Loading...
1347 MCMULLEN BOOTH RD NU.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGF.�AENTAGENCY National F7ood Insurance Program 184778 A1. Bailding Owner's Nart►e BRYCE A. o°�-Zq-1�_ °�\S3�-do0- Oo�o ELEVATION CERTIFICATE Important: Read the instructions on pages 1J9 SECTION A - PROPERTY INFORNEATION A2. Building Street Address {inciuding Apt., Unit, Sui#e, andlor Bidg. No.} or R.O. Raute and Box No. 1347 NORTti MCMULLEN Bt?OTH ROAD City CLEARWATER Slate Fl ZIP Code 33759 A3. Property Description (Lot and Blodc Numbers, Tax Paroel Number, Legal Oescriptian, etc.} OMB No. 1fi60-OOQ8 Expiratian Date: July 31; 2Q95 A4. Bullding Use (e.g., Residential, Non-Residential, Addition, Accessary, etc.) RESIDENTIAL A5. Latltude/Longitude: Lat. 27°58'38.91"N Long. 82°42'21.22'W HorizorKal Datum: � NAD 1927 � NAD 1963 A6. Ariach at least 2 photographs of lhe building if lhe Certificate is being used to obtain flood insuranc2. A7. Buiiding Diagram Number 1A A8. For a building with a crawlspace or enGosure(s): A9. For a building with an atlached garage: a} Square foatage of crewlspace or enclosure(s) j�J(@ sq R a) Square footage of ariached garage N/A sq k b) Number of permanerrt flood openings in lhe crawlspace b) Num6er of permanent flood openings in the attached garage or endosure(s) within 1.0 foot above adjacent grade 0 within 1.0 foat above adjacerrt grade 0 c) Total net area of flood openings In AB.b 0 sq in c) Total net area of flootl apenfngs in A9.b fl sq In d) Engineered floo� openings? ❑ Yss � No d) Engineered Hood openings? ❑ Yes � No SECTION B- FLOOD IIVSURANCE RATE MAP {FIRMj INFORMATION B1. NF{P Community Name & Community Number B2. County Name B3. Stafe 125096 PINELLAS Fiorida 64. MapiPanel Number B6. Suffix B6. �IRM Index Date 87. FIRM Panel 68. Fiood 69. Base Flaod Elevation(s} (Zone 12103C0127 G 9l3/2003 Effective/Revised Daie Zone{s} AO, use base fload depth) 913l2003 X/AE 9 i37fl. InGicate tlte source of the Base Flood Elevation (BFE) data or 6ase flaod depth entered in Item B9. ❑ FIS Profile � FIRM ❑ Community Determined ❑ Other/Source: _ 611. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1888 ❑ OthedSource: � B12. 1s the building located in a Coastel Barrier Resources System (CBRS) area or Otherwise Protec[ed Area (OPA)7 ❑ Yes � No Designation Date: ❑ CBRS ❑ OPA SECTlON C- BUII.DING ELEVATlON INFQRMATiON (SURVEY REQ4�IRED} C1. Bullding elevatlons ere based on: ❑ Consirudfon Drawings' ❑ Building Under Construction' � Finiahed Construction `A new Elevation Certificate will be required when construction of the bullding is complete. C2. Elevations - Zones A1-A30, AE, P�H, A(wfth BFE), VE, V1-V30, V(with BFE), AR, ARlA, AR/AE, ARIA1�430, ARlAH, AR/AO. Complete Items C2.a-h below accordfng fo the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark UHlized: CITY OF CLEARWATE�t Verdcal Datum: NAVD 1988 Indicate elevation datum used for the elev8tlons in items a) through h} below. ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as fhat used far the BFE. Check the measurement used. a) Top of bottom floor (induding basement, crawlspace, or enclosure floor) 1� � feel ❑ meters b) Top of the next highe► floor N/A � feet ❑' meters c) Bottom of tha towest horizontal structura! ritember (V �ones aniyj N_;_,,A � feet ❑ meters d) Attadted garage (top of slab) N/A � feet ❑ meters e) Lowest eievaU� of machinery ar equipment serviang ihe building 10�. � feel ❑ meters (Dascribe type of equipment and location in Comments) � Lowest adjacent (finished) grade next to bui:ding (LAGj 10.8 � feet ❑ mete�s g) Highest adjacent (finlshed) grade next to building (HAG) 10.9 � feet � meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including sVuctural support NfA � feet ❑ meters SEC710N D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFIGATION This c.ertification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify efevation informatlon. ! cerNly that the 1n/ormaHon orr tiiis Certlficate �epresents my best efforts to interpret the data avaflable. ' 1 urtderstand fhat any false statement may be punishable by firte or imp»sor+mant undar 18 t!. S. Code, Section 1001. ,� g 1 i F r c q r � Check here if comments are provided on badc of form. Were latitude and longitude in Section A provided by a �� F ❑ Check here if attachments. licensed land surveyor? � Yes ❑ No N0' Z�' Certifier's Name Clyde 0. McNeai Lirznse Number 2883 Tfle Registered Prafessional Surveyor Company Name TARGET SURVEYING, LLC Address 6250 N Military Trail #102 City West Palm Beach Skate FL ZfP Code 33407 plgitalty s g bY ayda I DN' CN = �nc. _ ��.,.� �/"��'` e:.2013.09.3f1 Signature �--7" Date 9l2812413 Telsphone (561)840-48Q0 �._ 15:ot:37-0a'Oa' , F�MA Form 086-4-33 {7112) See reverse si8e for continuation. Replaces all previous editions. ELEVATtON CEi2TIFICATE. naae 2 IMPORTANT: In these spaces, copy the correspanding information from &ection A. Buiidir�g Street Address (inciuding Ap�, Unit, Sulte, andior Bidg. No.) or P.p. Route and Box No. 1347 NORTH MCMULLEN BODTH RdAd Clty CLEARWATER Staie FL ZIP Cade 33759 er~ ' uC �tumber SECTION D— SURVEYOR, ENGINEER, QR ARCHITECT C�RTIFICATItJN (CfJNTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2} insurance agenUcompany, and (3) building owner. Comments ELEVAi14NS IN SECTCON C2-E ARE ELEVATIONS OF Signature �� Dake 8/28l2013 SEGTION E— BUILDING ELEVAT30N INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE} For Zones AO and A(without BFE), complete Items Ei--E5. If the Certificate is intended to support a LOMA or LOMR-F request, cnmplete Sections A, B, and C, For Items E1�4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provfde elevation infarmakion for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjaoent grede (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basemen� crawlspace, or enclosure) is _� ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom Boor (including basemeM, crawlspace, or enGosurej fs __ ❑ fest � meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with pertnanent flood openings provided in Section A ttems 8 and/or 9(see pages 8-9 of Instructions), the next higher floor (elevalion C2.b in the diagrams) of the building is �❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Altached garage (top af slab) Is ; � ❑ teet ❑ meters ❑ a6ove or ❑ below the HAG. E4. Top of platform of machinery andlor equipment servicing the building is ,_,_; _❑ feet ❑ mefers ❑ above or 0 6elow the HAG. E5. Zone AO only: If no flood depth number is avaiiable, is the tap of the bottom floor elevated in accordance with the community's floodplain managemertt ordinance7 ❑ Yes ❑ Na ❑ Unknown. The lacal official must certify this informaiion in Section G. SECTIOM F— PROPERTY OWNER (OR OWNER'S REPRESENTATlVE) CERTIFICATION The property owner or ov�ter's suthorized 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 correcl ta the best of my knowledge. Property Owner's or Owner's AuthoHzed Representallve's Name Address �I�fi$iUt`8 Comments Gity 0$i2 State Telephane SECTION G — COMMUNITY INFORMATION (OPTIQNAI� The local oKCial who is authori¢ed by law or ordlnance to admfnister the communii}+'s floodplain management ordinanCe Can cor of this Elevation Certiflcate. Complete the applicable item(s) and sign below. Chedc the measurement used in Items GS-G10. In ZIP Gode Check here if atiachmenEs. iediorts A, 8, C{or E), and Rico only, er�ter meters. G1. � The information in Section C was taken from other documerrtation that has been signed and sealed by a licenaed surveyor, engineer, or archltect who is authorized by iaw to certlfy elevetion informatlon. {Indlcate the source and date oT the elevation data in the Comments are�a below.) v2. ❑ A oommuniry offiaal completed S�.�tton E for a building located in Zona A(wkfiout a FEMA-issued or cornmunity-issued BFE) or Zone AO. G3. ❑ The following Infortnation (Items G4--G10) is provided tor Community floodplain management purposes. G4. Permit fVumber G5. Da#e Perretit {ssued G6. Date Certificate Qf CompliancelOccupancy issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-built lowest floor (including 6asement) of the building: .__ ❑ feet � meters Datum ,,� G8. BFE or (in Zone AO) depth of flooding at the buflding site: �� ❑ feet ❑ meters datum G10. Community's deslgn flood elevaY�on: „Y,�,,,,_�, ❑ feet ❑ meters Datum _ Local Ofllc{al's Name Community Name Signature Commerrts Title Telephone Date � Check here if attBChment5. FEMA Form 088-0-33 (7/12} Fteplaces all previous ecfitions. s • EL�VATION CERTIFICATE, page 3 gu�lclir�g Phot�graphs See Instructions for ltern A6. (194776) iMPpRTANT: In these spaces, copy the correspca�ading information from Sectian A. Building Street Address (including Apt., Unit, Suite, ar.dtor Qldg. Pvo.j or P.O. Rout2 and Box No. 1347 N(?RTH NtCMULLEN BC}OTH ROAD City GLEARWATER State FL Z!F Code 33759 FOR INSURANCE Ct}MPANY U5E Po#icy Number NAIC hJumber 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 a�l photographs with date taken; "Front Viev�i' and "Rear View"; and, if required, "Right Side View" end "Left Side View." When applicable, phatographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting mpre photographs than will ft on this page, use the Cantinuation Page. e�°'� ��� �. �. FROIVr v��w €� � � � � `\� �EMA Form 086-0-33 {7/12) Repiaces ali previous editians. ELEVATION CER7IFICA7E, page 4 Building Photographs Continuatian Page (194776) IMPORTANT: In these spaces, copy �fe corresponding information from Section A. FOR INSURANC�;COMPANY U8� Building Street Addness (induding Apt., Untt, Sulte, andlor eldg. No.) or P.O. Route and Box No. 'Pd'icy Number 1347 NORTH MCMULLEN BOdTH ROAD City CLEARWATER Sta#e FL ZIP Code 33759 'Comparry NAfC Nymber° If subm+tting more photographs than wiil fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front Vevd' and "Rear Vevfl'; and, ff required, "Right Side Yew" and "Left Side View." When appiicsble, photographs must show the foundation with representative exampies of the flaod opanings or vents, as indicated in Section A8. FEMA ForM 086-0-33 (7112} Replaces ail previous editions.