37 WINDWARD IS RDu.s. ��urrw�Kr oF rro� sECUn�rr
FEOERAL EMEROENCY MANAOEMENT AOENCY
Nariona! Flood Insurance Progmm
ELEVATION CERTIFICATE
Important: Resd the instructlons on pages 1�9.
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A2. Building Street Addrasa (inclucing A�•, Unit� Suits, andlor Bldg. No.) or PA_ Routa �d Box No.
37 WINDWARD ISLAND ROAD
City CLEARWATER
Stata FL ZIP Code 33767
OMB No. 1660-0008
Expiratiort Date: July 31, 2015
FOR INSURMICE COMPANY U5E
�. �operty �escx�ao� (�a �,d eack N�,ers, Tax Parcel N�xnber. � oe�on. ecc_)
iSLAND ESTATES OF CLEARWATER UNIT 4 LOT 24; �i109-29-15-d3362-000-0240
�C4. Building Use (e.g., Residentiel, Non-Residential, llddition, Aocessory, etc.) RESIDENTIAL
A5. LatRudeJLongitude: Lat. 2T�8'28.23"N Lwtg. �2�48'38.27"W Horizontal Dahur►: ❑ NAD 1927 � NAD 1983
AB. Attach ffi lesst 2 photographs of tha buiidM�g it the Cartlflcate is being used to obtain flood h�surance.
A7. Building Diagram Number �
A8. Fw a lwiidfng with a crawlapsc� ar enclosurs(s): A9. For a build&�g with an attact�ed garage:
a) 5quare footags oi craMrlspsce or �ure18) � �i ft 81 Square �tsge a anact�ed 9arage � sq ft
b) Numbw of permanent flood operm�gs in the crawlapace b) Number d psrmanent 11ood openkgs in ths attached garage
or endosure(s> wkFa�, �.o root atrnre adjacenc grade t � within t.o roa aeove adjace�t 9rade 4
c) Total net area of tlood openings i� A8.b 1.785 sq in c) Total r�et area of Aood openinqs in A9.b Q sq in
d) Engineered lbod openin�? ❑ Yes � No d) Engineered flood ope�ings? ❑ Yes � No
SECTION B— FLOOD INSURANCE RATE MAP (FlR1A) INFORIAATION
Bi . NFIP Community Natte & Communily Number B2. Courr�+ Name 83. State
CITY OF CLEARWATER PINELLAS FLORI�A
B4. MapJPanel Number 65. SuMix B6. FIRM Index Dffie B7. FIRM Panel B8. Fiood B9. Base Flood Elevation(s) (Zone
12103C0108H H 08/18/2009 EffectivalR� Dffie ZonE(s) AO, uss base fbod dspth)
E�70. Incticata me sou�e of the Bass Flood Elevation (BFE) data or base Aood depth e�tered in Item B9.
❑ FIS Profile � FIRM ❑ Community Determined ❑ Other/Source:
Bi t. irxlic�.ate ele�radon datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 p OtheNSource:
812. Is the bu�ng locffied in a Coastal Barrier Resouress System (CBRS) area or Olhsrvrise Prdeeted Area (OPA)? ❑ Yes � No
Designation Date: . p CBRS ❑ OPA
SECTION C— BWI.OING ELEVATION INFORMATION (SURVEY RE�1tNREDj
C1. Buildirg elevaUats are based on: ❑ COnsduction Ikawings' ❑ Buildiny Ur�' Construction' � Finished ConstruCtion
•A new Elevffiiai CeAfflcate wiU ba requlred when cor�structlon d the buildng is canplete.
C2. Elevetions — Zorws A1 A30, AE, AH, A(witli BFE), VE, V1—V30, V(with BFE), AR, AR/A, AR/AE, AR/A1 A30, ARlAH, AR/AO. Complote ftems C2.a-h
below according to the buUding diagraun spedAed In Item A7. In PueRo Rico only, enter meters.
Berx�mark Utiflzed_ G04.5 Vert�al Dahx»: NAV
IrWicffie siavation datum uEed for tha elevations in Mems e) through h) below. ❑ NGVD 1929 � NAYO 1988 O pfier/SourCg:
Datwn used for �ng elevadons must be the same as tt►ai used for the BFE.
a) Top of bottom floor (Indudirg besement, crawispace, or enclosure Aoor)
b) Top of ths nsxt Fughsr Aoor
c} Bottom ot the lorvest horizoMel structural member (V 2ones o�lY)
d) Attached yaraqe (top of slab)
e) Lowest etevatan of mactunery or equipment serviang the bu�ng
(Doscxib� type of equipmont and locadon in Commants)
� Lorvest adjacent (fini.shedj grade next to buiiding (lAG)
9) Highest adlacent (flr�ished) grade next to building (HAG)
h) Loweat adjacerrt grade at IoMreat elevafion of dedc a stai�s, i�clu�ng structurai support
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Chsck d� measuremant used.
� feet ❑ meters
� 1�9ef ❑ meters
� fwt ❑ meters
� faat ❑ rr�ers
� teet ❑ meters
� feot ❑ meters
� (eet ❑ meters
� MAt ❑ mAterb
SECTION D— SURVEYDR, ENGINEER, OR /1RCHTECT CERTIFICATION
This c�tification is to be aigned end 9ealed by a land wrveyor, engineer. or architect authorized by iaw to certify elov�ion
inMrtnaUon. I c�t!/y that the /n1o►rnatfor► ort tN/a CeRiRcate �qor�ser#s my best e1►a►ts to irMerp�t N►e data avaftable.
I unde►sra.rd aiar arry felse sraremer►r may be punisha6+e by �ine a ir►�orisor►merrrt ur►de.18 u.S. cooe. seaeor► tvot. :
me s �
� Check here if oommei�ts are p►ovided on b�lc of form. Were ladtude and lo�gihide in SecUon A provided by a�
p cr,sck nere if attacNments. �Icensed land sunreYor? p ves � No �
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Certifiers N�na ERIC J. HENDRA, P.E.
Title PRESIDENT
Addrecs 5028
Signature _ ;
License Nurr�ber FL48883
Company N�ne HENDRA 8 ASSOCiATES, INC.
Gty TAMPA State FL ZIP Code 33629
Da�e 9/19/13
Te{eptwne 813-419-7878
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FEMA form OSB-0-33 (7/12} See rev�erae side tor oor�nua�ion. Replaoes E� preyiot� edib"ons,
ATION
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IMPORTANT: In these spaces, copy the corresponding inforrination from Section A.
Building Street Address (including Apt., Unit, Suite, ar�d/or Bidg. No.) or P_O_ Route and Box No.
37 WINDWARD ISLAND ROAD
City CLEARWATER
State FL ZIP Code 33767
FOR IFIStJRANCE COMPANY USE
P�olicy NUmber:
Compar�► NAIG Number:
SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments
Item A7. - Subject prop. is a residential 2 story structure with crawispace, with vents. attached garage Garage has no vents. Crawispace access is blocked up
by wood panel with no vents.
Iltem 69. - Subject property lies within Zone AE for the emirety with base flood elevation of 11.0.
Item C2.e. - A/C condenser reside on the north side.
Signature
Date 9/19/13
SECTION E'- BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO a�d 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 Ei-E4, use natural grade, if available. Check the measurement used. In Puerto Rico oniy, enter meters.
E1. Provide elevation information for the following and check the appropriate boxes io 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 enciosure) is N/A_ � feet ❑ meters ❑ above or � below the HAG.
b) Top of bottom floor (including basement, crawispace, 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 f�g. � feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage (top of slab) is N/A. � feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is WA. � 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 communiry's floodplain managemerrt
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 Owner's Authorized Representative's Name
Address
Signature
Comments
City
Date
State ZIP Code
Telephone
❑ �heck here if attachme�ts.
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the communiry's fbodplain managemeM ordinance can compiete 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-G10. In Puerto Rico only, er�ter 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 CommeMs 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-G10) is provided for communiry floodplain management purposes.
G4. Permit Number
N/A
G5. Date Permit Issued
N/A
G6. Date Certificate Of Compliance/Occupancy Issued
N/A
G7. This permit has been issued for: ❑ New Construction ❑ Substantial tmprovement
G8. Elevation of as-built lowest floor (including basement) of the building: N�A. � feet ❑ meters
G9. BFE or (in Zone AO) depth of flooding at the building site: IV(A. � feet ❑ meters
G10. Community's design flood elevation: IVL. � feet ❑ meters
Local Official's Name
Community Name
Signature
Comments
Titie
Telephone
Date
Datum
Datum
Datum
❑ Check here if attachments.
FEMA Form 086-0-33 (7/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 3 guilding Photographs
See Instructions for Item A6.
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.
37 WINDWARD ISLAND ROAD
City CLEARWATER State FL ZIP Code 33767
FOR INSURANCE COMPANY USE
Policy Number:
Company NAIC Number:
If using the Elevation Certificate to obtain NFIP flood insurance, affix at leasi 2 building photographs below according to the instructions
for Item A6. Identify all photographs with date taken; "Front View" and °Rear View"; and, if required, "Right Side View" and "Left Side
View." When applicable, photographs must show the foundation with representative examp�es of the flood openings or vents, as
indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.
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Front and southwest corner of building. View NE
FEMA Form 086-0-33 (7/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 4 guilding Photographs
Continuation Page
IMPORTANT: In these spaces, copy the corresponding information from Section A.
Building Street Address (including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No.
37 WINDWARD ISLAND ROAD
City CLEARWATER State FL ZIP Code 33767
FOR INSURANCE COMPANY USE
Policy Number:
Company NAIC Number:
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs
with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable,
photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.
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Rear and northeast. View SW
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FEMA Form 086-0-33 (7/12) Replaces a�l previous editions.
ELEVATION CERTIFICATE page 5
Building Photographs
Continuation Page
IMPORTANT: In these s ces, co the cor ndin infom�ation from Section A FOR INSURAP
Building Street Address (including Apt., Unii, Suite, andior Bldg. No.) or P.O. Route and Box No. Policy Number
37 WINDWARD ISLAND ROAD
TER State FL ZI
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with:
date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must
show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.
Southwest corner of building view of South side. View NE