929 BRUCE AVEi!_�u.OEPAF2tMENTOFHOME�ANDS�GURiiY �L�V��'�� ���������7E
FEOEIxfiL EAtERG@NCY MANAGEMEIVT AGENCY
.1'ulKiru7t I•7ruxf lr�artr�anck Frr�;�r,n�e i►nportant: Read thc� inrtruetions o�t pages 1�9
SECTiC?N A - Pf2flPEf27Y iNfORMATtON
At. Buiiding Owner's Name itt)�i�� �2 i" :=€�tU�_TAatN l,�_,�„f; �;,
_ --._. . _ _ _ . _ ;
O�,it3 No. 16n4-OJ08 ;
rxpiration Oate: Juiy 31, 2015 ;
I�OR tNSURANCE COMPANY US��
Policy Number:
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�' R2. 6uilding Street Address (including Apt . Unit, Su�te, andlor Bidg. No.) or i�.0 K2ouia and Eiox Na. Canpany NRIC Numher.
923 F3f�U4F AVG
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�. Cily CI,�ARWATEf2 State f=L ZIP Cade 33rui
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A3� Praperty peseription {Lot and Block Numbers, Tax Parcel Number, Lega! Descr�piicn, etc.) -
FARCEI i0 - �5-29-t 5-54�66 �44-ut��10 NOT FOFi COM115Tt2UCTION, htOT FOi2 ��SIGN
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A4. 6uifding Use (e.g_, Residential, Non•l�esidential, Additio�, Accessory, eta) RE�S�I�f_NjiA4 �
A5. LatitudeiLongitude: lat. 2j'S9�5;3_Long. -�� qg�3�,�_ Honzontaf Catum�. ("_J NAD i927 X NAa 1�83
A6. Attach a! least 2 photographs of the buitding if the CertiGcafe is being used to obtain tioai insurance.
A7. Buiiding DiBgram Numher fA
A8. For a buikling with a crawispaCa or enciosure(sj: A9. For a builCing wiiii an attached garage:
a) Square footage of crar+tispace or enciosure(s) +JIA sq ft aj Squere toatage of attached garage �t1Q sq tt
b) Number of per�nanent flood opeoings in ihe �rawispace b} Numbe� of permanent flood openings in tl�e attached ga�aga
or enc4osure{�) wfthin 1.0 faot above adjacent gratle *1;A within 1 A�oot aDova adjacent g�ade Nt�t
. c) Taiai' neE area of flocsd apenings in A8.b N;�1 sq in c) Tatal net a�ea of F�od operings in A9.b Nt�! sq in
d} Engineered flood openings? Q Yes X Na d) Engineered tioad openings? ❑ Yes X No
Si�CTiON B-�LOOD INSURANCE RATE MAP {FIRMj INFORHIATiON
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i—� __ ______---_ ___. _ _ _.:..
81. NFIP Community Name 8 Cammunity iVumber i 62. Ccrunty Name i Ei3. Sfate �
* CIT`( O� CL�ARWATEF2- t2509G �niTJCl.k.{�5 � f tqRIDA �
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ea. rAaplPanel Number E35. 5uffix 36, FIRM Inciex Oate E37 Fif2i44 Panei E3$ F1o<xi t39 Base Flood Etevation(s) (Zone �
12t0�C-q102 G 67_It 31200� EffeclivetRevised Data ior e{s} AE�, use base Rood degth�
09/U3i2003 A{_ � t S f
_...._.._. __�.__ .__ _____._ _.___ __.______u_.__. �.v _.._.. J
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.810. Indicate the source of the Base filood Elevaiion (BFE) daia or base fiooci depth entered in Item 89.
-; ❑�IS Profile X FiRF�A (� Gommunity Qeiermined ❑ OFherlSourca:
61 t.• indicate elevation dsium used for BFE in 4tem 86: � NGVD �929 X IVRVf3 1988 (.] OthedSou�ce:
Rt 2 Is the buitding locateti in a Coastat Barrisr Rasources System (CBRS) area or t�thenvise Prptected A�ea {OPA)'? ' Q Yes X No
Designatian Oate: [� C8R5 O OPA
3EC710N C- BUILqfNG ELEVATi�N iNfi�RMATiON (SURYEY REQUIRE[3j �
Ct. Buitding elevations are baset! on: ❑ Construction Drawings' Q euilding Under t:onstruction' X Finished Constructian
'A new Elevation Ce�titicate wiil be required when construction of the buiiding is compiete.
G2. �levations -Zo�es A1-A30, AE, AH, A(with aFEj, VE, V1-V30. V(witri BFE), AR, AR;A, ARJAE, AFi;At-A30, A('�fRH, AR/AO. Comptete {ler�s C2:a=�� __���
below 2ccording to the bui(di�g diagram specified +n item A7. in Puerto Rico onty, enter meEers. ;a ��: �
Benchmaric UtiNzed: A�Q504 Vert�cai Oatum. Nt�Vq_1.�$$ � � 1.�---°�.._.__
Indtcate efe�ation datum used for the etevations in �tems a} thraugh h} betow. [a NGVO 1929 X NAVD � 9r38 L7 OthertSource: ______ ��; �� °-°°-�""'2r.
Datum used for bailding elevations must Ese tiae same as tha# ased for the BF�. �� :% � �� t
� ,"rt �"�
Check the measuremenf used. � , ; � _ �� � %-_
�� ��.. ,,
a) Top af bottorn floor (inGuding 6aserrent, crawispac�, ar enctosure #toor) �i �! X feet (� meters �� �� �' F� !
b} 7op of the next higher fio4� , �� `i -�
CJ_ �1 XQ feet (� meters �<` `
c) Bot2om of Ehe (ow�st horizo+itai structucai member V Zones cnf � ;—
t Y1 �if � X f�et ❑ mete�s t�' r' €
d) Attached garaqe Etap of slab} d�y X fe�t ❑ m�ters ��` ��y �
e} t,oweet elevation of machtnery or squipment servicir�� the bu;tding •t.� X!eet (� rneters � ri; � �.
(Oescribe typa of equipment and bcation in Comme�ts) ��� `�f --
f} Lowesk adjacent (finished) grade nexi t� building {lAG} ;3 g X f�;et �'j meters c.7 '� '"� ���._,.
gi Highest adjacent {finished) orade next to bui;ding (HAG} q 4 X feet 3 T` ��-°-- °
❑ n;eters a � 5�
h� lewest adjac8nt grade at fowast a,evation ot decK or sta;rs. inctudfr�g struclural support N1.J� X feet ❑ meters ' � �-------�--�.�
SEC710N t) - SUFtVEYOFt, ENGIN��Ft, OR ARCHlTECT CER7lFICAilOtv
7his certification is ta be signed anB sealed by a land su�veyor, engineer, ar arcnitect authorized by iaw to certify elevation -------------- ---
information. l Certify that tlie r'qfont�atrait c» thrs CeRiticate re�resents nty hpst eflais to inlerpr�t thrt data ava;;aUJs. � �
! iindersto»d that any false statement may be punishabla by /ins or irnprisonn3nnt unUer 18 U.S. Cwi¢, SectiQn : QCi �(��� � ,�
� Check here ii comments are provided on back nf form. Were iabfude and 14ngitudQ in 5ection R provided by a �. � ,�- �!
[j Check here +f attact7ments. licensed tand surveycr7 ;�� Yes [] No �
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Ceri�flei s Name LEWNO F. QySAR� - _`� Lirs�ise Number 3�59 ►��
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Ti,le N.l S Company Name t�LA SUiib�YS � � �
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Addtass 388�3 PR GRF5S AVC #id; Cf� FiAPf ( S _ _ __. �` _.
� - Y S ate t-t ZIP Code ttn� �
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S�gnature '��� � Dais 1QI132Qt9 Telaphorze 23�-443-1uo4 �V
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��M��a�n,�8 .a.3�c7J1�i 929 BRUCE AVE
BCP2014-12083
�OOF MOUNTED SOLAR SYSTEM
�H� 11 MAN. ROBERT `
aii previous c�ditions.
e�t�i!�
tMPOftTAN7: in these spaces, copy the corresponding inforEnation fro�n Sectio{z A.
Buiiding StreetAddress (includ[ng Apf., Unii. Suife, a�dior 8ldg. No.} or P.O. Route and 6ox No.
s2s ��t�c� r�v�
City CI.EARWATrf2
State f=t.Ot'2lt�R ZIP Cocte 3:31i�7
FOR INSURANCE COMPANY USE
Policy Number
Company N�IC Number:
SEC714N D- SURVEYOR, ENGIhiEER, Oit ARCMIiECT GEi2TIFtCAT10N (CONi1NUE0�
C;opy both s�des of ihis Eievat+on Certifrcate for {tj cammunity oificial. (2) insurance agenUcompany, and (3t building owner.
_. . ,_____ _ �_ . . _ �._ __ _� _ _._ _ _. ___ __._. .. --- _ __ _ __ . _ .
Camm�nts GPS GQc}12DINA TFS VJt�Rt� F1�K9eN E=l�Gh9 c,ptJt;�.r �Al2 I`! i. NO t` rqi2 CGir1S f`f2UC Cit�N. N(� r FOFt iJt�SlGh;. r�_C�Ut3 LONI�
DET�iZMtNAiION F'ROVID�i� BY F�C�OI) INSIt�IiTS. ifil5 UfiTA+IVAS Pk2�f�ARE[� i�Cli 1=f_(:CJD iNSUi?Af�lC(� Nt)Itl�t>:�f��S ONIY.THf= I�QUiP141t3NT
US�:D IS G!?'S. TNt�f�E EXIS'( � A t}, �� (1�Nt? Y[= �fi�tS} �1.lJS e3t7 w�ltJ�S�F�Rf�:Claf(7P1. I T�"�t 115�l�Sc17 i1�1 C2tC} IS TNt; CONCRE iE A�i� CONOi (It�NII�fE;
PAD. OATE OF FIELC7 W 16/ 20�
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Signatvre Oate t0�t �r20t�1
SECTIO@rE - BI.IILt}ItYG E�EYA710N iNFORN1ATfON {SURV�Y NOT FtEQUIREDj F012 ZONE ACJ ANO ZQNE A(W17HOUT BF�}
Fo� Zones AO and A(wiihout BFEj, comple4e kems E4 -E5. If the G�riificat� is intended to support a ti�MA ar L(��rtf2-F request, compiete Sect+ons A, B,
and C. �or items Et-�E4, ose natural grade, if evailable. Check the measurement used. M Puertu Rico oniy, enter metecs.
Et. Provide elevation informalion far tha faflowing and check the appropriate boxes to show whether the elevatia� is above ar below the highest adacent
grade {HAG) and the lowest adjacent grade {tAG).
a) top of botiam Roor {i�ctuding basement, crawispace, or endosure} is ❑ feet ❑ meters ❑ above or Q below th� HAG.
b) Top of bottom ilaor {inciuding basement, crawlspace, Or endosure) Is __�_ __u__ ❑ feet ❑ meters [�j above or (4j beiow [he IAG.
E2. For Buikling Diagrams 6-9 with pstmanent flood ope�iings provided in 5ection A Iisms 8 and/or 9(see pages 8-9 of Instrucdons), the next higher fivor
•, (eleuation C2.b tn the diagrams) of the buiiding is _,_ _._ _[� f�et ❑ meters (] above or (� below the tlAG.
E3. Attached garege {top of slab) is __�_ (� ferst (1 msiers [� above or ❑ beiow the h1AG.
E4. Top of platfocm of machinery and/or equipmeni sarvicing the building ±s T__.,.� ,_.,. __ [J feet L�7 meters � above or Q befavr 1he FfAG.
E5, Zone AO oniy: If no flopd depth number is available, is fhe top ot the bottam fioor elevated in accordance with Ihe community's fioodpiairt managament
ardina�ce? [] Yes [� No ❑ Unknown. 7he locat o�cral must cerii�iy Ehis information in Sectian G.
SEC710N �- PROPERTY OWNEi2 (OR OWNEf2'3 t2EPftESENTATIVE) CERTtFICATiQN
The praperty owner or owner's author7zed representative who cc�mpletes Sections A, 8, and E for Zane A{w�thout a FEMA•issued or community-issued DFE)
or Zone AQ mu5t sign here. The skatements in Sectians A, 8, and E are correct to ihe best af my knowiedge.
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Properiy Owner's ar Owner's Ftuthonze�f Representatwe s Name
-- — --�.- ��-; �„�,_ _ _____ . �___ --_.�_ ____�______� —__._._____.._ __� _ .__.___ _ ... __
Address `1 (�► �� 1 r ! f� �� � f� ,..�� rv�� ,� ._ Ciry St�te ZtP Code _
' • Signatuce
�omments
�.'�, � � �i�i�
bate
_�.---,_____�_ _.,_.___ ____ _ _.___._._
7elephone
_ .__--.��_----__________''-7 ��G��ire �i atiachmen,a.
_ `"...;<-..-`-:��.tQ . . = �(yM�RUNtTY ENFORMAiION (4RTiQNAI.)
� The locaT official who is authorized by law or ordinance to adrriinis`tErthe conwnuniiy's flaodplairt rnanagement a�dinance can complate Sections A, 6, C{or E), end G
o! thi� Elavation Certificate. Complete the applicabie item(s} and sign belotiu Check the measurement used in Items G8•-GtO. In Puerto Rico onty, enter niaters.
G1. []� The information irt Sec6on C was taken from other documentation that has been sigr.2d and seaied by a license�i surveyor, engineer, or arch+teci who
• is authorized by Iaw fo certify elavalion informatfon. (Indicate the source and date cf the etevation data in the Comments area belaw.}
G2. ❑ A community oNcial campleted Secfion E for a building iocated in Zone A(without a FEMA-issued or communiry-�ssued BFE} or Zone AO.
G3. (� The (ollowing informaiion (Items G4-G70} is provided for community Flobdplain management pu�poses.
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� G�i Permit Number G5. QaEe Permit Issued ( G6. Date Certificate Of Cornpt�ancelOccuparscy Issued ;
_. ._ _ __,_e__ _ __ _�_____ _ _. �___. _ _ __ _._.-- __ . --- __. _---- ---__ __._ , _ __ __�
G7. This pe�mi# has been issued for_ ❑ New Construction C� Substaniial lmprovornent
GS. Elevation of as-buiit Iowest ftoor (including basementj of ths buifding: ______ v._,_ � feet (� meiers �atum
� ___.__ _
G9. EiFE or (in Zona AO} depfh oE flooding at the ou+lding site _^� [J teet ❑ meters Datum
G14. Communiry's design flood elevatiorr _____._ ___n _ ❑ feet Q moters Datur�i
loca! Offitial's tJame
CornmuniEy �1ame
SignBture�����
Cprnr�t6nlS �J.
FEh1A Form 486-Q-33 (7l12)
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Title _
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Tetephone •
Date
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[1 ChecK here,if atf�chrt enis.
Replac�s a,l psevious cdit:ons�
ELEVA7lOt� CEi2TIfICATE, ���� � guiiding Phvt+��raphs
See lnstructio�s for item A6.
IMP{3RTANT: tn these spaces, copy th+� carresponding infarrn�tian irom Sec#ion A.
8uiiding 5tr�et Address (including Apt., Unit Sude, �ndaor Bldg. Nu } or P.O. Roate and Box Nu.�..� �.��
9i8 �FiUCE AV�
_ _� __._ . . . . __.. �_. e.�.� � �
Gity CI.�A�WR`i�R 5t8te �t.OftfIDA ZEP Ctde 33767
FOR 1HivURAN�CE Cflf�PA�tY tlS�
Policy tdumber:
if using #fre Ei�evation Certiiicate to obtain NFtP flood insursnce. aifix at least 2 building photographs below acr.�rd`mg tn the instruct�ns
for It$m A8. tdentifi�r ai! p�sot+c�raphs with date taken; "�roni View" and "Rear �ew"� and, if r�quired, "Right Side View° and "left 51de
View." When appiicable, phokographs must show the %�undation with representative exampies of the flaod cspen�nc�s or vents, as
indicated ir� Seciion A8. if submifi+ng mare photographs than wiil fif on this page, use the Corrtinua2ion Page.
�RUNT VI�W 14i1312t394
REAR VI�Vlt 1t}i1�i�n1�
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FEMA Form 088-Q-33 (7112j � Repi�ces ait prerrious edifictns.