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22 BAY ESPLANADE'U.S. DEPA'RTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY Nationa! Flood lnsurance Program �mportant: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION A1. Building Owner's Name MATHURA PROPERTIES #5. LLC A2. Building Street Address (including Apt., Unit. Suite, and/or Bidg. No.) or P.O. Route and Box No. 22 BAY ESPLANADE City CLEARWATER State FL ZIP Code 33767 OMB No. 1660-0008 Expiration Date: July 31, 2015 POlicy Nurriber. Comparry NAIC Number. A3. Property Description (�ot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 12, BLOCK 8, REVISED MAP OF CLEARWATER BEACH (PB 11, PG 5) A4. Building Use (e.g., Resicfentiai, Non-Residendal, Addition, Accessory, etc.) NON-RESIDENTIAL A5. Latitude/Longitude: Lat 27. 50 N Long. -082.8271 WHorizontai Datum: ❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being us� to obtain flood insurance. A7. Buitding Oiagram Number 5 A8. For a building with a crawispace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enGosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft b) Number of pertnanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enGosure{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 A8.b 0 sq in c) Total 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 B1. NFIP Commurtity Name 8� Community Number 62. County Name CiTY OF CLEARWATER 125096 PINELLAS, INCORPORATED AREAS B4. MaplPanel Number 85. Suffix B6. FIRM index Date B7. FIRM Panel B8. Ffood 12103C / 0102 G 9/3/03 EffectivelRevised Date Zone(s) 9/3/03 AE 83. State FL B9. Base Flood Elevation(s) (Zone AO, use base flood depth) 12 FEET B10. Indicate the source of the Base Flood Elevatlon (BFE) data or base flood depth entered in Item 89. ❑ FIS Profile � FIRM ❑ Community Determined ❑ OthedSource: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ OtheNSource: 612. Is the building located in a Coastal Barrier Resources Syst�n (CBRS) area or OthenNise Protected Area (OPA)? ❑ Yes � No Designation Date: N!A ❑ CBRS ❑ OPA SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIREO) C1. Building elevations are based on: ❑ Constructlon Drawi�gs' ❑ Building Under Construction" � Finished Construcdon 'A new Elevation Certificate will be required when construckion 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, ARlA1-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 U6lized: CLEARWATER BM H-02 Vertical Datum: NAVD 1988 Indicate elevation datum used for tfie 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 (inGuding basement, crawispace, or enctosure floor) 14.94 � feet ❑ meters b) Top of the next higher floor N.A ❑ feet ❑ meters c) Bottom of the bwest horizontai structural member (V Zones oniy) N.A ❑ feet ❑ meters d) Attached garage (top of slab) N.A ❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building ON.ROOF ❑ feet ❑ meters (Describe rype of equipment and location in Comments) � lowest adjacent (finished) grade next to building (LAG) �.30 � feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) ¢.58 � teet ❑ meters h) Lowest adjacent grade at lowest elevation of dedc or stairs, including structural support 5.� � feet ❑ meters SEGTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certifica6on is co be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevaUon infortnation. ( certify that the information on this Cerdficate represents my best efforts to interpret the data available. � t' i,� � l understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 100L ��\� , ❑ Check here if comments are provided on badc of form. Were latltude and longitude in Section A provided by a -.'`� �L".+ `4.� �-, � � Check here if attachments. licensed land surveyor'? � Yes ❑ No ; c��'� _ �. ., . Certifier's Name Justln D. Gamer TiUe Licensed Surveyor Address 631 N. Tamiami Trail License Number 6896 Company Name Florida Engineering 8 Surveying LLC Gty Nokomis State FL ZIP Code 34275 Telephone 941-485-3100 � 'a��. #` �s�'� � .� ��' .. � u�l � 1 ....�� +• Ss • ., •�' � . � ,�/}/'�' ' � +>> ��J-%qc�l�� `� f / r��Ft�� FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. ELEVAT'ION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the carresponding information from Section A. Buiiding SVeet Address (induding Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. 22 BAY ESPLANADE Ciry CLEARWATER State FL ZIP Code 33767 FOR INSURANCE C4NlPANY USE Policy Number: Company NAIC Number. SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERtIFICATION (CONTINUED) Copy both sides of this Elevation Gertificate for (1) community official, (2) insurance agenUcompany, and (3) building owner. Comments SEE ATTACHED FdR COMMENTS Date .�� /i �. SECFie'N E- BUI�DING ELEV�AUFIN INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO a�d A(without BFE}, complete Items E1-E5. if the Certificate is intended to support a LOMA or IOMR-F request, complete Sections A, B, and C. For Items E1-E4, use nahual grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E 1. Provide elevation informatlon for the foilowing 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 (inciuding basement, crawlspace, or enGosure) is ❑ feet ❑ meters ❑ above or � below the HAG. b) Top of bottom floor (inGuding basement, crawlspace, or enGosure) is . 0 feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams Cr9 with permanent flood openings provided in Section A Items 8 andlor 9(see pages 8-9 of Instructions), the ne�ct highar floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platfoRn of machinery andlor equipment servicing the building is ❑ feet ❑ meters ❑ above or � below the HAG. E5. Zone AO only: tf no flood depth �umber is availabie, is the top of tlie bottom floor elevated in accordance with the community's floodpiain management ordinance? ❑ Yes ❑ No ❑ Unknown. The Iocal official must certify this infortnation 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 2one AO must sign here. The statements in Se.ctions A, B, and E are correct to the best of my knowledge. Property OHmer's or Owner's Authorized Representative's Name Address Signature Comments City Date State ZIP Code Telephone L] Check here if attachments. SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official wfio is authorized by law or ordinance to administer the crommunity's floodplain management ordinance qn complete Sections A, 8, C(w E), and G of this Elevation Certificate. Complete the appliqble item(s) and sign bebw. Chedc the measurement used in Items G8-G10. in Puerto Rico oMy, enter metexs. G1. ❑ The intormation 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 taw 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 �mmunity-issued BFE) or Zone AO. G3. ❑ The following information (Items G4-G70) is provided tor community floodplain management purposes. G4. Pertnit Number G5. Date Pertnit Issued G6. Date Cefificate Of Compliance/Occupancy Issued G7. This pe►mit has been issued for: ❑ New Construction ❑ Substan6al Improvement G8. Elevation of as-built lonrest floor (inciuding basement) of the building: ❑ feet ❑ meters G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters G10. Community's design flood elevation: ❑ feet ❑ meters Local OfficiaPs Name Comm�ity Name Signature Comments Title Telephone Date Datum Datum Datum Check here if attachm ts FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 guiiding Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (inciuding Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. 22 BAY ESPLANADE 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. �' ' � � FRONT VIEW 5128/15 FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 guiiding Photographs Continuation Page IMPpRTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. Policy Number: 22 BAY ESPLANADE City CLEAWATER State F� ZiP Code 33767 Company NAIC Number: If submitting more photographs than will fit on the preceding page, afflx 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. . `•, i � � � � `z. i _� � � � � � � LEFT 51DE VIEW 5/28/ 15 ��,�' , v�� vVV-`�-`�� "� Replaces a!I previous editions. �� REAR VIEW 5l28/15 , �� , �. �a�„ � _ � ..-..: �. � ADDITIONAL COMMENTS• ��,, .( � ,'°" , -�" !� ;' �°': �. �� .� � RIGHT SIDE VIEW 5/28/ 15 � }� � ,+ , � � .=��" � .- ' THE BENCHMARK UTIUZED FOR THIS CERTIFICATE IS A CITY OF CLEARWATER BENCHMARK, #H-02, ELEVATION = 5.21 FEET, N.A.V.D. 1988. ELEVATIONS SHOWN ON THIS CERTIFICATE ARE REFERENCED TO N.A.V.D. 198$. THE LOWEST MACHINERY SERVICING THE BUILDING IS THE A/C UNIT AND IS LOCATED ON THE ROOF OF THE BUILDING. THE LATITUDE AND LONGITUDE AS SHOWN IN SECTION A5 WAS OBTAINIED USING A HAND HELD GPS DEVICE WITH AN ACCURACY OF 15 FEET ±. THE BUILDING SHOWN IN THE PICTURES ABOVE IS ON WOOD PILINGS WITH NO ENCLOSURE OR STORAGE AREAS BELOW. TH� BOTTOM OF THE BEAM ELEVATION = 13.30 FEET, N.A_V.D. 1988. THE BOTTOM OF THE ELEVATOR AREA IS AT ELEVATION=5.62 FEET. U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAIi'EMERGENCY MANAGEMENT AGENCY National Flood lnsurance Program A1. Building Owner's Name ELEVATIOI� CERTIFICATE Important: Read the instructions on pages 1-9 SECTION A - PROPERTY INFORMATION ES #5, LLC A2. Building Street Address (including Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. 22 BAY ESPLANADE City CLEARWATER State FL ZIP Code 33767 OMB No. 1660-0008 Expiration Date: July 31, 2015 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 12, BLOCK 8, REVISED MAP OF CLEARWATER BEACH (PB 11, PG 5) A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) NON-RESIDENTIAL A5. Latitude/Longitude: Lat. 27.9850 N Long. -082.8271 WHorizontal 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 5 A8. For a building with a crawlspace or enclosure(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 N/A 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 0 within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in c) Total 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 61. NFIP Community Name & Community Number 62. County Name CITY OF CLEARWATER 125096 PINELLAS, INCORPORATED AREAS B4. Map/Panel Number B5. Suffix 66. FIRM Index Date 67. FIRM Panel B8. Flood 12103C / 0102 G 9/3/03 Effective/Revised Date Zone(s) 9/3/03 AE 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile � FIRM ❑ 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 Othervvise Protected Area (OPA)? Designation Date: N/A ❑ CBRS ❑ OPA 63. State FL B9. Base Flood Elevation(s) (Zone AO, use base flood depth) 12 FEET ❑ Yes � No SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building 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/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: CLEARWATER BM H-02 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. a) Top of bottom floor (inGuding basement, crawlspace, or enclosure floor) 14.94 b) Top of the next higher floor N.A c) Bottom of the lowest horizontal structural member (V Zones only) N.A d) Attached garage (top of slab) N.A e) Lowest elevation of machinery or equipment servicing the building ON.ROOF (Describe type of equipment and location in Comments) Check the measurement used. � feet ❑ meters ❑ feet ❑ meters ❑ feet ❑ meters ❑ feet ❑ meters ❑ feet ❑ meters � Lowest ad�acent (finished) grade next to bwlding (LAG) 5.30 � feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 5.58 � feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 5.25 � feet ❑ meters SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION ,,,,,, ' r This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation ... � information. I certify that the information on this Certificate represents my best efforts to interpret the data availab/e. �� `'` �°...��+' '•• l understand that any fa/se statement may be punishab/e by fine or imprisonment under 18 U. S. Code, Section 1001. ;;,, - �'�' �• 4`i`� �' ❑ 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 i'� a�� /:=•.' Certifier's Name Justin D. Garner Title Licensed Surveyor Address 631 N. Tamia ' rail Signat r FEMA orm 086-0-33 (7/12) License Number 6896 Company Name Florida Engineering & Surveying LLC City Nokomis State FL ZIP Code 34275 Date 7 �3 �� Telephone 941-485-3100 See reverse side for continuation. -i��r� -- . - .�.� �. '��,�: � _ . \,b. � ,� - % o ��,�� . Replaces all previous editions. ELEVATION CERTIFICATE, 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 P.O. Route and Box No. 22 BAY ESPLANADE City CLEARWATER State FL ZIP Code 33767 FORINSURANCE Policy Number. Company NAIC Numbe r. SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community o�cial, (2) insurance agenUcompany, and (3) building owner. Comments SEE ATTACHED FOR COMMENTS Date -7//� / - BUILDING ELEV�O�INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A «� 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 ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including 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 ❑ 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 0 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 communiry'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. Property Owner's 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 AO. 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 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: ❑ feet ❑ meters Datum Local Official's Name Community Name Signature Comments FEMA Form 086-0-33 (7/12) Title Telephone Date Check here if attachments. Replaces all previous editions. , ELEVATION 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., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 22 BAY ESPLANADE City CLEARWATER State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Poiicy 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. j�� FEMA Form 086-0-33 (7/12) �'� ' � ;, FRONT VIEW 5/28/15 / , Replaces all previous editions. ��. � E�.EVA,TION 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. 22 BAY ESPLANADE City CLEAWATER 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. i � ! � ( �� , ,\ � LEFT SIDE VIEW 5/28/ 15 FEMA Form 086-0-33 (7/12) Replaces all previous editions. �M1.., � � � � ��, T�i � REAR VIEW 5/28/ 15 ;, ,� #_ ��4 �� ; x� —�__. �� ADDITIONAL COMMENTS: � ..4� � - � � �� t�;��: ^� � ;�'^' r ^,. ;�'� ' € , � / ' �„✓s_ �� ;. #r # � j�► � � ��}, � � # ��:z � ��.�� a� �.: � ; � �� , RIGHT SIDE VIEW 5/28/15 � �� ,�- ... THE BENCHMARK UTILIZED FOR THIS CERTIF�CATE IS A CITY OF CLEARWATER BENCHMARK, #H-02, ELEVATION = 5.21 FEET, N.A.V.D. 1988. ELEVATIONS SHOWN ON THIS CERTIFICATE ARE REFERENCED TO N.A.V.D. 1988. THE LOWEST MACHINERY SERVICING THE BUILDING IS THE A/C UNIT AND IS LOCATED ON THE ROOF OF THE BUILDING. THE LATITUDE AND LONGITUDE AS SHOWN IN SECTION A5 WAS OBTAINIED USING A HAND HELD GPS DEVICE WITH AN ACCURACY OF 15 FEET ±. THE BUILDING SHOWN IN THE PICTURES ABOVE IS ON WOOD PILINGS WITH NO ENCLOSURE OR STORAGE AREAS BELOW. THE BOTTOM OF THE BEAM ELEVATION = 13.30 FEET, N.A.V.D. 1988. THE BOTTOM OF THE ELEVATOR AREA IS AT ELEVATION=5.62 FEET. l,�'S:`DEP?_,ZTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY Nationa! Flood Insurance Program A1. Building Owner's Name MATHURA ELEVATIQN CERTIFICATE Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION #5, LLC A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 22 BAY ESPLANADE City CLEARWATER State FL ZIP Code 33767 _ OMB No. 1660-0008 Expiration Date: July 31, 2015 FOR INSURANCE COMPANY USE Policy Number: NAIC A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 12, BLOCK 8, REVISED MAP OF CLEARWATER BEACH (PB 11, PG 5) A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) NON-RESIDENTIAL A5. Latitude/Longitude: Lat. 27.9850 N Long. -082.8271 WHorizontal 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 5 A8. For a building with a crawlspace or enclosure(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 N/A 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 0 within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in c) Total 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 B1. NFIP Community Name & Community Number B2. County Name CITY OF CLEARWATER 125096 PINELLAS, INCORPORATED AREAS 64. Map/Panel Number 65. Suffix 66. FIRM Index Date B7. FIRM Panel 68. Flood 12103C / 0102 G 9!3/03 Effective/Revised Date Zone(s) 9/3/03 AE 63. State FL 69. Base Flood Elevation(s) (Zone AO, use base flood depth) 12 FEET 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 69: ❑ 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 Designation Date: ❑ CBRS ❑ OPA SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* � Building Under Construction' ❑ Finished Con '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/AO. Comple below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: CLEARWATER BM H-02 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 u: o °��N _ �' ..*. (i N � O c� � �maN W �.��°� � --I W rn O�D (rn/� W '� 0° r � n z a) Top of bottom floor (inGuding basement, crawlspace, or enclosure floor 14.94 D � ) � feet ❑ meter = b) Top of the next higher floor N.A ❑ feet ❑ meter � rn c) Bottom of the lowest horizontal structural member (V Zones only) N.A ❑ feet ❑ meter N d) Attached garage (top of slab) N.A ❑ feet ❑ meter � e) Lowest elevation of machinery or equipment servicing the building N.A ❑ feet ❑ meter D (Describe type of equipment and location in Comments) � Lowest adjacent (finished) grade next to building (LAG) 4.80 � feet ❑ meter. g) Highest adjacent (finished) grade next to building (HAG) 5.30 � feet ❑ meter. h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 4.60 � feet ❑ meter, SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information on this Certificate represents my best efforts to interpret the data avai/ab/e. I understand that any false statement may be punishab/e by fine or imprisonment under 18 U.S. Code, Section 1001. 3' "" ❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a :�� .,� � Ll,�� .'-.� �, � � Check here if attachments. licensed land surveyor? � Yes ❑ No `" � � y� Certifier's Name Justin D. Gamer License Number 6896 '� -�g �,;'� t:� Title Licensed Surveyor Company Name Florida Engineering & Surveying LLC - ^{ " � .� �r - Address FEMA Form 086-0-33 (7/12) City Nokomis Date State FL ZIP Code 34275 Telephone 941-485-3100 See reverse side for continuation. � .' P.: . � i_� ,�,. � cr � �"�Nff,� •.. .'� �., �.." �J �" �i:�l��%`v�t - 4��; . ' �°�.•�s:tiam�; Replaces all previous editions. -=�ON CERTIFICATE, page 2 ` TANT: In these spaces, copy the corresponding information from Section A. g Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. ,�,Y ESPLANADE <CLEARWATER State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number: SECTION D— SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) <` opy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner. ' Comments SEE ATTACHED FOR COMMENTS �� SECTION E— BUILDING EL�YA�ICj�N 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 ❑ feet ❑ meters ❑ above or � below the HAG. b) Top of bottom floor (including 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 ❑ 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) 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. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ 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 AO. 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 Construction ❑ Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: ❑ feet ❑ meters G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters G10. Community's design flood elevation: ❑ feet ❑ meters Local Official's Name Community Name Signature Comments FEMA Form 086-0-33 (7/12) Title Telephone Date Datum Datum Datum Check here if attachments. Replaces all previous editions. �iEVN►TION 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., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. 22 BAY ESPLANADE 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. � : ...� T� �_x FRONT VIEW 3/4/ 15 �� , , � �v � ` � ; _ �� k ' � �� ,.�. " � � •� � 1 .�� ,-_ , , .� ., . ; � , � ��,��,s= �'��= � , Y •£ � t' . R �` y _ . � � ��. - , � �� { i.b .$. . � �� REAR VIEW 3/4/ 15 FEMA Form 086-0-33 (7/12) Replaces all previous editions. ADDITIONAL COMMENTS: THE BENCHMARK UTILIZED FOR THIS CERTIFICATE IS A CITY OF CLEARWATER BENCHMARK, #H-02, ELEVATION = 5.21 FEET, N.A.V.D. 1988. ELEVATIONS SHOWN ON THIS CERTIFICATE ARE REFERENCED TO N.A.V.D. 1988. THERE WAS NO MACHINERY SERVICING THE BUILDING AT TIME OF CERTIFICATE, 3/4/15. THE LATITUDE AND LONGITUDE AS SHOWN IN SECTION A5 WAS OBTAINIED USING A HAND HELD GPS DEVICE WITH AN ACCURACY OF 15 FEET ±. THE BUILDING SHOWN IN THE PICTURES ABOVE IS ON WOOD PILINGS WITH NO ENCLOSURE OR STORAGE AREAS BELOW. THE BOTTOM OF THE BEAM ELEVATION = 13.30 FEET, N.A.V.D. 1988.