1111 SPENCER AVE u P
U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB NO. 1660-0008
Fedgral Emergency ManagementAgency Expires March 31,2012
National Flood Insurance Program Important: Read the instructions on pages 1-9.
SECTION A-PROPERTY INFORMATION �`�, h,��►,1� � - ,� n`
A1. Building Owner's Name Christa M.Kirby � � ' �* '
��` �.� �� �:w� ��,a.���� ��
A2. Building Street Address(inGuding Apt.,Unit,Suite,and/or Bidg.No.)or P.O.Route and Box No. "� �l�, N�MIi �"
r� ,
1111 Spencer Avenue ����•-�.��'
�;H �����e� state F` z�P�de 33�56 1111 S P E N C E R AV E
A3. Property DescripGon(Lot and Blodc Numbers,Tax Parcel Number,Legal Description,etc.)
Lot 50,Live Oak Estates BCP2009-12119
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential
A5. Latitude/longitude:Lat.27.954615 Long.-82.767744 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 1A
A8. For a building with a crawispace or enGosure(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 �,VLA sq ft
b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage
enGosure(s)within 1.0 foot above adjacent grade N�A within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A8.b �A sq in c) Total net area of flood openings in A9.b NLA sq in
d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
61.NFIP Community Name 8 Community Number B2.County Name B3.State
City of Clearvwater 125096 Pinellas FL
B4.Map/Panel Number B5.Suffix B6.FIRM Index 87.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
12103C0109 H Date EffectivelRevised Date Zone(s) AO,use base flood depth)
&1&09 5-17-05 AE 32'
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)
612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes � No
Designation Date ❑ CBRS ❑ OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY RE�UIRED)
C1. Building elevations are based on: ❑ Construction Drawings' � Building Under Construction" ❑ Finished Construction
"A new ElevaGon Certificate will be required when constructlon 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 349 FLHDVertical Datum ELEV=71.36'(N.A.V.D.) ��'`� �
Conversion/Comments �"�e..� cc��
Check the measurement used. p� ��
a) Top of bottom floor(inGuding basement,crawlspace,or enGosure floor),�,�.22 �feet ❑meters(Puerto Rico only) o t�� Y�
b To of the next hi her floor N. fe ���� �' ~ � �1� �
) P 9 � � e�r Cfl:�►gt (Pue o R�ico on�x) � '�° � ,., �1
r_, i7�j.`
c) Bottom of the lowest ho�izontal structural member(V Zones only) N.A _��eqE� ,�e '����d�"'���cb�r�'y#�`��"� �� f "�
d) Atta c h e d garage(top o f s la b) I V.A -��4 �8 t[c 3��o�� �fi 1 � �e�1 �"
, �� ;
e) lowest elevation of machinery or equipment servicing the building N.A eL, ��c��,�:`� �'� � �;a ,";�
(Describe rype of equipment and location in Comments) u'�f-'`��` 'ti�-"`�! �� ��"�"�' 'f�f�,�� � � �
� � ;�
� Lowest adjacent(finished)grade next to building(LAG) ,�.4 �feet ❑meters(Puerto Rico only) � ' n ';:�
g) Highest adjacent(finished)grade next to building(HAG) �.� �feet ❑meters(Puerto Ri nly � �'�
s °"°""`"f at.
h) Lowest adjacent grade at lowest elevation of deck or stairs,inGuding N.� ��.feeL,,.[]�l�iet�rs(Puert co � �� �
struCtural su rt __..,_�,,_ w._W._.. ._ .� .
SECTION D-SURVEYOR, ENGINEER,OR ARCi�i1���T.,Sc,_ERTIFICATION ' �-
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation '
. ��
infortnation. I certify that the information on this Certf�icate represents my best efforts to interpret the data available. � '`' '' r ',,
1 understand that any false statement may be punishable by rne a imprisonment under 18 U.S.Code,Section 1001. �' �� " `'�"'� �'�'?`
.� +,�''.+'� �,�,���J��� �r
� Check here if comments are provided on badc of form. Were latltude and longitude in Section A provided by a � ,,��t , �1��t r�r.'.! , � '
licensed land surveyor? � Yes ❑ No ;._:�w' ;�C• � ;, .
Certifiers Name Philip C.Stock License Number RlS#3035 � " ;�o.:.fl:+�'. � "
`� �. :.
Title President Company Name Target Land Surveying,Inc. "� �' �C: � ��
� .. ��o��efY;
Address 516 Lakeside Place Ciry Largo State FL ZIP Code 33771 `,r��'�; , �'� '� " � V
�" ,r,,, � a'�Z'�'iQ
Signatur � _ Date 1-22-10 Telephone (727)784-0573 �4� �'� ""���'"�� _
�
FEMA Form 81-31, Mar 09 See reverse side for continuation. Replace§all previous editions
� IMPORTANT: In these spaces,copy the corresponding information from Section A. ��Fb��" �r,�f�t�e'����npa�!�llse; ,
Building SVeet Address(including Apt.,Unit,Suite,and/or Bidg.No.)or P.O.Route and Box No. �P'�II IV��,°
�
111�1 Spencer Avenue �: � �� .,�.z,� -�r;_��. -� �
Ciry Clearvvater State FL ZIP Code 33756 �; „h�NA1,�'�Ni�1b9r,�; '
'�� .��s
SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
Copy both sides of this ElevaGon Certificate for(1)community official,(2)insurance agenUcompany,and(3)building owner.
Comments
Job#100119.02
This flood certificateMis for the stucture urader constuction
,t
��;t�►►tt����"t
Signature 4��� �° e __ Date 1-22-10
' '���•. ❑ Check here if attachments
SEGTl01�• UI �' t�V'p►TION FNFORMATION(SURVEY NOT RE6IUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
'� °� � (l 7" � l 1 .. �^. „
For Zor�s`�i40�tnd�(�it�ut B �omplete ltems E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B,
and C. fo�;lterris E�-E4,�se na�ra4tgr$de,if available. Check the measurement used. In PueRo Rico only,enter meters.
�... • •�t r� ' `V�
E1. Prowc�ere,v8t�on inforr431�tio�o�tfie following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grad"e��t� ���.�e.ba'ves'`'��c,�acent grade(LAG).
a)Top bf�t�,�loor'�inGu�di7ig t�asement,crawlspace,or endosure)is ❑feet ❑meters ❑above or❑below the HAG.
b)Top of l�dttqm�I�r(iA�l�udin,g:p��sement,crawlspace,or endosure)is . ❑feet ❑meters ❑above or❑ below the LAG.
E2. For Building Diagram�6-9 witf�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 platfortn of machlnery 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 communiry's floodplain management
ordinance? ❑Yes ❑ No ❑ Unknown. The local official must certiy fhis 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 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 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 communitys 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. Chedc 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 infortnation. (Indicate the source and date of the elevation data in the Comments area below.)
G2.❑ A communiry 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(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
Communiry Name Telephone
Signature Date
Comments
❑Check here if attachments
FEMA Form 81-31, Mar 09 Replaces ail previous editions
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