3147 JOHNS PKWYU.S. DEFARTMENT OF HOMELAND SECURITY
Federal Einergency Management Agency
National Flood insurance Program
A1. Building Owner's Name STEVEN
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-9.
SECTION A - PROPERTY INFORM�":TION
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
3147 JOHNS PARKWAY
City CLEARWATER State t=L ZIP Code 33759
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
16 29 16 44172 000 0100
OMB No. 1660-0008
Expires March 31, 2012
For Insurance Company Use:
Policy Number
Company NAIC Number
A4. Building Use (e.g., Residential, t�on-Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. 27.9641 Long. 82.7066 Horizontal Datum: � NAD 1927 ❑ NAD 1983
A6. Attach at least 2 photographs of the building if the CeRificate 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 crawispace or enclosure(s) 0 sq ft a) Square footage of attached garage 0 sq ft
b) No. of permanent flood openings in the crawispace or b) No. of permanent flood openings in the attached garage
enclosure(s) within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b 0 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 B2. County Name B3. State
CITY OF CLEARWATER 125096 PINELLAS FL
64. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel 68. Flood 69. Base Flood Elevation(s) (Zone
12103C0129 G Date Effective/Revised Date Zone(s) AO, use base flood depth)
5/17/05 9/3/03 AE 9
810. Indicate tne source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69.
❑ FIS Profile � FIRM ❑ Community Determined ❑ Other (Describe) _
611. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 ❑ Other (Describe)
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise 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, ARlA1-A30, AR/AH, AR/AO. Complete Items C2.a-h
below according to the building diagram specified in Item A7. Use the same datum as the BFE.
Benchmark Utilized PCEVertical Datum 1988 �
Conversion/Comments
Check the measurement used.
a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 9.42 � feet ❑ meters (Puerto Rico only) � �'
b) Top of the next higher floor 18.72 � feet ❑ meters (Puerto Rico only) � J
c) Bottom of the lowest horizontal structural member (V Zones only) N.A � feet ❑ meters (Puerto Rico only) �
d) Attached garage (top of slab) 9.42 � feet ❑ meters (Puerto Rico only) (`� �
e) Lowest elevation of machinery or equipment servicing the building 11.89 � feet ❑ meters (Puerto Rico only) ��-="
(Describe type of equipment and location in Comments) \ �
� Lowest adjacent (finished) grade next to building (LAG) 9.3 � feet ❑ meters (Puerto Rico only) ��,,, j
g) Highest adjacent (finished) grade next to building (HAG) 9.4 � feet ❑ meters (Puerto Rico only) /� (
h) Lowest adjacent grade at lowest elevation of deck or stairs, including N.A � 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. 1 certify that the information on this Cerfificate represents my besf e(forts to interpret the data available.
! understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. �'�., � q�9
� Check here if comments are provided on back of form. Wer e l a t i t u d e a n d l o n g i t u d e i n S e c t i o n A p r o v i d e d b}� a �/j�� ��! �
licensed land sunreyor? � Yes ❑ No $ ,,',
�����:�f��s
Certifier's Name GINO FURLANO License Number 5044 �' ✓
Title VICE PRESIDENT Company Name ALL COUNTY SURVEYORS
PARK BLVD #108
Signature
FF_Mf# FonFn 8?-�1. Mar 09
City LAUDERHILL
Telephone 954-
r � �� �
See reverse side for continuation. Replaces all previous editions
IMPORTANT: in these spaces, copy the corres�onding information from Section A. � For insurance Company �Jse:
� Building Street Address (including Apt., Unit, Suite, and/or 31dg. No.) or P.O. Route and Box No. Policy Number
3147 JOHNS PARKWAY
City CLEARWATERState FL ZIP Code 33759 Company NAIC 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 PARTIAL TOPOGRAPHIC SURVEY
JOB # 09-33400 BM# PCE 'AG0450' ELEV = 5.87 C2E =A/C
Signature Date 12/9/09
// f / ❑ Check here if attachments
NG ELEVATION INFORMATION (SURVEY NOT REQUtRED) FOR ZONE AO AND ZONE A(WITHOUT B
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, 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 ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage (top of slab) is . ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platfonn of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or 0 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 o�cial 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 sfatements in Sections A, 8, and E are correcf to the best of my knowiedge.
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 o�cial 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 belqw. 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 communiiy floodplain management purposes.
G4. Permit 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 dR�•iyn fiood elevation ❑ feet ❑ meters (PR) Datum
Local Official's Name
Community Name
Signature
Commenta
Title
Telephone
Date
Check here if attachments
, ,. . „�,.-. � ,,, �....__., �, �, � �.,_ �� _ _ , . , . .. , , . : , .. . Replaces atl previous editions, ,
0•119062 -
. . .. • :::"��i-uv�Y�e�r�i: ��l�as�WLa✓:
NATIONAL FLOODJNSURANCE PROGRAM
ELEVATION CERTIFICATE
Read the instructions on pages 1- 7.
SECTION A• PROPERTY OWNER INFORMATION
BUILDING OWNER'S NAME
Steven J. Sciandra
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.
3147 Johns Parkway
u. iVl. t�: ivo. :sU�i7=U077 . . . _
Expires December 31, 200E
For Insurance Company Use:
Policv Number
Gompany
CITY STATE ZIP CODE
Clearwater FL 33759
PROPERTY DESCRIPTION (Lot and Blodc Numbers, Tax Parcel Number, Legal Description, etc.) -
Lot 10, JOHNS PARKWAY, Plat Book 29, Page 41
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
Residential
IATITUDElLONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):
( ##° - ##' - ##.#!k" or ##.�� � NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other.
SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP COMMUNITY NAME & COMMl1NffY NUMBER I B2. COUNTY NAME -
125096CityofCieaiwa�r Pinellas �ND��,�D�,�..� C,
FL
B4. MAP AND PANEL B7. FIRM PANEL 69. BASE FLOOD ELEVATION(S)
NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTIVEIftEVISED DATE 88. FLOOD ZONE(S) (Zone A0, use depih of flooding)
►2s o9l.pp18 - D g.($.012 8/19/1991 A10 10 _
a �u. ir��w�e u�e source or me case riooa tievaaon ��srt� aa[a or oase noon qeptn entered in tiy.
❑ FIS Profile ❑K FIRM ❑ Canmuni� Determined ❑ Otl�er (Desaibe): _
B11. Indicate the elevation datum used for the BFE in 69: ❑x NGVD 1929 ❑ NAVD 1988 ❑ Other (Desaibe): _
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Olheruuise Protec�d Area (OPA)? ❑ Yes x� No ' naGon Date �1��'►�
SECTION C• BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construc�on Dra�vings' ❑ Building Under Constnxtion* � Finished Construc6a�
*A new Elevation Certficate will be required when consUuction of the building is oomplete.
C2. Building Diagram Number S(Select the building diagram most simila� to fhe building fa which this certificate is being completed - see pages 6 and 7. If no diagram - /�
accurately repr�ts the building, provide a sketch a photograph.)
C3. Elevatia�s - Zones A1,A30, AE, AH, A(with BFE), VE, V1-V30, V(with BFE), AR, AR/A, AWAE, AWA1 A30, AWAH, AWAO ..�
Complete Items C3.-a-i below accading to the building diagram speafied in Item C2. State the datum used. If the datum is different from the datum used fa the BFE in
Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided a the Comments area of �
Section D or Section G, as appropiiate, to docximent the datum oonversion. `�
Datuml'►29 ConversionlComments �iA-
Elevation reference mark used �ca n� Cbes the elevation reference mark used appe� on the FIRM? ❑ Yes � No 0
o a) Top of bottan floa� (induding baserr�ent or endosure) 10 .10 ft.(m) �
o b) Top of next higherfloor 19 .4 ft.(m) � �G� � �
o c) Bottan af lowest haizont� structur� member (V zones only) v IA ._ft.(m) y m /� �
o d) Attached 9arage (top of slab) N i4 ._ft.(m) E� �
o e) Lowest e l evation o f m a c hinery a n d lor equipment W@ '""'
serviang the building (Desaibe in a Canments area) �2 l � ft.(m) �' �
o fl Lowest adjacent (finished) grade (LAG) 9.5 ft.(m) z' � \
o g) Highest adjacent (finishec� grade IHAG) �. 9 ft.(m} �� ,-� j
v � 4
o h) No. of permanent openings (flood vents) within 1 ft. above atljacent grade a�A �
o i) Total area of all permanent openings (flood vents) in C3.h �sq. in. (sq. an) � �
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 t�� certify elevation information. �
I certrfy that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. �
I understand that any false statemenf may be punishable by fine or imprisonment under 18 U.S Code Secfion 1001
CERTIFIER'S NAME Carl M. Smith, Louis R. F�irez, I�y Roberts �CENSE NUMBER #3762, �304, #3144
TITLE Land Surveyor
ADDRESS
950 South Winter Park, 2nd Floor,
SIGNATURE
Casselberry
��
NAME Fr�t Finanaal Surveyors, Inc.
STATE
FL
TELEPHONE
407-977 7010
ZIP CODE
32707
FEMA Form 81-31, January 2003 See reverse side for continuation. Replaces all previous editions
nni v�� i r�n �. n � u iwc a�+uvc.a� ,
BUILDING STREET ADDRESS (Induding
3147 Johns Parkway
CIIY
Clearwater
� .. ..r.... .� . ...... . .. � .... . .. .. . .. .
Uni� Su'de, ancllor Bklg. No.) OR P.O. ROUTE AND BOX N0.
STATE
FL
_ . .... � „ ��,���.,,�r., . ,
Policy Number
ZIP CODE � Canpany NAIC Number
33759
SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
� Copy both sitles of this Elevation Cer6ficate for (1) canmunity offia�, (2) insurance agenUcompany, and (3) building owner.
COMMENTS
0-119062
� iJ S � G"'� � aJ
� 3 2 � S �Fvn r'�-( C u N,'�'
❑ Check here if 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 Eleva6on Cerfificate is intended fa use as suppating informafion fa a LOMA a LOMR-F,
Section C must be completed.
E1. Building Diagram Number _(Select the building diagram most similar to the building fa which ihis certificate is being completed — see pages 6 and 7. If no diagram accurately
represents the building, provide a sketch or photogr�h.)
E2. The top of the bottom floor (including basement a endosure) of the building is _ ft.(m) _in.(cm) {] above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, 'rf availabie).
E3. Fa Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevatetl floor (elevation b) of the buiiding is _ ft.(m) _in.(cm) above the highest adjaoent
grade. Complete items C3.h and C3.i on front of fam.
E4. The top of the platform of machinery andlor equipment serviang the building is _ ft.(m) _in.(cm) � above or ❑ below (chedc one) the highest adjacent grade. (Use _
natural grade, 'rf available), -
E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floa elevated in accadarxe with the community's floodplain management ordinance?
❑ Yes ❑ No ❑ Unknaum. The local off'iaal must certi(y this infamation in Sedion G.
SECTION F- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property amer a owners authaized re�resentative who completes Secfions A, B, C(Items C3.h antl C3.i only), and E for Zone A(without a FEMA-issuetl a community-
issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
SIGNATURE
COMMENTS
CITY
DATE
STATE ZIP CODE
TELEPHONE
❑ Chedc here if attachments
SECTION G • COMMUNITY INFORMATION (OPTIONAL)
The local official who is auth�orized by law or ordinance to administer the communii�s floodplain management ordin�ce can complete Sections A, B, C(or E), �d G of this Elevation
Cerlificate. Canplete the applicable item(s) �d sign belaw.
G1. ❑ The information �� 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
a loca! law to ce�tify elevation �nfar�a6on. (Indicate the source antl date of the elevation data in the Canments area bebw.)
G2. � A community offia�l campleted Section E fa a building located in Zone A(without a FEMA-issuetl a communily-issued BF� a Zone A0.
G3. � The fdlowing information (items G4-G9) is provided for community floodpi�n management purposes.
G4. PERMIT NUMBER
G7. This pe�mit has been issued fa: ❑ New Construc�iion ❑ Substantial Improvement
G8. Elevation of as-built lowest floor (induding baserrient) of the building is:
G9. BFE or (in Zone AO) depth of flooding at the builtling site is:
LOCAL OFFICIAL'S NAME
COMMUNITY NAME
SIGNATURE
COMMENTS
FEMA Form 81-31, January 2003
G6. DATE CERTIFICATE OF
_. _fl.(m)
_. _ ft.(m)
TITLE
TELEPHONE
DATE
ISSUED
Datum:
Datum:
] Check he�e if attachments
Replaces all previous editions