2723 VIA CAPRI BLDG 800 FEDERAI_EiNE�tGENCYMANAt3EMENTAGENCY p,�,B. fyo. 30&7-00�
� , NATIONAL FLOOD INSURAPICIE PROGRAM
,
• EL�/�4�9�IV CERTIFICATE �pires Juiy 31, 2002
� Irn artar� Read tfie instructlo�on es 1 -T.
SECTION A-PROPE3ZTY OWNER INFORMATtON F�or fnsurance Company t1se:
BUILDING OWNER'S NAME Policy Number
tNG STREET ADDRESS(Indudiny Apt.,Unit,Suite,and/or Bldg.No.)OR P.q.ROUTE AND BOX NO. Campany NAIC Nwnber
Venezia at Baywatch - Building #800 - 2723 Via Capri
Clearwater, :i, �� ZIPCODE
33764
PROPERTY DESCRIPTION(Lot and 81odc Numbers,Tax Parcel Number,Legal Description,etc.)
Tax Folio No. 29/29/16/00000/220/0200
BUILDING USE(e.g.,Residentlal,No�-residential,Addidon,Accessory,eta Use Comments sedlon if�ecessary.)
Residential
LATITUDFJLONGITUDE(OPTIONAL) HORIZONTAt DATUM: SOURCE: ❑GPS(Type):_____
( ##°-#F#'-##.#�' or �.� Q NAD 1927 ❑NAD 1983
❑USGS Quad Map ❑Other.-----
SECTiON B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME 8�COMMUNITY NUMBER BZ.COUNTY NAME 83.STATE �
Pinellas Count FL Unincor . 125139 Pinellas Florida �
84.MAP AND PANEL B5.SUFFIX B6.F(RM INDD( B7.FlRM PANEL B8.FLOOD B9.BASE FLOOD ELEVATION(a
NUMBER DATE EFFECTIVEJREVISED DATE ZONE(S) (Zone AO,use depth of lfoodir�;
0128 D 8 18 92 8 19 91 AE 10
B10. Indicate the souroe of the Base Flood Elevation(BF�data or base flood depth entered in B9.
❑ FIS Prafile �FIRM ❑Community Detertnined ❑Other(Describe):-----
B11.Indicate!he elevation datum used for the BFE in B9:�NGVD 1929 ❑NAVD 1988 ❑Othec(Describe):_____
812.Is the building located in a Caastal 8arrier Resources System(CBRS)area or Othervuise Proteded Area(OPA)? ❑Yes� No �
Designation Date ____
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. Buiiding elevations are based on:�Construc�ion Drawings' � Buiiding Under Construdion" ❑Fnished Construdion
'A new El�on Ce�tificate wili be required when construc�ion of the building is complete. '
C2,�{liding Diagram Number 1 (Seled the building diagram most sim7ar to the building for which this certificate is being compieted-see ,
�es 6 and 7. If no diagram accurately represents the.buiiding,provide a sketch or photograph.)
C3. Elevations-Zones A1-A30,AE,AH,A(with BF�,VE,V1-V30,V(with BFE�,AR,AR/A,AR/AE,AR/A1-A30,AR/AN,AR/AO
Complete Items C3a-i below accord(ng 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 Section B,cornert the datum to that used for the BFE. Show field measurements and datum conversion
calcvl Use the space provided or the Comments area of Sedion D or Section G,as appropriate,to�o�um�;,tk�s�t,um cor�versi:,-_
Datum�� ConversioNComments r1�A_ � ,�a' <A�� �
. , �K.^ ��.." atlN .p'k*..0
Elevation reference mark used Does the elevation reference maric used appear on the FIRM? 'Q Y��i -�tp� >> ��,;''� '� � ' ,.
❑ a)Top of bottom floor(nduding basement or endosure) 10 , 1 }�,(m� � � ' :v �
❑ b)Top of next higher floo� n a ._g,(m� w f-��? .���;5 ��� ,
. �a
❑ c) Bottom of lowest horizontal structurai member(V zanes only) n/a . R.(m) �$ � ; �,�' ,� "�' ,� �;,
O d)At��garage(top of slab) n/a ,_}��m� � ��;1��.;�-� �f�
❑ e) Lowest eleva�on of machinery and/cr equipmerrt W��� :� � � "' q�z=.
servicing the buildin9 n/a ,_g,�m� �� °-=-�'�� � :� ;�!� �' ,
❑ �Lowest adjacent grade(LAG) n/a , R(m) z�, , ',° =-�/��-�-
O g) Highest adjacent grade(HAG) n/a,_ft,�m� ��' ,' y;:;-, '' � `°
❑ h No.of ermanerito enin � * ��r'�
) P p gs(flood vents)within 1 ft.above adjacerrt grade_n/a
❑ )Total area of all pertnanerit openings(flood.verrts)in C3h � sq.in. (sq.cm) - �' �' �.
SECTI�N D-S.URVEYOR,ENGINEER,OR ARCHITECT CERTIFlCATION
This certification is to be signed and sealed by a land surveyor,engineer,or ar�ited authorized by Iaw to certlfy elevation information..
1 cer�fy that the infamatron in Secbions A, 8, and C on this cer6ficate represents my best etnorts to interpret the data available.
I understand that any false statement may be punishable by ffne or imprisonment under 18 U S Code Section 1001
CERTIFIER 5 NAAAE UCF�I�ISE NUMBER
Allan F_ Oslamd PSM 659
n COMPANY NAME
rofessional Surveyor and Mapper Kinq Enqineerinq Associates, Inc
A � ���� STATE ZIP CODE
492 r' �' 03� 0 Tam a FL 33634
SI URE , DATE TELEPHONE
8 3-88 - 88 '
FEAAA Fortn 81-31,AUG 99 SEE REVERSE S1DE FOR CON1'INUATION REPLACES ALL PREVIOUS EDRIO�S
_ ____ _
�MP�R'TiOeiVT: !n these spaces,ca�Oy?he corresQonding ir�formation�rom Seclion�►.
,:�or h�surance CampanY t�e =`. ::;
�UILDING STRE�f,qDDRESS(Induding Apt,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AWD BOX NO. Po' Nurrd�er:
I�.Y:... . _, .;
- ' ldin #8 - 2723 V'a Ca �
, CI7Y � s ;
�TAT� Z!P CODE !Campany NAIC Nianber
Clearwater FL 33764 -
SECTION D-SURVE`IOR, ENGINEE92,OR ARCHITECT C�RTiFiCAT10N(CONTINUED)
Copy both sides of this Elevatian Certificate for(1)community official, (2}insurance agenUcompany,and(3)buitding owner.
COMMENTS
SECTION E-BUILDiNG ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE Ahere if attachmer�
(WlTHOUT BFE)
For 2one AO and Zone A(without BF�,complete Items E1 through E4. !f the Eleva�on Certificate is intended for use as supporting
information for a LOMA or LOMR-F, Section C must be completeal.
E1.Buiiding Diagram Number_(Seled the building diagram most similar to the building for which this certifificate is being completed—ses
pages 6 and 7. If no diagram aax�rately represents the bu7ding,provide a sketch or photograph.)
E2.The top af the bottcm floor(nduding basement or endosure)of the building is ,_ft.(m)_in.(cm)�above or ❑below{chedc one)
- the highest adjacer�t grade.
E3.For Buiiding Diagrams 6-8 with openings(see pag,e�,the next higher floor or elevated flaor(elevation b)of the building is
_ft.(m)_in.(cm)above the highest adjacerrt grade.
E4.For Zone AO only: If no flood depth number is avafiable,is the top of the bottom floor elevated in acwrdance with the communii�s �
floodplain manaqement ordinance?Q Yes �No ❑ Unknown The local official must certify this infortnation in Secction G
SECTION F•PROPERTY 01NNER(OR OWNER'S REPRESENTATNE)CERTIF�CATION
The property owner or owners authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or
community-issued BF�or Zone AO must sign here. �
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATNE'S NAME
ADDRESS CtTY STATE ZIP CODE
SIGNATURE . DATE TELEpyONE
COMMENTS
Check here if attachmer:�
SECTION G-COMMUNITY INFORMATION(OPT'IONAL) '
The local offiaal who is authorized by law or ordinance to administer the community's floodplain management ordinance pn compleie
Sections A, B,C(or E),and G of this Elevation Ce�tificate. Compiete the applicable iterre(s)and sign beiow.
G1. Q The infomnatfan in 5�ction C was taken from other documerrtation that has been signed and embossed by a licensed surveyor,
engineer,or atchitect who is authorized by state or loql law to certify elevation information. (Indicate the source and date of the
elevati�non data En the�omments area below.)
32. Q A community offiaal aampleted Sedion E for a building located in Zone A(without a FEMA-issued or community-issued BF�or
Zone AO.
33. Q The foltowing infoRnation (Items G4G9)is provided for communiiy floodplain management purposes.
G4.PERMIT NUM�ER G5. DATE pEi�MIT ISSUED G6. DATE CERTIFICATE OF COMPUANCEIOCCUPANCY
, ISSUED
37.This pertnit has been issued for. ❑New Construction�Substantial lmprovemer�t
38. Elevation cf as-built lowest flao�(induding basement)of the building is: ft.(m) Datum:
39. QFE or(in Zone AO)depth of flooding at the building site is: _ft.(m) Datum:�
LOCAL OFFiCWL'S NAME n�
COMMUNITY NAME TELEPHONE
SIGtVATURE DATE
COMMENTS
❑ Checic here if attaclimerns
'EMA Form 81-31,AUG 99 REPLACES ALL PREVIOUS EDITIONS