1430 GULF BLVD. � . �. . .. .... . ..... ... .,. ._ .... .. ., .
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° • - � �� - � - � FEDERAL EMEaGENCY MANA'�GEINENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
rtant: Read the instructions on paqes 1- 7.
SECTION A- PROPERTY OWNER INFORMATION
Building Owner's Name
Sand Key South Beach Association I! (Order No. 2005-219j
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.
1430 Gulf Boulevard
f . ��.� � . `* . . .,. , .. .. i l� < .
O.M.B. No. 3067-0077
Expires December 31, 2005
CITY STATE ZIP CODE
Clearwater FL
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
nee Company tJse:
umber
iV:NAIC Ncimber
BUILDING USE (e.g., Residential, No�-residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
Residential
LATITUDE/LONG�TUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):
( ##° - ##' - ##.##" or ##.#####°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other:
SECTION B- FLOOD INSURANCE RATE MAP (FlRM) INFORMATION
B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER 62. COUNTY NAME B3. STATE
Clearvvater 125096 Pinellas Florida
84. MAP AND PANEL 87. FIRM PANEL B9. BASE FLOOD ELEVATION(S)
NUMBER 85. SUFFIX 86. FIRM INDEX DATE EFFECTIVFJREVISED DATE 68. FLOOD ZONE(S) (Zone A0, use depth of floo�ng)
12103C0104 G 9/.i�Ll3 9!3/03 VE 14.0
610. IncScate the sou�ce of the Base Flood Elevation (BF� data or base flood depth entered in 89.
� FIS P�ofile � FIRM ❑ Communiiy Determined ❑ Ofher (Desaibe):
B11: Ind�cate the elevation dahm used for t�e BFE in B9: � NGVD 1929 � NAVD 1988 ❑ Othe� (Oesaibe):
B12. Is the buld�ng located in a Coastal Barrier R� System (CBRS) area a Otherwise Prote�ted Area (OPA)? ❑ Yes � No Designa6on Date_
SEC710N C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Buikling elevations are based on: 0 Construction Drawings* ❑ Buikling Under Construction' � Fnished Construction
'A �ew Eleva6on Certificate u,iN be required when construction of the building is canpiete.
C2. Buikiing Diagram Number 6(Select the building ciagram most similar to ihe building for which this cE�ttificate is being canpleted - see pages 6 and 7. If no c§agam accurately
re�xesenis the building, provide a ske�h or photogaph.)
C3. Elevations - Zones A1-A30, AE, AH, A(wiih BF�, VE, V1-V30, V(witit BFE), AR, AR/A, AR/AE, AWA1,430, AR/AH, ARlAO
Complete Items C3.-a-i below according to the budding ciagram specfied in Item C2. State ihe datr�m used. If the dab�m is cifferent fran the dah�m used for tt�e BFE in
Section B, cornreit tt�e dah�m to that used for the BFE. Shav field measurements and dahm corn�ersion calculation. Use the space prwided or the Carmen4s area of
Section D or Section G, as appropriate, to docunent the dah�m conversion.
Datum ConversionlCanrr�enls � `:
Elevation reference mark used nla Dces the elevation referer�mark used appear on the FIRM? ❑ Yes � No —� ��— �� �
❑ a) Top of bottan floor (nclucing basement or enclosure) 15. 4 it(m) m �� / ��
❑ b) Top of next higher floor 24 . 0 ft.(m) � �— ,` � j�
❑ c) Bottan of bwest hor¢ontal structural member (Vzones onfy) 13 . 3 ft(m) o o ��`� ��� �
❑� Attached garage (h�p of slab) n/a. _ft.(m) E � �'
❑ e) Low�est elevation of machinery andlor equipment W"
servicing the building (Descnbe in a Canmen� area) 6. 4 ft.(m) �� .�- %; - a ��
O� Lowest adjacent (finished) �ade (LAG) 4. 7 ft.(m) z� ',�1��'���
❑ g) Highest ac�acent (6nishec� gade (HAG) 5. 3 ft.(m) ��
d
❑ h) No. of permanent openings (flood venls) within 1 ft. abuve ac�acent gade 0 �
❑ i) Total area of all permanent openings (flood ven�) in C3.h n!a sq. in. (sq. an)
SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERIIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify eleva6on information.
I certify that the information in Sections A. B, and C on this certificate represents my best efforts to interpret the data available.
1 understand that any false statemenf may be punishable by Bne or imprisonmenf under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME C. Fred Deuel LICENSE NUMBER 827
TITLEProfessional Surveyor and Mapper COMPANY NAME C. Fred Deuel & ASSOdates, Inc.
ADDRESS
1620 FirstAvenue North
SIGNATURE j-�=�
/" .
c
/ /, .�
CITY
St Petersburg
DATE
5P9/05
STATE ZIP CODE
FL 33713
TELEPHONE
727�22�151
IMPORTANT: In these
BUIIDING STREET ADDRES
1430 Gulf Boutevard
CITY
Ciearwaler
t�e corresponding information from Section A.
nit, Suite: andla Bldj. No.) OR P O. ROl1TE AND BOX (V0.
STATE
FL
ZIP CODE
SECTION D- SURVEYOR, ENGINEER, ORARCHITECT CERTIFICATION(CONTINUED)
Copy both sides of this ElevaUon Ceitificate for (1) carmun�/ ofidal, (2) insutance agenticanparry, and (3) buikiing owr�er.
COMMEMS
BASIS OF BENCHMARK:
Designation: 15-90-DA-14
5.91
irisurance can�rylke
f?olicy {Vumber
NAVD 1988 DATUM ❑ Check here rf attachments
SEC110N E- BUILDING ELEVAl10N INFORMATiON (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(1MTHOUT BFE)
Fa Zone AO and Zone A(without BF�, canplete Items E1 Ihrough E4. If the Elevation Ce�Uficate is int�nded for use as supporting infamation for a LOMA or LOMR-F,
Section C must be completed.
Et. Builcing Diagam Nunber _(Select ihe builcing diagram mast similar to the building fa� this certificate is being carpleted -see pages 6 and 7. If no c3agam aocuratefy
reFxesents the building, pravide a sketch or photogaph.) ,
E2. The b�p of the botbm floor (nclucing basement or endosure) of the buitcing is _ ft(m) _in.(an) ❑ above or ❑ below (check one) the highest adjacent gade. (lJse
natural gade,'rfavailable).
E3. For Building Diagams 6-8 with openings (see page 7), the next higher floor or elevated floa (elevation b) of the bud�ng s_ R(m) _in.(an) above the highest adpcent
grade. Canplete items C3.h and C3.i on front of fam.
E4. The h�p of the platform of machinery ancYor equipment servicing the building is _ ft(m) _in.(an) ❑ above or ❑ bdow (che�lc one) the highest adjacent gade. (Use
natural gade, 'rf available).
E5. Fa Zone AO onfy: If no flood depth nunber s available, s the top of the bottan floor elevated in accordance with the camiuni�'s floo�lain management a��nce?
❑ Yes ❑ No ❑ Unknown. The la�l ofiaal mustcerti(y this infamation in Section G.
SECTION F- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFlCATION
The properiy owner or owner's aufha¢ed reExesenhative wtm canpletes Sections A, B, C Qtr�rs C3.h and C3. i only), and E fa Zone A(without a FEMA-issued a canmu�ly-
issued BF� or Zone AO must sign he�e. The statemerds in Secfions A, 8, C, and E are co�d to fhe besf of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STA1E ZIP CODE
SIGNATURE DATE TELEPHONE
COMMEMS
❑ Check here'rfaltacfunents
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local ��ficial who � author¢ec+ by law a adinance to adninister the communily's flooc�lain management ordinance can canplete Sections A, B, C(or E), and G of tlns Ele�ration
Certificate. Can�lete the applicable iter.�(s) and sign below.
G1. � The infa'mation in Secton C �aras h�ken fran other docunentation that has been signed and embossed by a licensed suNey�a, engineer, or architect who s autlia¢ed try state
or loca! law to cer�ty e',eva6on infamaUon. (Indicate the sour�e and date of ihe el�vafion data in the Canmen� ar� below.)
G2. [] A canmunity official r,ompleted Section E for a buiiding located in Zone A(without a FEMA=SSUed or commurufy�sued BF� a Zone A0.
G3. 0 The folowing infamation (Items G4-G9) is provided fa corrmuniiy floodplain management purposes.
G4 PERtvIIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUFD
G7. This permit has been issued fa: 0 New Cor�struction U Substantial ImExwement
G8. Elevation of as�uilt lov�est floor (induding basement) of the builcing is:
G9. BFE or (n Zone AO) depfh of floaing at the builcing site is:
LOCAL OFFICIAL'S NAME
COMMUNIiY NAME
SIGNATURE
COMMENTS
_ —n�m)
— — n(m)
TITLF
TEI�PHONE
DATE
Dahm:
Dahm:
--
, � A ,: � ;-, �' ; : , ;.; .,s : � FEDERAL �MER�ENCY M/�,NAGEMENT AG�ENCY O.M.B. No. 3067-0077
,-„ -'; ;;. NATIONAL FL�OD INSURA(VCE PROGRAM Expires December�31, 2005
ELEVATION CERTIFICATE
Read the instructions on paqes 1- 7.
SECTION A- PROPERTY OWNER INFORMATION
Buiiding Owner's Name
Sand Key South Beach Association II (Order No. 2005-219-2)
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.
1430 Gulf Boulevard
For Insurance Company Use:
Policy Number
Company NAIC Number
���J�. STATE ZIP CODE
Clearvvater FL �
PROPERIY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Generator Building
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
Accessory
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):
( ##° - ##' - ##.#t�" or ##.�°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other.
SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
61. NFIP COMMUNIlY NAME 8 COMMUNITY
Cleanvater 125096
�AP AND PANEL
NUMBER B5. SUFFIX B6. FIRM INDEX DATE
12103C0104 G 9I3/03
62. CWNTY
P'uiellas
87. FIRM PANEL
EFFECTIVEIREVISED DATE
9/3103
83.STATE
Fbrida
69. BASE FLOOD ELEVATION(:
B8. FLOOD ZONE(S) (Zone A0, use depth of flooding)
VE 14.0
B10. Ind'icate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
� FIS Profile � FIRM ❑ Community Determined ❑ Ofher (Describe):
611. Indicate the elevation datum used fa the BFE in B9: � NGVD 1929 � NAVD 1988 ❑ Other (Describe): _
612 Is the building located in a Coastal Barrier Resou�ces System (CBRS) area a Otlierwise Protected Area (OPA)? ❑ Yes � No Designation Date_
SECTION C- BUILDING ELEVATION INFORMATION (Sl1RVEY REQUIRED)
C1. Building elevations are based on: 0 Construction Drawings` ❑ Building Under Construction' � Finished Construction
*A new Elevation Certificate will be required when conshuction of the building is complete.
C2. BuikJing Diagram Number 1(Select the building diagram most similar to the building for which this certficate is being canpleted - see pages 6 and 7. If no diagram accurately
represents the buikling, provide a sketch or photograph.)
C3. Elevations — Zones A1-A30, AE, AH, A(w�h BFE), VE, V1-V30, V(with BFE), AR, AR1A, AR/AE, ARIA1-A30, AWAH, ARIAO
Complete Items C3: a� below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for tt�e BFE in
Seciion B, cornert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of
Section D or Section G, as appropriate, to document the datum conversion.
Datum Conversion/Comments _
Elevation reference mark used nla Does the elevation reference mark used appear on the FIRM? ❑ Yes � No
o a) Top of bottom floor (including basement ro e iclosure) 4. 3 ft.(m) � ��
o b) Top of ne� higher floor nla ._ft.(m) �'
d�
o c) Bottom of lowest horizontal structural member (V zones only) nla ._ft.(m) o 0
o d) Attached garage (top of slab) nla. _ft.(m) E � 1�L ,� '
w�
o e) Lowest elevation of machinery andlor equipment
� �'
servicing the buiiding (Describe in a Comments area) 5. 3 ft(m) E R
o� Lowest adjacent (finished) grade (LAG) 5. 8 ft.(m) �� ��� ��. f
o g) Highest adjacent (finished) grade (HAG) 6. 2 ft.(m) �
o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 0 �
o i) Total area of all permanent openings (flood vents) in C3.h nla sq. in. (sq. cm)
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.
! certi(y that the information in Sections A, B, and C on this certificate represents my best efforfs to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U S. Code Section 1001.
CERTIFIER'S NAME C. Fred Deuel LICENSE NUMBER 827
TITLEProfessional Surveyor and Mapper
r
ADDRESS
1620 First Avenue North
SIGNATURE /'=
COMPANY NAME C. Fred Deuel & Associates, Inc.
CITY
St. Petersburg
DATE
715105
STATE ZIP C(
FL 33713
TELEPHONE
727-822-4151
j _ IMROR�ANT: :in thes�
BUI�DING STREET ADDI
1430 Gulf Boulevard
CITY
Cleanvater
the
Apt, Uni� Suite, and/or Bidg
nfomiatian from Section A.
OR P.O. ROUTE AND BOX N0.
STATE
FL
For fnsuratice CompanyUse: . , , .
Policy Number
ZIP CODE � Company NAIC Number
SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certficate for (1) community officiai, (2) insurance agent/company, and (3) building owner.
COMMENTS
BASIS OF BENCHMARK:
Designation: 15-90-DA-14
Elevation: 5.91
NAVD 1988 DATUM ❑ Check here rf attachments
SECTION E- BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zone AO and Zone A(without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as suppo�ing information for a LOMA or LOMR-F,
Section C must be completed.
E1. Building Diagram Number _(Select the building diagram most similar to the buiiding for which this cerGficate is being completed - see pages 6 and 7. if no diagram accurately
represents the building, provide a sketch or photograph.)
E2. Tne fop o1 me bottom noa (inciuding nasement or enciosurej of fhe buiiding is _ it.(m) _in.(cmj L► above or ❑ beiow (checic one) ihe highest adjacent grade. (Use
natural grade, 'rf available).
E3. Fa BuikJing Diagrams 6-8 wifh openings (see page 7), the next higher floor or elevated floor (elevation b) of the buiiding is _ ft.(m) _in.(cm) above the highest adjacent
grade. Complete items C3.h and C3.i on front of form.
E4. The top of the pla�orm of machinery andlor equipment servicing the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use
natural grade,'rf available).
E5. For Zone AO only: If no 800d depth number is available, is the top of the bottom floor elevated in acxordance 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 REPRESENTATNE) CERTIFICATION
The property owner or owne�'s authorized representative who completes Sections A, B, C(Items C3.h and C3.i only), and E for Zone A(without a FEMA-issued or community-
issued BFE) or Zone AO must sign here. The statemerrts in Sections A, B, C, and E are correcc;t to the best of my knowledge.
PROPERTY OWNER'S OR
ADDRESS
COMMENTS
AUTHORIZED REPRESENTATIVE'S NAME
CITY
DATE
STATE ZIP CODE
TELEPHONE
-�"Check here 'rf attachments
SECTION G • CQMMUNITY INFORMATION (OPTIONAL)
The local official who is authaized 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.
G1. � The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state
or locaf law to certrfy elevation infoRnation. (Indicate the source and date of the elevation data in the Comments area below.)
G2. � A community official completed Section E for a buiiding located in Zone A(without a FEMA-issued or community-issued BFE) or Zone A0.
G3. � The following information (Items G4-G9) is provided for community floodplain management purposes.
G4. PERMIT NUMBER
G5. DATE
G7. This permit has been issued for. � New Construction ❑ Substantial Improvemenf
G8. Elevation of as-built lowest floor (including basement) of the building is:
G9. BFE or (in Zone AO) depth of flooding at the building site is:
LOCAL OFFICIAL'S NAME
COMMUNITY NAME
SIGNATURE
COMMENTS
G6. DATE CERTIFICATE OF
_ _ft.(m)
_ _ft.(m)
TITLE
TELEPHONE
DATE
Datum:
Datum: _
Check here if attachments