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655 GULFVIEW BLVD PcP 2.00c�— tZc�3?� --- Fc=DERAL EMERGENCY M!1"lAGEIv1ENT 11GENCY O.M.E3. No. 3067-0077 NATIONAL F1.00D INSURANCE PROGRl1M Expires July 31, 7_007_ ELEVATION CERTIFICATE — --- --- • Important: Read the instruclions on pages 1 -7. SECTION A-PROPERTY OWNER INFORMLITI�N I"or,:lnsurince Company Use .:: 6UI�.OING OWNER'S Nf1ME ��C,�,� �'o��cy Nunib�f S'�'��'H AN =-<- 9U�lD�Np STREET ADORESS(Inci�ding Apt.,Unil,Suile, and/or pldg.No.)OR P.O.ROUTE�NO EiOX NO. Campany NAIC NumGer � : ----(�'S� Cs�U�Fv�Ew G31.�D. � ` • -- ----- _ ;... .. CI?Y ST/1TE P CODE CLEAQwATElt, QEACH ��-' --------- �3�7CO_T --- F'ROFERTI'�DESCRIFTION(lol and Block Numbers,Tax Parcel Number,legal Descriplion,el�c� L.o� 5 8 T N4� I� fSL,o;.;,K C __�gA��t?�---�u-g — -- -- ^VI�Udi3 USE(e.g..ResidenUal,Nornteslcienlia�,/lddilion,nccess ry,eta Use Commenls.eclion if neceseary.) pis C.o�+�Er�c.�AC. N o�E.c. �r.�vA�,►;y� 1�N�_ l/1TITUDE/LONGITU�E(OPTION/1L) fiORIZONTAI DATUM: SOURC�: �_�Gf S(Type):__^^ ( NH"-Np'-pN.Mq' or �q.ppNpp°) L�NAD 1927 ��N/1D 1983 L�USGS Ouad Map �--�Oiher - SECTION B-f��OD INSURl1NCE 12ATE MAP (FIRM� INFORMATION i B�.itFiF�^..c�.4L1UNIT�f R�nfNE 8 CvMMUNITY NUMBER 82.COUrJl'l NnME Fi3. STATE a2�o°�la-----C�EA�waTEt Q►ra!r'c.�.AS F�-oR�pq � �-__—_-- - — �-- -- 84.MAP AND P�NEL �85.SUFFIX 86.FIRM INDEX B7.FIRM PANEL E18. FLOOD �9. �nSE�LOOU ELFV�TIO�J(S) NUMBER � DATE EFFECTIVE/REVISED D�7E ZONE(S) (7_one/�O,usn depth of tlooding) i Oo 14 tw�,u Y 1 Ig91 Av4uyr �q tq � AE \ � ,o 0 B 70. Indicate the source o(the Base Flood ElevaUon(BFE)dala or base flood depth enlered iri 89. ��FIS Profile �FIRM (_�Community Delermined L�Olher(Describe): 811. Indicale ihe elevation datum used for 1he BFE in 89: 1��NGVO 1929 ��NAVD 1988 �_� Olher(Describe): 812 is she buti�ifng Ic,cated in s Coaslal�-.rrier Resou�ces 5yseerr�(CDRS)erea or Otherwise Pro(ected/lrea (OPl1)? (_� Yes �No Designalion Dale: SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) ��. Bciiaing eievations arP based on: ��Conslructio�i Drawings' ��Building Under Conslrucfion' (��Finished Conslruclion • 'l1 new Elevalion Ceriificale will be required when construclion ot the building is complele. C2. B�ilding Diagram Number�(Select the buiiding diagram most similar lo lhe building for which this certificate is being compleled-see pages 6 end 7. If no diagrem accurately represents the biiilding, provide a sketch or photograph.) C3. Elevalions-Zones A1-A30,AE,AH, A(with BFE), VE, V1-V30, V(wilh BFE),11R, !�R/A, AR//1F, !1R/A1-A30, /�R//�li, /�R/AO Complete Items C3a-i below according to the building diagram specilied in Ilem C2. State the datum used. If the datum is different�rom lhe datum used for lhe BFE in Section B, convert the datum to that used for the BFE. Show field measureinents and dalum conversion calculation. Use the space provided or the Commenls area of Section D or Section G, as appropria(e, lo document lhe clatUm conversion. Dalum Conversion/Comments ,. �-~ Elevalion reference mark used Does ihe elevation reference mark used appear on th �� 'f�s` �No O a To of boHom iloor includin basement or enclosure " •�� c, : �'�"" ) P � 9 1 $ .�R•(m) S . ,;�'.. O b)Top of next higher iloor 1'1 . l 1 R.(m) �' :�!� ''�� . o �t O c)8otlom of lowest horizontal siructural member(V zones only) N /Q_11.(m) „° _'F Z`q �!�` � '�� ''� O d)AHached garage(top of slab) N�._R.(m) g� `.,:�"��: u � " O e)Lowest elevation ot machinery and/or equipment °1 m ��, � �' �� F ; serv(cing the building �►��- Q� �-1 n_(m� a`= C :', �s � "� . ; �- °-'�.,,`��,�.��'..._ �"'tz}.,:..;:°�:j,.::..... . O ��owest adjacent grade(LAG) (p ,�n.(m� Z� .,�j� �, '��'" d,, � O gj Highest edjacenl grade(HAG) � ,�R.(m� �N �s;r��?� �7'%��'<`� ❑ h)No. of permanent openings(flood venls)within 1 R above adjacent grade�_ � `- '">.,�`�-'�'-�Q�,��:° O i)Tolal area ol all permanent openings(ffood venls)in C3h *•1�1�1 sq. in. (sq. cm) r"�ee��,�00�ai�`�`� SECTION D-SURVEYOR, [NGINEER,OR ARCHITECT CERTIt"ICATION This certification(s lo be signed and sealed by a land surveyor, engineer, or archilecl authorized by iaw lo certify eleva(ion inlonnafion. I certir}%(hal lhe inlormafion in Sec(ions A, 8, and C on(his cerii(rcale represenls my besl e(foris(o inferpref!he da(a availahle. (vndersland Ihat any falss slaiemenf ma;�bepunish�►.�le vy Fne or;mpiisonmenf under if3 U.S. Code, Secfion 1001. CERTIFIER'S N/1ME �NA�. L. H JyN�S UCENSE NUMU[R p`�-Y!c�,�,� -7I�iE �S��.SI'O�P.JT CCIJipANY NAME �RT1E.�Q.�`�� Cs- � SU�I�GV�1,�� ADDRESS � � CE,V LA T. �� C�EA4rvM'E2 ST/1TE �L� 7_If�CODE 3?J"��L .,.��2_ � SIGNnTURE DATE 1'2,—�_LpOp TELEI'110NE -12-j _ �,�17�2 +Z FcP�AA Fotm 81-31,AUCU 9S.� ;�� SEE REVERSE SIUF FOR CONTINU!\TION REPLACES l�LL PREVIOUS EDITIONS , � . , , �-:�. `,. IMPORTAN7: In these spaces,copy the corresponding Intormatfon from Secti�n A. " "� "' � Fo?;In�uianc�Company tlse' : ' ` pUIL011JG STREET ADDRESS(Including Apl.,Unit,Suile, and/or 81dg. No.)i�P P.O.ROUTE AND BOX NO. Po(icy Number ' — ----- ---- —--- ----__- - -- --- ` ��N :i7::TE �IF COUE .Go,i ari 1JA1�Number � . � y : _ :i : : .: . SECTION D-SURVEYOR, ENGINFER, QR AR�I{�T�CT C�RTIFICATION{^.ONTINU�D) . Copy both sides of lhis Elevalion Cerii(cate for(1)communily official, (2)insurance agenUcompany, and(3)�uilding owner. `y COMMENTS ' —.--_—.____ , �. , � . . , , � • `c • , � � ' . . • ' '. . . . ' ' • � ,.`f�.... . , � ., .�+.�—'-- (`Z Check here if aUachme�ils SECTION E-BUILDING ELEVA710N INFORMATION(SURVEY N�T REQUIRED) FOR ZUNE AO and ZONE A(WITHOUT BFE) ' �or Zone AO and Zone A(without BFE), complete Items E1 through E3. Jf the Eleva(ion Cerli(cafe is infended/or use as suppo�fing in/o�mafion(oi a LOMA u�LOMR-F, Seclion C musl be coinplefed. E 1. Buildiny Diayrarn N�rnber (Select the builUing diagram mosl sirnilar to Ihe building for whioh thls cerlifica(�is being completed— see pages 6 and 7. I1.no diagram accuralely represents the building, provide a sketch or photograph.) E2. The top of the botiom floor(including basement or enclosure) of the building is �(_�it.(m)L��in.(cm) �J above or Lj below � (check one)the highest adjacent yrade. ., , , , � -. E3. For Zone AO only: If no flood depth number is avallable, is the tot�of the boltom floor elevated in accordance with the community's (loodplain management ordinance? �_� Yes (_�No ��Unknown. The local officlal must certify this lnfomnalion in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION 7he properiy owner or owners aulhorized represenlative who completes Seclions A, B, and E for Zone A(without a FEMA-issued or cornrnunity-issued BFE) or Zone AO must sign here. PROPERTY OWIJER'S OR OWNER'S AUTHOR2ED REPRESENTFTIVE'S NAME —� ADDRESS CITY STATE ZIP CODE SIGNA7URE DATE TELEPHO E COMMENTS � � � Cher'C he�p if a�ta�h �ents SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is aulhorized by law or ordinance to adminisler the communily's floodplain management ordinance can compiete Sections A, B, C(or E), znd G of this Elevation Ceryif�cate. Complete the applicable item(s)and sign below. G1. ��The Infonnatio;� in Saction C was taken from olher documentation that Iias been signed and embossed by a Ilcensed surveyor, ei�gineer, o;arci�it�c1 vaP�o Is authorized by slale or local law to cerlify elevation In(ormalion. (Indicate the source and date of Ihe elevalion d'ata in il�e Cornmenls area below.) � G2. (_�A com�,wnitv a(:i::ial:,ninpleted Sectiori E for a building located in Zone.A(without a FEMA-issi��d or comm�nity-issued BFEI nr _:Zo��e l;O: _ - G3. �7he C�Ilowiny inlormat;�n(Items G4-G9)Is provided for community(loodplain managemenl purposes. G4.PERM4T�fJM�iCR�• GS. DATE PERMI7 I$SUED Gfi. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY y;� � � ISSUED � -- G7. This perrntl has bden issued (or. L� New ConsUuction Lf Sub:.'anlial Improvement Ge. Elevation of as-Guilt lowest floor(including basement)of lhe building is: _ _ _. __ __ ft.lm)Datum: G9. 8FE or(in lone AO)depth of(looding at the building site is; �ft.(rn}Uatum: �� y LOCAL OFFICIAL'S NAME TITLE --- COMMUNITY NAME 7EL[PHONE SIGNATURE � DATE . �� T ��-` COMMENTS ; - _ _ ` , , -�---------- ---� ,. . . - — I I Check here If allachmeMs FEMA Fam A1-31,AUG 99 REPLACES ALL PREVIOUS EDITIONS "'�' O°' ' °F NO1�1D � ELEVAT10N CERTIFICATE FEO�av.°�"`�N�w � �y N�tt3QOdv�e�o�. �m�� Re�d the instruc�ions on ppges 1—�. BECTK)N A — PROPERTY INFORYATION A1. Bte�di�tp OMrt�efs Nante CLEARWATER GRAFIDE DENELOPMEHT. LLC 86R GUL.FVIEW BL�ARKNr(i GARAGE BWI.�NIG) �' No.) or P.O. RouOe and Bmc No. Sts�e Fl. aP �Y � tt.at end Bbdc Nu�rs, Tsz Parcel Nunber. Lo� pesuiPdon. e 9, 10 b 11, BLOCK C. 6AYSIDE SUBDMgiON pg Sg p°G 9g TAX PARCEL �� 1 OMB No. 1$80-0008 �tion Date: Jt�ly 31, 2015 A4. Buil�ng Use (e.g.. Reside�. Non.�d�i. Add�ion. Aooessory, eEc.) "-�� ' HS. LatidudsJLongihWe: Lak 27'58'o1_O °�t t.qg. �2'49'33.8'1N Horimpr�tal Dat�im: ❑ NAD 1927 � NAD 1983 A8. AttaCri ik least 2 p�otographs of tbe bulldirg � fhe Ce►dit�le is being used to o6fain tbod i�wranos. AT. Building p�r� N�rr�ber $ A8. For a buNdbp witl� a� ar endosure(s): a) ��t�pe of �+�rk�os ore�osune(s} � $q ft �;or a Wu7dng with ��fac�ed g�a�e: b) Namber of pertnsnerd Aopd qaer�ings in fhe aawrlspaoe b� �� l@ sq ft a�losuro(s) wifhin 1.0 foot al�ore a�aoent 9rade t�18 � vrihin 1.0 �oot above �� a9e c� Er�ineerod flood� � in AS.b � a4 in c To1� net are� d Aood operugs in A9b openigs• ❑ Yea � No � � En�neered /bod openings? ❑ Y �� No � SEC710N B— FLOOp INBtJRANCE RpTE yAp (FlRI� INFORMATI�pN B1. I�IP Conxrwnity Narr�e 8 Corrwrxmitp Nprriber ��,�,� - G7Y OF CLEAitWATER 1250g6 B4. 'A� I��umber B6. SGtdroc B6. FIR�A Indax Osie B7. FIRIA Panel SJ18rZ009 Efiedive/Re�ised Da�e t'>EPTEII�ER 3, 2003 63. StaQe FLORIDrA 68. Flood �. Bate Flood Ebvabon(sI iZone �E � s AO. use b�se 11ood depth) AE12,VE13 610. IndiCale U�e source d the Base Ffood Elev�i0n (BFE) dab or baEe lbod deplh en6ered in IEe�n B�. ❑ FIS Pr�ile � FlRM ❑ Comnwnity DeFertnined ❑ Otl+er/Souroe: B11. Indica6e ebvadon d�tum used for BFE in IEsm B9: ❑ NGVD 1929 � NAVD 1986 ❑ Otlier/Sourcae: B12. Is tl�e bui�lp bcaMd in a Coe�al BPrrfe► Ret+cxiroes 8Ys�m (� area or OUienris� Proteded Mea {OPAi� ❑ Yes � No De�on Date: ❑ CBRS ❑ OPA 8ECTION C— BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) c1. Bu�d/inp ebvaCio�s ara aasee ore D construdion orawbgs• � Bu7d'ng unde� c«�cn�on- ❑ F'�ea co�on 'A new Elev�ion CerMl�be wi� be roquired wlfen oonsfrt�ion aFthe bu�ding is oompiele. C2. Elavations — Zones A1--�A30. AE. /1H. A(wNh �E). VE. W—�/30. V(wilh BFE). AR, AR/A. ARJAE, ARJA1—A30. AR/AH. AR/AO. Cornpisle Poems G2a-h I�stow acoorain8 to u�e buildins �ayr�m specifiee M� IOern A7. m Pue�bo R'ioo aiy. e� mde�s. Bendrn�ic lN"�I'i¢ed: �tTY OF G� Feuweizo "F-02" Vertical Da4m: ��1IATION 4.0574' NAVDBB IttdiCate ebY�liotl dehm used fior the ekvafions in i�»s 8) through h) below. ❑ NGW 1929 � NAVD 1968 ❑ OlhedSource: Dan�sft u�ed for builcSrg alevetions rtwst be the same ss U�at used i�or U�e BFE. Ct�eck the me�swerr�errt used. a) Top d botbom tloor (ir�n9 �. �p�oe, or endos�xe floo� 7.� � feet ❑ meleis b) Tap of ths neod hi�her tloor 1¢•Q � fset ❑ met�s c) eatom of the k�w�sst iwrimorq�l strudural member (v Zonss oroy) �.� � ia�et p me0eis a� Atraabd �.rsoe cmv o► s�ab� �l9r ,-_ O�t ❑ n�e�as e) t:owsst elevation of rt�adxnery or equipmei�t senicing the bu�dfig I�_ O tset ❑ tr�s {Describe type of eqtdprnent and loc8�ion in Carwr�) � La�+sst a�o� f� 9rade na�Q to bt�d's�8 p-/lG) t!,�/A_ ��eet � n�eoe�s s) � s�rn cr�s�sd� ��a ro a,�e�ng cwe►�� _ o r�c ❑ me�s h) �ow�est �ea�rt grade ac awest ekv�ion or aea� or smis. ir�duc6ng strudwal supporc wa_ ❑ tess O me�ars SECTION D— SURVEYOR, ENqNEER, OR ARCHITECT CERTIFlCATION 'rhis certiificaoton is to be siqned and sealed by a larw suv�syor, en�+eer, w� awboriaed by taw to oartity els,raUa, iMormalion. r ce�rL�fy tlt,sr aie i�/o►n�or► on a�TS ce�bca� ►e,v�eents my veat eAbr� �:r�lerprer �e mm avaiabAe_ ° >' , ur►aler�ta►►o ihat a�y fa�e st�me,rt n►a�• be,�u.rs/,abl, bY,ins w:,,v,+oa,rnent,.rder 18 U. S Code. se��ian 1Q01. /�� ¢� Gt�edc f�ere A oorm�ems are provided on b�dc d fam. Were lelid�de and lon�iude in Section A provided by a Qy. �, ❑ Ctieck here � aKaGrne�rts, � � � � Y� 0 � . � f` � �+ cert�ers �am. �n a vmu� t�se N�.n� i.s ss�a �ae suRVEY wwnc,� con�r,y � n�u� a Assocu►�s Addrass �OIfTH HERCULES AVE City CLEARWATER Sta1e FL aP Code 33764 !J . uaee F�LD []IATE 625/75 Telephone 727-822-4151 � V� �� v, _ � � '��+\, �� FEMA Fortn OB6-0-33 (7H� See rev�erse side for ooMinu�afion. Rep�oes � preyipus edi�ion8. :ixvA��vN s�T�ICATE, page 2 iM�rrra�rr: m�e �, �opy tne co�,ondin� �o�,�o�, �, sec�o� a Bui�rw stneet nddresa (Wx�hg /►vt. unit, Siu6e. anavor sw8. No.) or P.o. itoube ana emc No_ 858 8. CaULFVtEVY BLW. CiIY CLEARWATER StaGe F� aP Cade 3376T-26�3 �� SECTION D— 8URVEYOR, ENGINEfR, OR ARCHITECT CERTIFlCATION (CONTiNUED) �_ Copy bod� sides o1 this Elevation CeAiPr�e for (1) cortrr�.tily u1Rc�. t� i�rar�oe agerM/oompary, �d (3) bwldng owner. Conrnents A5: Latitude and ion�plqide rrere de�rraned by using foopie Earth. C�2a) E��p�� is not corrqble C2b) Efevation k � �*level� floor AddiGior►al ir�orena0ion: boltom of ela�rator shaR elevatlon = 2.3 feet Dabe FlEID WITE 625115 SECTlON E- BtpLDING ElEVATION tNFORMATION (SURVEY N�T REQWRED) FOR �ONE AO AND ZOI�IE A(NIITHOtR gFEj For Zaies AO and A(witf�o��t BFE). c�mplate 16ema E1-E5. If the Cerdficale is i�iendsd to aupport a La1NA or �OM2-F request, oomPlsle Sec�ions A, B, and C. For 16ems E1-E4, use rattral grade, � avai�bie. CNecic the me�u�neM ueed. in Puerko Rioo ady. er�er �t�e�eis. Ea. Provide eisvadon i�Onr�stion for n�s fonovrirg ana afaac nie appropria6e aovoes to ahow � u�e elava6on is abo�+�e or bslow n�e ni� adja�t yrade (tiAte) 8nd the bw�eat adjaoent yrade (I Ar)- a) Top of boaom Aoor C�x�udsg b�rrient. «awkpaoe, or endosure) is ❑ toec p rr�el�s p above or � beiow the w►c. b) Tw+ of botoom floor fr�ck�ding b�r�t, �p�e. or enaoswe) is O teee ❑ n�elers p aboMS « p bs�o�w me t�►G. E2. For SuNdkip Diaprams g.+g y�iq� p�r�r�rt f1�� a�d ii Section A I�ems 8 aMid/w 9(ses�p�es 8-9 of �SfrucGfons), the next tNgher Aoor (elsvadon C2.b in the 6syt�►ts) d tlte bu�firg is . ❑ iaet ❑ rnelers ❑ aba�e o► O t�ebw the HA�. �• � 9�8e (�P Of slab) is . ❑ ieet ❑ me�ers ❑ abova or ❑ below fhe FIAC'. E4. Top of pi�liwm of madtinery and/or equiprt�K seryicing �e �� i�t ❑ meters ❑ abare or Q bebw the HAG� ES. Zone AO aMy= N ra flood deptl� nurriber is available, is the �op of the botbom floor ele+rabed � aoaandsnoe wi0� the oo�rrr�ur�tys tloodplai� manap�r�t ordinanoe? p Yes O Wo � th�cnown. nie locai ar�ai musc ce�ity mis �on in sec7ion c. 8EC'I'ION F- PROPERTY QIIMNER (OR aWNER'S REPRESENTATNE) CER7'�ICATIQN 'fhe PropertY awner a ownefs authoriaed ropreaer�ne wtw oompb�es Secdons A, B. and E tor Zone A(wRMqit a FEMA-issued or oortrn� B�FE) ar zone ao mwt sign ncre. n�e � in sections n. a. and e�e correac � nie best cf mr knowleage. Property Ownsrs or Owners Aultiofiaed Repreaen�ue's Narr�e � -. � �:- � ,�-� :_�_„ �,. -� � � � � 3tate ZIP Code Tele�lwne ■ "i � i � � •r�q.�s�nn� S� - GC7N�UNITY d tf�is ElevabiDii Cerbific�s. � _-___ _ �_� __._._.._... ..... w....w.w� a..�.,.�,.�� «r�.a�e�ner� aarwn�e can colnpiele Se4ion6 A. Q Ci (or E�� and G C�� aVP� i�enKa) and sig� below. Clleck ffle measurerrle�rt used i� I�ems G�G10. Yt Pusr6D RiCO aMY, 8r10sr iife�s. G1. O The iMprnalion in Sec�ion C was Takan irom otl�er doamen�tion tliat t�as been signed and seabd by a iooneed wrvayor. �►. or archi�ect who is auffwrfzed bY isw to oerb(Y elevabion ir�qrr�a4ion. (Indica�e fhe souroe and dabe of the eleva�ion data a� ihe Cotrrt�s are� below.) G2. ❑ A oamtu�NtY �� P�d Section E firor a buAd'ing bc�6ed in Zone A(wiltwu[ a FEMA-iasued or BFE) or Zone /W. G3, ❑ The �oNorrkg iMonr�liwn (Itert�s C,4-C10) es pnvidad for carrrwn�YY floo�in mar�agemerk Purposes. DaOe G6. Date Cer6ific�e Of G7. This D� Itas bsen iswed for: ❑ Naw Co�p� � g� � C�B. Ebvatioit of asfi�iilt loweat 1ba (i�cludNtg basemerN) of the p�p�r�g � teet ❑ rneters G8. sFE or (in zone n�Q) aeptl, ot t�oo�fg � tne butl�ng siee. ❑ teet O me�s Ci�o. Conr�x�rs aesign fl000 Nevation: O �eet ❑ melers L.oql Olfiaafs Name �Y �� Sig�lma C.•.,,„ -,� :. Title Tebplqng f ��"7 Da4m O�atun D811r11 �S t1e►e f 9�adrt�aed�c fEMA Form 086-0-33 (7h� ReP�oes ap p`evious ed�ons_ ELEV74TION'CERTIFICATE, �ge a gu��ding Photographs See Instructions for Item 1�6. IMPORTANT: In these spaces, aopy tl�e correaPond�n9 �r�fortnation from Section A Suiiding Street Address (indu�ng qp�•. Unik Suite. and/or 655 S. GULFYlEVV BLVD. �l9, No.) or P.O. Rade and Box No. City CLEARWATER State FL ZIP Code 33767-2643 FOR INSURAWCE GOMPANY USE Pal�cy Nu�nber. ComPerty NAIC Number. If using the Eleyation Certific�ce to o�in NFIP flood insurance, affoc at Iea� 2� for Item A8. Identify aM photographs with date taken; "Frorrt 1�iev✓' and "Rear �!� nd,��if�P� below accor�ng to the instructions Vie�w." WFten appiicable, P�o9��$ must show the foundatipn with �'�ed, "Right Side �l�ev�' and `Left Side indicated in Sedion A8. If submirt�ing more �P��tative sxamples of the flood openings ar vents, as P�Q9�aphs than wdl fit on th� page, use the Continuation Page. ; .. . — .. ; . � ,• - , .--� q , - � P ;:� FRONT VIEW (NORT}i/STREET SIDE) 6/25/2015 � _ > T. � . ,.r RIGHT SIDE VIEW (WEST SIDE) 6/25/2015 '�! REAR VIEW (SOUTHM/ATER SIDE) 6/25/20'15 LEFT SIDE VlEW (SOUTH/WATER SIDE} 6l25/2015 FEMA Form 086-(3-33 �7��z) Replacses all previous editions. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency ELEVATION CERTIFICATE IMPORTANT: FOLLOW THE INSTRUCTIONS ON PAGES 9-16 OMB Control Number: 1660-0008 Cvniro4ir�n� 1 � /'�!1/7l1� 4 opy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agenUcompany, and (3) building owner.� `V v SECTION A- PROPERTY INFORMATION FORM INSURANCE COMPANY USE A1. Building Owner's Name CLEARWATER GRANDE DEVELOPMENT, LLC Policy Number: A2. Building Street Address (including Apt„ Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. Company NAIC 655 S. GULFVIEW BLVD. (PARKING GARAGE/HOTEL BUILDING) Number: City CLEARWATER State FL Zip Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) TAX PARCEL ID # 17-29-15-05004-003-0080, LOTS 8, 9, 10 8� 11, BLOCK C, BAYSIDE SUBDIVISION PB 38 PG 38 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) Non-Residential A5. Latitude/Longitude: Lat. 27 °58'01.0 "N Long. 82°49'33.6"V1�orizontal Datum: � NAD 1927 (P: 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 6 A8. For a building with a crawispace or enclosure(s): A9. For a buiiding with an attached garage: a) Square footage of crawispace or enclosure(s) 1574 sq ft a) Square footage of attached garage N/A sq ft b) Number of permanent flood openings in the b) Number of permanent flood openings crawlspace or enclosure(s) within 1.0 foot in the attached garage within 1.0 foot above adjacent grade � above adjacent grade N/A c) Totai net area of flood openings in A8.b 0 sq in c) Totai net area of flood openings in A9.b N/A sq in d) Engineered fiood openings? (°"' Yes (�' No d) Engineered flood openings? �""' Yes l� No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State CITY OF CLEARWATER 125096 Pinellas FL B4. Map/Panel Number B5. Suffix 66. FIRM Index Date B7. FIRM Panel Effective! 68. Flood Zone(s) B9. Base Flood Elevation(s) Revised Date (Zone AO, use base flood depth 12103C0104 G 08/18/2009 09/03/2003 AE 8 VE AE 12, VE 13 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69: �°'° FIS Profile �' FIRM {"'" Community Determined t�' Other/Source: B11. Indicate elevation datum used for BFE in Item 69: �"' NGVD 1929 �' NAVD 1988 Q"" Other/Source: B12. Is the buiiding located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? �" Yes t�" No Designation Date: 4°""' CBRS t''"' OPA SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: �'°' Construction Drawings" t'" Building Under Construction` �' Finished Construction 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. Compiete Items C2.a -h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. A new Elevation Certificate will be required when construction of the building is complete. Benchmark Utilized: CITY OF CLEARWATER "F-02" Vertical Datum: ELEVATION 4.0574' NAVD88 Indicate elevation datum used for the elevations in items a) through h) below. ('"' NGVD 1929 f�' NAVD 1988 E"" Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enciosure floor) �- 3 � feet �"' meters b) Top of the next higher floor 16 - 0 (': feet ('" meters c) Bottom of the lowest horizontal structural member (V Zones only) 15 - 3 �":°' feet �"" meters d) Attached garage (top of slab) N�A - t:' feet k°"' meters e) Lowest elevation of machinery or equipment servicing the building 17 - 0 (Describe type of equipment and location in Comments) �" feet (""' meters f) Lowest adjacent (finished) grade next to building (LAG) 5- 9 �' feet �" meters g) Highest adjacent (finished) grade next to building (HAG) �- 3 (: feet �'""' meters h) Lowest adjacent grade at lowest elevation of deck or stairs, inciuding 6- 0 structural support i feet �'"` meters FEMA Form 086-0-33 (7/15) Replaces all previous editions. Page 3 of 15 ELEVATION CERTIFICATE OMB Control Number: 1660-0008 Expiration: 11 /30/2018 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 interpret the dafa avarlable. I understand that any false statement may be qunishable by fine or imprisonment under 18 U. S. Code, Section 1001. Were latitude and longitude in Section A � � Check here if attachments. provided by a licensed land surveyor? ��T ' �' Yes �"' No `��,\%, ° ` � : �` , .a . Certifier's Name �,:` � � � "��' License Number �.. , �� DANA A. WYLLIE LS 5874 � '�+� ,� � ", ,� � �� Title SURVEY MANAGER Address 565 S. HERCULES AVE. � Company Name DEUEL 8 ASSOCIATES City State Zip Code CLEARWATER FL 33764 Date Telephone Field: 9/08/2016 (727) 822-4151 """ � y p - � . �/ � �. x., � -, ' Is�",. . ♦ ,c" , �' . � i0.+ k� . e ��= i t �,A _�O <% r`. ,rr `° �, t'ro �dw�... ��, 1;i ,,. • _... �, G �( yr, , ,� � �#4 i� � � �$ ; if r � � . a�, : rF .�k' � , , � � � � �� '� �opy both sides of this �fevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner. Comments (including type of equipment and location , per C2(e), if applicabie)" • A5: Latitude and longitude were determined by using Google Earth. A8 Enclosure areas consist of several stairwells & elevator shafts C2a) Elevation is ground floor C2b) Elevation is floor of 2nd level C2e) Elevation is bottom of domestic water pump electric motors on 2nd level. Air conditioner platform is at elevation 20.2 feet. Additional information: bottom of elevator shaft elevation = 2.3 feet NOTE: Plans reference "shear wall" along west wall of northwest corner enclosure (not field verified by this firm). Signature ��G.�t � �/(/�.I,��t'iC� Date .��/.3�ZO/rp SECTION E- BUILDING ELEV N INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A( TH UT 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, crawlspace, or enclosure) is b) Top of bottom floor (including basement, crawlspace, or enclosure) is ;"' feet (�°' meters ❑ above or � below the HAG. (' feet �'"" meters ❑ above or � below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is - ("' feet G"e 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 T'he property owner or owner's authorized representative who compietes Sections A, B, and E for Zone A(without a FEMA-is: �ommunity-issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knc Property Owner or Owner's Authorized Representative's Name: Address City State ZIP Code Signature Comments FEMA Form 086-0-33 (7/15) Date Telephone Replaces aii previous editions. � � Check here if attachments. Page 4 of 15 � .. BUILDING PHOTOGRAPHS See instructions for Item A6 OMB Control Number: 1660-0008 Expiration: 11 /30/2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. 655 S. GULFVIEW BLVD. (PARKING GARAGE BUILDING) Policy Number: City State Zi Code CLEARWATER FL p 33767 Company NAIC Number: If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 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." When applicable, photographs must show the foundation with representative exampies of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Pac�e. /1 � !: � �� . M�. �:�°�,..,,�... � "�,:::�� ;;t!�;�ark�sr��;n �I FRONT VIEW (NORTH SIDE) 9/13/2016 REAR VIEW (SOUTH SIDE) 9/13/2016 RIGHT VIEW (WEST SIDE) 9/13/2016 LEFT VIEW (EAST SIDE) 9/13/2016 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Page 6 of 15