1600 SUNSET DR U.S.D�~PARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
Federal Emergency ManagementAgency Expires March 31,2012
National Flood Insurance Program Important: Read the instructions on pages 1-9.
SECTION A-PROPERTY INFORMATION � ��` ��� ��B�Cbknpg�y,EJse:
A1. Building Owner's Name David W.Fritz&Michelle I.Fritz s ;� t1 F'
�:;
A2. Building Street Address(inGuding Apt.,Unit,Suite,and/or Bidg.No.)or P.O.Route and Box Na fCiffi'II�AyNAICi'Ni�mber
1600 Sunset Drive
City Cleanvater State FL ZIP Code 33755
A3. Property Description(Lot and Blodc Numbers,Tax Parcel Number,Legal Description,etc.)
ParcellD#09-29-15-55530-000-0440
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential
A5. Latitude/Longitude:Lat.27.9813858 Long.-82.798521 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 16
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage 696 sq ft
b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage
enclosure(s)within 1.0 foot above adjacent grade 0 within 1.0 foot above adJacent grade 0
c) Total net area of flood openings in AS.b 0 sq in c) Total net area of flood openings in A9.b 0 sq in
d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
81.NFIP Community Name&Community Number 62.County Name 63.State
Ciry of Clearvvater 125096 Pinellas FL
64.Map/Panel Number B5.Suffix B6.FIRM Index 67.FIRM Panel 68.Flood 69.Base Flood ElevaGon(s)(Zone
12103C0106 H Date Effective/Revised Date Zone(s) AO,use base flood depth)
&1&09 9-3-03 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 B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other(Describe)
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Othervvise Protected Area(OPA)? ❑ Yes � No
Designation Date N/A ❑ CBRS ❑ OPA
N � � � �
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REf�U j � �� �
'i � !" '�
C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction" , d t t° p �
'A new Elevation Certificate will be required when construction of the building is complete. (; �' � o D rn O
C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,A R(}�I�;/� A��n?�I P�e; � rn r � �
below according to the building diagram specified in Item A7. Use the same datum as the BFE. � !� � � � C
Benchmark Utilized CITY OF CLW H-O6 Vertical Datum ELEV=30.6793'(N.A.V.D.1 i � a � Z
` '=!_,?i�:i�fiP,G&DEVELC �
Conversion/Comments N/A �, C.i?`Y C>F CLEAP � W �
Check the measure►ient a�"-- � � m
a) Top of bottom floor(including basement,crawlspace,or enclosure floor)1yri.1� �feet ❑meters(Puerto Rico only) �. � �
b) Top of the next higher floor N.A �feet ❑meters(Puerto Rico only) `� Q
c) Bottom of the lowest horizontal structural member(V Zones only) N.A �feet ❑meters(Puerto Rico only) c�u �
d) Attached garage(top of slab) 14.68 �feet ❑meters(Puerto Rico only) D
e) Lowest elevation of machinery or equipment servicing the building 14.08 �feet ❑meters(Puerto Rico only) �
(Describe type of equipment and location in Comments)
:� �
f) Lowest adjacent(finished)grade next to building(LAG) 11.18 �feet ❑meters�(Puerto Rico only) �
g) Highest adjacent(finished)grade next to building(HAG) 15.3 �feet ❑meters(Puerto Rico only) W
h) Lowest adjacent grade at lowest elevation of deck or stairs,including N.A �feet ❑meters(Puerto Rico only)
structural support
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 certily that the infamation on this Certificate represents my best eA`orts to interpret the data available. '
1 understand that any false statement may be punishable by Fne or imprisonment under 18 U.S.Code,Section 1001. ,,'"� 4 � � �� �
�',� � �. :-, a„ •.
� Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a �� �'y � �^:''. j
licensed land surveyor? � Yes ❑ No ' �'✓' ' �' ''
„ s�� "!';�'
Certifier's Name Philip C.Stock License Number RLS#3035 " ,>
Title President Company Name Target Land Surveying,Ina � f�'�j�G��`�»
Address 516 Lakeside Place Ciry Largo State FL ZIP Code 33771 ��f�,f�/f.y • „�`.;�
Signature �, --Date 11-9-11 Telephone (727)784-0573 �','';+ °�s ,,}
FEMA Form 81- 1, Mar 09 See reverse side for continuation. Replaces all previous editions
.IMPORTANT: In these spaces,copy the corresponding information from Section A.
Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. � �;�� § ��� x�'
1600 Sunset Drive ����� � � � x ���*,�
City Clearwater State FL ZIP Code 33755
E.:� � �t� � _
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
Job#111028.03_ -� ` ` ��
C.2.e)=AIC Unif.�a c��, ' " �`,_
According to the pi ella .G�ddnt�+,��q�perty Appraiser,this house was built in 1956. At that time,FEMA Flood Maps did not exist.
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Si��atur�.�' - ��,` ,. f�,` _ Date 11-9-11
� ❑ Check here if attachments
'~` SEG�`.'�I, `@� DIN�,�E�VATIQW INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
�:: c ' . `„ � ; �' W `
For�oAe�;AQ•�r►�iA{Wllhqa�''B'F,�,);cbmpleter Jtems E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B,
and'�.:Fat I�ertjs E1-E4;W�,e�h,5tural grade,;if available. Check the measurement used. In Puerto Rico only,enter meters.
. � ., F �;.
E1. PrpGuie%leva�i8ff i= dhaGaA for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
gi'atle`(1-f�j,�!#tM't�lqw�`st adjacenYgrade(LAG).
a)Top�of,bo�tbhf flddr`(including basement,crawlspace,or endosure)is ❑feet ❑meters ❑above or❑below the HAG.
b)Top o�beSttc�m floor(including basement,crawlspace,or enGosure)is ❑feet ❑meters ❑above or❑ below the LAG.
E2. For Building Uiagrams 6-8�vith permanent flood openings provided in Section A Items 8 and/or 9(see pages&9 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,B,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
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 infortnation 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 communiry-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(inGuding 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
G10.Communiry's design flood elevation ❑feet ❑meters(PR)Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑Check here if attachments
FEMA Form 81-31, Mar 09 Replaces all previous editions