'E�" _.— ._. _. , �� .