354 LARBOARD WAYU.3.�EPARTMENTOFHOMELANDSECURlTY ELEVATION CERTIFICATE
.FEDERAL EMERGENCY MANALiEMENT AGENCY
NatfonalFloadPr�szvumceProgram �mportant: Read the instructions an pages 1-9.
SECTIdH A - PR�PPRTY INFORMATION
A1. Suilding Owner's htame Joanne B. Friedfand.
A2. Building Street Address (induding Apt, Llnit, Suite, andlor Bidg. No.) or P.p. Route and
35d Larbaarcl Way.
City Clearwater
5tate Ft ZiP Gode 33767
A3. Property Description (Lot and Blodc Numbers, Tax Paroel Number, l.egal Descrfptfon, efa)
PARCEL ID: 08-29-15-21819-OOQ-0030
G�
OMB No. 1680-0008
F�cpiration Date: July 3'!, 2015
A4, Building Use (e.g., Residentiat, Non-ResideMiai, Addl�on, Accessory, etc.) Resideotia]
A5. Latitude/Langifude: Lat, N! Long. j�j@ Horizontal Datum: ❑ NAD 1927 � NAD 9983
A6. Attach at 3east 2 phoEoyraphs of the building if the Certfflcate is being used to obtain ifood insurance.
A7. Buifding Diagram Number 9B
A8. For a buik3ing with a Crawlspace or enclosure(s): A9. For a buildi�g with aa attached garage:
a) Sqaare fnatage of crawlspace or enclosure(s) j�(� sq fE a) Square foofiage oi at#ached garage d00+. sq ft
b} Number of permanent flood openings in the crawlspave b) Number of permanent flood opanings in the aftached garage
ar enclosure{sJ within 1.0 foot above adjaceni grade P�A wlthin 1.0 foot above adjacent grads N/A
c) Total net area of flooci openings in AB.b jVj� sq in c) Total net ares of flood openings in A9.b N/A sq tn
d) Engfn�red ftood openings? ❑ Yss � No d) Engineered fload openings? ❑ Y� ��Eo
SECT[ON B- FLOt)D INSURANCE R,4TE MAP (FIRM) iNFORMATION
B1. NFIP Community Name & Communiry Number 82. Cout�ty Name
Clearwater -'l25096 Pine[las
B4_ Map/Panel Number B5. Suffnc B6. FIRM lndex Date B7. FtRM Panel
12'[03CQ007 � 8/181992* EffectiveiRevised Date
$/99/1999 8/181992"
8/19/1991
83. Stats
FLORtbA
B8. Flood 89. Base Flood Elsvatiort(s) (Zone
Zo�ne�(s} AO, nse base flood depthy
810. fnd(cate the source of the Base Fload Eievadon (BFE) data or base flood de�sth er�tered in ifem 89.
❑ FES Proflle � FIRM ❑ Community Determined � Other/Source:
B1 ?. Indicate etevatton datum used for BFE in ltem 69: � NGVD 1829 ❑ NAVD 1988 ❑ Other/Sourc�:
812. ts the building focated in a Coastal Barrier Resoar� Sysfem {CBRS) area or Otherwlse Protected Area (dPA)? ❑ Yes � No
Designation Date: kVlA Q CBRS ❑ OPA
SECTI�N G- BUlLD1NG ELEVATIOW INFORMAT1QId (SURVEY REQUIRED)
C't. 8uilding elevatiorts are based on: ❑ Construdaon Qrawi�gs' ❑$uildiog Under Construction' � Einished Construction
"A new Elevatiore Certificaie wAI be required when oonstruciion of the building is complete.
C2. Elevations - Zones A1�430, AE, AFi, A(wiih BFE),1iE, V1 V30, V{wrth BFE}, AR, AR/A, ARlAE, AR/A1-,A3D, ARlAH, AR/AO. Complete items C2.a-h
be[ow according to the building diagram specified in Item A7. la Pue[fo Rico onfy, enter meters.
Benchmark Utilized: _ Vertical Datum: 1929
Indicate eleva6on datum used for tha e[eva#ions in ftems a) through h) below. i� NGVD 1929 � NAVD 1988 O OthedSource:
Datum used for building elevations must be the same as that used for the BF�.
e) Tap of bottom floor (including basement, cxauvlspace, or endosure ftoor)
b) Top of the ne� higher floor
c} Bottom of ihe lowest horizontal structural member {V Zones only}
d) Atiached garage (top of slab)
e) Lowest elevat(on of machinery or equipment servicing ihe ba7dfng
{Describe fype of equipment and Iocaiion in Commer�ts)
f} Lawest adJaoent (finished) grade next to building (LAG)
g) Highest adjacent (finlshed) grade next #o bui6ding (HAG}
h} Lowest adjacent grade at Iowest elevat[on of dedt or stairs, including structura[ suppo�t
SECTION O - SURYEYOR, ENGI
11•�Z
WA.
�•
8_�„1
22.7] AC
8.7
$.9
WA.
Chedc the measurement used.
� feet p meters
p feet ❑ meters
❑ feet ❑ meters
� feeE ❑ meters
� feet ❑ meters
� feet ❑ meters
� feef ❑ mefers
❑ feet ❑ meters
OR ARCHITEC7 CERTIFICATIOI�
7his certification is to be signed and sealed tay a Eand surveyor, engineer, or atcEtlteci aufhorfzed by law ta certify e[e�
Information. ! ce ' e irrfomration on tl�i)s Cert�cate represenfs my best etfarfs tv inte►pret the da% avaltaWe.
1 understand any fa! statement may be punisha6fe by fine or �mprisonmerrt under 9$ U.S. Code, 5ecfion i001.
� Che here if com nts re provid on back of fiartn. Were latitude and longitude in Sectian A provfcled b
❑� eck here if atta m s_ /�'� licensed land surveyo�? ❑ Yes �( Wa
Name
Ti#� Sunreyor
Address 3701
Signature
FEMA Form 086-0-3 , /42)
Licanse Number �i:i419 •�;'.
Company Narne Swerdloff & Rerry Surveying, Inc.
City lake Mary State FI Z]P Code 32746
Date
Telepltone (407�-68&7631
See reverse side for cor�tinuation.
Replaces al( pre�ous editions.
�s��rn��vn v���n �v���� �„raa�ci
111�ORTANT: In these spaces, copy the comesponding infotrr�ation fram Section A.
Building 5treet Address (induding Apt, Unit, Suibe, and/or Bldg. Na.) or P.O. itoute and Sox Na. ��
35Q Larboard UVay.
City GlearwaEer Stabe FI ZIP Code 33767
nba[;.. '�, _
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NAIG::Dltiri'i��':';:_.''::�'._:::"; •:
SECTI�N D-St1RVEYOR, ENGINEER, ORARCHITECT CERTIFICATION {CONTfNIlED)
Copy both sides of this Efevatton Certificate for (1) community official, (2) insurance agerit/company, and {3) buiiding owner.
Comments SL- 60429 C2e is in reference to tise A/C Pad.
'" Sections B1 through B9: information based pre paneis noted hereon.
SignaEure Date � ,�
SECTION E- BUlLDtNG ELEYATION INFORMATION (SURVEY NOT REQU[R D) FOR ZONE AO AND ZONE A(IMTHOLI7 BF
For Zunes AO and A(wlthout BFE), oomplete lterns E1-E5. [f the CertiRcate is fntended to suppart a�OMA or LOMR F request, camplete Seciior�s A, B,
and C. For Items E1-E4, use natural grade, if avaiiable. Gheck the raeasurement used. In Puerta Rico ony, enter meters.
E1. Provide elevation information tor the foflowing and check the appropriate boxes to show whether the elevation is above or below ths highest adjacent
grade (HAG) and the lowest adjacent grade (LAG}.
a) Top of bottom floor (including basemeni, crawlspace, or andosure) Is ❑ feet ❑ meters ❑ above or � below the HAG_
b)1'op of bottom noor {inGuding bas�rnent, craw�pac�, or endosure) Is ❑ feet ❑ meters ❑ above or ❑ betow the LAG.
E2_ For Buikiing Diagrams 6-9 with permanent flood openings pravided in Section A Items 8 and/or 9(see pages 8--9 of InstrucHons), the next higher flaor
{elevation C2.b in #he diagrams) of the buikiing is j] feet ❑ meters ❑ above or Q beiow the HAG.
E3. Atiached aarage (top oi slab) is ❑ Faet � meters ❑ above or [] beEow the HAG_
Ea. Top of plafform of machinery andlor �uipmant servicing the building is ❑ feet ❑ meters ❑ abeve or � below the HAG. •
E5. Zone AQ only: lf no ftood dspth nurrtber is available, is the top of the bottom ftoor elevatec! in accordance with ihe cflmmuoit�s floodplaln management
orclinance? ❑ Yes ❑ No ❑ Unknown. The local officiaf must certify this irrfomtation in Section G.
SBCTION F- PRQPERTY QWNER (OR �WNER'S REPRESENTATIVEj CERTIFlCATEON
The property owner or owner's authorized representative who corripletes 5ections A, B, and E for Zone A(without a FEMA-ESSUed or community-issued BFE)
ar Zone AO musF sign here. The s�tements in Sec�oas A, B, and E are correct to the best of my knowledge.
Property Owner's or flwne�'s Authorized Represeritative's Meme
Address
S€gnature
CommenEs
City
Date
State ZEP Code
Telephone
Check here if attachmenis.
SECTION G � COMMUNITY INFORMATION (OPTIONAL)
The local officaaE who is authorized by law or ordinanca to admin�ter the �mmunity's floodplain management ordlnanoe can complebe Se�tions A, 8, C(or E}, and G
of this Elevation Certficate. Complete tF�e applipbi� item(s) and sign below. Check the measurement used in [tems GS-G10. In Puerto Ricp only, enter meiers.
G9. 0 The information in SecEion C was taken from oiher documerrtatlon that has been signed and sealed by a Ifaensed surveyor, engineer, or architect who
is authorized by law to oertiiy eleva6on information. (Indicate the source and daie af the elevation data in the Commerrts area below.)
G2. O A community offxaal completed Section E fot a building located in Zone A(without a FEMA-issued or community-issued BFE) or Zone AO.
G3. � The following informatlon (ltems G4-G10j is provided flor commc�nity floodplain management purposes.
G4. Permii Number
Aate Permit lssued
G6. Date Certiflcate
G7_ Thls permn has been Lssued for. 0 lVew Constructian
❑ Substar�tia! lmprovement
G8. Elevatlon of as-buiit lowest floor (including basement) of the building: � feet ❑ meters Qatum
G9. BFE or {In Zone AO) depth of flooding ak the buflding site: ❑ fset � meters Datum
G10. Community's design flood slevation: ❑ teet ❑ meters Daium
Local Of�aal's Name
Community Name
Signature
Comments
FEMA Farm 086-0-33 (7/92}
Trtle
Telephone
Date
Issued
Check here if atiachmer�ts
Replaces alt previous editions.