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2725 VIA CIPRIANI BLDG 700 FEDERAL EMEi�GENCY MANAGEMENT AGEAICY �� _ �yp, 3067-0U77 NATIONAL FLOOD INSURAPICIE PROGRAM �pi�es July 3'1, 2002 ��A��N C��0F1CA�� Importar� Read tfie Instructions on es 1 -7. SECTION A-PROPE}2TY OWNER INFORMATION For tnsurance Cort�any Use; BUILDINCy OVVNER'S NAME Poiiry Number ING STREET ADDRESS(induding Apt,Unit Suite,and/tlrg�a.Np.)O�P.O,ROUTE AND BOX NO. Camparry NAIC Number Be lagio at Baywatch - Builaing �700 - 2725 Via ipriani Clearwater, :::�, �� Z1P CODE PROPERTY DESCRIPTION(Lot and Blodc Numbers,Tax Parcel Number, 33764 Tax Folio No. 29/29/16/00000/220/0200 �9a1 Description,etc.) BUtLDING USE{e,g.,ResidenBal,Non-residential,Addition,Accessory,etc. Use Comments sedion if necessary.) Residential LATITUDF1lONGITUDE(OPTIONAL) HORIZONTAL DATUM: S011RCE ❑GPS(Type):_____ ( #*°-##'-##.#�" or #A�.� ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.----- SECTiON B-FLOOD INSURANCE RATE MAP(FlRM)INFORMATION B1.NFiP COMMUNITY NAME 8 COMMUNITY NUMBEft B2.COUNTY NAME B3.STATE ` Pinellas Count FL Unincor . 125139 Pinellas Florida � 84.MAP AND PANEL 65.SUFFIX B6.FIRM INDDC 67_FlRM PANEL 88.FLOOD B9.BASE FLOO�ELEVATION(S NUMBEft DATE EFFECTNElREVISED DATE ZONE(S) (Zone AO,use depth of 9oodir�; � 0128 D 8 18 92 8 19 91 AE 10 810.Indicate the source of the Base Flood Eievation(BF�data or base flood depth entered in 69. ❑ FIS Profile �FiRM ❑Community Detertnined ❑Other(Describe):_____ B11.Indicate ihe elevation datum used for the BFE in 89:�NGVD 1929 ❑NAVD 1988 ❑Other(Describe):____ B12.Is the buiiding tocated in a Coastal Barrier Resources System (CBRS)area or Otherwise Proteded Area(OPA)? ❑Yes� No � Designation Date ____ SECTION C-BUlLDING ELEVATION INEORMATION(SURVEY REQUIRED) C1. Buiiding ele�ations are based cn:0 Construdion Drawings' Q Buiiding Under Construc�ion' ❑Finished Construction 'A new Elevanon Certificate will be required when construction of the building is complete. � C ilding Diagram Number 1 (Seled the building diagram most sirtular to the building for which this certificate is being completed-see es 6 and 7. If no diagram accurately represents the.building, provide a sketch or photograph.) C3. levations—Zones A1-A30.AE,AH,A(with BF�,VE,V1-V30,V(with BF�,AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO Compiete Items C3a-i below accordtng to the building diagram specified in Item C2:State the datum used. If the datum is differerrt from the datum used for the BFE in Sedion B,cornert the datum to that used fo�the BFE Show field measurements and datum conversion calcul (]��y}J{J�Use the space provided or the Comments area of Sedion D or Section G, as appropriate,to documet�l�dat�m corrversir_ �/L.J a�.. `��(k Datum Cornersion/Comments NJA_ .��:, ;�. ;� r ':Fr�t� � Elevation reference marlc used Does the elevation reference mark used appear on the FIRM,? �' o••�� `��. ❑ a)Top of bottom floor(nduding basement or endosure) L O , 2 ft.(m) a�'� :f��,� � �` ❑ b)Tap of next higher floor n/a ft.�m� � r�'-S��' �� .� ` ��,• � � ,:. �, ❑ c)Bottom of bwest horizoMal strudural member(V zones only) n/a . R(m) �$ ,.� �—/ ^ G �! " _. ❑ cQ Attached garage(top of slab) n/a ._}�m ❑ e)Lowest elevation of machinery and/ar equipment ( > W� �„ ;ac�� ` � � � ' .,; senricing the building n/a , ft,(m� .8� '•, E.". `'� . .r „`'> ° � 0 �Lowest adjacent grade(LAG) n/a , tt.(m) _� �'�� D g)Highest adjacent grade(HAG n/a. ft. m ��' C" '�, -.: `.'�,.; � ��:;` � _ ( ) � ��-' «�2�.� ❑ h) No.of permanerrt openings(flood vents)within 1 ft.above adjacerrt grade_n/a 8 � ��, ❑ )Total area of all permanent openings(flood.vents)in C3h � sq.in. (sq.cm) T=.� SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or arc.iiitect authorized by law to certify elevation informatio�., I certify that the infom►ation in Sections A, B, and C on this ce►�ificate represents my best efforts to inte�r+et the data available. !understand that any false statement may be punishab/e by fine or imprisonmeht under 18 U S Code Secfion 1001 CERTIFIER S NAME UCF�l�$�,NUMBER All'an F_ Ocl�md' PGM �7 T� COMPANY NAAAE �rofessional 5urveyor and Mapper KinQ Enctineerinq Associates, Inc '4 � C� STATE ZIP CODE 4921 'al . 3 Tam a FL 33634 SIG RE DATE TELEPHONE � 8 3-88 -888 � FEMA Form 81-31,AUG 99 SEE REVERSE S1DE FOR CONTINUATION REPIACES ALL PREVIOUS EDITIO�.S bMP�R'Ti�7VT: !n these�paces,c��Oy�e carr�ponding ir�formation from Se�#ion�►. ,:�'or tnsurance Co �rry tlse �UILD�NG STRE�i'ADDRESS(Induding ApL,Unit,Suite,and/or 8 No.)OR P.O.ROUTE AP1D BOX NO. podc.yNumber, __ , Bella io at Baywatch - Building #700 - 27 5 Via Cipriani - - ClTY STATE Z!P CODE -Company iVAfC Nianber Clearwater FL 33764 - SECT[ON D-SURVE`IOR,ENGiNEER,OR ARC9i1TECT CERTIFICATION(CONTINUED) � Copy both sides of this Elevation Certificate for(1)community offiaat, (2)insurance agenUcompany, and(3)building awner. COMMENTS Check here if attacfimerEs SECTlON E-BUILDiNG ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND 20NE A(WITHOUT BFE� For Zone AO and Zone A(without BF�,complete Items E1 through E4. If the Eleva�orr CertiBcate is intended for use as suppor6ng information for a LOMA ar LOMR-F, Sectlon C m�st be comp/eted. E 1.Buiiding Diagram Number_(Seled the building diagram most similar to the building for which this certificate is being completed—see pages 6 and 7. If no diagram accurately represents the bu�lding;provide a sketch or photograph.) E2.The top of the bottom floor(induding basement or endosure�of the buiiding is �ft.(m)_in.(cm)�above or ❑ below{chedc one) = the highest adjacertt grade. E3.For Building Diagrams 6-8 with openings(see pag,e�,the next higher floor or elevated floor(elevation b)of the building is _ft.(m)_in.(cm)above the highest adjacent grade. E4.For Zone AO oniy: ff no floai depth number is available,is the top of the bottom floor elevated in acxordance with the communit�s . floodplain management ordinance?�Yes Q No ❑Unknown The local offiaal must cerafy this information in Sedion G SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFlCATION The property owner or owners autherized represeritative who completes Sedions A,B,and E for Zone A(without a FEMA-issued or community-issued BF�ar Zone AO must sign here. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATNE'S NAME ADORESS ClTY STATE Z1P CODE SIGNATURE . DATE TELEPHONE COMMENTS ❑ Check here if attachmer� SECTION G-COMMUNITY INFORMATION (OPTIONAL) ' The Ieql offiaai who is authorized by law or ordinancs to administer the community's floodplain management ordinance can complete Sections A, B,C(or�,and G of tt�is Elevatton Certificate. Complete the applicable item(s)and sign below. G1.Q The iriforma�on in Sedion G was taken from other documentatio�that has been signed and embossed by a licensed surveyor, engineer,or arch(ted w�o is authorized by state or loc�l law to certify elevation information. (Indicate the source and date of the elevaGon data i�the Comments area below.) 32.Q A community official complet�d Section E for a building located in Zone A(without a FEMA-issued or community-issued BF�or Zone AO. 33. Q The foltowing informatiors(Items G4G9)is provided for community floodplain management purposes. G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFtCATE OF COMPLIANCElOCCUPANCY ISSUED �7.This pertnit has been issued for. ❑ New Construdion 0 Substantial lmprovement 38. Elevation of as-built lowest floor(induding basement)of the building is: ft.(m) Datum: 39. E�FE or(in Zone AO)depth of flooding at the building site is: _ft.{m) Datum:_____ LOCAL OFFiCIAL'S NAME n� COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS ❑ Checic here if attaci�merrts 'EMA Form 81-31,AUG 99 REPLACES ALL PREVIOUS EDlT10NS