801 SNUG ISLANDU.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
ELEVATION CERTIFICATE
OMB No. 1660 -0008
Expiration Date: November 30, 2018
Important: Follow the instructions on pages 1 -9.
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
SECTION A — PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
Al. Building Owner's Name
Jeffrey Douglas Glass, Colleen Mary Glass
Policy Number:
A2. Budding Street Address (including Apt.. Unit. Suite, and /or Bldg. No.) or P.O. Route and
Box No.
801 Sung Island
Company NAiC Number:
City State ZIP Code
Clearwater Florida 33767
A3, Property Description (Lot and Block Numbers. Tax Parcel Number, Legal Description. etc.)
05- 29 -15- 43457- 000 -0360
A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) Residential
A5. Latitude /Longitude: Lat. 27 °59'34.47"W Long. 82°49'07.05"W Horizontal Datum: 0 NAD 1927 Ox NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
Al. Building Diagram Number 1B
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 0 sq ft
b) Number of permanent flood openings in the crawlspace or enctosure(s) within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b 0 sq in
d) Engineered flood openings? 0 Yes 0 No
A9. For a building with an attached garage:
a) Square footage of attached garage 576 sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 3
c) Total net area of flood openings in A9.b 221 sq in
d) Engineered flood openings? Ox Yes I] No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
125096 City of Clearwater
82. County Name
Pinellas
B3. State
Florida
84. Map /Panel
Number
12103C 0102
B5. Suffix
G
86. FIRM Index
Date
09/03/2003
137. FIRM Panel
Effective/
Revised Date
09/03/2003
B8. Flood Zone(s)
AE
B9. Base Flood Elevation(s)
(Zone AO. use Base
Flood Depth)
11
810, indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9:
0 FIS Profile x0 FIRM 0 Community Determined 0 Other /Source:
B11. Indicate elevation datum used for BFE in Item B9: 0 NGVD 1929 0 NAVD 1988 0 Other /Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes Ox No
Designation Date: 0 CBRS 0 OPA
FEMA Form 086 -0 -33 (7/15) Replaces all previous editions.
801 SNUG ISL
BCP2017 -09593
KITCHEN & BATH REMODEL
JEFFREY DOUGLAS GLASS
Zoning: Island Estates Atlas #: 249B
RECEIVED BY: T.V.
SEP 2 8 2017
PLANNING & DEVELOPMENT
CITY OF CLEARWATER
LEVATION CERTIFICATE
OMB No. 1660 -0008
Expiration Date: November 30, 2018
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.
801 Sung Island
Policy Number:
City State ZIP Code
Clearwater Florida 33767
Company NAIC Number
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based on: ■ Construction Drawings' 0 Building Under Construction" 0 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, AR/A1 -A30, AR/AH, AR/AO.
Complete Items C2.a -h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized: FDOT Benchmark Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a) through h) below.
0 NGVD 1929 0 NAVD 1988 ❑ 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 enclosure floor) 11, 65 0 feet ❑ meters
b) Top of the next higher floor n/a p feet [] meters
c) Bottom of the lowest horizontal structural member (V Zones only) n/a 0 feet 0 meters
d) Attached garage (top of slab) 10, 0 El feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 12 8 0 feet 0 meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 8, 4 0 feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 10, 1 0 feet 0 meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including n/a, 0 feet 0 meters
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 certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false
statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
Were latitude and longitude in Section A provided by a licensed land surveyor? ❑ Yes 0 No NJ Check here if attachments.
-
Certifier's Name License Number
f
Patrick K. Ireland 6637
„1CK lI
Q�aSIFic4 'O
n' ` e.
o NO. 8637 u
STATE OF a
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. °tOROOP' ,. 4 •
Rr r+HO su.*" +o
Title
Professional Land Surveyor
Company Name
LakeRidge Surveying and Mapping, LLC
Address
1399 Legendary Boulevard
City
Clermont
State ZIP Code
Florida 34711
Signature
Date Telephone
1_&.(7 (407) 385 -3151
Copy alp ges of this El vation cate
nd all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments (including type of equipment and location, per C2(e), if applicable)
C2e =a /c unit
job number 17 -1246 8/28/2017 Elevation certificate updated to add new a/c unit and smart vents in garage.
FEMA Form 086 -0-33 (7/15)
Replaces all previous editions.
Form Page 2 of 6
U.S.DEPAF2TMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
Federal Emergency Management Agency Expires March 31,2012
National Flood Insurance Program Important: Read the instructions on pages 1-9.
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
A1. Building Owner's Name ALAN R. ELIA, JR & DONNA E. TOMKINS Policy Number
A2. Building Street Address(including Apt., Unit,Suite, and/or Bidg. No.)or P.O.Route and Box No. Company NAIC Number
801 SNUG ISLAND
City State ZIP Code
CLEARWATER FL 33767
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
PARCEL, 05-29-15-43457-000-0360 �OT 36, UNIT 7B, ISLAND ESTATES, BOOK 64 PAGE 70, PINELLAS
A4. Building Use(e.g., Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL
A5. Latitude/Longitude:Lat.27°59'34.69"N Long.82°49'07.37"W Horizontal Datum: ❑ NAD 1927 x 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 ONE-A
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) 0 sq ft a) Square footage of attached garage 576 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 A8.b 0 sq in c) Total net area of flood openings in A9.b 0 sq in
d) En�ineered flood openings? ❑Yes X No d) Engineered flood openings? ❑ Yes X No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name&Community Number 62.County Name B3. State
TCITY OF CLEARWATER 125096 PINELLAS FL
64. Map/Panel Number B5.Suffix B6. FIRM Index 67. FIRM Panel 68. Flood B9. Base Flood Elevation(s)(Zone
Date Effective/Revised Date Zone(s) AO,use base flood depth)
12103C0102 � 08/18/09 09/03/03 AE 11.0
610. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69.
❑FIS Profile X FIRM ❑Community Determined ❑Other(Describe)
611. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 X NAVD 1988 ❑Other(Describe)
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes x No
Designation Date ❑CBRS ❑OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
1. Building elevations are based on: ❑Construction Drawings' ❑Building Under Construction' x 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,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-h
below according to the building diagram specified in Item A7. Use the same datum as the BFE.
Benchmark Utilized GPS Vertical Datum NAVD 1988
Conversion/Comments NONE Check the measurement used.
a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 11.56 x feet ❑meters(Puerto Rico only)
b) Top of the next higher floor NA x feet ❑meters(Puerto Rico only)
c) Bottom of the lowest horizontal structural member(V Zones only) NA x feet ❑meters(Puerto Rico only)
d) Attached garage(top of slab) 10.00 x feet ❑meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building AC 9.74 X feet ❑meters(Puerto Rico only)
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 8.50 x feet ❑meters(Puerto Rico only)
g) Highest adjacent(finished)grade next to building(HAG) 10.50 x feet ❑meters(Puerto Rico only)
h) Lowest adjacent grade at lowest elevation of deck or stairs,including 7.50 x 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 certify that the information on this Cerfificate represents my best efforts to interpret the data availab/e. . +�� ` `'P �r� . ''
l understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. �`a��i�A„�f,"������ '. � -,.
X Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ° ��:. ,��r xx �'� � °
licensed land surveyor? x Yes ❑No h',���,. �� � £
Certifier's Name: BILL HYATT License Number. LS 4636 b �„"`�,'�`���*�"��' ' ��
�
Title: PRESIDENT Company Name: KNOW IT NOW INC. 3f��(��R �
Address: 1497 MAIN STREET#321 City: DUNEDIN State: FL ZIP Code: 34698 �
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Signature Date: Telephone: 727-415-8305
��`'� 03/01/11
FEMA Form 81-31, Mar 09 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
801 SNUG ISLAND
City State ZIP Code Company NAIC Number
CLEARWATER FL 33767
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
NOT TO B�US��fOR CONSTRUCTION OR DESIGN, IS FOR FLOOD INSURANCE USE ONLY
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Si at � �� ���'"����' � Date 03/01/11 X Check�here if attachments
u}:�° SLCTI N E-B L�IG ELEVATION INFORMATION(SURVEY NOT REQUIRED) FOR ZONE AO AND.ZONE A(WITHOUT BFE)
�, �.� � � t,.r
`�`,�c Zones���nd,�1'�(wi�t BFE);'�prttplete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B,
an�C` Fqr fterr�l�'1 �4��se naturai grade,if available. Check the measurement used. In Puerto Rico only,enter meters.
E1. '=`��vi$ekelev n i{�formati�rn For the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
g�d�(HAG}'��{the lbvi+�s't adjacent grade(LAG).
a)�irf�l��t�F�tom'ff�it(iricluding basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or ❑below the HAG.
b)�op�p#botto�t fl�or(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or ❑below the LAG.
E2. For Building Diagtams 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 ❑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 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 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
G10. Community'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
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