141 DEVON DRaera� cmergency nnanagement Agency
itionai Flood Insurance Program
�1. guilding Owner's Name
Important: Read the instructions on pages 1-9.
SECTION A - PR�PERTY INFORMATION
1 �nNn ca a�w� �.� �.� i� cv � c '
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i2. Buiiding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. ; ,�, �, ��
� 41 DEVON DRIVE �,�, - �� �. �� ��,�� �`
Clty C�EARWATER BEACH State F� ZIP Code 33767 - '
�3. PropeRy Description (Lot and Biock Numbers, Tex Parcel Number� Legal Description, etc.)
.O? 44 , BAYSIDE SUBDIVISION -
+4. 9uilding Use (e.g„ ResidenNal, Non-Residential, Adaition, Accessory, etc.) A�SIDENTIAL
+5. LatitudelLongitude: Lat. 27.58�25" Long. 82.49,30„ Horizontal Datum: ❑ NAD 1927 � NAD 1983
�fi. Attach at least 2 photographs of the 6uiiding if the CeNficate is being used to obtain flood insurance.
�7. 8uilding Diagram Number 1
t8. For a buitding with a crawlspace or enclosure(s): �� � A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) N/g sq ft a) Square footage M attached garage �g sq ft
b) No. of permanent floai openings In the crawlspace o� b) No. of permanent ilood openings in the attacbed parage
enclosure(s) withi� 1.0 foot above adjacent grade wtthin 1.0 foot abo�re adjecern grade
c) Total net area of flood openings in AB.b � in c) Total net area of flood openln� ln A9.b sq In
d) Engineered flood openings? ❑ Yes ❑ No d) Engineered tlood openings? ❑ Yes ❑ No
SECTION B- FLOOD INSURANCE RATE MAP (FlRM) INFORMATION .
, 31. PJFIP Community Name & Communiry Number B2. County Name B3. State
:LEARWATER 125�6 _ PINELLAS FLORIDA
fap/Panel Number B5. Suffix 86. FIRM Index B7. FtRM Panel 88. Flood B9. Base Flood El9vatl+
12103C0102 G Date Effect(ve/Revlsed Oate Zone(s) AO, use base flood
9-03-03 9-03-03 AE , 11.0
0. Indicate the source of the Base Flood Elevatlon (BFE) data or base fiood depth entered In Item B9.
�. ❑ FIS Profile �J FIRM ❑ Community Determined ❑ Other (Describe)
, t. indicate elevatio� datum used for 9FE in Item 89: ❑ NGVD 1928 � NAVD 1986 ❑ Othe� (Describe)
2. Is the building located in a Coasiel Bercier Resources System CBRS) area or OUtenNise Protected Araa (OPA)? '❑ Yes � No
' Designation Date �(g �] CBRS ❑ OPA
SECTION C- BUILDINO ELEVATION INFORIIAATIOt�i (SUF�1/EY REQUIRED�
. Building elevaUons are based on: ❑ Consiruction Drawings* ❑ Buildl�g Under ConsWation* � Fniahed Construc;tion
*A new Elevation CertiHcate will be required when construction of the bullding is complete.
�. Elevations - 2ones At-A30, AE, AH, A(wiih BFE), VE, V1-V30, V(with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, ARJAO. Compiete Items C2.a-h
below according to the bullding diagram specified in item A7. Use the same datum as the BFE.
8enchmark Utilized CLEARWATER G-02'''"*1/ertical Datum NAVD'BS'*""ELEV. 4.82
ConversionlComments �yr(Q
� Check the measurement used.
a) Top of bottom floor (including basemern, crawlspace, or enGosure Aoor) I�A. ❑ fest ❑ meters (Puerto Rlco only)
bj Top of the next highe� floor $.$� � feet ❑ meters (Pueno Rlco only)
cj , Sottom of the �owest horizontat structural member (V Zones oniy) y/�. ❑ feet ❑ meters (Puerto R�o only)
ci� Attached garage (top ot slab) �.,�1 � feet [] meters (Puerto Rico only)
e) Lowest elevation of machinery or equipment senricing the building � feei
(D 'b t f ❑ meters (Puerto Rico only)
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1
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escn e ype o equ(pment and locabon In Commentsj , �
r) Lowest adjacent (finishedj grade next to building (tAG) 4.� � feet ❑ meters (Puerto Rico only) �
g) Higfiest adjacent (finished) grade next to buifding (HAG) g.g � faet ❑ meters (Puerto Rico only) �
h� Lowest adjacent grade at lowesi elevstion of deck or stairs, includin8 �J(g. ❑ feet ❑ meters (PueRo Rico only)
struCturdl support . ._
SECYION D- SURVEYOR; ENGINEER, OR ARCNITECT CEiiTIFICATlON �
ttis certification is to 6e signed and sealed by a land surveyor. englneer, or architect aud�orized by law to certify elevaUon
iformation. l certily that tl�e lnformafion on th�s Ceriiflcats represents my besf elfo►ts ro Irrtaip►et the data available.l �
rioerstanti ihat any false statement may be punishab/e by fine or impr'�sonmer�t under 18 US. Code, Section 700f. ❑ .' ';
Gheck here if comments are provided on back of form. Were latitude and longitude in Sec[fon A provfded by a •� � .
� �4.i�rc�4.��"�.`,.��"
licensed Iand surveyor? � Yes ❑ No � _ , ,- � `
:ertifier's Name WILLIAM C. KEATING Llcense Number 1528 * '� ''�'�'
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�itle LAND SUFiVEYOR Compa»y Name ALLIED SURVEYING
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nvvr� i tr� b�ate hl ZIP COde 33755
Date 9-27-12 Telephone 727-446-1263
See reverse side for continuation.
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Replaces ail previous editions
141 DEVON DR
BCP2014-01367
ADDITION
CHRIS GIOTAKIS
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