146 BAYSIDE DR11,S.D�PARTMENTOFHOMEUiNDSECURITY ELEVATION CERT(FlCATE
Federal EmergenCy Management A�ency �
NatiQne�l Flood�nsurance Program Important; Read the instruciions on pages 1-9,
A1
RANpAL !..
SECTION A - PROPERTY INFORMATION
A2. Build(ng Street Address (inciuding Apt., Untt, Suite, and/or Bldg. No.} or P,O. Route and Box No.
tA6 BAYSID� DRIVE
City CLEARWAT�R State FL ZIP Code 33767
A3, p�operty Des�ription (Lot and Block Numbets, TaX Parcel Number, Legal Descrlption, etc.)
BAYSIDE SUB NO. 3 LOT 11 & RIP RTS BLOCK A, PB 27 PG 74
A4. Buflding Use (e,g„ Residential, Non-Residentlal, Addltion, Accessory, etc.) RESIdENTIAL
A5. Latitudel�ong(tude: Lat. � 7 27 �812 Long. 2 A9 31
A6. Attach at least 2 photographs of the bullding If the Ced�cate is being
A7. Bufiding Diagram Number tA
A8. For a building with a crawlapace or enclosura(s);
a) 5quare footaga of crawispace or enclosure(s) �,�@¢
b) No, of permanettt flood openings in the crawlspace or
encEosure(s) withln 1.0 foot above adJacent grade 0
c) Tq,tal nat area of flood openings In AB.b 0
d) �ngineered flood openings? [� Yes � No
'OMB No.1680-0008
�xpires March 39, 2012
Horizontal Datum: ❑ NAD 1927 � NAq 1983
used to obtain flood Insurance.
A9. For a building with an pRt � garage:
s4 � a) Square footage of attached garage , � sq ft
b) No. of perma�ent flood openings in the attaChed garage
withln 1.0 foot above adjacent grade 0
sq in c) Total net area of flood openings in A9.4 0 sq In
d) �ngineeted flood openings7 1� Yes � No
SECTION �- FLOpD INSURANC£ RATE MAP (FlRM) INFORMATION
61. NFIP Community Name � Community Number 82. County Name B3. State
CITY OF CLEARWATER 125096 PINELLAS FLORIDA
B1U, Indicate the source of the ease Flood �levation (BFE) data or base flood depth entared fn Item B9,
❑ FIS Prafil� � FIRM . p Community petermined [a Other (Describe) _
811. Indicate elevetion datum used for BFE In Item 69: 0 NGVD 1929 � NAVD 1988 0 Other (Dascribe)
512. Is the buflding located in a Goestat Serrier Resources Systam (CBRS} area or OthOrwlse Protected Area (OPA)7 ❑ Yes � No
Designation Date ❑ CBRS �J OPA
S�CTfON C• BUILDING EL�VATION INFORMATION (SURV�Y REQUIRED)
C1. Bullding elevations are based on: G] Construction Drawfngs' ❑ 8ullding Under Canstructlon` � Finished Construction
"A new Elevativn Certfflcate will be reguired when construction of the building is complete. •
C2. Elevations — Zones A1-A30, AE, AH, A(with 8FE), VE, Vt-V30, V(with BFE), AR, AR/A, AWAE, AR/A1-A30, AR/AH, AR/AO. Comp[ete Items C2.a-h
below according to the bullding diagram specifiad in Item A7. Use the seme datum as the BFE.
Benchlnark UOlfzed PIM C.O,�SK AURAL A 1/ertical Datum NAV DATUM 1988 ELEV=11.82
ConverslaNCommants
Chack the measurement used.
a) Top qE bottom floor pnduding basement, crawlspace, or enciosure floor) �.Q5 � feet (] meters (Puerto R�o only)
b) Top ofthe next higher floor ,�0.�7 � feet ❑ meters (PUerto Rico only)
C) Bottom of the lowest horizpntal structural merriber (V �ones only) �.,�,_ [] feet ❑ meters (Puertq Rfco only)
d)e�%,AtMohed garage (top of slab) • ¢.QQ � feet ❑ meters (Puerta Rlco o�ly)
ej i.owest elevaUpn of machinery or equlpment servicing tha building 7.61 � feet ❑ meters (Puerto Rlco only)
(Descrlbe typa of equfpment and location in Comments)
� Lowest adjacent (flnished) gtade next to building (LAG) 5.4 � feet ❑ meters (Puerto Rico only)
g) Hfghest adjacent (flnlshed) grade next to building (HAG) ¢.� � feet ❑ meters (Puerto Rtco oniy)
h) Lowest adjaCent grade at lowcst �levatlon of deck or stairs, including �(g. ❑ feet ❑ metats (Puerto Rlco only)
struCturel Suppart
SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTII=ICATION
This csrt(flcatlon Is to be slgned and sealed by a land surveyor, engineer, or architact authorixed by law to certify elevati�
informatlon. / ce�tify that the informaUon on th/s CeMlficate represents my best efforts to interpref the data ava!!able.
! undarstand thel any false stetement mey be punishable by fine or lmprisonment under 98 U. S. Code, Sect/on i001.
�J Chack here If Comments are provided on back of fo�m. Were fatitude and longitude in Saction A provided by a
Iicensed land surveyor? � Yes ❑ No
Certffie�'s Name LAUREN R. PENiVY License Number #4931
Title IAND SURVEYOR Company Name L.f2. PENNY & ASSOCIATES, INC.
Address i0730 102 AVE N City SEMINOLE State FL ZIP Code 33778
S(gnature � � Date Telephone 727-398-436Q
�ir,.,r�- �-!/-.2G/u
FEMA Form 81-31, Mar 09
See reverse side for continuation.
�- �. �'�-�
�yy3�
PLAGE
S�AL
HERE
—//-,2utu
Replaces all previous editions
tMPORTAN7: In these spaces, copy iF:e corresponding informatlon from Section A.
146
City
Apt., Unit, Suite, andior Bidg. No.) or P.O. Route and Box Np,
State �L ZIP Code 33767
SECTION D- SURVEYOR, ENGIy.�ER, OR AF2CHITEGT CERTIFICATIqN (CONTINUED)
Copy both sides of thls Elevatlon Certjficate (or (1) communfty offlclal, (2) Insurance agenUcompany, and (3} bullding owner.
Commenis �01IVEST ELEVATED� MACHINERY IS AN ELECTRICAL OUTLET �
i�1.rrM %— //— �G�a
Signafure � Date
[Jf Check here ?; ettachrnents
SECTION E- BUILbING EL�VATION INFORMATION (SURVEY NOT REQUIREp) FOR ZONE AO AND ZONE A(WITHOUT BFS)
Far Zones AO and A(without BFE), complete Items E1-E5. ]f the Certificate Es intended to support a LOMA or LOMR-P request, complefe Sectfons A,
and C. For Items E1-E4, use rtaturat grade, if avallab�e. Check the measurement used. tn Puarto Rico onty, enter meters.
E1
E2.
E3.
E4.
Pravlde elevatfon information for the foilowing and cheak the appropriate boxes to shoW whether tha elevation is above or below the highest adjacent
grade (HAG) and the lowe$t adJace�t grade (I-AG). . .
a) Top.of bottom floor (including basement, crawispace, or enclosure) is ❑ feet Q meters ❑ above or [7 below the HAG.
b} Top of bottom floor (including basement, crawispace, or enclosure) fs ❑ feet ❑ meters � above or ❑ befow the I.AG.
For Bullding D(agrams 8-9 with permanent flood oponings provided in Sectlon A items 8 and/or 9(see ages e-e of Instructions), the next higher flool'
(etevatlon C2.b In the dlagrams) of the buflding Is [] feet �J meters � above or � below the HAG.
Attached garage (top of siab) is ❑ feet � meters ❑ above or ❑ below lhe HAG,
Top of platform of machinery andlor equipment servicing the bullding is ❑ feet ❑ meters p above or � below the HAG.
E5. Zone AO oniy: (f no flood depth number Is available, is the top of the bottom floor elevated In accordance with the community's floodplain management
ordinance7 ❑ Yes ❑ No Q Unknown, The local official musl cedify this informetion in Section G,
' SECTION F- PROPERTY bWNER (OR OWNER'S REPRES�NTATIVE) �ERTIFICATION
The property owner or owner's authorized represe�tative who completes Sectlons A, B, and E for Zone A(without a FEMA-issued or community-fssued BFE)
or Zone AO must sign here. The sfatements In Sections A, B, and E arg correct fo the besf of my knowledge.
Property Owne�'s or Ow�er's Authorized Representative's Name
Address
Signature
Comments
fhe local offlcl�t who !s authorizad
�nd G of this Ele�ation Certificata.
City
Date
SECTION G - COMAAUNITY INFORMATION
law or ordfnanca to adminlster the community's floodplain m
implete the applicable Item(s) and sign below. Check the m�
State ZIP Code
Telephone
ordinance can complete Sections A, B,
used in Items G8 and G9.
31. ❑ The infortnatlon in Sectfon C was taken from other doc�mentatlon that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authodzed by law to certify elevation information. (Indlcate the source and date of tha elevation data ln the Comments araa below.)
32. ❑ A cbmmunity official compieted Section E fot a building located in Zone A(wffhout a F�YA-issuact or cornmunity-lssued sFE) or zone AO.
a3. ❑ The following Infotmation (Items G4-G9) is provided for communify floodplain managemetlt purposes.
G4. Permtt Number G5. Date Permit issued G6. Date Certificate Of CompliancelOccupancy issued
37. 7hls permit has been Issuad for; ❑ New Construction � Substantial Improvement
3g. E(evadon of as-bu3ft lowest floor (including basement) of the building; ❑ feet ❑ meters (PR) Datum
39. BFE or (in Zone AO) depth of flooding at the buliding site: ❑ feet ❑ maters (PR) Datum
390. Community's design flood elevatlon . ❑ faet ❑ meters (PR) Datum
Local Qfficial's Name
Tltle
Community Name Teiephone �
Signature
Comments
FEMA Form 81-31, Mar 09
_p Chepk her@ i( attachm�nts
Replaces al! previous ed(tions