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31 ISLAND WAY #102, US. DEPARTMENT OF HOMELAND SECURfTY FEDERAL EMERGEriCY MANAGEMENT AGENCY National Phad Uunrmuc Pmgram �g a � i5 ELEVATION CERTlFICATE IMPORTAN'f: Follow the instructions on pages 1-9. SECTION A — PROPERTY INFORMATION A1_ Building Owner's Name EUGENIA AND DANIEL OSTOLAZA A2. Building Street Address (including ApL, Unii, Suite, andJor Bidg_ No_) or F?O. Route and Box No. y � 3u;� o�o0 3�s oMe rvo. lssa000s Expiration Date: July 31, 2015 FOR iNSURANCE COMPANY USE� Policy Num�r: Compary NAIC Numher: � � CLEARWATF�2 "w•` F� • `�� ••••••° 33767-2135 A3. Property description (Lot and Block Numbers, Tax Parcei Number, Legai Description, etc.) PARCEI 0�29-15-41348-000-0102, HORIZON HOUSE CU-OP UNiT 102, UNRECORQED PLAT, PINELLAS COUNTY, FLORIDA A4. Buiiding Use (e.g., Residential. Non-Residential, Addttion, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat Z�•9755 Long. $28�62 Horizontai Datum: ❑ NAD 1927 Ox NAD 1983 A6. Attach at least 2 photographs of the buiiding if the Certificate is being used to obtain flood insurance. A7. Buildin� Dia�ram Number ONE-A A8. for a building with a crawlspace or enclosure(s): A9. Far a building wfth an attached garage: a) Square footage of crawlspace w enclosure(s) wA sq ft a) Square footage of aitached garage � sq ft b) No. of permanent flood openings in ihe crawlspace or b) Number of pertnanerrt flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade wA within 1.0 foot above adj�ent gade ►� c) Total net area of flood openings in A8.b wA sq in c) Total �et area of flood openings in A9.b wA sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B— FLOOD INSURANCE RATE MAP (FlRM) INFORMATION 61. NFlP Communitv Name & Communitv Number CLEARWATER CffY OF 125096 64. Map/Panel Number B5. Suffuc 66. FlRM Index Date 12103C0102 OS/18I2009 B2_ County Name P�NEllAs 67. FlRM Panel Effective/ Revised Date 09/03f2003 B8. Flood AE I63. State FL Base Flood Eievation{s) (Zone AQ, use base flood depth) 12Q Ff 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in item 89: ❑ FlS Profile � FlRM ❑ Community Determined ❑ Other/Source: Bii.lndicate elevation datum used far BFE in ftem 69: ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barcier Resources System (CBRS) area or Othervvise Protected Area (OPA)? ❑ Yes � No Designation Date: / / ❑ CBRS ❑ OPA SECTION C— BUILDING ELEVATION 1NFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Co�struction'� � 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 BF�, VE, Vi-V30, V(with BFE7, AR, AR/A, AR/AE, AR/Ai-A30, AR/AH, AR/A0. Complete ttems C2.a-h below according to the building diagram specified in ftem A7. In Puerto Rico only, enter meters. BenChmark UUUzed: GPS Vertical Datum: �� 19� Indicaie elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. �- �--v , � i;- �� . , ��- 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 equipmeni servicing the building (Describe type of equipment and location in Comments) � lowest adjacent (finished) gratle ne�ct to building (LAG) p� Highest adjacent (finished) grade next to building (HAG) h} lowest adjacent grade at lowest elevation of deck or stairs, including sttuctural support Check the measuremerrt used� �1,�� t�� 8-� � feet ❑ meters 2025 � feet ❑ meters A (}S wa � feet ❑ meters F+.�[� ?°`� �'1 f� wp � feet ❑ meters �o.s`' � feet ❑ meters 4'?.fi/t D11�3U`1� «ri.T�r.nm.i � c�oP B ac�r 6•� � feet ❑ meters b.so � feet ❑ meters 6•� � feet ❑ meters SECTION D- SURYEYOR� ENGINEER, OR ARCHI'iECT CERTIFlCATtON This certification is to be signed and sealed by a land surveyor, engineer, or a►chitect authorized by law to certify elevaUOn � information. 1 certify that the informaiion on this Certificate represents my best etTorts to Interpret the data a►allaWe. 1 understand that any false sbtement may be punishable by fine or imprlsonment under 28 U.S Code, Section 1001. �� i Ei �� r� _ ❑ Check here if comments are provided on back of form. ❑ Check here if attachments. Certifier's Name BILL H. HYATT, .IR Title PRESIDENT Address 1497 MAIN STREET #321 Signature FEMA Fortn 086-Q33 (7J12) f , Were lalitude and longitude in Section A provided by a licensed land surveyof? � Yes ❑ No Compary Name KNOW ff NOW tNC Ciry DUNEDIN 920_13 I License Number #-0636 State ZIP Caie FL 34698 Telephone (7271415-8305 See reverse side for continuation. a� -�sr- `�t'. �w 4636 i r�re or I LORIU:\ Replaces all previous editions. ELEVATIOAI CERTIFlCATE, page 2 IMPORTANT: In tl�se sP��: �PY ��P�� from Sec�n A. Building SVeet Address (iricluding Apt, Unit, Suite, and/or Bidg_ No.) or P.O. Route and Box No. 31 ISLAND WAY APAR7MENT #102 ��y State ZIP Code CLEARWATd2 FL 33757-2135 FOR INSl3RANCE COMPANY USE PoIicY Number: Corttpatry NAIC SEC'f10N D- SURVEYOR, ENGtNEER, OR ARCHITEGT GERTiFlCAT10N (CON'FIWUED) Copy both sides of this Elevatla� Certificate for (1) commun'rty offtcial, (2) insurance agent/comparry, and (3) building owner. Comments iF EQUIPMENT IS USTED ON PRIOR PAGE IS BASE OF AIR CONDITiONER UNIT THiS CERTIFICATE IS NOT TO BE USED FOR CONSTRUCTION OR DfSIGN, IS FOR FI.00D INSURANCE USE ONLY " UNIT 102 Ef.EV iS 20.25 IS ON SECOND FLOOR OF BUILD4NG Signatufe / i l"` '"f �� Date 092QI2013 SECTION E- BUILDlN6 ELEVATION INFORMAT{ON {SUitVEY NOT REQUtREDj FOR ZONE AO AND Z�IYE A(WtTHOUT BFE) For Zones AO and A(without Bf�, compiete ttems E1-E5. ff the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A. B,and G. For ftems E1-E4, use naturai grade, if availabie. Check the measuremerrt used. in Puerto Rico ordy, eMer meters. E1. Provide etevadan informaGOn For the foilowing and check the appropriate boxes to show whether tt�e elevation is above or beiow the highest adjacent �ade (HAG) and the {awest adjacent grade (LA6). aj Top of bottom floor (including trasement, crawispace, or enclosure) is b3 Top of bottom floor (including basement, crawlspace, or enclosure) is � feet p meters � above or � below the HAG, � feet ❑ meters � above or ❑ below the LAG_ E2. For Building Diagrams 6-9 with permanerit flood openings providetl in Section A items 8 and/or 9(see pages 8-9 of Insiructions), the next higher floor (elevation C2.b in the diagrams� of the building is w. A � feet ❑ meters � above or ❑ belaw the HAG. E3. Attached garage (top of slab) is . � feet ❑ meters � above or ❑ below the HAG. E4. Top of platForm of machinery and/or equipmer�t servicing the building is . � feet ❑ meters � abrnre or � below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the battom floar elevated in accordance with the community's floodptai� management ordinance? � Yes ❑ No ❑ Unknown. The locai official must certify this iniormation in Section G. SECTION F- PROPERTIf OWNER (OR OWNER'S REPRESENTATIYE) CERTIFlCATION The property owner or owner's autho�ized representative who completes Sections A, B, and E fnr 2one A(without a FEMA-issued or commun'ity-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 or Owner's Auihorized Represerrtative's Name Address Signature Comments City Date State Z1P Code Teiephone ❑ Check here rf attachments. SECTIOW � - COMMUNITY INFORMATION {OPTIONAL) The local official who is authorized by law or ordinanc:e to administer the community's flaodpiain management ordinarice can complete Sections A, B, C(or E}, and G of this Elevation Ce�tificate. Complete the applicabte item{s) and sign beiow. Check the measurement used in Items GS-G10. in Puerto Rico onty, enter meters. Gi. ❑ The information in Section C was taken from other dacumentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify efevation information. (Ind+cate the source and date of the elevation data in the Comments area below.) G2. ❑ A community afficial completed Section E for a build'mg located in Zone A(withoui a FEMA-issued or c�mmunity-issued BFE} or Zone AO. G3. ❑ The following information (ftems G4-69� is provided for community floodpfain managemeM purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occuparicy Issued G7. This permit has been issuetl for: � New Co�struction ❑ Substantial Improvement G8. Elevation of as-buitt lowesi floor (including basement) af the building: G9. BFE or (in Zone AO) depth of flooding at the building site: G10.Gommunit}r's design flood elevatiorv Local OfficiaPs Name Gommunity Name Signature Comments TiUe CLEARWATER ClTY OF Telephone Date ❑ feet O meters Datum ❑ feet ❑ meters Datum ❑ feet ❑ meters Datum ❑ Check here ff attachmeMS. FEMA Form 086433 {7/12) Reptaces all previous editions. ELEVATI�N CERTiFICATE �UILDING PHOTOGRAPHS �4NTINUATtON PAGE Building Street Address (including Apt_, Unit, Suite, and/or Bidg. No_} or P.O. Route and Box No. ADDRESS: 3i ISLAND WAY #102 CLEARWATER, FL 33767 PICS TAKEN 9/17/2013 FRONT VIEW AND CONTINUING AROUND BUILDiNG �. � '�-+�. .� � '"'!!r�`,� ��,,,,,�+,� , ;r � �ra�� ; � ' ""f � �t 1� �a ;�°Ea�+Aaai,i�+r� ,� - �. � =-�a , , � +��4 r�r _�_�� ,, � ��=---...i�r��= ��. - , -.. `� .u`..,.�` ,,, h � : �i� ��' ".. �.�_•• � ��'�� '��t� � • __r�'-��,x� � . �$�' rori,n»,,�; � � , - � � •-_. ...,_._ ... 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Annual Premium Comparison 2012 2013 Short-Termed • 2013-2014 ` COVERAGE EFF DATE COMPANY VALUES DEDUCTIBLES PREMIUM EFF DATE COMPANY VALUES DEDUCTBLES PREMIUM EFF DATE COMPANY VALUES DEDUCTIEiLEB �N� 2I2g112 - Amencan $250,000 Blg $2,000 Bldg N1A $p � ti28173 - American $250,000 Blg $2.OIX1 �a��ql �, � AA/ iHi FI� $3,160.00 2126114 Bankers $100,000 Cont $2,000 Cc�idunb� 2128113 Bankers $100,000 Cont $2,000 ConYents 5112113 - 12112113 - United $15,000 Wadai l �ran�al�� A? 1 11 Properly 5112112- Century Centu Sure 25,561,213 $5,000 $16,708.43 �ti�p114 Specialty $25,561,213 g5,000Allt�ih�u1'�+nb� S X-Wind 5112113 Surety $27,457,300 $5,000 $21,721.35 12I13113 ry ty$ 5112113 - 12112113 - - Equlpment 5112112- Travelers $27,157,000 $5,000 $775.00 �y131�3 Travelers $25,177,813 $5,000 $441.00 �2��y�4 Travelers $25,561,213 $'�.�� '��N� Breakdown 5112113 12i12113.- General 5112112- Landmark $2MM/$1MM $0 $5,516.85 Arch Specialty $2MMl$1MM $0 $6,135.46 �y121t4 Arch Specialty $2MMl$1MM qn �n.l u� Ai� Llabllity 5112113 American __ _ 5112113- Great �y�ti13- dm i I,!� Ar 5112/12- Great $�� $5,000 $��92200 12113113 American $900,0(10 $5,000 $1,132.53 �p112114 Federal $900,000 �/,' 4 Crime 5112113 American United 5112113- UniledStates 12112113- UnitedSlates $�,000,000 $1,INUi t�1��•�� Diredors& 5112112- Stales $1,000,000 $1,000 $1,075.81 �y�3i13 Liability $�,000,000 $1,000 $634.14 �2112114 Liabiiity Officers 5112113 Liability 5l12113 - 12112/13 - 5112112- Federal $15,000,000 $0 $2,569.85 �ti131t3 Federal $15,000,000 $0 $1,578.41 12112114 Federal $15,000,000— t�� '1=A��I:Ii Umbrella 5112/13 5112113- Continental 1 211 2/13- Continental $500.00(1 xn 4uh'1ni yyorlcers 5112112- Continental $500,000 $0 $590.00 �p113113 Casualty $5�'�0 $0 $653.60 12��y�4 Casualt _____ _ Comp 5112/13 Casualt 12112/13 - 1 %, I Aw. � .nimidw 12113112- 3%Hurr,Calendar $147,830.00 NIA $0.00 12112114 Cdizens $?.`>,238.00O ilAl111H11Mi Wind Ghzens $25,112,813 1�� All � qh�n Wmd 12113113 $7,Of10 All Other Wind _– ._-. i�� . _...... .e.�., � � �=