The URL can be used to link to this page

741 MANDALAY AVEtJ.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB N0. 1660-0008 ,FEDERAL EMERGENCY MANAGEMENT AGENCY Expiration Date: July 31, 2015 National Flood [ncurance Progmm IMPORTANT: Follow the instructions on pages 1-9. � SECTION A - PROPERTY INFORMATIUN A1. Buildin� Owner's Name A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P0. Route and Box No. FOR INSURANCE COMPANY Policy Ntimber. I Company NAIC Numbec USE City CLEARWATER State F� ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legai Description, etc.) PARCEL OS-29-15-54666-014-0030, BLOCK 14, LOT 3, MANDALAY SUB, PLAT BOOK 014, PAGE 032, PINELLAS COUNTY, FLORIDA A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESiDENTIAL A5. Latitude/Longitude: Lat. 27��» Long. 8z.8265 Horizontal Datum: ❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain fiood insurance. A7. Building Diagram Number ONE-A A8. For a building with a crawlspace or enclosure(s): A9. For a buifding with an attached garage: a) Square footage of crawlspace or enclosure(s) N�A sq ft a) Square footage of attached garage N'°` 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 N�'�' within 1.0 foot above adjacent grade NA c) Total net area of flood openings in A8.b N�A sq in c) Total net area of flood openings in A9.b N�p` sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No 61. NFIP SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION VLCNRVYMICRI.II ��OF N25096r g2• County Name pINELLAS 63. State F� 84. Map/Panel Number 65. Suffix 66. FIRM Index Date 67. FlRM Panel Effective/ 88. Flood Zone(s) B9. Base Flood Eievation(s) (Zone Revised Date A0, use base flood depth) 12103C0102 G 08/18/2009 09/03/2003 AE 11.0 FT 610.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: 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 (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes � No Designation Date: / / ❑ CBRS ❑ OPA SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQi11RED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Buiiding Under Construction* � Finished Construction *A new Elevation Certificate will 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/A1-A30, AR/AH, AR/A0. Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: �PS Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in 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. Check the measurement used a) Top of bottom floor (including basement, crawlspace, or enclosure floor) b) Top of the next 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) f) Lowest adjacent (finished) grade next to buiiding (LAG) g) Highest adjacent (finished) grade ne� to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 6.83 � feet ❑ meters N/A � feet ❑ meters N/A � feet ❑ meters N/A � feet ❑ meters 6_8 � feet ❑ meters 6_3 � feet ❑ meters 6_5 � feet ❑ meters 6_3 � 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 that the information on this Certificate represents my best efforts to inierpret 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 surveyo(? � Yes ❑ No Certifier's Name BILL H. HYATT, JR Title PRESIDENT Address 1497 MAIN STREET #321 Signature FEMA Form 086-0-33 (7/12) � License Number #4636 Company Name KNOW IT NOW INC City State ZIP Cc DUNEDIN FL 34698 Daie Telephone 11-20-2013 (727)415-8305 See reverse side for continuation. ��ct: ��. w 4C�36 ti 1:1Ii�: C)t�. i�E,OR1J);l Replaces all previous editions. ELEVATION CERTIFlCATE, page 2 IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P0. Route and Box No. 741 MANDALAY AVENUE City State ZIP Code CLEARWATER FL 33767 FOR INSURANCE COMPANY llSE 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 agent/company, and (3) building owner. COfnttl@ntS �F EQUIPMENT IS LISTED ON PRIOR PAGE IS BASE OF AIR CONDITIONER UNIT THIS CERTIFICATE IS NOT TO BE USED FOR CONSTRUCTION OR DESIGN, IS FOR FLOOD INSURANCE USE ONLY Signature %�.��'`�� Date ��20/2013 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, compiete Sections A, B,and C. For Items E1—E4, use naturai 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, crawispace, or enclosure) is . � feet ❑ meters � above or ❑ below the HAG. b) Top of bottom floor (inciuding 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 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 Iaw to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community officiai 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—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 ❑ Substantial 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 building site: . ❑ feet ❑ meters Datum G10.Community's design flood elevation: Local Official's Name Community Name Signature Comments Titie CLEARWATER CITY OF TelephOne Date ❑ feet ❑ meters Datum ❑ Check here if attachments. FEMA Form 086-033 (7/12) Repiaces ail previous editions. ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS CONTINUATION PAGE Building Street Address (including Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. ADDRESS: 741 MANDALAY AVE CLEARWATER, FL 33767 PICS TAKEN 11/19/2013 FRONT VIEW AND CONTINUING AROUND BUILDING �[„ ' L� ; ��. �.�,;:. � �, �.Y�� . .. ,�. � �f �,�: �.. k � �f�jpN#^�...§l� u 4��y ,; � �� p. ' w.'�oie � � � ., ;� �� "' � < , � �� .��- � "*� ` w 5�' a ; i 4: _ � _ �� ; � � ° � ta, � � � �' . ��. . .. � * �� ' ., € yt� q ;,�� ` ��,�< � � �f�� xf � ,��„�; ,�` �� k '� W' � �" �� r f * ., � . r �� Sy.^` � � �• � 7R" , ��`��s.��„ , ' ;�' �1� , �w �r � . �� Y� " '? " �'�:s' � + � �- .Y4 � �� r. � " ��i ' , ,� �� ' -r R. R+� �m. v e .t: ;� s �� i r� 4k', � .F^ , �-a � y� ,�' � � �� " � �$��: �._ � . �� „. �� `�.,,� �w �' �� -:� � �� .' �' � �' �: � � g � � ,� � r� � �` � ;u � �k��y �� ,�� :. « c ,�'' � � � ��P . 'hA' iMr�'� . �� e� r„&�' �.,:, > � I� s` , �� .. f �+' i �, , n,:; � � a = � � ',�� a u t ,+' � �� , ,�s,+:,r�' .r' . . � ��}# �e � . .�" � #� ��, I�'4� � .: : �`` `i� u� � �� ,� �� '"�6 .. ' �i`',�r,�lsyf�� !� ��' `�"�' .;r�x,.as +'�yCr��tl��n��l'�'�� .� . �; � W I ,K.;< -�,. s K � � � �� . � 9�� z° �``�, �� -�