1519 TALISKER DR �TMENT OF HOMEU4ND SECUR(TY ELE'ii/6►Ti IOf�i �rtRTiFIC/�TE oMB�°. ��a°°08
derat Emergency Managemerrt Agency E�mires Febnrarv 2$.2009
. �"lational Flood Insurance Program Important Read the instructions on pages 1-8.
SEGTION A-PROPERTY INFORMATION For insurance Company Use:
A1. BuiWing Owr�e�s htame BEAZER HOMES Poliry Number
. Buifding Street Address(irtcluding Apt..Und,Suite,and/w Bldg.No.)or P.O.Rotrte a�Box No. Company NAIC Number
1519 TALISI�R DR
City CLEARWATER State FL ZIP Code33755
A3. Property Description(Lot and Blodc Ntanbers,Tax Paroel Number,L�al ) � � �n��.�
LOT 7,BLOCK 3,HIGHLAND GLEN ���,... �Q ���
A4. Building Use(e.g.,Residerrtial,Non-Residential,Addition,Accessory,etc.)RESIDENTIAL
A5. Latitude/Longitude:Lat. Long. Horizontal Datum:❑ NAD 1927 � NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to ob2ain flood insurance.
A7. Building Diagram Number7
A8. For a buitding with a cxawl space or enGosure(s),pravide A9. For a build'mg witt►an attached garage,provide:
a) Square footage of crawl space or enclosure(s) NA sq ft a) Square footage of attached garage NA sq ft
b) No.of permanent flood openings in the crawl space or b) No.of peRnanent flood openings in the attached garage
endasure(s)walls within 1.0 foot above adjacent grade NA waits within 1.0 foot above adjac�nt grade NA
c} Total net area of flood openings in AB.b NA sq in c) Total net ar�ea of flood openings in A9.b NA sq in
T
SECTION B-FLOOD INSURANCE RATE MAP(FIRM�INFORMATION
67.IVFIP Community Name 8�Community Number B2.County Name 63.State
CLEARWATER 125096 PINELLAS FLORIDA
B4.Map/Panel Number B5.Suffoc B6.FIRM tndex B7.F1RM Panel 68.Flood 69.Base Flood Elevation(s)(Zane
Date EffedivelRevised Date Zone(s) AO,use base flood depth)
12103C0107 H 9/3/03 9/3/03 AE,X 19'
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)
B 1. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 �NAVD 1988 ❑Other(Describe)
Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes �No
Designation DateN/A ❑CBRS ❑OPA
SECTION C-BU1LDfNG ELEVATIiDN INFORMATfON(SURVEY REQU{RED)
C1. Building elevatians are based on: ❑ConstruQion Drawings` �Building Under Construction' ❑Finistred Cortst�dian
A new Elevat+on CeRificate will be requined when construdion of tMe buuilditig is complete.
C2. Etevations-Zones A1-A30,AE,AH,A(vrith BF�,VE.V1-V30,V(with BFE�,AR,AR/A,AR/AE,AR/A1-R30.AWAH,AWAO. Com�e#e Items C2.a-g
below according to the bwilding diagram spectified in Item A7.
Benchmark Utilized HIGHLAND E Vertical Datum 1988
ConversioMComments NONE
Check the measuremerrt used.
a) Top of bottom floor(inGuding basement,crawl space,or enclosure floor)_ 27.00 �feet ❑meters{Puerto Rico only)
b} Top of the next higher floor NA. �feet ❑meters(Puerto Rico only)
c) Bottom of the lowest horizontal structu�al member(V Zones only) NA. �feet ❑meters(Puerto Rico only)
d) Attached garage(top of s{ab) NA. �feet ❑meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building NA. �feet ❑meters(Puerto Rico only)
(Describe type of equipment in Comments)
fl Lowest adjacent(firtished)grade(LAG) 26.7 �feet ❑meters(Puerto Rico only) _
r -._
g) Highest adjacent(frnished)grade(HAG) NA. �feet ❑meters(Puerto Rico onl�c�'�J-� �v °��
�,t=s
SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFIGATION w r` ,` +�,
This certification is to be signed and seal�by a land surveyor,engincer,or archded authorized by taw to certify elevation
information. 1 ce►6fy that the rnf�matia+on this Ce�ficate represer►ts my best effiorts to i►rte►pret d�e data ava�aWe.
l understand fhat ar►y false statement may be purrishab/e by fine or impri�n�nt urrder i8 U.S. Code,Section 1001. -
❑ Chedc here if c�nmertts are provided on badc of form. � . � ;
�, , .s q1p
rtfier's Name JOIiN R BEACH Lioerise Number 2984 , �K`
�
� rt�. . _� �.P .
e PLS Comparry tJame JOFiN R.BEACH�ASSOC.,INC. ��
Address 911 ST.PETERSBURG DR W City OLDSaMR State FL ZIP Code 34677 r �
Signatu 4/9/08 Telephone 813-854-1276
F o 1-31,February 2006 See reverse side for continuation. epl s all previous edfions
IMPORTANT: {n the�spaces,copy the cornespondir�g information from Section A For Insurance Company Us"�;
Buildi�Street AddrESS(induding Apt.,Unit,Suite,aridlor Bldg.No.)or P.O.Route and Box No. Policy Number
1519 TALISI�R
City CLEARWATER StateFLZIP Code 33755 Company NAIC Number
SECTION D-SURVEYOR,ENGiNEER,OR ARCHITECT CERT{FICATION(CONTINUED) _
Copy both sides of this Eievation Certificate for(1)c�mmtfnity o�fficial,(2)insurance agerrt/c�mpany,and{3)bui�mg c�vmer.
CommeMs
Signature Date 4/9lOS
❑ Check here if attachments
SECTION E- DIN LEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(VNITHOUT BFE)
For Zones AO an witho ,complete Items E1-E5. if the Certificate is iMended to support a LOMA or LOMR-F request,complete Sectior�s A,B,
and C. For ftem,s E1-E4,use natural grade,rf available. Chedc the measurement used. In Puerto Rico only,enter meters.
E1. Provide elevation ir�formation for the following and check the appropriate bo�ces 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 enGosure)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 pertnanent flood openings provided in Section A ftems 8 and/or 9(see page 8 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 availabfe,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 infortnation in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owner's authorized represerrtative who c�mpletes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE)
or Zone AO must sign here. The statemer►ts in Sections A,8,ar►d E are caoonect to the best of my knowledg�e.
Property Owner's or Oumer's Authorized Representative's Name .
Address City 5tate ZIP Code
Signature Date Telephone
Commertts
❑Check here'rf attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain managemeM ordi�ance 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 documerrtation that has been signed and sealed by a licensed surveyor,engineer,or architect who
is authorized by law to certify e�evation information. (t�dicate the source and date of the elevation data in the Commerrts area below.)
G2.❑ A community official completed Section E for a building located in Zone A(Nrithout a FEMA-issued or community-issued BFE)or Zone AO.
G3.❑ The foUowir�g irtformation(Items G4.-G9.)is provided for community floodplain management pu►poses.
G4. Permit Number G5. Date Permit Issued G6. Dffie Certificate Of Compliance/Oocupancy 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
Local OfficiaPs Name T��
Commurtity Name Tefephone
Signature . Date
Commerrts
❑Check here if attachments
FEMA Form 81-31, February 2006 Replaces all previous edirtions