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216 SKIFF POINT_ _ ` �x __ __ U.S.C?�PARTMlENT OF HOMELAND SECURITY ELEVATION CERTIFICATE onns No. �sso-0008 Expires March 31,2012 Federal Emergency Management Agency National Fbod Insurance Program Important Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION Far Insurance Company Use. A1. Buitding Owner's Name Pamela and Eamest T.Butler Policy Numk� A2. Building Street Address(including Apt.,Unit,Suite,andlor Bidg.No.)or P.O.Route and Box No. Company NAIC Number > 216 Sk'rff Point City Clearwater State FL ZIP Code 33767 A3. Property Description{Lot and Blodc Numbers,Tax Parcel Numbar,Legal Description,etcJ Unit 216,Skiff Harbour Townhouse Condominiums,Condon'�inium Book 48,Page 38,Parcei ID�08-29-15-82270-000-2160 A4. Building Use(e.g.,Residentiat,N�-Residential,Addition,Axessory,etc.)Residential A5. Latitude/Longitude:l.at.27 58'56.03"N Long.$�49'08.94"W Horizontal Datum: ❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building iF the Certificate is being used to obtain flood insuranoe. A7. Building Oiagram Number 7 A8. For a building with a crawlspaoe or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspaoe or enGosure(s) 7�g sq ft a) Square footage of att�hed garage �/A s4 ft b) No.of pertnanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adJacent grade Q within 1.0 foot above adjaoent grade Q c) Total net area of flood openings in A8.b Q sq i� c) Total net area of flood openings in A9.b Q sq in d) Engineered flood openingsT ❑ Yes � No d) Engineered flood openings? [] Yas � No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name 8 Community Number B2.County Name �•S�� City of Clearwater 125096 Pi�ellas F� B4.Map/Panel Number 65.Suffix B6.FIRM Index 67.FIRM Panel B8.Flood 69.Base Flood Elevation(s)(Zone 12103C0102 G Date Effedive/Revised Date Zone(s) AO,use base flood depth) S/18/09 9/3/03 � �2� B10. Indicate the source of the Base Flood Elevation(BFE)data o�base flood depth entered in Item B9. ❑ FIS Profile � FIRM ❑ Community Determined ❑ Other(Describe)N� 611. Indicate elevation datum used for 8FE in It�n B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other(Describe) 1�/ 612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Proteded Area(OPA)? ❑ Yes � No Desiynation Date 1�1 ❑ CBRS ❑ OPA SECTION C-BUILDING E�EVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based an: ❑ Construction Drawings" ❑ Building Under Construdion" � Finfshed ConsVuction 'A new Etevation Certif'�cate will be required when c.onstruction of the building is complete. C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,Vi-V30,V(with BFE),AR,AR/A,AR/AE,AR/A7-A30,AR/AH,AR/AO. Complete Items C2.a-h below according to the building diagram specifi�in Item A7. Use the same datum as the BFE. Benchmadc Utilized �itv Of Clearwater Vertical Datum NAVD-1988 Convereion/Comments�G-04.5 Chedc the measuremeM used. a) Top of bottom floor(induding basement,crawlspace,or endosure floor)F.1 I�feet ❑meters(PueRo Rico only) b) Top of the next higher floor ]�.� �feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) �1 . �feet ❑mete�s(Puerto Rico only) d) Attached garage(top of slab) N�._ �feet ❑meters(Puerto Wco only) e) Lowest elevation of machinery or equipment servicing the buildiny �.1 �feet ❑meters(Puerto Rico only) (Describe type of equipment and bcation io Comments) � Lowest adjacant(finished)grade ne�Q to building(lAG) ¢.Q �feet ❑meters(Puerto Ric:o only) g) Highest adjacent(finished)grade ne�d to building(HAG) ¢.1 �feet ❑meters(Puerto Rico only) h) Lowest adjaoent grade at lowest elevation of dedc or stairs,including ¢.1 �feet ❑meters(Puerto Rico ony) struciural suppoR ---- SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION r��.�.�..�n ■ � r ,q�ln7!l�MYll��ir�� This certification is to be signed and sealed by a land surveyor,eng�neer,or archded authonzed by law to cerhfy elevaUon ��{�.��`� P�+ information. 1 certify that the infamation on this Certificate►epresents my best efforts to interpret the data available.! �,�s �s '��...,,,�: ,�.,, ,„, understand that any false statement may be punishable by fine or imprisa�ment under 18 U.S.Code,Section 1001.� w�" Fa� ;�y�1�i��•� � -. Check here if comments are provided on badc of form. Were latitude and longitude in Sedion A provided by a �� ,�,, �,. �: licensed land surveyoi't � Yes ❑ No �.� ��. Certifiers Name Donald E.Armstrong,Jr. License Number 5083 , ��; ,'��3��"�'��'� ,�.,y �, , , . Title Owner Company Name Don Armstrong Land Surveying,LLC ' '/.(,?��+;�1��• ' �'•� '� �� Address 2187 North Green Ridge Place City Palm Harbor State FL ZIP Code 34683 !��t ��Ig� , � Signature Date 10/15/12 Telephone 727-772-8134 _ _ _ _ _ � , _ IMPQRTAN7; In these spaces,copy the corresponding information from Section A. For Insurano��Gompany Use: Building SVeet Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Polic�t Nwllber 2 Sandpiper Road City Clearwater State FL ZIP Code 33767 Comp+9ny NAIC Murnbef SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Coav both sides of this Elevation Certificate for(1)communitV ofFicial,(21 insurance asaent/comaanv,and(3)buildinq owner. Commenis Lowest Machinery in Item C2 e)is a Hot Water Heater located inside of Enclosure.Latitude and Longitude were determined using the Pinellas PropertY Appraisers GIS Map. Signature Date 10/15/12 Check here if attachments SECTION E-BUILDI G ELEVATION INFORMATION(SURVEY NOT REQUIRED�FOR ZONE AO AND ZONE A(1MTHOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to suDDOrt a LOMA or LOMR-F request,complete Sections A,B, and C. For Items E1-E4,use natural grade,'rf available. Chedc the measurement used. In Puerto Rico only,enter meters. E1. Provide elevatfon iMormatlon for the following and check the appropriate boxes to show whether the e�evation is above or below the highest adjacent grade(HAG)and the lowest adjaoent grade(LAG). a)Top of bottom floor(Including basement,crawlapace,or endosure)is ❑feet ❑meters ❑above or�below the HAG. b)Top of bottom floor(inGudiny basement,crawlspace,or endosure)is . ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Sedion A ttems 8 andlor 9(see pages&9 of Instructions),the next higher floor (elava6on C2.b in the diagrams)of the building is ❑feet ❑meters ❑above o� ❑below tha HAG. E3. Attached garape(top of slab)is . ❑feet ❑meters ❑above or ❑betow the HAG. E4. Top of platfortn of machinery andlor equipment serviang the buildi�g is ❑feet ❑meters ❑above or Q below the HAG. E5. Zone AO onty: If no flood depth number is available,is the top of the bottom floor elevated in axordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑ Unknown. The local official must cartiy this infortnation in Section G. SECTION F-PROPERTY OWNER(OR OWNER'3 REPRESENTATIVE)CERTIFICATION i _- The property owner or owners authorized representative who cwnpbtes Sedions A,8,and E for Zone A(without a FEMA-isaued or community-issuad BFE) or Zone AO must sign here. 7he statements in Sedions A,8,end E aie comact to U�e best of my Ivawledge. Property Owner's or Ownar's Authorized Representaave's Name Addre&s City State ZIP Code Signature Date Telephone Comments ❑Chedc here if attachments � ��I��i��l�� 1�� Oli�� SECTION G-COMMUNITY INFORMATION(OPTIONAL) The loca!oificial who is authorized by law or ordinanoe to a�dminister the cornmumty's floodplain managemerrt ord�nanc;e cen c:omplete Sactwns A,B,C(or E), and G of this Elevation CeRificate. Complete the applicable item(s)and siyn below. Chedc tha measuroment used in Items G8 and G9. G1.❑ The information in Section C was taken from other documeMation that has been signed and sealed by a licensed sunreyor,engi�eer,or architec:t who is authorized by law to ceRify elevation information. (Indicate the souroe and date of the elevation data in the Commonts area below.) G2.❑ A community official completed Secxio�E tor a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.❑ The following information(Items G4-G9)Is provided for community floodplain manayement purposes. G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of CompliancelOccupancy Issuad G7. This pertnit has been issued for: ❑New Conatruction ❑Substantial Improvement G8. Elevation of as-built lowest floor(InGuding basement)of the building: ❑feet ❑meters(PR)Datum G9. BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR)Datum G10.Community's design flood elavation ❑feet ❑metera(PR)Datum Local Official's Name Title Commu�iry Name Talephone Signature Date Comments rl Chedc here if attachmenta