2721 VIA MURANO BLDG 300 F�DERAL EiNE�tGENCY MAPIAGE3WEAIT AG�lCY O.�AH.B. IVo. 3067-i7077^
� ' NATiONAL FLOOD INSURANC�PROGRAlW �p�res July 31, ZOt�2
. � �L�v�►�ioN c���r�F1c�►��
Importar� Read the i�tructtons on ges t -7.
SECTION A-PROPERT'V OWNER INFORMATION For Uisuraoce C�pany t1se;
ING OWNER'S NAME Poliry Nurnber
B LDING STREET ADDRESS(Induding Apt,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Nurt�er
Venezia at Ba atch - Buildin #300 - 2721 Via Murano -
C1 arwater, .::�, �FL Z33764E
PROPERTY DESCRiPTiON(Lot and Btodt Numbea,Tax Paroel Number,Legal Description,etc.)
Tax Folio No. 29/29/16/00000/220/0200
BUILDING USE(e.g.,Residential, Non-residential,Addition,Accessory,eta Use Cortmerds section if necessary.)
Residential
IATITUDElLONGITUDE(OP170NAL) HORfZONTAt DATUM: SOURCE: ❑GPS(Type):_____
( #/�°-##'-#�.�#" or �#.#l�k� ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other._____
SECTION B-PLOaD INSURANCE RATE MAP(F1RIU�INFORMATION
81.NFIP COMMUNITY NAME 8�COMMUNITY NUMBER B2.COUMY NAME 83.STATE i
Pinellas Count , FL Unincor . 125139 Pinellas Florida i
B4.MAP AND PANEL B5.SUFFIX B6.FIRM INDDC 87.FiRM PANEi. 88.FLOOD B9.BASE F�OOD ELEVATION(a €
NUMBER DATE EFFECTII/E/REVISED DATE ZONE(S) (Zone AO,use depth of 9oodirg.j (
0128 D 8 18 92 8 19 91 AE IO f
810. Indicate the saurce of the Sase Fiood Elevation(BF�data or base flood depth errtered in 89.
❑ FIS Profile �J FIRM ❑Community Detertnined ❑Other(Describe):_____
811. lndicate the elevatlon datum used for the BFE in 69:�NGVD 1929 ❑NAVD 1988 ❑Other(Desc:ribe):____
B12. Is the bu�7ding tocated in a Coastal Barrier Resources System(CBRS)area or Othervuise Proteded Area(OPA)? ❑Yes� No �
Designatian Date ____
SECTION C-BUILDING ELEVATtON INFORMATiON (SURVEY REQUIRED)
C1.Building elevatiorts are based on:�Construction Drawings' Q Building Under ConsUudian' ❑Finished Construction
•A new Elevation Certificate will be required when construdion of the buiiding is complete.
C' Iding Diagram Number 1 (Seled the building diagram most similar to the buiiding for which this certificate is being completed-see
ges 6 and 7. If no diagram accurately represents the building,provide a sketch or photograph.)
C3. Elevations-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
Complete Items C3a-i below according 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 Sec�ion B,convert the datum to that used for the BFE. Show field measurements and datum conversion
calcvl Use the space provided or the Commerrts area of Sedion D or Section G,as appropriate,to doc�qnet�t�.'th�idatum cornersir._
� �
Datum�� ConversioNComments NJA_ ,.�:�' a a , t���
Elevation reference mark used Does the elevation reference marlc used appear on the FIRhi1?�[�,� , i�$��'°°� ' "�,,�. ,
❑ a)Top of bottom floor(nduding basement or endosure) 10 .2 ft.(m) m �- . � �,,
O b)Top of next higher floor n/a ._ft.(m) � � ,�;i�-S� ��'��
0 c) Bottom of lowest horizontal sUvctural member(V zones only) n/a . R(m) �� � � "� ,�+,+ �' =
❑ �Attact�ed garage(top of slab) n/a• ft-(m) �Q ��� ��`�.� `"� -i
❑ e) Lowest elevation af machinery and/or equipment W�� � =F'�• y �° ^°�
servicing the buiiding n/a ._ft.(m) E� �' j� '�,���� � �
G�'"-y:�����-�����..�-��/
a �Lowest adjace�t grade(LAG) n/a •_�-(m) z'� �a /'� "°•��v=� �`
0 g) Highest adjacent grade(HAG) n a._ft(m) �y ��?,,� ;; i��='''
❑ h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade nf a_ s� �'h"�'A=�-,�--
❑ )Total area of all pertnanentopenings(flood�vertts)in C3h 0 sq.in. (sq.cm)
SECTION D-SURVEYOR,ENGtNEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and seaied by a land surveyor,engineer,or architect authorized by law to certify elevation information..
I certrfy that the informa6on in Sec�ons A, B, and C on fhis ce�Gficate represents my best eflnrts to inte�pref the data available:
_1 understand that any false statement may be punishable by flne or imprisonment under 18 U.S. Cade, Secdon 1001.
CERTtFIER'S NAME UCE,1�$�,NUMBER
Allan F_ Ocl �nd� PSM 4b�y
COMPANY NAME
��ofessional Surveyor and Mapper Kin En i.neerin Associates Inc.
SS CITY STATE ZIP CODE
4921 M H St Tam a FL 33634
SIGNATURE �/7'F/Ol TELEPHONE
1G 8 3-88 -8881
FEMA Fortn 81-31,AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDI'flO�S
_- _—
iMP�RTANT: 9n these�pac�s,copy tlte�ora�sponding anforma#ion fraom Sectio�A. ,-Fori�urance
BUILDING STRE�"f t1DDRESS Qndudi ���� -
Venezia at Ba �� Unit,S 'te aod/or 81�g No. OR�O.ROUTEAND BOX NO. Pol�rNumber
ywatch - Building �3b0 2�a� �ia urano - ,
C1Tl Z1P CODE `C ';-- NAIC N�anber
Clearwater, SFL� 33764 ��y
SECTtON D-SURVEI(OR, ENGINEER,OR ARCHiTECT C�RTIFtCATION(CONTINUED)
Copy both sides of this Elevation Ceraficate for(1)cammunity official, {2)insurance agerrt/company,and(3)buiiding owner.
COMMENTS
Check here if attachmer:gs
SECTION E-BUILDING ELEVATION INEORMA710N(SURVEY NOT REQUlRED)FOR ZONE AO AND ZONE A(1MTHOUT BFE)
For Zone AO and Zone A(without BFt�,complete Items E1 through E4. If the Elevation Certificat+e is intended for use as supporting
irrfom►adon for a LOMA or LOMR-F, Section C must be completed.�
E1. Building 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 building,provide a sketch or photograph.j
E2.The top of the bottom floor(induding basement or endosure)of the building is _ft.(m)_in.{cm) ❑above or ❑below{checic one)
the highest adjacerrt grade.
E3.For Building Diagrams 6-8 with openings(see pag,e�,the next higher floor or alevated floor(elevation b)of the building is
_ft.(m)_in.(cm)above the highest adjacent grade.
E4. For Zone AO only: If no flood depth number is available,is the t�p of the bottom floor elevated in accordance with the community's
_ floodplain management ordinance?0 Yes Q No ❑Unknown The local oifiaal must certify this information in Sec�tion G
SEC'T10N F PROPERTY OWNER(OR OWNER'S REPRESENTATIVE�CERTIFICATION
The property owner or owners authorized representative who completes Sedions A,B,and E for Zone A{without a FEMA-issued o�
communiiy-issued BF�or Zone AO must sign here.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATNE'S NAME
���� C�n STATE Z1P CODE
5i�i�wTURE DATE TELEPHONE
COMMEN'�S
_
❑Check here if attachmer.�s
SECTION G-COMMUNITY INFORMATION(OPTIONAL) '
The locai offiaal who is authorfz�i by law or ordinance to administer the communiiy's floodplain management ordinance can complete
Sedions A, 8,C(or�,and G of this Elevation Certificate. Complete the applicable item(s)and sign below.
G1.Q The infoRna��n in Seciion C was taken from other documentation that has besn signed and embossed by a licensed surveyor,
enginegr,or architect who is authorized by state or local law to certify elevation ir�formation. (Indicate the source and date of the
elevatfar�data in the Camments area below.)
G2.�A c4mmunity offiaal a�mpleted Sectian E for a building located in Zone A(without a FEMA-issued o�community-issued BF�or
2one AO.
33. �The fallowing information(Ifems G4-G9)is provided for community floodpiain management purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G&. DATE CERTIFICATE OF COMPUANCFJOCCUPANCY
ISSUED
37.This permit has been issued for. ❑New Ccnstruction Q Substarrtiaf�tmprovement
�8. Elevation cf as-built I.owest floor(including basement)of the building is; fL(m) Datum:
39• QFE or(in Zone AO)depth of flooding at the building site is: _ft.(m) Datum:_____
LOCAL OFFICIAL'S NAME T�
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMMENTS
❑Checic here if attacttmer�ts
�EMA Form 81-31,AUG 99 REPLACES ALL PREI/IOUS EDlTIONS