2747 VIA CAPRI BLDG 1100 FEDERdL EMEiZGENCY MANACaEMENT AGENCY � j�.�, No. 3067-0077
�, , . NATiONAL FLOOD INSUR.4NCE PROGRAM �p�res July 31, 2002
*' , ' . EL�/AT901V CEFt7'�F1CA�E
� im ortar� Read the tnstructions an es 1 -7.
SECTION A-PROPER7Y OWNER INFORMATION Eor fnsurance Corr�any Use:
BUILDING OWNER'S NAME
• Foliry Number
ING STREET ADDRESS(tr�dudinQ,q�t,Un' Suite,andJo g No,)OR P.O.ROUTE AND BOX NO. Comparry NAIC Number
Venezia at Baywatch - Bui-lding �1�a0 - �17�9! Via Capri
� Z!P CODE
Clearwater, ?� ST 33764
PTaxE Folios No��9%29%16%0�0000%220%0200�Number,Legal Description,etc.)
BUILDING USE{e.g.,Residentlal,Mon-rosidential,Addition,Accessary,etc. Use Comments sedion if�ecessary.)
Residential
UITITUDEILONGITUDE(OP170NAL) HORIZONTAL DATUM: SOURCE ❑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 NUMBER BZ.COUNTY NAME B3.S ATE �
Pinellas Count , FL Unincor . 125139 Pinellas Florida i
84.MAP AND PANEL B5.SUFFIX B6.FiRM INDDC B7.FIRM PANEL Be.FLOOD B9.BASE FLOOD ELEVATION� �
NUMBER DATE EFFECl1NEJREVISED DATE ZONE(S) (Zane AO,use depth of Roodir�;
0128 D 8 18 92 8 19 91 AE 10 •. f
B10. Indicate the source of the Base Flood Elevation{BF�data or base flood depth entered in 69.
❑ FIS Profile Q FIRM ❑Community Determined ❑Other(Describe):____
B 11.Indicate the elevation datum used for the BFE in B9:�NGVD 1929 ❑ NAVD 1988 ❑Other(Describe):____
B12.ls the building located in a Caastal Barrier Resources System(CSRS)area or Othervuise Proteded Area(OPA)? ❑Yes� No
Designation Date ____
SECTION C-BUlLDING ELEVATlON INFORMATION(SURVEY REQUIRED)
C1. Buiiding ele�ations are based on:�Consbvctlon Drawings` Q Buiiding Under Construdion' ❑Fnished Construction
'A new Elevation Certificate will be required when construction of the building is complete. �
C2�ding Diagram Number 1 (Seled the building dlagram most sim'lar to the buiiding for which this certificate is being completed-see
es 6 and 7. If no dlagram accurately represents the.building.provide a sketch or photograph.}
C3. Elevations-Zones A1-A30,AE,AH,A(with BFE�,VE,V1-V30,V(with BFE�,AR,AR/A,ARIAE.AR/A1 A30,AR/AH,AR/AO
Complete Items C3a-i below according to the building dtagram specified in Item C2.State the datum used. if the datum is d'rffererrt from
the datum used for the BFE in Sedion B,cornert the datum to that used for the BFE. Show ffeld measurements and datum conversion
catcul Use the space provided or the Comments area of Sedion D or Section G,as appropriate,to document the datum coriversi�r_
Datum�� CornersioNComments NJA_ F .
: M�� ��qway����.,o�qa ^�
Elevation reference mark used Does the elevation reference maiic used appear on the FIRM? �]Yeg,� ' � �``?
❑ a)Top of bottom floor(induding basement or endosure) 10 . 1 }t,(m) a • * - .���� �,
O b)Top of neut highe�floo� n a , g,(m) w .�'.'��'-✓-�'`���'•I` ,, ., _
^ �� 4 � .�,'y M� . .:, J.+ .
❑ c) Bottom of lowest horizoMal sbuc�ural member(V zones only) n/a ft.(m) $ °O�` „�/z �c�,/L-, �� "
❑ �Attached garage(top of slab) n/a ,_}Z,(m) �� � : �ra
0 e Lowest elevation of machin u,� ...� N �:-���'` � �;•" � � _,
) ery and/or equipment ^�.�
_m �I �,. 1
servicing the buildin9 n/a _ft.(m) �� T � �
D �Lowest adjacent grade(LAG) n/a _g,(m� ��, '> " , • ,; "'
w �J �!�"� `:"'
❑ g) Highest adjacent grade(HAG) n/a,_R(m) b "�', "'� °'=a�,a. <`�'.�,`�' -
a h) No.of permanertt openings(flood vents)within 1 ft.above adjacerrt grade_i?/a � „��9�a�' �;� ����i���
❑ )Total area of all permanentopenings(flood.verrts)in C3h � sq.in. (sq.cm) - "`��.,,�... .
SECTION D-SURVEYOR, ENGINEER,OR ARCtiITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or archited authorized by law to certify e(evatio�t information.
1 certfy that dte infoimation in Sections A, B, and C on this certihcafe represents my best efforis to inteipret the data available. �
I undersfand that any false statement may be punisheble by fine or imprisonmeht under 18 U S Code Section 1001
CERTIFIER'S NAAAE UC��$�,NUMBER
A1 1 an F_ Oc 1 t�nrl _ P4M 7y
�rofessional Surveyor and Mapper COMPANY NAME
Kina Enqineerinq Associates, Inc
� - CITY STATE ZIP CODE
4921 M orial S 0 Tam a FL 33634
SI RE DATE TEk.EPHONE
8 3-88 -888 �
F€MA Fortn 81-31,AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDtT10�iS
BMPORTi�A1T: In these spaces, cr�py�he carresponding information from Seclion,�. ,:�or tnsurance Ca
B�ILDING STRE�T,+�DDRESS tndudin A - �U`�-'�` `
� 9 Pt,Unit,Suite,and/or Bld .No.)OR P.O.ROUTE AND BOX NO. Po' Number.
Venezia at Ba watch - Building #1100 - 27 7 Via Capri - � _
CITY STATE ZIP CODE `Cam an NAl .
Clearwater p y C Nianber
FL 33764
SECTION D-SURVEYOR,ENGINEE9Z,OR ARC6iITECT CFRTIFiCAT10N(CONTINUED)
Copy both sides of this Elevation Certificate for(1)community official, (2)insurance agenUcompany, and(3)building owner.
COMMENTS
Check here if attachmer�s
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zone AO and Zone A(without BFE),complete Items E1 through E4. If the Eleva6on Certificate is intended tor use as supporting
in/ormation for a LOMA or LOMR-F, Sect/on C must be comp/eted.
E1.Buiiding Diagram Number_(Select the building diagram most similar to the building for which this certificate is being completed—see
pages 6 and 7. If no diagram accuratefy represents ihe buiiding;provide a sketch or photograph.)
E2.The top of the bottom floor(induding basement or endosure)of the building is _ft,(m)_in,(cm) 0 above or ❑below(d�edc one)
- the highest adjacerrt grade.
E3.For Buiiding Diagrams 6-8 with openings(see pag,e�,the neict higher floor or elevated floor(eiev�ation b)of the building is
_R(m)_in.(cm)above the highest adjacent grade.
E4.For Zone AO oniy: If no flood depth number is avaiiable,is the top of the bottom floor elevated in accordance with the communii�s .
floodplain management ardinance?Q Yes �No ❑ Unknown The iocal offiaal must certity this infortnation in Sedion G
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESElVTATNE)CERTIFlCATION
The property owner or owner's authorized representative who completes Sedions A, B,and E for Zone A(without a FEMA-issued or
community-issued BF�orZone AO must sign here.
PROPERTY OWNER'S OR OWNER'S AUTHOWZED REPRESENTATNE'S NAME
ADORESS CITY STATE Z1P CODE
SIGNATURE . DATE TELEPHONE
COMMENTS
❑ Check here if attachmer,�
SECTION G-COMMUNITY INFORMATION (OPTIONAL) �
The loql offiaal who is autharized by law or ordinance to administer the community's floodplain management ordinance can complete
Sedions A, B,�(or�,and�C of this Elevation Certfipte. Complete the applicable item(s)and sign below.
G1. Q ThP information in Sectio!e C was taken from other documentation that has been signed and embossed by a licensed surveyor,
engineer,or architec+who is authorized by state or locai law to certify elevatiun information. (Indcate the source and date of the
�slevation data in the Cqmments area below.)
32•�A.cor�munity�fifiaal co:nple2ed Section E for a building located in Zone A(without a FEMA-issued ar community-issued BFE�or
Zone A.O.
33. 0 The foliovs�irrg infi�m;�tion(ft�ms G4G9)is provided for community floodplain management purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY
, ISSUED
37•T'his permit has been issued for. ❑New Construction Q Substantial lmprovement
38. Elevation of as-built towest floor(induding basement)af the building is: _ft.(m) Datum:
39.f�FE or(in Zone AO)depth of fiooding at the building site is: _ft.(m) Datum:_____
LOCAL OFFtCWL'S NAME �E
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMMENTS
❑ Checfc here if attaclimems
'EMA Form 81-31,AUG 99 - REPLACES ALL PREVfOUS EDITIONS