3083 OAK CREEK DR NU.S. �PARTMENT OF HOM�LANd SECURITY
FEDERAL EMERGENCY 111ANA�NT AGENCY
Nanovrvt Ftood Ixswm�ce Progmm
A
ELEVATfON CERTIFICATE
Importarrt: Read the instructions on pages 1-9.
SECTI�N A - PROPERTY INFORMATION
A2. Buil�ng Sheet Address Cux�u�n9 A�-, U�. Su�e, and/ar Bidg. No.) a� P.O. Rarte and Box No.
3083 OAK CREEN ONE NpRTH
City CLEAWATER �� � �P � �.
OMB No. 1660-OpOg
E.��ratihon Date: July 31, 2015
FOR tNSURANCE GCNNPANY USE
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A3. Pr�tY D�d�tion (Lot and Blodc i�kmbers. Tax Paroei l�hmber, Lc9a� pe�iption. ¢�c.)
LOT 26, OAK CREEK AT COUNTI/gipE / PARCEL IDiR 16-2&16-82133-000-026p
A4. B�ng Use {e_g., Residenlial. Non-Re�l, A�ddi6on, Aooe�ory. etc.) RESIDENTlAL
A5. Latitudell.ongitude: L.at 28.04606Q N l.tu�g. 82.710691 W HorizoMai Datutn: ❑ NAD 1927 � WAD 1983
A6. Attach ffi least 2 PhotograPhs of the birikiing if tl�e Cettifica� is being �ed to obta� flood insurance.
A7. Building Diagr�n N�xnbel' 1
A8. For a building with a pawlspace or endo�xe(s)_ A9. For a bw7d�g with an attad�ed
e) �9� �ot�e of cxawlspaoe or en�une(s) N/A 9��
b) Number of peimar�ent flood s9 ft a) Sq�re fiootage of attached garage §�Q sq ft
��� ) P�n�t flood openings in Ute attached 9a►a9e
or enc�ur�s) wAhin 1.0 foot abov�e adjaoent g��� WA b Nunber of
c) T� net area of fload oper�ngs in A8.b wA within 1A foort above ad'�aCent 9rade .4
d� En9ineered flood � s4 in c) Total net anea of flood operrvangs in A9.b Q sq in
�' � Y� � NO d) Engi�eered itood openingg? ❑ Yes � No
SfCTION B- FLOOD It�URANCE RATE MAP (FIRM) INFORNIATION
B7. NFIP Commuroty Name & Cqmmunj�y Number g�
UNICORPORATED PINELLAS COUNTY / 125139 PINEL�LAS �
B4. MapJF�anel Number B5. Sui�oc B6. FIRM Irxiex Date B7. FlRM Panei
12103C0087 G g�lg2ppg Eflective/Revised Date
_ 9l03t2003
B3. State
FLORIDA
68. Flood 69. Base Flood Elevador�(s) (Zone
evado
Z� s) AO, use base flood depth)
810. Indir,ate the souroe aF U�e Base Fiood Elevahon FE daia � ba�e flood �
(B ) depth e+rter+ed m !�m B9.
❑ FlS Prof�e �I FlRM ❑ Commurriiy De6ertnined ❑ pthedSouroe:
B11. Indicaie elevation datum used for BFE in ltem 69: ❑ NGVD 1929 � NAVD 1988 ❑ oa�erisou�oe:
B 12. is the bu�d'mg Mcated m a Coastal Bartier Resaxoes S�rste�n (CBRS) anaa or OB�en�rise Protecbed Area (OPA)? Q Yes � No
Designation DaGe: WA ❑ CBRS ❑ OPA
SECTION C- BUILDING ELEVATION INFOIiMpTlpN (SURVEY REQUIRED)
c1. swlding de�►atia�s ane nased on: ❑ co�,on Drawrt�s` O Buiiamg ur� Co�uctlon- � F� consrrudion
*A ne�nr Elevetion Certificate w� be required when oonstru�ion af the bu�d'mg � oomplete.
C2. Elevations-Zaies A1-,A30, AE. AH, A(with BFE). VE. V1-V30, V(with BFEj, AR, AR/A, AWqE, qR/A1�q3p� p�R/qH, qR/AO. Complete Items C2.a-h
���9 �� b�n9 diegram speafied in Item A7. In Puerto Rioo oNy, e� meters.
Ber�marlc UtiGzed: CITY CLE�►RWATER 1�-16 Vertiql Dahxrr. IWqyp gg ELFV=24_31
indicaie elevation dahm us�! for the elevations m items a} tlxou� h) betow. 0 NGVD 1929 � NAVD 1988 ❑ Q�r/Souroe_
Datixn used for building �leva6ons must be the same as that used for ttie BFE.
Chedc the measu�emerrt used.
a) ToP of b�tom floor ('mdud'a�g basement, cra�dspaoe. or endosune floor) 11-¢ � feet ❑ meters
b) TaP of ttie nexk higher floor N!A ❑ feet ❑ meters
c) Bottom of ihe lowest hor3zontal s6�u�ural r�mber (V Zones only) �A Q feet ❑ meters
d� At�c� sera� (top °f siab� 14•� � eeet p meters
e) Lowest eievation of machinery pr eq�ent servi�g �e
c�esaibe irpe af eqtripment and �ocaGo� in co�,�me�s) �'ms 10.9 � feet O rt�ters
� Lowest ad)aoent (firu,at�ed) grade ne�d to bu�d'ng (LAG) 10.
9) H�9� �1Ja� (�mshed) 9rade next to buibin9 EHAG) 1.Q ��t ❑ meters
n) Lowest aajacern gr�e ac bw�t e�e+►ation or aedc or staas, inaud� �,�p„� �_ � reet ❑ mecers
�9 support _1Q•4_ � tcet ❑ meters
SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT Cqt71FICATION
This cerUfication +s to be signed and se�ed by a hand se�veyor> �, or ard�i�ect a�horized by law to certit�r elevatlan �
information. / aemfy tltat the ivdbr►n�on an this Cer6�iCete reprasents my be� eNo�rts to i►terprat Ehe data avaiable_
/ una�erstand th�at arry false s�lbm�ent maY ae P�bAa by fine or impisor� w�der ?8 U S Cod�e, Seclion J00�J."' ,, -
� Che�k her�e if c�nxnents are provided on badc of form. Were I�hide and �gitude in Section A provided py a.�
❑ Chedc her�e if �. Goensed IarW surveya? � Yes ❑ No '
cer�rg n� euc�NE r crauoEU. License Nunber PLS 4821 ,
Tit� LAND SURVEYOR
Addr�ess 2321 PIN OAK LAI� EAST
Signatur+e y.q������
_�C!
FEMA Form 086-0�,33 (7/12)
CamParry Narree SEI_F
Cdy CLEAitWATER
U�e fil032014
S�� �.
Z1P Code 33759
Teieptane 727 459-9186
See reverse side for oordinua6on.
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Replaces a11 prevw�s
ELEVATION CERTIFICATE, page 2
IMPORTANT: in Uiese spac�. coPY the correspond'm9 information fmm Se�tion A.
Buiiding Streei Address ("mduding Apt-, Unft, Suite, anci/� Bldg. No.) or P.O. Rarte and Bo�c No-
3083 OAK CREEK DRIVE NORTH
City CLEARWATER State FL ZIP Code 33761
FOR INSURANCE COMPANY USE
poGcy Nunber:
Compa�y NAIC Pitanber:
SECTION D- SURVEYOR, El�M�NEER, OR ARCHITEGT CERTlFlCATION (CONTINUED)
Copy both sides � th� Elevatia► Gertificate for (1) commurrity oifiaal. (2) insura°ce a9e��Pa�Y� and (3) building owr�r.
Commetrts
1. GARAGE SQUARE FOOTAGE CALCULTEO FROM PROPERT�' AF'PR�SER INFO_
2, IOWEST MECHN�CAL BEING THE A!C UNIT ON THE EAST AND WEST SIDE OF STRUCTURE• BOTH BEING THE SAME ELFVATION.
Signatur�e
SECTION E
Date
INFORMATION (SURVEY NOT RE(�UIRED) FOR ZONE AO AND ZONE A
e items E1-�5_ If tt� Ce�tificate is irrtended to support a LOMA or LOMR-F request, compiete Sedions A B.
For Zones AO and A(wi�a� BFE), complet
and C. For Rems E1-E4, use nat�xal grade, if availabte_ Chedclhe measuremerrt used. in Puerto Rico ony, enter meters-
E1. Provide elevation i►�formation for the following and d�edc the approPriate bo�ac�s to show whether the elevation is above or below the highest adjacent
grade iHAG) and the lowest ad)aoer►t 9rade MG)• fcet ❑ meters ❑ above a� � below the HAG.
a) Top of bottom floor (induding basen►ent. c�awlsPace, or endosure) is �� � m� � abowe or � 6elanr the LAG.
b) Top of bottom floa� ��ducing basement, c�sPace, or end�ure) is •- ❑
E2. For Buiid'mg Diagrams G 9 v�ith Permar►ent R°°d openi�9$ P�'O�� in Sec�ion A Items 8 andlor 9(sce pages 8--9 of Ir�tr►�lions). the nead hi9her floor
teet m�ers ❑ above or ❑ below the HAG.
(elevation C2.b in the diagrams) of the biril�ng is - ❑ �
E3. Attached garage (top of slab) is . ❑ feet ❑ meters ❑ ab°ve a❑ b�� ��G.
E4. Top of platform of machinery anNor equipmerrt senrian9 the buiiding is . ❑ feet ❑ meters ❑ abo�e or � bebw the MAG.
E5. Zone AO oniy: If no flood depth r►umber is available, is the top of tt�e bottom floor elevated in accordance with the �mmunity's flood�ain management
ordinance? ❑ Yes ❑ No ❑ UnknoNm. The �ocat offiaai must certify this infortnation in Section G.
SECTION F- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The proper►y owner or owner's authorized representative who canPietes Sectioris A, B. and E for Zone A(wikhout a FEMA-issued or corr►municYassued BFE)
or Zone AO must sign here. The stat� in Secdons A, B, and E are comed to the best of my knowled9e•
Property Owners or Owne�'s Authaized Repr�esentateve's Name
Address
Signature
Cornrr�erris
City
Date
State ZIP Code
Telephone
❑ Chedc t�ere if attachments.
SECTION G - C�MMMUNITY INFORMATION (OPTIONAL)
The Iocai otficial wFro is authorized by iaw or ordinance to administet'the comm�s floodplain management orcfinance can com�te Se�s A. B, C(or E}, and G
of this Eleva6on Cer6ficate• ComPiete the a�plicable �rt►is) and s�n bdaw. Chedc the measurement used in Ifierns G8-G10. tn Puerto Ric� only� errter meters.
G1. ❑ The infortnation in Sedi� C was taken from other doaanentation tl�at has been signed and sealed by a dc�ensed surveYor. entJmew. or archited who
is authorized by law to certifj+ elevation i�ormation. (Indicate the source and date of the elevation data in the Commerrts area below.)
G2. ❑ A comm�ity of�ial oom�ted Section E fa a building located in Zone A(without a FEMA-issued a' c�ommurity-issued BF� a Zone AO.
G3. ❑ � �onowirx� in€wmation pcems ca--�� o) is arnviaed ror canmuniry tioodp�a�, managemern w,rposes-
G4_ Permit Niunber C5. Date Pe�rnit issued
G6. Date CeftifiCa� Of Compl"ianae/Oocupancy Issued
G7. This P� � been issued for: ❑ New ConsUuction ❑ SubstaMia� Improv�nent
G8. Elewdtion of as-bui7t lowest tloor (induding basement) of U�e bui�din9: ❑ feet O�ers
G9. BFE or (n Zone AO) dePth ai floodm9 at the buitdi►�g si�e: ❑ feet ❑ meters
G10. Communiqt's design flood elevation: �� ��t�
Local Offidafs Name
Community Name
Signature
Title
Telephone
Date
�.
�. ,
�. ,
Comments
❑ �hedc here if attac�ur►eMs.
FEMA Form 086-0-33 (7��2) Replaces afl 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 Addness (induding Apt., Unit, Suite, andlor Bidg. No.) or P.O. Route and Box No.
3083 OAK CREEK DRIVE W.
City CLEARWATER State FL ZIP Code 33761
FOR INSURANCE COMPANY USE
Policy Number.
Company NAIC Number.
tf 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; 'Frorrt VevJ' and "Rear vevw; and, if required, °Right Side VieW and °Left Side
Vew." When applicaWe, photographs must show the founda6on with representative examples of the flood openings or vents, as
indicated in Section A8. If submit6ng more photographs than will fit on this page, use the Continuation Page.
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FRONT VIEW (6/OZ/2U14)
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FEMA Form 086-0-33 (7/12) Replaces all previous edifions.
ELEVATION CERTIFICATE, page 4 gu�Iding Photographs
Continuation Page
IMPORTANT: In these spaces, copy the corr�ponding information from Section A.
Building Street Address (induding Apt., Unit, Suite, and/or Bldg. No.) or P_O. Route and Box No.
3U83 OAK CREEiC DRIVE N.
City CLEARWATER State FL ZIP Code 33761
FOR INSURANCE COMPANY USE
Policy Number.
Company NAIC Number.
If submitting more photographs than will fit on the preceding page, affix the addifional photographs below. ldentify all photographs
with: date taken; "Front Uew" and "Rear vev�'; and, if required, 'Right Side Vev� and `Left Side vew.' When applicable,
photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.
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RIGHT SIDE (6/02l2Q14)
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LEFT SIDE (6/02/2014)
FEMA Form 086-0-33 (7/12) Replaces all previous ediiions.