945 BRUCE AVEu.s. o�p,anfru�Frr oF �o�u�uan s�cu�rr ELEII:ATiC��t GERTIFiCATE
FEDERAL ENI�ROEHCY INAMA{iEMENT ACaENCY
;i�U1ttNKll �If1�7t� Itt3ttlCtJiCC P`FO�fQM IiiI�Q�A�i{: R��d 4Ii� I:I�R�OTi� OI� ��� �'"W.
3E�Ti+I�N A — PRQPER'EY INPC1RMAiEON
At. 8uiidi�c� C}wnsr's Fl�me R4jBEf��' J: ItN� LtN[}A J. i�U�3ll.tt3.S' tA-76612
A2. B�itdiag Street Addreaa (inafwK4ing Apt�, tJn�, Suite, �ndla� Bklg; Ncs.) or F'.t7. Raute and �ox N�_
C�fy C(:i?At�i{NAT�R
State �� ZIP Cade 3376'i
QM8 Na. 1 8
E.�piration oate. July 31, 2ats�
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:E t:OMPANY US�
I�tUmt�f:
A3. Pro�rty DBSCtiption (lot and 8fock Numbers, Tax Parcei Number, tegai i)asGrip#on, atc.) _�.�� �__�
PAiiCEI iD - 05-29-1v�54��8-4�8-Ofl24 NO7 FOF2 CdN87RUCT10FE, NG1T �tNi CS�SIGN
A4. Bu�lding Use �e.g„ Resulenaiel, Non-Reside�aEiai, Artd��an, �4r,cassexy, et�.} ��� �. _ _ _ � � _ ..,_,�
A5. C�fitudeflan�iiude: Lat. ��`5��7" l,ong. -��.��'��,�;. Heriaontai C�edum: (� NA� 182i �C %iAD 198�
A6. Aitach at f�ast 2 attotographs of ihe buikl�r�g if ttse Cert�ficaGa is beir� t�ed ta c�6tain Rood insurance.
A7. Buiid'ing Diagr�m N�tmbst ;�t
A8. fiar a buikf in� with �a cr�+rxispace cr enctosu�eis?: A9. Far a bui&iinp wilh an atka�ct�d gatage;
a) Sc�uare tootage nf arawlspar� s�r enc#oaure(s} t+� s4 � �3 �i�e toaia�e of attxhed garage � sQ �t
b} Number uf �imanent fload vp�enings in threr crawtspar,e b} Numder W permanenf flood apenasgs i�► the atta�ch+exi �arage
4r enctosu�e(s) within f.� toot abcve �djac:erK gtade � wRh#n t.d toaE abave �ijacer►t gr�le E�/
c) tataf nat area ot i�pcd open�ngs in A8.b � sq in c} Tat�ri net area � f�ai apenings in A9.b t� sq in
cf} Engirsaered fl4od q�nings? Q Yes X Dto dj �r�ineered i�a�d � ?
npen�ngs [� Ye.s X Fio
S�CTIC�N �— FC�#i4O lNBURAN�E RA7`E MAP (FIRM} 1NFORANATt1:JN
8t , tUF�P Cur+�nrurr�y Na� 8�ommun�ty Number 82. Courrty i+�e
GtTY tJF CLEARVYAT�i2- 12�a496 PINEL#AS
,__..___ ___._ � .—
B4. MaplPanei Number 65. �uffu� 8&. F1RNI [ndsx U�te �7. FIf2M P8ne1 �
12443C-Q102 t; � Qif18J2�A9 ��er.tiVB�eYiSBd C1�te
_._ _ �1031�Of?3
83. Si�te
FI.QR#DA
B$. �ktbd �J. B�s� �bod ElevatiostZa} (2one
Za � s} A4, u�s base flaod depth}
- ..�.._. ,.. � _ ____-.___ � ..
810. indicate the �surce o1 the Base Flocxt Et�ration (B�Ej data or bese ftocd r�ptA eatered in ftem �8.
[j FiS Prof�Ie X Fti?M Q Gc�t►munity C2eteimir�ed (� ahe[1SaureB«
811. lndtcate �teuatiaa datum used t�r BFE in item 89: C3 NGYD 1928 ?t NAVb 1988 (� OtiEerlSaurca:
812, Is the building {acated in �€ Caa�tal Barrier Resauctss System (GBR�j area or t)iherv�e Pruteaad Area (t1PA}? Q Yea X�fo ,� �1
Designatian Oate: [� GBR3 (� OPA `,..}
5ECT14N +� - BUiLb1NQ EI.EifAT#O�1 iNFt'3RMAtWAf (SUF!'VEY RE4UIREE3i i,s�
C1, Building eievallons sre based an: [j Cwtatruction Clrawinys' (� gui�ting Urnler Gor�structhm" X Fiaished Gonstruction `v,,.,j
"A new Elevation Certitkate wilt 3�a required when construckicn of the buiktity� ta t�mp�te. `
C2. Eie�2tions - Zot�s At-R3t3, AE, l�H, A{dv€#ts 8Ft'�� VE, V�--V3fl. V(w�ft 6FEj. RR, A�i11A. A#ttA�, AR1Ai-A30, AWAti, AfltAO. C.,a�npte#a Ifems G2.�-h
below according tn the bu�iing diagram specified in It2m A?. !n Pu+�fa R�:o only, entex metara. t
B�nchmaAc Uti€ized: A���,�� Vertica! Datum: ��{D 1998 �
indir.afe elevatior� datum used for the elevatians � r`tems a} ifivat�gh M} Deiow. Ci NGVD 192�1 � NAVCt 1988 CI Other/�rc�: ,�
L?atum used far buiiding etev3tions musi he the sairce as thst �d %r the8f'E. --�
GFteek EAe me8suterst6nt uSed.
a) �`op of bottan tbor (inciudiny� basement, crawlspac�, or er�k�sur� floor) �.� X teet Q mefers
b) t"op of the next higher fioot �•� X� %et [3 meters
c} Bo#tom of the tawest hariauntai structural �rsambec (Y Zgr�s onht} �[.� X feet (� meters
a� �n�ct,ed ��aqe �w� o� s�a�} �;� x r� ��e�e�
e) 4ocw�st eteuatian of machinery ar equipmerrt ssrvicirrg the buikfi� �.� X faet (� mete�s
(Describe type of equipment artd location in Camm�nts}
� Lowest adjacen4 (finishedj grade neact to buikiit�g (LAGj �:� X teet [] rr+eters
g} Highesf adja�rtt (fittishad} grade nead to build#ng (NAG) �;� X feet [,1 meters
h) lawest adjacent grade �t Icr,vesi e�uat�orr of ctedc or s#�irs, irtcludi� siru�2ur�t ;tuppat j�l.� K feet ❑ eYaaters
SEGTIt3N t3 -BItRY�Yt?F2, ENf`sINEF.R, 4R ARCNI'iECT CERT1FtCAAtiOM
ihis cnrtification is fo be signetl �nd sealed by a t�nd surveyor, engin�er, ot a�rch#ect auiha�izec! isy law Eo txrlify efe�r�tlon
intarmatian. t cenlily Uta2 the inlS�rnatiun on tt+is Certif'�ata rap�sa�s my best eilorts ta Inierjsret Me data availsbte.
� understarnd ihat eny lalse statemartt rney be purrlshabd� by fine av' /mplfsorr»ter�t �tdeT f8 tJ. S GOd� SectFott iUOi.
� Che�ck here if ct�mments a�e prov&fed on back af form. Were FatiEude and tongitude � Secflon A provkftd by a
� Check here tf attac�tte�ts. Iics+�ed tand �un�eyor? Q`� Yes (] No
Cettifiet's Netrte �EtAtet[} �. �kySARCJ�
te
l�Cense NumDer 3859
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Tiite £� L.5 Cornppny Narn� FCA S11�1t�YS
Address 388+1 PR Ft�SS RV�. 1�14 City MA���S �_..... Stats �i. ZfP Cade 34144
Signature
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iT�te 101'f�t'�ptd T+D�BP��� 239-4U3-76t�ii
See reverse side f�r con�inuation.
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Replaces atl previous �ditions.
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IMP+C)RTANi; in th�ae a�ra�cea. co�ty ths ccrresponding 9nfornra�ian fc°�m 8ection A.
Bu�iiding Street Acitlres� (iricludittg Apt., Urtit. Suite, andtor BEdg. Mo.) or P.O. Ruute and 8nx tVn.
�4� RRt1C� AV�
Gity GL�Al�W,�TGR State FlORtt7A i!t' Gcde �7�7
Ft7ii INSt�iANCE Ct}MPANY USE
P'aliCy t�umber:
Gompany N11tG Number.
SECTIC'!N tt - SURVEI/t)!2, ENt31NEEit, +DR Ali+GNITE+CT CERTIFIGATtON {GON'fINU�E�)
Capy both s�es of this Etevation Gertificats for (1} cc�nmunity oHGCia#. (2) i�u�anc� agentJaompany, end t3}bui{ding oamer.
__.__.. _�_._.w �ma.�. �., . .._
Comments GPS Ci3t�l�t�11VAT�S Vx1�f2E �'AK�td �M �O�C;i»E �iN. N07 FQR CC�Ai�TRUC"f'EC�N, �7 �Ott i3�3lGW. PLOO� ZOt�t�
DE'�ERMtNATiiJN Pi�(1VC0�0 8'f ��t�C3D 1Pt�I�HT�. iNIS t7A�`A WAS PF�tEPAREt� FClii �1.�G! #M�UftflN�E PURP'OSE'�u i}Ni.Y,TH� �titJtPM�tYT
IJS�tJ IS GPS. 7F#�RE �XiS S A 0.2' CI "� S} i��.tt5 t3i� MIi�1ti� P!�£GtS1i7N: ITENi LlST�C3 tN G2(e} �� TME �f,iNG�tET� AtR C{}[VOtT4flNlNG
pAC3, (:3ATE C3� FIEIt:� i0fi3! 14f ��"
� .1r.r�+��r ° Y1E}G� �"'
Signature f"' ' (��'' - - �/ Date tS?J1312�td
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3ECilC1 E- B�UILt�!iNii ELEtitAT1fJN! INF'QRM�►TION ��URt�EY NOT ttEQUIFtED} F4R ZONE AO AND 2CiNE A{1MTHQUi BF�
For Zanes At7 and A(withaut 8FE}„ cCmpfe#e ikems �1-E5. if the Certitkate is �Stended t4 support a LpAAA or LUMR-F ra4uest,. canplete 5ec�ions A, B.
and C, For {tems Ei--E4, us�a natural grade, i� avaRfahls. Gheck the rrteasuremer� used. In Pue�to R'sca anty, enter rneters.
E1. Provide alevatian fntorrnat°son fot ttre foito�vC�g and cF�eck ths aApe'��iat� b�ix+a� to �h�ri+r whether the �6�+aEitsn is at�e or C�alovr the higi�f axfjacerrt
grade (NA�} and the I�,vest adjac�nt grade {IAG}�
a) Top af battom 800r {inctu�ng bas�ment, craw�pace. or enddswe) is Q feet (� mekers ❑ above ar � be�ow ihe HAC3.
bj Tap af bottom Hcx�r {Inctudtng basemeni, �rawispace, a endosure) � Q iee2 ❑ mstets ❑ abave or ❑ Bstow #he iAG.
E2. For Buildirig Dlagrams 6-9 with petmanent flood openings prov��l in Sectl+an A Items 8 andtor 9(see es 8-9 oi instruCtrons}, the next �tigher floor
{eleva�4n CZ,ta in the dia�tam$} of tErB bttJldl�tg is ❑ teat ❑ met8ts [j �bdve or �iow Ehs HAC3.
E3. Attached garaqe (toP of �i�b? is C] feet � m�sters L7 a&orre or Q t�bw the NAG,
Ed, Top of piationn of machinsry andlor equipment s+arvicing the i�r�iin9 ia �7 feet C� mattess Cj abave or [j below the HAG.
E5. 2ene AO ortfy: tf �r� f�csas# depth rtumber 'ss avai�ble, is the t4p af � boftom �r el�,raied 3n accc�rdan�e with tha comr�un�y's fioodplain managernenf
ardinance? [j Yes (� Fio [j Ur�known. The loca! r�ff`iaaE must s�rtiPyrthls informatbn in S�tian (3.
��CTC4N F- F'Rt�PERTY OiNNEfi {i"�R OWNER'� EiEPRESENTA�'IYEj C�R�'iFICATiON
The pfnperty owne� nr owne�'� autharized r�p�resentative wflo cc�nptetes Secfions A. 8. and E far Zc�c�e A(v�thout a FEMA-issu� or commun�yr-issued 8��}
or Zone A4 must sign here. The ststems�t$ in Sectfons A. B, articf E are car€ed to the best of my knawledge.
Property Owne�'s or Owner's Authorized Repre�ntative's iVar� �.��
Addr�ss
Signatu►e
Comments
SEC�ION G -»
Gity
Date
Stata ZiP Code
Tefephon+a
■ :s �::r.r,f- ; -
71re Iuca� aftiaal w#ro is auEhcsr�ed by Eaw oc ardinan�a to �iminiseer the co�nnun�+'s .' managerrre� adirtanc� csn cw�rrpteEe Sections A, 8, C(ar E}, and G
oi` this Elevatiaf +Gertificat$. Canp�e tire appticatafe it�n(s) and sign bebw. C.heck the m�asurement used in ttems G&G1i}. In Puerto Rko anly, enter mefers.
Gt. ❑ The infotmatian i�f Section C was iaken from csttrer doeumer�ta#ion 2hat ha� heen signed aaci seated by a ticensed surveyor, engineer, ar archifect wrMo
is autharized by law tc �rtify e�vation in#atmation. {End�ate the sEwrce snd date �fhe elevatinn data ir► the Comments a�rea betow:j
G2. Q A canmunity official cumpleted Sectian E iar a building focated in 2ane A{w�#raut a�EMA-i�sued ar community-issued BFEj or Zone Ad.
G3. a The follawinq intrsrrnaticss� (items G4-G1�� is proviid�d �or community Aaaiplain mar�a$eme� purposes.
Permit Number
[�ate PermR Issu�f
r,e. oate cert�cata
G7. Fhis permit Mas be�n issued fw: �j N�w Cpnstruc:tinn Q$ubstar►tiai improveme»t
G8. E�evati�n at as-built �owest �oor {in�tud'€ng basement3 ot the #uilding: p teet Q meters
G9. BFE or (in Zone AO} depth of ft�ing at the buiiding site: Q ftef ('� m,eters
G t U. Community's des�gn ftood eieva�tio�s; _,._..� C� taet (� meters
Lacai OflioiaPs Nams
Camrnunity Name
S�nature
Comments
Fi�'7
7'etephor►e
Oate �
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-- (.� �h�,t►�re if �tfachments.
�EMA Form 086-U-3� ('T112j Repiac�s a!i prevvious e�itions,
E��YAi(ON CER71l=t�ATE, ���� � g��idi�+� Pltt�tt��r�tphs
�ee instn�ctia�s for ttam A6,
IMPORTAN7s t�r thesa space�, ccpy tt�e corre�p�ndi�ng tnformatian iicrm Sect�on A.
Buitding Street Address (including Apt.. Unit. Suite, andtor Bldg. Na:j or P.Q. Ftoute and Hox Nn.�
��#5 BRUC� AV�
City CIE�RWAiER
Siate �t„(�iit01� ZiP Co+ie 33787
�tsR ��su�nrtcE eo�np�tr�Y us�
Company
Ifi using fhe EEevation Certificate to obtain NFIP ttnod insur�nce, aifix at ie�st 2 buiiding pi��tographs below arxxsrding t4 the instruct�ns
[or ltem A6. tderttify ali phota�raphs with date taken; '"Frant VEew" and °Rear Viev�'; and, it rec�a�ired, "Right Side View" and �Left 5ide
View." Wh�n applicak�e, Pho#ographs rnust show the foundat�at wi#h repr�sentative e�mples of thr� flaod apenings c,r vents, as
indicate�i in Section A8. tf subrnitting mrare phq#�sgraphs than wiik �t on fhis �ge, use Ehe Cor�tirtuatior� P�ge.
I.EF"f S(t3E ViEW 1(It13l�E}14 _
FEMA Farm t186-4-33 (7112) � Repl�es all previaus editions.