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941 MANDALAY AVEU.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 FEDERAL EMERGENCY MANAGEMENT AGENCY National Flood Insurance Program IMPORTANT: Follow the instructions on pages 1-9. Expiration Date: July 31, 2015 A1. Building Owner's Name BEN AND GEORGIA MANOS A2. Buiiding Street Address (including Apt., Unit, SECTION A - PROPERTY INFORMATION , and/or Bldg. No.) or PO. Route and Box No. FOR INSURANCE COMPANV USE Policy Number. Number: ��� CLEARWATER State F� ZIP Code 33767-1037 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) PARCEL 05-29-15-54666-059-0010, BLOCK 59, LOT 1, MANDALAY SUB, PLAT BOOK 014, PAGE 032, PINELLAS COUNTY, FLORIDA A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RfSIDENTIAL A5. Latitude/Longitude: Lat. 27��5 Long. - 82•8262 Horizontai Datum: ❑ NAD 1927 0 NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Buitding Diagram Number EIGHT A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 243� sq ft a) Square footage of attached garage 231 sq ft b) No. of permanent flood openings in the crawlspace or b) Number of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade 4 within 1.0 foot above adjacent grade NA c) Total net area of flood openings in A8.b 2269 sq in c) Total net area of flood openings in A9.b N�'4 sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP CommunCLFARWATER�CITY OF N250�r 62• County Name P�NELLAS 63. State FL B4. Map/Panel Number 65. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ 88. Flood Zone(s) B9. Base Flood Elevation(s) (Zone Revised Date AO, use base flood depth) 12103C0102 G OS/18l2009 09/03/2003 AE 11,p FT 610. indicate the source of the Base Flood Elevation (BFE) data or base flood 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 1988 ❑ Other/Source: 612.Is the building located in a Coastal Barrier Resources System (CBRSj area or Otherwise Protected Area (OPA)? ❑ Yes � No Designation Date: / / ❑ CBRS ❑ OPA SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* � Finished Construction *A new Elevation Certificate will be required when construction of the building is compiete. �� ` C2. Elevations - Zones A1-A30, AE, AH, A(with BFE), VE, V1-V30, V(with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: GPS Verticai Datum: NAVD 1988 Indicate elevation datum used for the elevations i� 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. a) Top of bottom floor (including basement, crawlspace, or enciosure 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 equipment servicing the building (Describe type of equipment and location in Comments) fl Lowest adjacent (finished) grade next to building (�AG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or st,airs, including structural support Check the measurement used. 5.5 � feet ❑ meters 6.56 � feet ❑ meters N/A � feet ❑ meters 5.76 � feet ❑ meters NA � feet ❑ meters 5_5 � feet ❑ meters 5_6 � feet ❑ meters 5_5 � feet ❑ meters 4., l r,�"; �. �`, ti __i �.. _4� .,. • _"1 r" � ,--. .-... �_� ��. SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certiiy elevation information. 1 certify that the information on this Certificate represenis my best efforts to interpret the data avaiiable. �, ,_ '� = H r �� 1 unders[and that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 5001. �. +^ 0�,,5� ���, ❑ Check here if comments are provided on back of form. ❑ Check here if attachments. Were latitude and longitude in Section A provided by a licensed land surveyor? � Yes ❑ No FEMA Form 086-0-33 (7/12) ` See reverse side for continuation. Replaces aii previous editions. ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the corresponding ir�formation from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P0. Route and Box No. Policy Number: 941 MANDALAY AVENUE �itY State ZIP Code Comparry NAIC Number. CLEARWATER i ' �� ,': FL 33767-1037 � yE a,;�. �SECT�ON D'� SWRV�YOR, ENGINEER, OR ARCHITECT CERTIFlCATION (CONTINUED) Copy both sides of this"a�'t n Certi%ate fCir ��) .co�nmunity official, (2) insurance agent/company, and (3) building owner. �, � .,sy� , Comments p,C Ut�iFfilS,C�N TH� ROC?F�1� ` LQIN�ST.�l�00s'�l E E �TIC�'JS 6,56 FEET, NEXT H►GHER ELEVATION IS 7.22 FEET .... °; � 1 �� . a' ,� '�! � . 4,1 /J!� �r�yl � :.. , .� ! ..� iJ . . � . : - �. . Signature ' `g � �,'' ' � Date `�G�_ � .. � � :'. Ar � � " OS/28/2014 SECTION `E �"+t�,IILDIN��LEV�Cf'ION INFORMATION (SURVEY NOT REQUtRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones A0 and A(wFthp�tt; BFE), complete Items E1—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is . � feet ❑ meters � above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is . � feet ❑ meters � above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is N� . A � feet ❑ meters � above or ❑ below the HAG. E3. Attached garage (top of slab) is . � feet ❑ meters � above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is . � feet ❑ meters � above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodpiain management ordinance? � Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F— PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFlCATION The property owner or owner's authorized 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 correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address Signature Comments City State ZIP Code Date Telephone ❑ Check here if attachments. SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C(or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE) or 2one A0. G3. ❑ The following information (Items G4—G9) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantiai Improvement G8. Elevation of as-built lowest floor (including basement) of the building: . ❑ feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the buiiding site: . ❑ feet ❑ meters Datum G10. Community's design flood elevation: . ❑ feet ❑ meters Datum Local Official's Name Title Community Name CLEARWATER CITY OF Teiephone Signature Date Comments ❑ Check here if attachments. FEMA Form 086-433 (7/12) Replaces aii previous editions. ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS CONTINUATION PAGE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) o� P.O. Route and Box No. ADDRESS: 941 MANDALAY AVE CLEARWATER, FL 33767 PICS TAKEN 5/27/2014 FRONT VIEW AND CONTINUING AROUND BUILDING <� � �: : , � W x 1 � ��� � e ,„��� � � ��fotr-.:., ��` � �,.. � ._ _ �u .._.�.� .... � � . , . , af �.... �,�� i � � �� . ,� y �'✓� a� " y. ��&� ��� � � � , �.. .,:�,� �",.� a�1�, ' _ ' °aflrli ..-... � ii � .�.� . �,� < � . ` — � � "��� _�`* � � � - '"�.. �.- , n, J,% � - �++� � ��:�s� v wx•,,a�:+�'E,�, �,a�.,,_ �. Lyf Y► i �� e.- `- H� �IIi �r1 �`"� ;,o. ,�. '' � ,�b;.. 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