725 ELDORADO AVE ��P�� �� -o� �� �
U.S.DEPARTMENTOF HOMEIAND SECURITY ELEVATI(JN CERTlFfCATE
FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008
Nnliortnl flood/nturnnce Program �mportant: Read the instructions on pages 1-9. Expiration Date:July 31,2015
SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE
A1. Building Owners Name FRED&JOY THOMAS Policy Number:
A2. Building Street Address(induding Apt.,Unit,Suite,artd/or BMg.No.)or P.O.Route and Box No. Compaty NAIC NUmber:
725 ELDQRADO AVE
City CLEARWATER State FL ZiP Code 33767
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 5,BIOCK 12 MADALAY SUBDIVISION / P.i#05-29-15-54666-012-0050
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.?RESIDENTIAL
A5. LatitudelLongitude:Lat.27 59 26.11 N Long.82 45 38:53 W Horizontal Datum: ❑ NAD 1927 � NAD 1983
A6. Attach at least 2 photographs of the building it the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 6
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawispace or enclosure(s) N/A sq ft a) Square footage of attached garage 572 sq ft
b) Number of permanent flood openings in the crawlspace b) Number of permanent flaod openings in the attached garage
or enclosure(s)within 1.0 foot above adjacent grade NtA within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in AB.b N/A sq in c) Total net area of flood openings in A9.b 0 sq in
d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No
SECTION B-FLOOD INSURANCE RATE MAP�FIRM)INFORMATION
81.NFIP Community Name R Community Number 62.County Name B3.State
CITY OF CL�ARWATER/125096 PINELLAS FLORIDA
64.MaplPanel Number 65.Suffix B6.FIRM Index Date 67.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
12103C0102 G 8l18/2009 Effective/Revised Date Zone(s) AO,use base flood depth)
� 9103/2003 VE/AE 13.0/12.0
B10. Indicate the souroe of the Base Flood Elevation(BFE)data or base flood depth entered in Item 89.
❑ FIS Profile � FIRM ❑ Community Detertnined ❑ Other/Source:
611. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other/Sou�e:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Othervvise Protected Area(OPA)? ❑ Yes � No
Designation Dafe:N/A ❑ CBRS ❑ OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. BUilding elevations are based on: ❑ Consiruction Drawings" ❑ Building Under Construction* � Finished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations-2ones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO.Complete Items C2.a-h
below accorcling to the building diagram specified in Item A7.In Puerto Rico only,enter meters.
Benchmark Utilized:DNR 15-93-DA-09 Ve�tical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below. ❑NGVD 1929 �NAVD 1988 ❑Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a)Top of bottom floor(including basement,crawlspace,or enclosure floor) 7.7 �feet ❑meters
b)Top of the next higher floor 16.3 �feet ❑meters
c) Bottom of the lowest hori�ontal structural member(V Zones only) 14.3 ❑feet ❑meters
d)AttachLd garage(top of slab) 7.2 �feet ❑meters
e)Lowest elevation of machinery or equipment servicing the building 7.1 �feet ❑meters
(Describe type of equipment and location in Comments)
� Lowest adjacent(finished)grade next to building(LAG) 6.7 �feet ❑meters
g)Highest adjacent(finished)grade next to building(HAG) 7.1 �feet ❑meters
h)lowest adjacent grade at lowest elevation of deck or stairs,including structural support N/A. ❑feet ❑meters
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation
information. I cerfify that the infomrafion on this Cerfifrcate represents my best eflorts to interpret the data ava�7able.
1 urrderstand that any/alse statement may be punishabfe by fine or imprisornnent under 18 U.S.Code.Section 1001. p
� Check here if comments are provided on badc of fortn. Were latitude a�d longitude in Sedion A provided by a �L� �1'J L �
❑ Check here if attachments. licensed land surveyo(? � Yes ❑ No
�
Certifier's Name EUGENE T CAUDELL License Number PLS 4821 /�' '
`��� �'�
THIe LAND SURVEYOR Comparry Name SELF �;.
Address 2321 PIN OAK LANE EAST City CIEARWATER State FL ZIP Code 33759
Signature - � Date 3/15/2013 Telephone 727 459-9186
FEMA Form 0 6-0-33(7/12) SP.P_. !P,V2f5�;;ide for continuation Replaces ail previous editions.
ELEVATION CERTiFICATE,page 2 �C� `����`� c� �g
IMPORTANT:in these spaces,copy the conresponding infom�ation from Section A. FOR INSURANCE COMPANY USE
Building Street Address(inGuding Apt_,U�it,Suite,andlor Bldg.No.)w P.O.Route and Box No. Policy Nunber.
725 ELEDORADO AVE
City CLEARWATER State FL ZIP Code 33767 Company NAIC Number.
�� SECTION D—SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)building owner. •
Comments MECHANICAL ELEVATION SHO'WN HEREON IS THE WESTERLY A!C COMPF2ESSOR ON SOUTH SIDE OF STRUCTURE
NEXT HIGHER FLOOR ELEVATI�N MEASURED FROM DECK ON 2ND FLOOR
Signature ��!' Date � � �
��'1 , iP/��—
SECTION —BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR Z NE AO AND ZONE A(WITHOl1T BFE)
For Zones AO and A(without BFE),complete Items E1—E5.If the Certificate is intended to suppoit a LOMA or LOMR-F request,complete Sections A,B,
and C.For Items E1—E4,use natural grade,if availabfe.Check the measurement used. In Puerto Riw only,enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade(HAG)and the lowest adjacent grade(LAG).
a)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or�below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor
(elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG.
E3. Attached garage(top of slab}is ❑feet ❑meters ❑above or ❑below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or�below the HAG.
E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's iloodplain management
ordinance? ❑Yes ❑ No.❑ Unknown.The local official must certify this information in Section G.
SECTION F—PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued w community-issued BFE)
or Zone AO must sign here.The statements in Sedions A,B,and E are correct to the best of my knowledge.
Property Owner's or Owners Authorized Representative's Name
Addr�ss City State ZIP Code
Signature Date Telephone
Comments
❑Check here if attachme�ts.
SECTION G—COMMUNITY INFORMATION(OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Secti�s A,B,C(or E),and G
of this Elevation Certific:ate.Complete the applicable item(s)and sign below.Chedc the measurement used in Items G8--G10.In Puerto Rioo only,enter meters.
G1.❑ The information in Section C was taken from other documerrtation that has been signed and sealed by a licensed surveyor,engineer,or architect who
is authorized by law to oertify elevation information. (Indicate the source and date of the elevation data in the CommeMs area below.)
G2.❑ A comjr►unity official cortfi'pleted Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO.
G3.❑ The following information(Items G4—G10)is provided for community floodplain management purposes.
G4.Permit Number G5. Date Permit Issued G6. Dale Certificate Of CompliancelOccupancy Issued
G7. This permit has been issued for: ❑New Construction ❑Substantial Improvemerrt
G8. Elevation of as-built lowest floor(inGuding basement)of the building: ❑feet ❑meters Datwn
G9. BFE or(in Zone AO)depth of flooding at 1he building site: ❑feet ❑mete►s Datum
G10.Community's design flood elevation: ❑feet ❑meters Datum
Local Official's Name Tdle
Community Name Telephone
Signature Date
Comments - •
❑Check here if attachments.
FEMA Form D$6-d-33(�/12) Replaces all previous ed+tions.
Z,.� �:3 -p�2 �-(q' (
U.S.DEPARTMENTOFHOMELANDSECURITY ELEVATION CERTIFIGATE
FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008
Nationnl Flood/nsurance Program Important: Read the instructions on pages 1-9. Expiration Date:July 31, 2015
SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE
A7. Buiiding Owners Name FRED 8 JOY THOMAS Policy Nunber:
A2. Building Street Address(induding Apt.,Unit,Suile,and/or Bidg.No.)or P.O.Route and Box No. Company NAIC Nurnber:
725 ELDORADO AVE
City CLEARWATER State FL ZIP Code 33767
A3. Property Description(Lot and Block Numbers,Tax Paroel Number,Legal Description,etc.)
LOT 5,BLOCK 12 MADALAY SUBDIVISION / P.I#05-29-15-54666-012-0050
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,eic.)RESIDENTIAL
A5. Latitude/Longitude:l,at.27 59 26.11 N Long.82 49 38.53 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 insurance.
A7. Building Diagram Number 6
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawispace or enciosure(s) N/A sq ft a) Square footage of attached garage 572 s4 ft
b) Number of permanent flood openings in the crawlspace b) Number of pertnanent ifood openings in the attached garage
or enclosure(s)within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in AS.b N!A sq in c) Total net area of flood openings in A9.b 0 sq in
d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name&Community Number B2.County Name 63.State
CITY OF CL�ARWATER/125096 PINELLAS FLORIDA
64.Map/Panel Number B5.Suffix 66.FIRM Index Date B7.FIRM Panel 88.Flood B9.Base Flood Elevation(s)(Zone
12103C0102 � G 8/18/2009 Effective/Revised Date Zone(s) AO,use base flood depth)
9l03/2003 VE/A� 13.0/12.0
810. Indicate the sour�ce of the Base Flood Elevation(BFE)data or base flood depth entered in ttem 89.
❑ FIS Profile � FIRM ❑ Community Determined ❑ OtherlSource:
611. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ OthedSource:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes � No
Designation bate:N/A ❑ CBRS ❑ OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. BGilding elevations are based on: ❑ Construction Drewings* ❑ Building Under Construction* � Finished Construction
*A new Elevation Certificate will be required when constn�ction of the building is complete.
C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/A0.Complete Items C2.a-h
below according to the building diagram specified in Item A7.In Puerto Rico only,enter meters.
Benchmark Utilized:DNR 15-93-DA-09 Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below. ❑NGVD 1929 �NAVD 1988 ❑OthedSource:
Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a)Top oi bottom floor(inGuding basement,crawlspace,or enclosure floor) 7.7 �feet ❑meters
b)Top of the next higher floor 16.3 �feet ❑meters
c) Bottom of the lowest hori�ontal structural member(V Zones only) 14.� ❑feet ❑meters
d)Attach�d garage(top of slab) 7.2 �feet ❑meters
e)Lowest elevation of machinery or equipmern senricing the building 7.1 �feet ❑meters
(Describe type of equipment and location in Comments)
� Lowest adjacent(finished)grade next to building(IAG) 6.7 �feet ❑meters
g)Highest adjacent(finished)grade next to building(HAG) 7.1 �feet ❑meters
h)Lowest adjacent grade at lowest elevation of deck or stairs,including strudural support N/A. ❑feet ❑meters
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION ..+t*��••;,;, : :„
��; ..�r-
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation ', •�; ;,:,, �-., ;•� •'
information.!certity that the infom►ation on this Cerii�icate nspreser►fs my best eflorts to interpret the data avadab/e. =�-.,j�',�'�
!urrderstarrd that any false stafemerrt may be punishabk by fir►e or imprisonrrrent under 18 U S.Code,Sec6on 1001. s,�' �- ' , • � ��� '
� Check here if comments are provided on badc of form. Were latitude and longitude in Section A provided by a ��/:t��� ���-
❑ Check here if attachmerrts. licensed land surveyo�? � Yes ❑ No . , �.,,,,- ',*_' � ` '
� � . ,_��-.
Certifier's Name EUGENE T CAUDEIL License Number PLS 4821 ;, �• �. - ��,
Title LAND SURVEYOR Comparry Name SELF '++ '��� t' ,
't, -Jtt�''.s•�'��1-
Address 2321 PIN OAK LANE EAST City CLEARWATER State FL ZIP Code 33759 �, '= : �`� .
Signature -�' Date 3/15/2013 Telephone 727 459-9186 ,R,����4'��Fy`-.
FEMA Form 0 6-0-33(7/12) See reverse side for continuation. Replaces all previous editions.
ELEVATION CERTIFICATE, page 2
IMPORTANT:In these spaces,copy the corresponding iMormation from Section A. FOR INSURANCE COMPANY USE
Building Street Address(induding Apt.,Unit,Suite,and/or Bldg.No.}or P.O.Route ar►d Box No. Policy Number:
725 ELEDORADO AVE
City CLEARWATER State FL ZIP Code 33767 Comparry NAIC Number.
�� SECTION D—SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
Copy both sides of this Elevation Certificate for(1)communiry officia�,(2)insurance agenUcompany,and(3)building owner. •
Comments MECHANICAL ELEVATION SHOWN HEREON IS THE WESTERLY A/C COMPRESSOR ON SOUTH SIDE OF STRUCTURE
NEXT HIGHER FLOOR ELEVATION MEASURED FROM DECK ON 2ND FIOOR
Signature �i/"' Date
�-it , �r'�r� � .`>
SECTION —BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR Z NE AO AND ZONE A(WtTHOUT BFE)
For Zones AO and A(without BFE),complete Items E1—E5.If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B,
and C.For Items E1—E4,use natural grade,if available.Check the measurement used. In Puerto Rico only,enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade(HAG)and the lowest adjacent grade(LAG).
a)Top of bottom floor(including basement,crawlspace,or enclosur�e)is ❑feet ❑meters ❑above or�below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enGosure)is ❑feet ❑meters ❑above or❑ below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor
(elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG.
E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG.
E4. Top of platfoRn of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or 0 be�ow the HAG.
E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? ❑Yes ❑ No.❑ Unknown.The local official must certify this information in Section G.
SECTION F—PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE)
or Zone AO must sign here.The statements in Sections A,B,and E are correct to the best of my knowledge.
Property Owner's or Owne�s Authorized Representative's Name
Addrg�ss Ciry State ZIP Code
Signature Date Telephone
Comments
❑Check here if attachments.
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G
of this Elevation Cert'fic:ate.Complete the applicable item(s)and sign below.Checic the measurement used in Items G8-G10.In Puerto Rico only,enter meters.
G1.❑ The information in Section C was taken from other documerrtation that has been signed and sealed by a licensed surveyor,engineer,or architect who
is authorized by law to oertify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2.❑ A com,[nunity oKicial cort�`pleted Section E for a building located in Zone A(without a FEMA-issued or oommuniry-issued BFE)or Zone AO.
G3.❑ The folfowing information(Items G4—G10)is provided for community floodplain management purposes.
G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of ComplianoelOccupancy Issued
G7. This permit has been issued for: ❑New Construction ❑Substantial Improvemerrt
G8. Elevation of as-buift lowest floor(including basement)of the bulding: ❑feet ❑meters Datum
G9. BFE or(in Zone AO)depth of floading at the building site: ❑feet ❑meters Datum
G10.Community's design flood elevation: ❑feet ❑meters Datum
Local Offiaal's Name Tdle
Community Name Telephone
Signature Date
Comments -
❑Check here if attachments.
FEMA Form 086-0-33(7/12) Replaces all previous editions.