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8 MIDWAY ISLAND' U.S. DEPAR'i"eNENT OF HOME�AND SECURITY FED�RAL EMERGENCY MANAGEMENT AGENCY National Flood Insurance Program ELEVATION CERTIFICATE importa�t: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION PAUL W & ZOZ, DANIELLE A2. Building Street Address (inciuding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 8 MIDWAY ISLAND City CLEARWATER State FL ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) ISLAND ESTATES OF CLEARWATER UNIT 3 LOT 14; ID#08-29-15-43344-000-0140 OMB No. 1660-0008 Expiration Date: July 31, 2015 FOR INSURANCE COMPANY USE A4. Building Use (e.g., Residential, Non-Residential, Addition, A�essory, etc.) RESIDENTIAL A5. LatitudelLongitude: Lat. 27°58'27.04"N Long. 82°48'47.21"W Horizontal Datum: ❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1A A8. For a building with a crawlspace or enciosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) N/A sq ft a} Square footage of attached garage 644 sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b N/A sq in c) Totai net area of flood openings in A9.b 0 sq in d} Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bi. NFIP Community Name & Community Number 62. County Name 63. State CITY OF CLEARWATER #125096 PINELLAS FLORIDA B4. Map/Panel Number 65. Suffix 66. FIRM Index Date B7. FIRM Panel 68. Flood B9. Base Flood Elevation(s) (Zone 12103C0102G G 08/18/209 Effective/Revised Date Zone(s) AO, use base flood depth) 09/03/2003 VE 13 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69. ❑ FIS Profile � FIRM ❑ Community Determined ❑ Other/Source: Bi i. 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 (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes � No �,,, Designation Date: N/A ❑ CBRS ❑ OPA SECTION C- BUILDING ELEVATION INFt?RMATlON (SURVEY REQUIRED) 4 Ci� C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction' � Finished Construction � *A new Elevation Certificate wifl be required when construction of the building is complete. C2. Elevations -Zones A1-A30, AE, AH, A{with BFE), VE, V1-V30, V(with BFE), AR, AR/A, AR/AE, AR/Ai-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: G-04.5 Vertical Datum: NAVD88 indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 � NAVD 1988 ❑ Other/So,urce: 1 Datum used for building elevations must be the same as that used for the BFE. � Check the measuremerit used. a) Top of bottom floor (including basement, crawlspace, or enciosure floor) 6.3 � feet ❑ meters ` b} Top of the next higher floor 16.6 � feet ❑ meters �` c) Bottom of the lowest horizontal structural member (V Zones only) 5.0 � feet ❑ meters � d) Attached garage (top of slab) 5.9 � feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 6.1 � feet ❑ meters � (Describe type of equipment and location in Comments) f) Lowest adjacer�t (finished) grade next to building (LAG) 5.1 � feet ❑ meters �� g) Highest adjacent (finished) grade next to building (HAG) 6.1 � feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structurai support N/A._ � feet ❑ meters J SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION ,,�� v ��,,, This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. ! certify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. � Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a � ❑ Check here if attachments. licensed land surveyor? ❑ Yes � No : Certifier's Name ERIC J. HENDRA, P.E. License Number FL48883 ! Title PRESIDENT Address 5028 W EST Signature ,,,_� Company Name HENDRA & ASSOCIATES, INC. City TAMPA Date 8/30/14 State FL ZIP Code 33629 Telephone 813-419-7878 �\��G ,� G E N SF �O /��: .��Q , . � �9 f� � , � �''`°'�u�„-; �r � �, Eric J'He'ndra, P.E. ; � ?J �� SrATEfAF ; ll1 �� , 8/30/14 ,� 11,! • j��S -�tORtOA ' �\�� ���i�S��NAi-.Ea��`` FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. tLtVq,l IUN l:tH I 1tIl:A 1 t, page z IMRORTAI�T: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. 8 MIDWAY ISLAND City CLEARWATER State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number: SECTION D— SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2} insurance agenUcompany, and (3) building owner. Comments Item A7. - Subject prop. is a residential 2 story structure 2-car garage with NO crawlspace, with vents. Slab on grade. illtem B9. - Subject property lies partly in Zone VE13 & the majority in AE12. Item C2.c. - Lowest structural member is base of finished floor slab. Item C2.e. - A/C condensers reside on the N side. Signature Date 8/30/14 SECTION E� BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without 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 N/A._ � feet ❑ meters ❑ above or � below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is N/A._ � 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 Insiructions), 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 NiA._ � feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery andlor equipment servicing the building is WA._ � feet ❑ meters ❑ above or � below the HAG. E5. Zone AO only: If no fiood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F— PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION 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. Prope►ty Owner's or Owner's Authorized Representative's Name Address Signature Comments City Date State Telephone ZIP Code Check here ff attachments. SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain managemerd ordinance can complete Sections A, B, C(or E), and G of this Elevation Certificate. Complete the applicable Rem(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico onty, eriter 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 Zone AO. G3. ❑ The following information (Items G4—G10) is provided for community floodplain management purposes. G4. Permit Number N/A G5. Date Perrnit issued N/A G6. Date Certificate Of Compliance/Occupancy Issued N/A G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-buiit lowest floor (including basement) of the buiiding: N/A. � feet ❑ meters G9. BFE or (in Zone AO) depth of flooding at the building site: Gt 0. Community's design flood elevation: Local Official's Name Community Name Signature Comments N/A. � feet ❑ meters N/A. � feet ❑ meters Title Telephone Date Datum Datum Datum Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. � E�EVATiON CERTIFICATE, page 3 guilding Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unft, Suite, and/or Bldg. No.) or P.O. Route and Box No. 8 MIDWAY ISLAND City CLEARWATER State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number: 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 all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. � z .- M ,r��.., �' � � �;��� � � � � � . .. .' � � � �., t.� .eF Y � � _ . .. . ... . . . .. ,�� � � - � � „, ��� t,.,r� ... .. . '�-�-» ,. r; . � a, t E�1�!".<"+!+e„c.'i^ra`* v,2 �� y.. . �!�!! ����� � � . t°'� � �;� .. ��� ��� � . . � � .;� �� ` �! "'`�.,� `''�' . _._� },,, ,�.y} ,L�'� �: �.y '� �,, y�py {� .. �� �..':8'�' '4'+r� i�iii ,Vp r�:° . � � '�� ��,.,.a,.� �: ,�� � �e. � ��'�����f�`5� � ��f � . _ � ___,. � � ��� �� ��*•� i 3 � k a�'�� �� � � 'xr "."�+: �� e�. � _ a ;.y�„" .. .. . r ' ♦ ' �`��' 4-� Y' , �„ ��z." � �ac �"�`►� � �; `3 � � .. �..w Front and North East face of bld HAG View NW �€���f�i.: ���. �c�.. � r� � � r � � :.�a � �'� r Side and South face of building. View FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEV'ATION CERTIFICATE, page 4 guilding Photographs Continuation Page IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 8 MIDWAY �SLAND City CLEWATER State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number: ___ If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. �.. �.. ��. °• �- �r',, �4��" '.s�'!' � ���� � � w`' � �^' �,' � ������ � :��� _ � -.�..�� �_-�,.w_.� -W-� _..� Yp 44,. i f;; � 4` Southwest corner and side of building. View N North side of building w/ A.0 units. View W ,�; ��.�?� � : � . ' ` X°` ' � '" y � _ � � : � ' � �.'�f '� Q�� ��„,�*;� . ,� �� � ��, � �". . . �. �r'.';� �r �.�+,� ,a.r� , : . �, x 4 �r. � , .;' a' � : : .,�„' � '� � ' �,�, , ^ y � e _ �;�.„la.�- . . �.. `�, �� . ., .yea^""`; fi - , ; x .. . , . . __:..,,.. r. . ..a � . � . .. . . .. � : _ � � �� � � .. � . � b ' ]��� $ I �° � � � '$ g�#� �m, '� q 3, . _ d �N '�` i''� �.. � �aa,� �ra , � � S q ✓'� .. ' �' . :d .. ... " .. � h �t �'� � r �" :�1 � �� � � :,���� , . �� � -,� �� . �. :� � , � � . : ..� �. �, �: ... , _� , K �_ �, ��..�:�`.._. . 1 _ _._,�,���� , . .�,����'`� . � . . Rear and Northwest corner of building. [LAG] View E Rear of building. View SE. FEMA Form 086-0-33 (7/12) Replaces all previous editions.