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45 PAPAYA ST. � U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY Natiorra! Flood Insurance Program s Name East Papaya ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 45 Papaya Street City Clearwater State FL ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Pinellas County Parcel ID # 08-29-15-02592-001-0421 OMB No. 1660-0008� Expiration Date: July 31, 2015 FOR INSURANCE COMPANY USE A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) Commerciai . A5. Latitude/Longitude: Lat. 27.979809 Long. -82.826532 Horizontal Datum: ❑ NAD 1927 � NAD 1983 , • A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. °' • A7. Buiiding Diagram Number 1A + A8. For a building with a crawlspace or enciosure(s): A9. For a building with an attached garage: a) Square footage of crawispace or enclosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N!A sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B- FLOOD INSURANCE RATE MAP (FIRMj INFORMATION ,,, B1. NFIP Community Name & Community Number 62. County Name B3. State '� City of Clearwater 125096 Pinellas Fiorida `�~�- B4. Map/Panef Number B5. Suffix B6. FIRM Index Date 67. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone � 12103C0102 G Spetember 03, 2003 Effective/Revised Date 2one(s) AO, use base flood depth) Spetember 03, 2003 AE 11.0' =+ B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69. ❑ FIS Profile � FIRM ❑ Community Determined ❑ Other/Source: "':� 611. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: ;� 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, AR/Ai-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: Clearwater Benchmark G-03 Vertical Datum: NAVD1988 ��° indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 � NAVD 1988 ❑ OtherlSource: � Datum used for building elevations must be the same as that used for the BFE. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) b) Top of the ne� higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) � Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to buiiding (HAG) 6.50 N/A. N/A. N/A. 12.32 5.8 6.4 Check the measurement used. � feet ❑ meters ❑ feet ❑ meters ❑ feet ❑ meters ❑ feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters ^,.,. M -,.. �-� I'1`j h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A. ❑ feet � ❑ meters _} SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION � , ��� ��� ,��r-� =�1 This certif�cation is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the infamation on this Certificate represents my best efforts to interpret the data available. ' `� �,�'o,� I understand that any false statement may be punishab/e by �ne or imprisonment under 18 U. S. Code, Section 1001. �.� ���, y' Yi f � � Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a '�� �� � ''�' � � Check here if attachments. �`� EoJ.i' a; €' ��= licensed land surveyor? � Yes ❑ No �� - _ e . +,.,d�/� .'�' Certifier's Name Christopher C. Chittum Title Licensed Surveyor Address 5830 Nebraska Avenue Signature A � , /j FEMA Form 086-0-33 (7/12) Company Name Davris, Inc City New Port Richey Date August 28, 2014 License Number 5167 State FL ZIP Code 34652 Telephone 727-232-3800 See reverse side for continuation. � � i�" ' w ;!'i .���°�� , � i � • � ;.s'�����'` ' �� `��� • 4� � • �% . �• '•°•• `�,� ti+� , €� . .��i''�^� ��..,�'Q� .,`,`♦ '����,,,�,��s Replaces all previous editions. ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (inciuding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 45 Papaya Street City Clearwater State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number: SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner. Comments Davris, Inc. Project # 14032 Lowest Machinery elevation shown in section C2e is the air conditioner. Signature Date August 28, 2014 SECTIO - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND 20NE A(WITHOUT BFE) 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 � befow the HAG. b) Top of bottom floor (inciuding basement, crawlspace, 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 bui�ding 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 platforrn of machinery andlor equipment servicing the building is . ❑ 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 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 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 knowiedge. Property Owner's or Owner's Authorized Representative's Name Add ress Signature Comments City Date State Telephone ZIP Code Check here if attachments. SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official 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 below. Check the measurement used in Items G8-G10. In Puerto Rico only, enter meters. G1. ❑ The infortnation 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 infortnation. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community o�cial 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 community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Cert�cate Of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-built lowest floor (inciuding basement) of the building: ❑ feet G9. BFE or (in Zone AO) depth of flooding at the building site: G10. Community's design flood elevation: Locai OfficiaC�' �Fame' Community Name , Signature Comments "�, : ❑ feet ❑ feet Title Telephone Date ❑ meters Datum ❑ meters Datum ❑ meters Datum Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. M ELEVATION CERTIFICATE, page 3 gu�Iding 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. 45 Papaya Street City Clearvvater State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number: If using the E�evation Certificate to obtain NFIP flood insurance, affix at least 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 examples 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. FRONT VIEW R ; m- � > � '�� �.�`�)� ... SIDE VIEW ,:x * .��'� �:. �,�� ��� . �: .I f � ` , �� � ��-�__ � `� , ...<���.� f 1 �� `� �k � ; .�`�` .� p _ � ���_� - _ — : .,, : - `� — er = .�� : re � _ _��--�` ■ -' ':� .#-r_ � .•:�c, � � �. ,:. � � �. �" � � ����� �� � ,: n, Y " ,'�� 1r;� -s'�; ""�"� �_., , ' .. � �,��+5', v,� �F v^� y,��+ � �# � �u= '� .k v�; �; _ FEMA FOCm 0$6-0-33 (7/12) nc�ia�,ca au Ni�..�..�.� �..���..��� U.S. DEPARTMENT OF HOAAELAND 3ECURITY ELEVATION CERTIFICATE FE�DERAL EMERGENCY MANAGEMENT AGENCY OMB NO. 1660-0008 A�S/ional Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date: Juiy 31, 2015 ' SECTION A- PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Building Owner's Name East Papaya Holdings, LLC Policy Number. A2. Building Street Address (including Apt., Unit, Suite, andlor Bidg. No.) or P.O. Route and Box No. Company NAIC Number. 45 Papaya Street City Clearwater State FL ZIP Code 33767 A3. Property Description (Lot and Blodc Numbers, Tax Parcel Number, Legal Descriptio�, etc.) Pinellas County Parcei ID # 0&29-15-02592-001-0421 A4. Building Use (e.g., Residerrtial, Non-Residential, Addition, Acxessory, etc.) Commercial A5. Latitude/Longitude: Lat. 27.979809 Long. -82.826532 Horizontal Datum: ❑ NAD 7927 � NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insuranoe. A7. Building Diagram Number 1A A8. For a building Hrith a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft b) Number of permanent flood openings i� the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openingsl ❑ Yes � No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bi. NFIP Community Name & Community Number 62. County Name B3. State City of Clearwater 125096 Pine{las Florida B4. Map/Panel Number B5. Suffa 66. FIRM Index Date B7. FIRM Panel 68. Flood B9. Base Flood Elevation(s) (Zone 12103C0102 G Spetember 03, 2003 Effective/Revised Date Zone(s) AO, use base flood depth} Spetembe� 03, 2003 AE 11.0' B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile � FIRM ❑ Community Determined ❑ OtherlSounce: 611. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 ❑ OthedSource: 812. Is the building located in a Coastal Barrier Resources System (CBRS) area or Othervvise Protected Area (OPA)? ❑ Yes � No Designation Date: ❑ CBRS ❑ OPA SECTION C- BUI�DING ELEVATION INFORMATION (SURVEY REQUIRED) � C1. Building elevations are based on: ❑ Construction Drawings' � Building Under Construdion* ❑ Finished Construction `A new E{evation Certficate will be required when construdion of the building is complete. C2. Elevations -Zones A1-�30, AE, AH, A(with BFE), VE, V1-V30, V(with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. � Benchmark Utilized: Clearwater Benchmark G-03 Vertical Datum: NAVD1988 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: � Datum used for building etevations must be the same as that used for the BFE. a) Top of bottom floor (inGuding basement, crawlspace, or enclosure floor) 6.� b) Top of the next higher floor WA. c) Bottom of the lowest horizontal strudural member (V Zones only) N/A. d) Attached garage (top of slab) NlA. e) Lowest elevation of machinery or equipment senricing the building N/A. Check the measurement used. � feet ❑ meters ❑ feet p meters ❑ feet ❑ meters O feet ❑ meters � feet ❑ meters � .. � �� �v ,_�, I � (Describe type of equipment and bcation in Comments) � � Lowest adjacent (finished) grade next to building (lAG) 5.0 � feet ❑ meters _\ H' hest ad acent finished rade next to buildin HAG 5.5 � feet ❑ meters �'J 9) �9 J ( ) 9 9 ( ) ^ h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A. ❑ feet ❑ meters (�/ •1 �. � SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or a�chitect authorized by law to certify elevation `''3 �,� r`, ,� information. ! certify that the information on this Certificate mpresents my best efl`orts to inte►pret the data available. :r.,, , �,� r f, 1 understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, SecSon 9001. ';��{, .,��� ;. `r ''A � Check here if comments are provided on badc of form. Were latitude and tongitude in Section A provided by a i' �����,�/ �. ., ,w,. .� � Check here if attachments. licensed land surveyor? � Yes ❑ No ; ''"�S�7.r,, `�- '; �° Certifiers Name Christopher C. Chittum Title Licensed Surveyor Address 5830 Nebraska Signature ,� � Company Name Davris, Inc City New Port Richey Date April 22, 2014 License Number 5167 Siate FL Z!P Code 34652 Telephone 727-232-3800 =- ;�'SM �i�7 , _ �: - .' ��y<x��� : • = � ,+ �LG:-�t�:; : ' ;��� ; . '•. : � •, �a : , ,.• , , . - ``;;;• •�...�..•�' r�r�.� �t"� f �'1/)� � r 17' ��` �4+�� �, $4r� v} a' ,,.�ti tdi�=t�}►4i� FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE, page 2 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. 45 Papaya Street City Clearwater State FL ZIP Code 33767 FOR INSURANCE COMPANY USE � Policy Number: ' Company NAIC Number. SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Cert�cate for (1) communiry officiai, (2) insurance agent/company, and (3) buiiding owner. Comments Davris, Inc. Project # 14032 Signature Date April 22, 2014 SECTION E- BUILDING ELEVATION INFORMATION (SURVEY NOT RE(�UIRED) FOR 20NE AO AND ZONE A(WITHOUT BFE) 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. Chedc the measurement used. In Puerto Rico only, enter mefe�s. 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 (inGuding basement, crawlspace, or enGosure) is ❑ feet ❑ meters ❑ above or � below the HAG. b) Top of bottom floor (including basement, crawlspace, 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 andlor 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 platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or Q 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 manageme�t 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 owners 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 coRect to the best of my knowledge. Property Owner's or Owners Authorized Representative's Name Address Signature Comments City Date State Telephone ZIP Code Chedc here if attachments. SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the c�mmunity's floodplain managemerrt ordinance can complete Sedions A, B, C(or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Chedc the measurement used in Items G&-G10. In Pue�to Rico ony, enter 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 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-G10) is provided for communiry floodplain management pu�poses. G4. Pennit Number G5. Date Pertnit Issued G6. Date Cert�cate 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 G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters G10. Communiry's design flood elevation: ❑ feet ❑ meters Local Official's Name Community Name Signature �;omments Title Telephone Date Datum Datum Datum Check here if attachments. FEMA Form 08&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 Bidg. No.) or P.O. Route and Box No. 45 Papaya Street 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 least 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 examples of the flood openings or vents, as indicated in Seetion A8. If submitting more photographs than will fit on this page, use the Continuation Page. FRONT VIEW SIDE VIEW :�.�i y. •` � .,K -�! � � �� _ ,<,. .. -:,„,, ,�� �, ,� _,� °'" ---� ��s�__ � � . � r . � .� �,�'- . �}. _, p ' .� � > . wr*�z � � � ��E "� ��.. ,.r� ' ., w �.'!+!r ' � � �s . ;., �o�wo a .e � 's sr.� - , . -...-- x wo y F � ,n � - . _ . ':`� . � �t `�r%,. -= � .e s . ° ° ��-'X ,� ;, ��„�: ., t�� 4� ����.. � �.���: .� „� , �,„ � ., _ �. , � �=� . :e � , . ,. . . , -, � �" '" ` � �. x�^ , _� � r ,� �. �'A� - . ,5 � �� - Y $ � � � ' y �a �`• ,� �.�:. -b T� , � - .�i,- FEMA Form 086-0-33 (7/12) Replaces all previous editions.