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801 ISLAND WAYPage 7 of 4; not valid without all four pages. U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY Nadonal F1ood Insurance Program A1. A2. Building Street Address (including Apt. ELEVATION CERTIFICATE IMPORTANT: Follow the instructions on pages 1-9. SECTION A — PROPERTY INFORMATION and/or Bidg. No.) or F.'O. Route and Box No. OMB No. 1660-0008 Expiration Date: July 31, 2015 FOR INSURANCE COMPANY USE Policy Num6er: Number: CLEARWATER BEACH ur t,oae FLORIDA 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) TAX PARCEL ID: 05-29-15-43458-000-0330 A4. Buildmg Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.)RESIDENTIAL A5. Latitude/Longitude: Lat.27 59 35.7 N Long.82 49 13.4 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 1g A8. For a building with a crawlspace or enclosure{s): A9. For a 6uilding with an attached garage: a) Square footage of crawlspace or enciosure(s) NiA sq ft a) Square footage of attached garage 506 sq ft b) Number of permanent flood openings fn the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade 0 within 1,0 foot above adjacent grade 0 c) Total net area of flood openings in AS.b 0 sq in c) Total net area of flood openings in A9.b n sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B— FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Name & B2. County Name Number I B5. Suffix I 86. FIRM index Date I B7. FIRM Panel Effective/ BS. Flood Revised Date B3. State B9. Base Flood Elevati� AO, use base flood 121 �3C - 0102 � G � 8/18/2009 � 09/03/03 I AE I 11 & 12 B10, 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: 611.Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 �] NAVD 1988 ❑ Other/Source: B12.Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)1 ❑ Yes � No Designation Date: / / ❑ CBRS ❑ OPA SECTION C- BUILDING ELEVATtON INFORMATION (SURVEY REQUIRED) Ci. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* Q Finished Construction � *A new Elevation Certificate will be required when construction of the building is complete. �\ C2. Elevations - Zones Al-A30, AE, AH, A(with BFE), VE, V1-V30, V(with BFE), AR, AR/A, AR/AE, AR/Ai-A30, AR/AH, AR/A0. Complete Items � C2.a-h below according to the building diagram specified in Item A7. In Puerta Rico only, enter meters. O Benchmark Utilized: L-1�IET GPS NETWORK :: Vertical Datum: NAVD 88 indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: �� Datum used for buildine elevations must be the same ac that used tnr the RFF 1 a} Top of bottom floor (including basement, crawispace, 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 equipment servicing the building (Describe type of equipment and location in Comments) fl �owest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade ne� to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support Q .�1_ N/A . N/A , a ,51 8 .24 7 .21 R ,14 N/A Check the measurement used. � feet ❑ meters �] feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters SECTION D— SURVEYOR, ENGINEER, OR ARCHITECT CERTIFlCATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify ihat the information on this Ceriificate represenfs my besf efforfs to interpret the daia available. L 1 understand that any false siatemeni may be punishable by fine or imprisonment under 18 U.S. Code, S@Ct10I1 lOOl. Q+ C�gt I F ICqTF � Check here if cornments 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 No. �a�3 i / STATE OF ��OR lOj FEMA Form 0$6-433 (Revised 7/12) See reverse side for continuation. Replaces all previous editions. {REV.1 10/2712014) �� �1 '�. � Page 2 of 4; not valid without all four pages. ELEVATION CERTIFICATE, page 2 IMPORTANT: in these spaces, copy the correspondfng iMormation fiom 5ection A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or PO. Route and Box No. City State ZIP Code FL1410.2427EC FOR IN5URANCE COMPANY USE Policy Number: Company NAIC Number: SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFlCATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, {2� insurance agent/company, and {3) building owner. Comments NOTE: C2.E = AC UNIT PAD. NOTE: THIS ELEVATION CERTIFICATE IS ONLY VALID FOR THE PERSON OR PERSONS NAMED ON THIS ('FRTIFI('ATF TNIC f FRTIFIt^nTG ic GnR Gi nnn iniS��� p�RP(�,RFC f1N1 Y THF INF(]gpdgij(]p� � ru�S CFRTIFjj`er� GN(�UI fl N(u�_ USED FOR CONSTRUCTION OR PLANNING. ELEV. OF 32' X 30' SCREENED POOL ENCLOSURE=8.67 NAVD 88. Signature �� „�QO,I - . Date 10/27/2014 �~�� CENTERLINE ROAD ELEVATIOM 447 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 _i`1LA_ . � feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is �Il� . � 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 NLA. � feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is �I/2. � 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 floodplain 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 Date State ZIP Code 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 Zone A0. G3. ❑ The following information (Items G4-G10) 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 Constructioh ❑ Substantial Improvemeht 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 building site: . ❑ feet ❑ meters Datum G10.Community's design flood elevation: . ❑ feet ❑ meters Datum Local Official's Name Community Name Signature Comments FEMA Form 086-0-33 (Revised 7/12) Title Telephone Date ❑ Check here if attachments. Replaces all previous editions. Page 3 of 4; not valid without all four pages. ELEVATION CERTiFICATE, page 3 BUILDING PHOTOGRAPHS See Instructions for Item A6. FL1410.2427EC IMPORTANT: In these spaces, copy the corresponding iMormation from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unii, Suite, and/or Bldg. No.) or P0. Route and Box No. Policy Number: 801 ISLAND WAY City State ZIP Code Company NAIC Number: CLEARWATER BEACH FL 33767 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. FF20NT PROPERTY PICTURE 10/24/2014 -�,�� ��. ; 7af'. _.A�. �f i'��1 �+� � ��¢��r � �=�4� , ; � � � �� r � .� Y �: x j" _ ..:�h�. �� r� " �h RIGHT PROPERTY PICTURE 10/24/2014 �, t ��� � =1 � � �r', : �'�. �' - t ;: ; � � �� r=� � r:_ r'�` � ` �? '�*;; � � �R , . � a n.- z' ,���' a ; �� � �_���� �� � , � � �: �.t ' ���� � �� � . REAR PROPERTY PICTURE 10/24/2014 �� ,e, �:i q' . i � ,. • �, �'� �. ;� • � � j` � i • �{ '' t �%+a� ��, � j � _Y LEFT PROPERTY PICTURE 10/24I2014 FEMA Form 086-0-33 (Revised 7/12) Repiaces all previous editions. Page 4 of 4; not valid without all four pages. ELEVATION CERTIFICATE, page 4 BUILDING PHOTOGRAPHS Continuation Page FEMA Form 086433 (Revised 7/12) Replaces all previous editions.