306 LEEWARD ISLANDU.S. DEPARTMENT OF HOMEIAND SECURITY ELEVATION CERTIFICATE
FEDERAL ENlERGENCY MANAGEMENT AGENCY
Nationa! Flood lnswance Program �mportant: Read the instKuctions on pages 1-9.
OMB No. 1660-0008
Expiration Date: July 31, 2015
SECTION A- PROPE�2TY tNFORMATiON FOR il
Building Owners Name BRIAN 8 ANDREA NEWDECK P�
A2. Building Street Address (inGudirg Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No.
306 LEEWARD ISLAND
City CLEARWATER
State FL ZtP Code 33767
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A3. Property Description (Lot and Blodc Numbers, Tax Parcei Number, Legal Descriptio�, etc.)
LOT 56, UNIT 1 ISLAND ESTATES OF CLEARWATER
A4. Building Use (e.g.. ResideMial, Non-Residenqal, Addition, Accessory, etc.) RESiDENTIAL
A5. LatitudelLongRude: Lat. 27°58'49.13"N Long. 82°48'53.24"W Horizorrtai 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 tA
A8. For a building with a crawlspace or endosure{s): A9. For a building with an attached garage:
a) Square footage of crawlspace w encbsure(s) WA sq ft a) Square footage of attached garage 4� sq ft
b) Number of pertnanent flood openings in Me crawlspace b) Number of permanent flood openings in tl�e attached garage
or encbsure(s) within 1.0 foot above adjacent gr�de NUA withi� 1.0 foot above adjacent grade 4
c) Total net area of flood openings in A8.b I�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
61. NFIP Community Name & Community Number 62. County Name
CITY OF CLEARWATER 12509G PINELLAS
64. MapJPa�l Nixnber B5. Suffuc B6. FIRM Index Date 67. FIRM Panel
12103C0102 G 9/3/03 Efledive/Revised Date
9/3I03
63. State
FLORIDA
B8. Flood 69 Base Fbod Elevation(s) (2one
Zone(s) AO, use base flood depth)
qE 11'
610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69.
❑ FIS Profile � FIRM ❑ Community Determined ❑ OchedSource:
611. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 ❑ OthedSource:
612. Is the building bcated in a Coastal Barrier Resources System (CBRS) area w OMenvise Protected Area (OPA)? ❑ Yes � No
Designafan Date: WA ❑ CBRS ❑ OPA
SECTION C- BUILDiNG ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building e�evations are based on: ❑ Construdion Drawings' ❑ Building Under Construction' � Finished Consiruction
'A new Elevation Certificata will be required when construdion of the building is complete.
C2. Elevations - Zones Ai-n30, AE, AH. A(with BFE), VE, V1-V3d, V(with BFE}, AR, ARfA, RRiAE, A�/A i-r130, AWAFi, AR/AO. Compi2te ka-rss C2.a-h
bebw according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchma�lc Utilized: G-04.5 Vertical Dat�m: NAVD 1988
Indicate eleva6on datum used for the elevations in items a) through h) below. � NGVD 1929 � NAVD 1988 ❑ OtheNSource:
Datum used for building elevations must be the same as that used for the BFE.
Check ttie measurement used.
a) Top of bottom floor (induding basemeM, crawlspace, or enclosure floor) 6.19 � feet ❑ meters
b) Top of the next higher floor N/A. � feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) N/A. � feet ❑ meters
d) Attached garage (top of slab) �.,'i$ � feet ❑ meters
e) Lowest elevation of machinery or equipmeM servicing the building 7.15 � feet ❑ meters
(Describe type of equipment and bcation in Comments)
� Lowest adjacent (finished) grade r�xt to buikling (LAG) 5.2 � feet ❑ meters
g) Highest adjacent (finished) grade ne�d to building (HAG) 5.3 � feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, i�cluding strudural support N/A. � feet ❑ meters
SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION n�_
This certification � to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation
infortnation. 1 cerfify that the infnmration on this Ce�iiflcate represents my best elfats to interpret the data ava�7abfe.
I unrterstand fhat any fafse statement may be punisha6le 6y fine or imprisonmenf ur�der 18 U. S. Code, Sec6on 1001.
� Chedc here if comments are provided on badc af form. Were latitude and longitude in Section A provided by a
O check here if attacnments. ticensed land suneyor? � Yes ❑ No
Certifier's Name JOHN R BEACH
License Number 2984
TiUe P.L.S. Company Name JOHN R. BEACH 8 ASSOCIATES, tNC.
Address 911 ST. PETERSBURG DR W Ciry OLDSMAR State FL ZtP Code 34677
Date 5/30/2013 Telephone 813-854-1276
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(7/�2) See reverse side for continuation. Replaces a11 previous ecimons.
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IMPORTANT: In these spaces, copy the corresponding information from Section A FOR INSURANCE COMPANY USE
Building Street Address (induding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Pali�y Number.
306 LEEWARD ISLAND
City CIEARWATER State FL ZIP Code 33767 Canpany NAlC-Number:
SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1y c�mmunity official, (2) insurance agent/canpany, and (3) buiidi�g owner.
Comments C2(e) = A/C ELEV
Signature.
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_�r=iT�'t�?��rl�ik]
E- BI�LDING ELEVATION INFORMATION (SURYEY NOT REQUIRED) FOR ZONE AO AND ZONE A
For �Si�AO and A(without BFE), complete Items E1-E5. If the CeRificate a intended to support a LOMA or LOMR-F request, complete Sectioru A, B,
a�d C. For Items E7-£4, use natural grade, ff available. Chec�c the measurement used. In Pueno Rico only, enter meters.
Et. Provide elevation ir�formaCron 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 adjaoent grade (LAG).
a) Top of bottom floor (including basement, ctawlspace, or endosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
b) Top of bottom floor (induding basement, aawlspace, or encbsu►e) is o�t o�� o� o� o n� ��►c.
E2. For Building Diagrams 6-9 with pertnanent flood openings provided in Section A Items 8 andla 9(see pages 8-9 of Instructions), the neM higher floor
(elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ bebw the HAG.
E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of ptatform of machinery andtor equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E5. Zone AO ony: If no flood depth number is available, is the top oi the bottom floor elevated in accordance with the canmunity's floodplain management
ordinance? ❑ Yes ❑ No ❑ Unknov�m. The local official must certify tt�is intormation in Section G.
SECTION F- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owners authorized representative who completes Sections A, B, and E for Zone A(without a FEMA-issued or canmunity-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 Owners or Owner's Authorized Representative's Name
Address
Signature
Comments
City
Date
State
Telephone
ZIP Code
Check here ff attachments.
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The bcal official who is authorized by law or ordinance to administer the community's floodplaln managernent ordinar►ce can complete Sedions A, B, C(or E), and G
of this Elevation CeRficate. Complete the applipble item(s) and sign below. Check the measuremeM used in Items G8-G10. In Puerto Rico only, enter meters.
G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A cAmmunity offiGial «�mmpteted Sedion E for a building located in Zone A(without a FEMA-issued or community-issued BFE) or Zone AO.
G3. ❑ The folbwfng infortnation (Items G4-G10) is provided for community floodplain management purposes.
G4. Pertnit Number G5. Date Permit tssued G6. Date Certificate Of Complia�ce/Occupancy Issued
G7. This perrnit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as-buiR lowest floor (includi� basement) of the building:
G9. BFE or (in Zone AO) depth of flooding at the building srte:
G10. Community's design flood elevation:
Local Official's Name
Community Name
Signature
Comments
❑ feet � meters Datum
❑ feet p meters �atum
❑ feet ❑ meters Datum
Title
Telephone
Date
Chedc here if attachments.
FEMA Form 086-0-33 (7/12) Replaces all previous editions.