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2755 VIA CAPRI BLDG 1200 FEDERAL EMEitGEPICY MANAGEMEN�AGEAICY p,�.B. No. 3067-0t�77 �'� NATiONAL FLOOD INSURANC�PROGRAM � ' • ` ' Expires Juiy 31, 2002 ! ' ' ' , � EL�/AT901V CEFtTlFiGATE � Im ortar� Read tfie tnstructio�on a es 1 -7. SECTION A-PROPERTY OWNER INFORMATION For fnsurance Co�airy 11se; BUILDING OVVNER'S NAME . Poliay Number INC�STREETADDRESg(Indudi gApL,.0 Suite,a �/ r �a No. OR P.O.ROUTE ANQ BOX NO. Campany NAIC Number Venezia at Baywatch - B�dg. #f�'00 - �7��Via �apri - C earwater, �, ST� Z!P CODE 33764 PROPERTY DESCRIPTION(Lot and Blodc Numbers,Tax Parcel Number.Legal Description,etc.) Tax Folio No. 29/29/16/00000/220/0200 BUILDING USE(e.g.,Residentiai,Non-residential,Addition,Accessory,eta LJse Comments sedion if necessary.) Residential LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(fype):_____ ( #q�°-##'-##.�/#" or #�.#� ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.----- SECTION B-FLOOD INSURANCE RATE MAP(FiRM)INFORMATION B1.NFIP COMMUNITY NAME 8�COMMUNITY NUMBER 62.COUNTY NAME B3.STATE Pinellas Count FL Unincor . 125139 Pinellas Florida � 84.MAP AND PANEL B5.SUFFIX 66.FiRM INDDC 87_FIRM PANEL 88.FLOOO 89.BASE FLO00 ELE1/ATiON� I NUMBER DATE EFFECTiVElREVISED DATE ZONE(S) (Zone AO,use depth of;food'mg; � 0128 D 8 18 92 8 19 91 AE Ip B10. Indicate the source of the Base Flood Elevation(BF�data or base flood depth entered in B9. ❑ FIS Profile �FIRM ❑Community Detertnined ❑Other(Describe):_____ 811. Indicate the elevatlon datum used for the BFE in 89:�NGVD 1929 ❑NAVD 1988 ❑Other(Describe):____ 812.Is the building located in a Coastal Barrier Resources System(CBRS)area or Othervuise Proteded Area(OPA)? ❑Yes� No Designation Date_____ SECTION C-BUILDlNG ELEVATION INFORMATION(SURVEY REQUIRED) C1.Buiid(ng elevations are based on:Q Construction Drawings' Q Buiiding Under Construdion' ❑Finished Construction 'A new Elevation Certificate wiil be required when consUucBon of the building is complete. � C2�Iding Diagram Number 1 (Seled the building diagram most sim7ar to the buiiding 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.Eievations—Zones A1-A30,AE,AH,A(with BF�,VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,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 differertt from the datum used for the BPE in Sedion B,cornert the datum to that used for the BFE. Show field measurements and datum conversion calcul Use the space provided or the Comments area of Section D or Section G,as appropriate,to,dacumertE$�e,d�tur`ri cAr�versar-_ ,,,:. �. Datum�� CornersioNComments N,/A_ � �5� . ��;r :4f�; � Elevation reference mark used Does the elevation reference mark used appearon the FIRM? ,p Y,��lo .-. - 5�:`f.� � ' ❑ a)Top of bottom floor(nduding basement or endosure) 10 , 1 }t,(m) � � ��, � A ,. ❑ b)Top of next higher floor n a , �,(m) N ��/.� ��"A 3�`��° J��r 0 c) Bottom of lowest harizw�tal strudurai member(V zones only) n/a . R(m) 9 m ;�3� �_ _� r�r � � ❑ d)Attached garage(top of stab) n/a _}t,(m) .�� : ;� „ � j � „T O e) Lowest elevation of machinery and/or equipment W '° � �'- M� .,� � ��, � �1 � serviang the buiidin9 n/a _ft.(m) S� '', '�F �. '��,'/.�' � : 0 fl Lowest adjacent grade(LAG) n/a g,�m� Z�, ��1�,:-!��'� 0 gj Highest ad�acent grade(HAG) n/a _ft,�m� :�' '^ `•° "��;: - , . �...., ❑ h) No.of permanerit openings(flood vents)within 1 �.above adjacerrt grade_n/a � ❑ )Total area of all pem�anerrt.openings(flood.verrts)in C3h�sq,in. (sq.cm) SECTION D-S.URVEYOR, ENGfNEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or an�itec!authorized by law to cenify e(evation infortnation., 1 ce�fify that the informa�ion in Secdions A, B, and C on this certlficate rep�sents my best efforts to inte►pret the data available. _I understand that any fa/se statement may be punishable by Bne o�imprisonment urtder 18 U S Code Section J001 CERTIFlER S NAME L1CF�I��NUMBER __ A1 1 an F_ OS 1 i�nr7 _ PSM n COMPANY NAME �rofessional 5urveyor and Mapper Kina Enaineerin Associates, Inc A � C� STATE ZIP CODE SI NRE 2Z Memoria St Tam a FL 33634 • �/1�/O l TELEPHONE - � �'- �`--� 813 880 8881 � F€MA Fortn 81-31,AUG 99 SEE REVERSE SIOE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIO�iS �MP�R'�,�AlT: 9n these�pac�s,cmpy the corresponding information from Section,4. ' ,::�or Insurance Campar,y Use � �UILDING STRE�7',qDDRESS Indudin • � 9 APt,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AP1D 80X NO. Po Number . -.._: --.. . Venezia at Ba atch - Bldg. #1200 - 2755 Via Capri --- � - • - ' C� Z!P CODE Cam an PlA1C Nim�ber Clearwater F�A� P_,.Y 33764 SECTtON D-SURVEYOR,ENGiNEER,OR ARC7i1TECT C�RT1FiCAT10N(CONTINUED) Copy both sides of this Elevation Certificate for(1)community ofiaal, (2}insurance agenUcompany, and(3)building owner. COMMENTS Check here if attachmer�Es SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND 7ANE A(WITHOUT BFE) For Zone AO and Zone A(without BF�,complete Items E1 through E4. !f the Elevadon Ce�tificate is interrded for use as supporting inloRnation for a LOMA or LOMR-F, Sect/on C must be camp/eteaf. E1.Buiiding Diagram Number_(Seled the building diagram most similar to the building for which this cerbficate is being compieted—see pages 6 and 7. If no diagram accurately represents the buiiding;provide a sketch or photograph.) E2.The top of the bottom floor�nduding basement or endosure)of the building is _ft.(m)_in,(cm)�above or ❑below(checfc one) - the highest adjacerrt 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 _R(m)_in.(cm)above the highest adjacent grade, E4.For Zone AO only: If no flood depth number is available,is the top of the bottom flaor elevated in accardance with the communii�s floodplain management ordinance?�Yes �No ❑ Unknown The local offiaal must certify this information in Secbon G SECTION F PROPERTY OWNER(OR OWNER'S REPRESENTATNE�CERTtFlCATION The property owner or owners authorized represer�ative 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 AUTHORIZED REPRESENTATNE' NAME ADDRESS CITY STATE ZIP CODE SIGNATURE . DATE TELEPHONE COMMENTS ❑ Check here if attachmer,� SECTION G-COMMUNITY INFORMATION(OPTIONAL) ' The local offiaal who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sedions A, B,C(ar�,and G of this Elevation Certificate. Complete the applicable item(s)and sign below. G1.�The informatlon in S�ciion C was taken from other documeMation that has been signed and embossed by a licensed surveyar, engineer,or ar�chited who is authorized by state or loc�l Iaw to certify elevation infortnatlon. (Indicate the source and date of the elevation data in the Comments area below.) 32.Q A community c.a('icial completed SecKion E for a building located in Zone A(without a FEMA-issued or community-issued BFE7 or Zone AO. 33. Q The following infortnation(Items G4-G9)is provided for community floodplain management purposes. G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFtCATE OF COMPLIANCE/OCCi1PANCY ISSUED 37.This pertnit has been issued for. ❑New Construdion� Substantial lmprovemerrt 38. Elevation of as-built lowest flao�(induding basement)af the building is: _ft.(m) Datum: 39. �FE or(in Zone AO)depth of flooding at the building site is: _ft.{m) Datum:_____ LOCAL OFFiCWL'S NAME n� COMMUNITY NAME TELFPHONE SIGNATURE DATE COMMENTS ❑ Check here if attachmer�s 'EMA Form 89-31,AUG 99 REPLACES ALL PREVIOUS EDITIONS