1850 STEVENSON AVE U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB NO. 1660-0008
.- Federal Emergency Management Agency EXPIRES MARCH 31 2012
National Flood Insurance Program ICYlp01't811t: R@ad th2 II1St�UCtIOf1S O� P89BS 1-9. (FEMA EXTENDED DATE)
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
A1. Building Owner's Name BLYTHE A LAMY Pdicy Number
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bidg.No.)or P.O.Route and Box No. Company NAIC Numb�
1850 STEVENSON AVENUE PRE FIRM-BUILT 1961
City CLEARWATER State FL ZIP Code 33755-1854
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
PARCEL 03-29-15-88128-002-0170, BLOCK B, LOT 17, SUNSET POINT 2ND ADD, PLAT BOOK 008, PAGE 014
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)RESIDENTIAL
A5. Latitude/Longitude:�at. 27.9886 Long. 82.7910 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 SEVEN
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 0 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 1 within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b �2 sq in c) To#al net area of flood openings in A9.b � sq in
d) Engineered flood openings? ❑Yes X No d) Engineered flood openings? ❑ Yes X No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
61.NFIP Community Name&Communfty Number 62.County Name 63.State
CLEARWATER CITY OF 125096 PINELIAS FL
B4.Map/Panel Number B5.Suffix B6.FIRM Index 67.FIRM Panel BS. Flood B9. Base Flood Elevation(s)(Zone
Date EffectivelRevised Date Zone(s) AO,use base flood depth)
12103C0106 H 08/18/2009 05/17/2005 AE 12.0 FEET
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth errtered in Item B9.
❑FIS Profile x FIRM ❑Community Determined ❑Other(Describe)
B11. Indicate elevation datum used for BFE in Item 69: _NGVD 1929 X NAVD 1988 ❑Other(Describe)
612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Othervvise 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 Cert�cate 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 spec�ed in Item A7. Use the same datum as the BFE.
Benchmark Utilized CITY BM I-06 Vertical Datum NAVD 1988
Conversion/Comments NONE Check the measurement used.
a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 4.19 X feet ❑meters(Puerto Rico only)
b) Top of the next higher floor 11.19 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) NA X feet ❑meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building 4.79 x feet ❑meters(Puerto Rico only)
(Describe type of equipment and location in Comments)
� Lowest adjacent(finished)grade next to building(LAG) 4.19 x feet ❑meters(Puerto Rico only)
g) Highest adjacent(finished)grade next to building(HAG) 10.39 x feet ❑meters(Puerto Rico only)
h) Lowest adjacent grade at lowest elevation of deck or stairs,including 4.19 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 Certificate represents my best effnrts to interpret the data available. ,� `��;,,�,< :�;.��4�
I understand that any false statement may be punishable by�ne or imprisonment under 18 U.S.Code,Section 1001. �`V�����k�qM��
. ..
XCheck here if comments are provided on back of form. Were latitude and longitude in Section A provided by a �,�e3�}�kSl��>'�
licensed land surveyor? X Yes ❑No : � l f����"�
f /�'1
C e r t i f i e r's N a m e: B I L L H Y A T T L i c e n s e N u m b e r. L S 4 6 3 6 ���'-���,�,�
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Title: PRESIDENT Company Name: KNOW IT NOW INC - ��'{�+�1 ���
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Address: 1497 MAIN STREET#321 City: DUNEDIN State: FL ZIP Code: 34698 ;'�•�����;�`�'�
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Signature �-'�"'°7��- Date: 4!2/12 Telephone: 727-415-8305 ���-
FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces,copy the corresponding infortnation from Section A. For Insurance Compa�y Use:
, Building Street Address(inciuding Apt.,Unit,Suite, and/or Bidg.No.)or P.O.Route and Box No. Pdicy Number
1850 STEVEN50N AVENUE
City CLEARWATER State FL ZIP Code 33755-1854 Company NAIC Number
SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTiNUED)
Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agenticompany,and(3)building owner.
Comments
- ���.. t���' �".'�-.
HOUSE HAS FIVE VEN'�3�BUT ONL�C�1����IN A FOOT OF GRADE
EQUIPMENT ON PRI�R��GE�I�IR�QON(,�IONIN(6`UNIT
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Si nature ��"��^"'"��'�'7�� Date 4/2/12 X Check here if attachments
SEC'G� E-�U, ;, E ll► „ INFOtZMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE�
, .. � * p r r ' . . .
For Zones AO a�i�(w��ut�}g c'b�`�ete lfems E1-E5. If the Cert�cate is intended to support a LOMA or LOMR-F request,complete Sections A,B,
and C. For Item�=':�� E�; s�'i�tu��l�rads,ff avai1a61e. Check the measurement used. In Puerto Rico only,enter meters.
E1. Provide elev�t►On���`f0.r�he fallowing and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade(HAG)and the it`�g�f ad�cent grade(LAG).
a)Top of bottom floor(mcfutling basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or ❑below the HAG.
b)Top of bottom f{oor(indluding basement,crawlspace,or enclosure)is ❑fee� ❑meters ❑above or �below the LAG.
E2. For Building Diagrams 6-9 wRh 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? OYes ❑No ❑Unknown. The local official must certify this information in S�tion 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. Ti�statements in Secfions A,8,and E are conect 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 communiry's floodplain management ordinance can complete Sections A,B,C(or E),
and G of this Elevation Cert�cate. 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 surveyw,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 ofticial 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 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
FEMA Form 81-31, Mar 09 Replaces all previous editions
� ❑Check here if attachments
Building Photographs
See Instructions for Item A6.
Fw Insurance Company Use:
Building Street Address(inGuding Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number
1850 STEVENSON AVENUE
Clty CLEARWATER State FL ZIP COd@ 33755-1854 Canpany NAIC Number
If using the Etevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the
instructions for Item A6. Identify all photographs with: date taken; "Front Viev+/' and "Rear Viev�J'; and, if required, "Right Side
Vievd' and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the
reverse.
PICS TAKEN 41-12
FRONT VIEW
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CONTINUED ON NEXT PAGE
FEMA Form 81-31, Mar 09 Replaces all previous editions
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REAR VIEW
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Instructions—Page 2