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618 SNUG ISLANDC U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Man�emeM Agency National Flood Insurance P�ogram ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORlMATION A2. Buiiding Street Address (inch�ding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route a� Box No. 618 Snug island City Ciearwater State FL ZIP Code 33767 OMB No. 166a000� Expires March 31, 2012 �anY ilse: A3. Property Descxiption (Lot and Bbdc Numbers, Tan Parcei Number, Legai Description, etc.) Parcel ID#: 05-29-i 5-43456-077 -0040 A4. Building Use (e.g., Residerrtial, Non-Residentiai, Addi6on, Accessory, etc.) Residentiai A5. Latitude/Longitude: Lat 27.987114 Long. -82.817566 Horizontal Datum: ❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs af the buikling "rf the Certificate is being used to obtain flood ir�surance. A7. Building Diagram Number 1 B A8. For a bullding with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square foot�e of crawisp� or encbsure(s) N/A sq ft a) Square footage of arttacFied garage �4 sq ft b) hlo. of Permanent flood o�enings in the crawispace or b) No. of permanent flood openings in the attached garaye enclosure(sj within 1.0 foot above adjacent grade 0 within 1.0 foot above adj�ent grade Q cj Total net area of flood openings in AB.b 0 sq in c) Total net area of flood openings in A9.b Q sq in d) Engineered flood openings? ❑ Yes � No dj Engineered flopd openir�s? ❑ Yes � No SECTION B- FLOOD INSURANCE RATE MAP (FlRI{I� INFORMATION Rt AICID l�............. _. _.. ._. .. .,,,.........�.�� ..a��c a �vnm�u�niy rvUlilDEf 82. County Name gg City of Clearwater 125096 Pinellas FL 64. Map/panel Number B5. Suffix B6. FIRM Index 67. FIRM Panel B8. Flood 12103C0102 G Date Effective/Revised Date Zone(s) 8-18-09 9-3-03 AE B10. Indicate the source of the Base Flood Eleyation (BFE) data or base fload depth entered in Item 89. ❑ F1S Profile � FIRM ❑ Community Determiried ❑ pther �pescribe� B11 • Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NqVp � ggg � ptyer �pescribe� _ 812. Is the bu�ding located in a Coastal Barrier Resourr.es Sysiem (CBRS) area a� Otherwise Protected Area (aPA)? Designabon Date WA ❑ CBRS ❑ OPA ao, use � flood de�n� 11' ❑ Yes � Na SECTION C- BUiLDING ELEVATION INFORMATION (SURVEY REQUIRED) Ci. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' � Finished Construction 'A new Elevation Certificate wip be reyuired when constn�ction of the building is complete. C2. Elevations — Zones A1-A30, AE, AH, A(with BFE), VE, V1-V30, V(with BFE), AR, AR/A, ARJAE, AR/Ai-A30, AR/AH, AR/AO. Complete (tems C2.a-h below accordi� to tt� building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized �ITY OF CLRWT 1-03 5 Ver6cal Datum ELEV= 6.412' (N.A.V.D 1 ConversioNComments WA a) Top of twttom floor (inGuding basement, crawlspace, or er►closure floor) 7.�,4 b) Top of the next higher floor N.A c) Bottom of the lovve,st horizontal structural member (V Zones on1Y) LV.A dj Attached garage (top of slab) 7.25 e? Lowest elevation of machinery or equipment servicing the building 7.91 (�escxibe type of equipment and tocation in Comme►ris) f) Lowest adjaceni (finished) grdde nexc to building (LAG) 7,i g) Highest adjacent (finished) grade next to builcting (HAG) 7.5 h} Lowest adjacent grade at lowest elevation of dedc or stairs, inGuding IV.A ctn�rfi�r�l c��n.....� Check U�e measurement used. � feet ❑ meters (Puerto Rico only) � feet ❑ meters (Puerto Rico only) � feei ❑ meters (Puerto Rico only) � feet ❑ meters (Puerto Rico only) � feet ❑ meters (Pue�to Rico only) � feet ❑ metsrs (Puerto Rico only) � feet ❑ meters (pusrto Rico onlq) � teet ❑ meters (Puerto Rico only) sECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFlCATION This certificatio� fs to be signed and sealed by a land surveyor, engineer, or arch7tect authorized by law to certiiy elevation iMortnation. 1 cetify that the information on this Certiticate represents my best efforts to interpret the data available. 1 undeistand that any false statemem rrtay be punishable by firre or imprisonment under 18 U.S. Code, Sectinn >Op1. � Check here 'rf comments are provided on b�lc ot form. Were latitude and lorgitude in Section A provided by a licer�sed land surveyor? � Yes ❑ No Certifier'S Name PhiNp C. Stodc License Number RLS#3035 Title President Company Name Targei Land Surveying, Inc. Address 516 Lakeside Place City Largo State FL ZIP Code 33771 Signature Dffie 12-4-12 Telephone (727j 784p573 FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions : In these spaces, copy the corresponding infonnation from Section q, �,�r 618 Snug island City Clearwater State FL Z)P Code 33767 or P.O. Route and Box No. '....., ..,.... ,.......,�a SECTION D- SURYEYOR, ENGINEER, OR ARCtiiTECT CER77FICATION (CONTINUED) Copy both sides of this Elevalion Cer6ficate for (i) community officiaf, (2) insurance agent/company, and (3) buiiding owner. Commerrts Job # 121126.p8 C.2.e) = A/C Unit According to the Pinellas County Property Appraiser, this structure was buiit in 1969. At that fime, FEMA Hood maps did not ebst. Signature Date 12-4-12 Check t�ere if attachments SECTfON E- BUILDING ELEVA710N INFORNATION (SURVEY NOT RE(�UIRED) FOR ZONE AO AND ZONE A(WRHOUT BFE) For Zones AO and A(without 8FE), compiete Rems Ei-E5. If the Certificate is intended to support a LOMA or LOMR-F request, comptete Sections A, B, and C. For ftems Ei-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide eievatan informatio� for the foNowing and check the appropriate boxes to shoar whether the elevation is above or bebw the Frighast adjacent grade (HAG) and the lowest adj�ent grade (LAG). a) Top of bottom floor (inciuding basemerrt, crawlspace, or endosure) is ❑ feet ❑ meters ❑ above or ❑ bebw the HAG. b) Top of bottom floor (including besemerit, crawfspace, or endosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Buiiding Diagrams 6-9 with permanar►t flood openings provided in Sectian A Items 8 andlor 9(see ges &9 of Instructions), ihe next h�her floor (elevation C2.b in the diagrams) of the building is . ❑ feet ❑ meters ❑ above ar�below the HAG. E3. Att�hed 9arage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/ar equipment servicing the building is ❑ feet ❑ meters ❑ above or � below the HqG. E5. Zone AO only: ff no fiooci depth number is available, is tfie top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknowm. The tocal official must certify this irrforma6on in Sec6on G. SECTION F- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authori2ed representative who completes Sections A, B, and E for Zone A(without a FEMA-issued or communiry-issued BFE) or Zone AO must sign here. The statemenis in Sectio� A, B, and E are correct to ihe besf of my knowtedge. ProPerty Owne�'s or Owner's Authorized Representative's Narne Address . City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments SECTION G - COMMUNfTY INFORMATION (OPTIONAL) The �� o�a� �h° �S authorized bY �aw a� ardinance 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. Chedc the measwement used in Items G8 and G9. G1. ❑ The inforrnation in Section C was taken from other documerrtation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (I�icate the sa�rce and date of tF� elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A(widmut a FEMA-issued or community-issued BFE) or Zone AO. G3. ❑ The fotlowing information (Items G4-G9) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy �ssued G7. This permit has been issued for: ❑ New Construction ❑ Substa�fial Improvement G8. Elevation of as-built lowest floor (including basement) ot the building: ❑ feet ❑ meters (PR) Datum G9. BFE or (in Zone AO) depth of fboding at the building si[e: ❑ feet ❑ meters (PR) Datum G10. Communiry's design ftood elevation ❑ feet ❑ meters (PR) Datum �ocal Official's Name Community Name Signature Comments Trtle Tetephone Date Check here if attachments FEMA Form 8i-31, Mar 09 Replaces ap previous editions �sunamg Sireet Address (inciuding Apt., Unit, 618 Snug Isiand City Ciearwater State Fi ZIP Code 33767 Building Photographs See Instructions for Item A6. For Insurance Company Use: and/or Bldg. No.) or P.O. Route and Box No. Po�icv Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two buiiding 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.° If submitting more photographs than will fit on this page, use the Continuation Page on the reverse. "Front View" — Pictures Taken 11-�R-� � � K �� , _ . ,... . : . . ,..�. , '- �. , , _�_.._,_ ._..._ _ ... "Rear View' — Pictures Taken 1 1-28-12 � _ ffi . _ '� � ��'�: �. ��-:tt �-._ �' �� _ -, __ �,�-�-.. `"`",�,,,, � �.��. - _ �b. t �,- f ��. :. � Building Photographs Continuation Page ---.__..._.__.-,-----_.__ ._�__,._____ Building Street Address {including Apt_, Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No 6i8 Snug island c.ity Ciearwater 5tate FL ZiP Code 33767 �or tnsurance Company Use: Poliey Number if submitting mare photographs than will fit on the preceding page, affix the additional photographs below. Identify alI photagraphs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." "Left Side View" - Pictures Taken 11-28-12 � �_:;,:� � - � � ::,, : ,�<s� _ �� . � �� _ ,w.�.� � � �- � � � � .��, �� Y� ��•�. ,�. � . �� _ . � } . cae view — rictures I aken 1 1-2$-12 _� .,.,� �._ __ .. �; - = �� ,'�'� ; �..-�s � � ��.� �: . ��:. � � �� r. ��.��r.� �� .� � � �� ,�� - �� .� �`�� ::� � ' d �.u�'