1020 SEDEEVA ST ��
li'S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
� Exoires Februarv 28. 2009
"�ederal Emergency Management Agency
National Flood Insurance Program Important: Read the instructions on pages 1-8.
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
A1. Building Owner's Name SUSAN L. COLE Policy Number
A2. Building Street Address(including Apt., Unit,Suite,and/or Bidg.No.)or P.O. Route and Box Na Company NAIC Number
1020 SEDEEVA STREET 1 �20 S E D E EVA ST
City CLEARWATER State F� ZIP Code 33755
A3. Property Description (Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) ��r�oo"-065'14
03-29-15-28674-001-0060 FLORIDENA BLOCK A, LOT 5 LESS N 63 FT&LESS W 20 FT OF S 132 FT&W 35 FT OF LOT 6
A4. Building Use(e.g., Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. N 27.9969 Long.W 82.79415 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. Buiiding 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 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 N/A walis within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in AB.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
61. NFIP Community Name&Community Number 62.County Name B3.State
CITY OF CLEARWATER 125096 PINELLAS COUNTY FL
84. Map/Panel Number 65.Suffix 66. FIRM Index 67. FIRM Panel B8.Flood B9. Base Flood Elevation(s)(Zone
Date Effective/Revised Date Zone(s) AO,use base flood depth)
12103C-0106 H 5-17-05 5-17-05 AE 12'
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 69: ❑ NGVD 1929 � NAVD 1988 ❑Other(Describe)
B12. Is the building iocated 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 REGIUIRED)
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,AFUAt-A30,AR/AH,AR/AO. Com -�
below according to the building diagram specified in Item A7. � �._..-�-��
Benchmark Utilized CITY OF CLEARWATER I-06 Vertical Datum NAVD 88 � �-J�-�
Conversion/Comments N/A '�" ^
Check the measurement used. � �1�►�1
� m �
a) Top of bottom floor(including tiasement,crawl space,or enclosure floor)_ 9.75 �feet ❑meters(Puerto Rico only) � � l`!CJ
b) Top of the next higher floor N.A ��eet ❑meters(Puerto Rico only) -� � w1 �..�f"�E
c) Bottom of the lowest horizontal structural member(V Zones only) N.A �feet ❑meters(Puerto Rico only) �� �
�
d) Attached garage(top of slab) N.A ��eet ❑meters(Puerto Rico onlyj �{! rv
o (.�'
e) Lowest elevation of machinery or equipment servicing the building 9.46 �feet ❑meters(Puerto Rico only) ;� o ---.
(Describe type of equipment in Comments) r'' °O •
f) Lowest adjacent(finished)grade(LAG) 9.2 �feet ❑meters(Puerto Rico only) �'r� �y�`�
�
g) Highest adjacent(finished)grade(HAG) 9.4 �jeet ❑meters(Puerto Rico only) rnV "Y:'���
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 on this Certificate represents my best efforts to interpret the data available.
1 understand that any false statement may be punishab/e by fine or imprisonment under 18 U.S. Code,Section 1001.
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� Check here if comments are provided on back of form. ;� � ':c:,,, �; "-
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Certifier's Name GEORGE A.SHIMP I11 Job No. 080172 License Number 6137 j ''. ,��.� `�" �
`R K
Title VICE PRESIDENT Com an Name GEORGE A.SHIMP II&ASSOCIATES,INC. " .�°`
.�
Address 3301 DESOTO BLVD.,SUITE D Ci PALM HARBOR State FL ZIP Code 34683 ��'""'�"����
�Y .: .
ature Date 07-09-2008 Telephone 727-784-5496 #613'� DA'FE:µ�� ��
.�, , ��-�
FEMA Form 81-31, February 2006 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(including Apt., Unit, Suite,and/or Bldg.No.)or P.O. Route and Box No. Policy Number
1020 SEDEEVA STREET
City CLEARWATER State FL ZIP Code 33�55 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)building owner.
Comments C2.e)AIR CONDITIONER
� _ �,� 1►L_
Signature Date 07-09-2008
� Check here if attachments
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REGIUIRED) 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 communiry-issued BFE)
or Zone AO m ust 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 City State ZIP Code
Signature Date Telephone
Camments _
❑Check here if attachments
' SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local official who is authonzed by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B, C(or E),
and G of this Elevati0n 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.)
C�2. ❑ A community official compieted 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 pQrmit 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
U.S. DEFARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB NO. 1660-0008
Exnires Februarv 28. 2009
Federal Emergency Management Agency
National Flood insurance Program Important: Read the instructions on pages 1-8.
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
A1. Building Owner's Name SUSAN L.COLE Policy Number
A2. Building Street Address(inciuding Apt., Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Company NAIC Number
1020 SEDEEVA STREET 1020 S E D E E VA S T
City CLEARWATER State FL ZIP Code 33755
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) �CP2�0�-Ofi514
03-29-15-28674-001-0060 FLORIDENA BLOCK A, LOT 5 LESS N 63 FT&LESS W 20 FT OF S 132 FT&W 35 FT OF�OT 6
A4. Building Use(e.g., Residentiai,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat.N 27.9969 �ong.W 82.79415 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 1
A8. For a building with a crawi 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 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 N/A
c) Total net area of flood openings in AB.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
61.NFIP Community Name&Community Number B2.County Name B3.State
CITY OF CLEARWATER 125096 PINELLAS COUNTY FL
64. Map/Panei Number 65.Suffix B6. 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-0106 H 5-17-05 5-17-05 AE 12'
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)
611. 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 RE�UIRED)
C1. Building elevations are based on: ❑Construction Drawings' ❑ Building Under Construction* � Finishecl 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 buiiding diagram specified in Item A7.
Benchmark Utilized CITY OF CLEARWATER I-06 Vertical Datum NAVD 88 �} �
Conversion/Comments N/A � '��
�
• Check the measurement used.
a) Top of bottom floor(including basement,crawl space,or enclosure floor)_ 9.75 �feet ❑meters(Puerto Rico only) 1 ,� � u uu
b) Top of the next higher floor N.A �teet ❑meters(Puerto Rico only) j r-�i, � �j
-4 "'�
c) Bottom of the lowest horizontal structural member(V Zones only) N.A �feet ❑meters(Puerto Rico only) fi �
t-.+ �`�
d) Attached garage(top of slab) N.A ��eet ❑meters(Puerto Rico only) � m �
e) Lowest elevation of machinery or equipment servicing the building 9.46 �feet ❑meters(Puerto Rico only) { ,;,p �--'
(Describe type of equipment in Comments) � r� o '"
f) Lowest adjacent(finished)grade(LAG) 9.2 �fieet ❑meters(Puerto Rico only) I �'f o°o '�'
g) Highest adjacent(finished)grade(HAG) 9.4 �feet ❑meters(Puerto Rico only) 1,��-' ��?rJ
�
SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION � ==--
This certification is to be signed and sealed by a Iand surveyor,engineer,or architect authorized by law to certify elevation
information. 1 certify fhat the information on this Certificate represents my besi efforts to inierpret the data availab/e.
I understand fhaf any fa/se 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. , �g :f� �'f �
� �1; �-
Certifier's Name GEORGE A.SHIMP III Job No. 080172 License Number 6137 � �, � f: 3 --
Title VICE PRESIDENT Company Name GEORGE A.SHIMP II&ASSOCIATES,WC. �f .,:-
�E��e��r� :y
Address 3301 DESOTO BLVD.,SUITE D Ciry PALM HARBOR State FL ZIP Code 34683 .,�;�. � '
ture Date 07-09-2008 Telephone 727-784-5496 #6�37 DATE: �� �
�,..����
FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions
r
IMPORTANT: 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 "
1020 SEDEEVA STREET
City CLEARWATER State Fl. ZIP Code 33755 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)building owner.
Comments C2.e)AIR CONDITIONER
�f�� �,��
Signature Date 07-09-2008
� Check here if attachments
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT RE�UIRED)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 Sectio�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 ftoodplain 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 besf of my know/edge.
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 who is authonzed 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 betow. Check the measurement used in Items G8.and G9.
G1. ❑ The iriformation in Section C was taken from other documentation that has been signed and seaied 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
Signature Date
Comments
❑Check here if attachments
FEMA Form 81-31, February 2006 Replaces all previous editions
�i , t '
Building Photographs
� See Instructions for Item A6.
'I i For Insurance Company Use:
Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poiicy rvumber
1020 SEDEEVA STREET
Clty CLEARWATER State FL ZIP COd@ 33755 CompanyNAlCNumber
I If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to
i 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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