304 SPRING CT U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB NO. 1660-0008
Federal Emerg�ncy Management Agency ExDires Februarv 28.2009
Nation,al Flood Insurance Program Important: Read the instructions on pages 1-8.
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
A1. Building Owner's Name Policy Number
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number
304 Spring Ct
City Clearwater State FL ZIP Code 33755 � � ��1 '� �S- Q��a1
A3. Property Description(Lot and Blodc Numbers,Tax Parcel Number,Legal Descri ti ,e c.
City of Clearwater Permit No.BCP 2005-09821 Q q ��� ��'� ,� .. ��7 . /�1� �
��fJ
A4. Building Use(e.g.,Residential,Non-Residential,Add'Rion,Accessory,etc.) Residential
A5. Latitude/Longitude:Lat.27.97 N Long.82.80 W Horizontal Datum: ❑ NAD 1927 � NAD 1983
A6. Attach at least 2 photographs of the building ff the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 1
A8. For a building with a crawl space or enGosure(s),provide A9. For a building with an attached garage,provide:
a) Square footage of crawl space or enGosure(s) N/A sq ft a) Square footage of attached garage 7150 sq ft
b) No.of permanent flood openings in the crawl space or b) No.of pertnanent flood openings in the attached garage
enclosure(s)walls within 1.0 foot above adjacent grade N/A walls within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b 0 sq in
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name&Community Number 62.County Name B3.State
Clearwater,City of 125096 Pinellas FL
B4.Map/Panel Number 65.Suffix 66.FIRM Index 67.FIRM Panel 68.Flood 69.Base Flood Elevation(s)(Zone
Date Effective/Revised Date Zone(s) AO,use base flood depth)
12103C/0106 H 05/17/2005 05/17/2005 VE,AE 8�X VE=14,AE=12
B10. 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)
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 Proteded Area(OPA)? �Yes �No
Designation Date N/A ❑CBRS ❑OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. Building elevations are based on: ❑Construction Drawings* ❑Building Under Construction* �Finished Construction
*A new Elevation Cert�cate will be required when construdion of the building is complete.
C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,ARlAE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-g
below according to the building diagram specified in Item A7.
Benchmark Utilized Citv of Clearvvater G-05 Vertical Datum NAVD 1988
Conversion/Comments N/A
Check the measurement used. /�,�
a) Top of bottom floor(inGuding basement,crawl space,or enclosure floor)_ 24.8 �feet ❑meters(Puerto Rico only) �+ ���
b) Top of the next higher floor 36.8 �feet ❑meters(Puerto Rico only) ��,l,�,��
c) Bottom of the lowest horizontal structural member(V Zones only) N/A. ❑feet ❑meters(Puerto Rico only) v��
d) Attached garage(top of slab) 22.6 �feet ❑meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building 22.7 �feet ❑meters(Puerto Rico only)
(Describe rype of equipment in Comments)
fl Lowest adjacent(finished)grade(LAG) 11.0 �feet ❑meters(Puerto Rico only)
g) Highest adjacent(finished)grade(HAG) 22.5 �feet ❑meters(Puerto Rico only)
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or archited authorized by law to certify elevation
infortnation. 1 certify that the infom►ation on this Certificate represents my best efl`orts to inte�pret the data availa6le.
l understand thaf any fa/se statement may be punishable by fine or imprisonment under 18 U.S. Code,Sec6on 100L '�_, -_
� Check here if comments are provided on badc of form.
Certifier's Name Patrick J Collins License Number 5523 � � �,��'
� ��i . ,>, .
Title PLS Company Name Select Surveying lnc. � .; ���',�� .
�5 . � t�U'�` ;. '" <,.
Addr�ess 315 S Delaware Ave#2 City Tampa State FL ZIP Code 33606 ���'3 � �" "
�tv; ���-�.��
S i gnature � Date 1-22-0 9 T e l ep h o n e 8 1 3-2 5&3 2 10 ,z,}.l,vr;�,� ' ; ;
L./ •
%r: ,tr� -
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
304 Spnng Ct
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 agenUc�mpany,and(3)building owner.
Comments C2.c)Top of next highest floor is an estimation only.
C2.e)Lowest elevation of machinery servicing the building refers to air conditioner on Northerly side of residence.
A9.a)Garage square footage is approximate only.
NOTE:THERE IS NO PART OF THE LIVING AREA OF THE HOME WHICH FALLS WITHIN ZONE"AE";LIVING AREA IS ENTIRELY WITHIN
ZONE"X".
Signature Date 1-22-09
, ❑ Check here if attachments
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WtTHOUT BFE)
For Zones AO and A(without BFE),complete Items E1-E5. If the CeR�cate 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 fotlowing and chedc 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 Section A Items 8 and/or 9(see page 8 of Instructions),the ne�ct 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 owne�'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 heroe. The statements in Sections A,8,and E are co►rect to the best of my knowledge.
Property Owner's or Owners 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. Chedc 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 cert'rfy elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2.❑ A community o�cial 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 Cert�cate Of Compliance/Occupancy Issued
G7.This permit has been issued for: ❑New Construction ❑Substantial�mprovement
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
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑Check here if attachments
� Building Photographs '
See Instructions for Item A6.
For Insurance Company Use:
Building Street Address(including Apt, Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number
304 Spring Ct
City Clearwater State FL ZIP COde 33755 CompanyNAlCNumber
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least finro 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." If submitting more photographs than will fit on this page, use the Continuation Page,
following.
FRONT VIEW
,- �.
�
.,,e�..�.
�,���""� �„e,.�
..� ��"� `„
„�1 r,_
,,_,,.
� � �, ,..�" .' �
� , �4,, � � � � � ��ilt �
� � i
.. - ' ......
� � , e
�� 1
�� � i g
J
.��+wr.s.'..�., ..
_ ���"•
a�.,.
.a.�'..'°... , ."'°.�.r'....
��.�.. . � �w�'�+� "�L
REAR VIEW
� � �
�.,_`�" + � `� i�:
r �r ` ;, '
-;r
;.,� i�. �- t� ., , , ,� , �,,
�: ' �� c,,r' � ,e�fa
&�y�.+ '� K �,. Z�`� � �
.. q= _^� .. f !'�. t
+► "�== � � i � „� '`, � �- t� c. c. �
.. I� � � . �� � � 4��,_, ±'��i '� . ..
..� � i � ■ '� � .
� ! ;:
tlilt� (11 ��': i} � � . �t�~�
�, � �t
� �tl Ili,� y, . �
:
� �
� ..,..: �...F 3".�. ...� .. .
�e�� +n_w ra
�i"a'::�H.��_iY
� , �
r
BUILDING DIAGRAMS
The following eight diagrams illustrate various types of buildings. Compare the features of the building being
certified with the feaxures shown in the diagrams and select the diagram most applicable. Enter the diagram
number in Item A7., the square footage of crawl space or enclosure(s) and the area of flood openings in square
inches in Items A8.a-c, the square footage of attached garage and the area of flood openings in square inches in
Items A9.a-c,and the elevations in Items C2.a-g.
In A zones. the floor elevation is taken at the top fuushed surface of the floor indicated; in V zones, the floor
elevation is taken at the bottom of the lowest horizontal structural member (see drawing in instructions for
Section C).
DIAGRAM 1 DIAGRAM 2
Ali slab-on-grade single-and multiple-floor buildings All single-and muitiple-floor buildings with basement
(other than splitaevel)and high-rise buildings,either (other than split-level)and high-rise buildings with
detached or row type(e.g.,townhouses);with or basement,either detached or row type(e.g.,
without attached ara e. townhouses •with or wRhout attached ara e.
Distloguiahing Feature—The bottom floor(basemeM or underground
Distinguishing Feature—The bottom floor is at or above ground levei garage)is below ground level(grade)on all sides. Bwldings constructed
(grade)on at least one side.' above aawl spaces that are below grade on all sides should also use this
C2.b diagram.'
CZ.B i NEXT HIGHER � C2.a � �
� FLOOR
� C2.b
NEXT HIGHER
FLOOR
GRADE BOTTOM FLOOR
\ GRADE
\ BOTTOM FLOOR
�� � (BASEMENT)
,.- , :: ;
.:: -;' • ,; , . : , �
. ... . .. . . .'.: :;. ,. :. �
F f
:�.'c -.�� .:�s � -�_�;
Fd�e�rnnetl by ��t�r(nir�d#�y °
. �2`:f� _ �cist�ny'gr�tle) . :�f'9. 'exrs�r�>gPede} '�: . . , . .
DIAGRAM 3 DIAGRAM 4
All split-level buildings that are slab-0n�rade,either All split-level buildings(other than slab-on-grade),
detached or row type(e.g.,townhouses);with or either detached or row type(e.g.,townhouses);with or
without attached garage. without attached garage.
Distiaguishing FeaWre—The bottom floor(exduding garage)is at or Distinguishing Feature—The bottom floor(basemeM or underground
above ground levei(grade)on at least one side.' garage)is below ground level(grade)on all sides. Buddings constructed
above crawl spaces that are below grade on all sides should also use this
diagram.`
C2.a ; � � ;
' � C2.b C2.a ; i C2.b
�
HIGHER i
FLOORS i HIGHER �
NEXT HIGHER GRADE FLOORS
FLOOR NEXT HIGHER
RADE gOTTOM BOTiOM FLOOR FLOOR
\ ,:: ;::.....:•... •. ....:,.•. •-.......:.,�..� .•.•..•; BASEMENT _
LOOR
y ... �;C.i:,..:'.,;:.j'^'''•.'::::;...;':,•;:` _ �.�k k
�'�"s.-. ....t•-:!' -
;-�:.
'•�d�t
`Fl�l[1
l I ti
� ste�np r+ed
':{. .1?y�::;`:�.:�:�:=.�•'i::;:;��:��`:�::;�.;:;�::�:':�;i``;��:-:;��:::�; W
'.:�F'•.'i: . ���..�. ..... ... . .J •.�.� . . . ... . . . ..
•"'r'�2:•�=j:: -existi..''•'rade.. . . . .. - . . . ... - "�2:f g existin rade
�9� ').:.,::• . . 9 9 )
" A floor that is below ground level(grade)on all sides is considered a basement even if the floor is used for living purposes,or as an office,
gazage,workshop,etc.
Instructions-Page 7