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131 MIDWAY ISLAND� U.S. DE�'ARTME[JT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Read.the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION A1. Building Owner's Name MAZAS INVESTMENTS, LLC A2. Buildiny StrE�t Address (including Apt., Unit, Suite. andior Bldg. No.) or P.O. Route and Box No. 131 MIDWAY ISLAND City CLEARWATER State FL ZIP Code 33767 OMB No. 1660-0008 Expires March 31, 2012 For Insurance Gompany Use: Policy Number Company NAIC Number A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 37, ISLAND ESTATES OF CLEARWATER, P.B. 47, PGS. 62 & 63, PINELLAS COUNTY, FLORIDA. TAX PARCEL # 08-29-15-43344-000-0370 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 28deq09' 19.88" N Long. 82 deg. 51' 21.09" W. Horizontal Datum: ❑ NAD 1927 � NAD 1983 A6. Attacli at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1A A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) NA sq ft a) Square footage of attached garage 452 sq ft b) No. of permanent 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 NA within 1.0 foot above adjacent grade 0 c) Tofal net area of flood openings in A8.b NA 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 62. County Name B3. State � CITY OF CLEARWATER #125096 PINELLAS FLORIDA B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profiie � FIRM ❑ Community Determined ❑ Other (Describe) B11. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 ❑ Other (Describe) B12. Is the building located in a Coastai Barrier Resources System (CBRS) area or Othenvise Protected Area (OPA)? ❑ Yes � No Designation Date ❑ CBRS ❑ OPA SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' � Finished Construction 'A new Elevation Certificate will be required when construction 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, AWA1-A30, AR/AH, AR/AO. Compiete items C2.a-h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized N.O.S. RM-4 Vertical Datum NAVD 1988 Conversion/Comments NONE Check the measurement used. a) Top of bottom floor (including basement, crawispace, or enciosure floor) 8..67 � feet ❑ meters (Puerto Rico only) b) Top of the next higher floor N/A.. ❑ feet ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) N/A. ❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) 8.29 � feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 8.33 � feet ❑ meters (Puerto Rico o�ly) (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 8.0 � feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) 8.4 � feet ❑ meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including NlA. ❑ feet ❑ meters (Puerto Rico only) structural support 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 certify that the information on this Certificate represents my best etforts to interpret the data available.l iz�� e�c� ;'. , fy J�� '.� undersfand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code. Section 1001. � .` * o„ ,.�•• �. �' ', Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a � '�'` •� �0 �it �� licensed land surveyor? � Yes ❑ No :��; :� ��LAC�'��ri..� Certifiers Name DAVID K. PREVOT TiUe PROFESS!ONAL SURVEYOR & fv1APPER Address 6154-A SPRINGER DRIVE City PORT RICHEY Signature — -- - _ -- - License Number 4934 ''� _ _ . _. _ _ --- --- Co�r��pany Name Br;l' Lr1ND SURVEYING . State FL ZIP Code -- --- --- __ ._- --- - __. _ Date 12-12 1 Z Telephone 727-�i45-1738 � � �^v ��:�'�34E `., , Y, • f �HERE � � > -• � rtf" ' /Z✓R..� � " ` . �� ;. r. -� a.Tj�' ;1�i� %�` ` . FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces �II`previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit. Suite, and/or Bldg. No.) or P.O. Route and Box No. 131 MIDWAY ISLAND City CLEARWATER State FL ZIP Code 33767 � �i Num SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Ceriificate ior (1 I community official, (2j insurance agenticompany. and (3) building owner. Comments SECTION C2 e= ELEVATION OF THE BOTTOM OF OUTSIDE AIR-CONDITIONING UNIT. Signature Date 12-12-12 NAIC Number Check here if attachments SECTION E- BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT 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 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 ❑ beiow 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 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, 8, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address Signature Comments City Date State ZIP Code Telephone ❑ 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 Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8 and G9. 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 community official completed 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-G9) is provided for community floodplain management purposes. G4. i'ermrt Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-built lowest floor (including 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 elevation Local Ofiicial s Narne Community Name Signature Comments ❑ feet ❑ meters (PR) Datum Title Telephone Date Check here if attachments FEMA Form 81-31, Mar 09 Repiaces ali previous editions � � Builc�ing Photographs C ontiniiat�on Pa�c 12-1(li l iFEC — - -- -- --- --- — -- __-- 131 MIDWAY [SLAND � For insurance compan� use: — - -- l3uildina Strect address includin :� t., l�u�t, �uitc ur PO Buz Polic� lumber Cit�° CLEARWATER STATE FLORIDA "I.ip 33767 Compan�� NAIC Number If submitting more pl�otographs than �cill tit on the procecding page, affix the additional photographs belo�c. Identifi� all photographs wi[l�: date takcn:"frout cic��" and "rcar ��ic��" and if required ," right side" and "Icft side ��ic�c". FRONT VIEW -��,.....,...� -_� �i,l `i�.-�� . _� I.y: "_\____:�j i ° ��.�lsli�a I_� i.��',�I_��; �� -� � �E�� ,� z y �:�� ; PLANNING & �EV�LC��3��'� "�,��;�: ' �': CITY OF t��C:s�;�aav�..��'�;� DATE T.�KF.N 12-08 -12 RIGHT VIEW T�� ,� - ��.. �,''x; , . . f s,$�. ..:'.;,� �. r , � 131 MIDWAY ISL BCP2012-12347 INTERIOR REMODEL MAZAS, BILL Zoning: Island Estates Neighbor Atlas #: 2676