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3141 GULF TO BAY BLVD_ rU.S. Dt�AFtTMENTOF HOMELAND SECURITY ELEVATION CERTIFIC FEDERAL EMERGENCY MANAGEMENT AGENCY ATE National Flood Irtsurance Program Important: Read the instructions on pages 7-9. A1. Building Owner's Name CITY OF CLEARWATER SECTION A- PROPERTY INFORMATION A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 3141 GULF TO BAY BLVD (EAST WASTE TREATMENT CONTROL ROOM) Ciry CLEARWATER State FL ZIP Code 33759-4506 OMB No. 1660-0008 Expiration Date: July 31, 2015 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) MYRON A. SMITH'S BAY VIEW SUBDIVISION E'LY 300FT OF TRACT B TAX PARCEL ID #16-29-16-83106-000-0207 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) NON-RESIDENTIAL A5. Latitude/Longitude: Lat. 27 °57' 37.4"N Long. -82°42 24.8"W A6. Attach at least 2 photographs of the building 'rf the Cert�cate is being used to obtain flood insurance�ontal Datum: ❑ NAp 1 g27 � N,qD 1983 A7. Building Diagram Number 1A A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 82 4 g ft A9. For a building with an attached garage: b) Number of permanent flood openings in the crawlspace Q a) Square footage of attached garage N/q �� or enclosure(s) within 1.0 foot above adjacent grade p b) Number of permanent flood openings in the attached garage c) Total net area of flood openings in A8.b Within 1.0 foot above adjacent grade N/q d) Engineered flood openings? ❑ Yes � No � sq in c) Total net area of flood openings in A9.b J�/A sq in d) Engineered flood openings? ❑ Yes � No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP Community Name & Commun' Number CITY OF CLEARWATER 125096 � B2• County Name PINELLAS 64. Map/Panel Number B5. Suffix 66. FIRM Index Date 12103C0129 G 8/18/2009 B7. FIRM Panel Effective/Revised Date SEPTEMBER B3. State FLORIDA B8. Flood B9. Base Flood Elevation(s) (Zone 3, 2003 Z qE�g� AO, use base flood depth) 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69. 9 ❑ FIS Profile � FIRM ❑ Community Determined 611. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 192g ��her/Source: 612. Is the building located in a Coastal Barrier Resources System (CBRS) area o�r Othervvise Protect�ed Area (OPAj?. Designation Date: ❑ CBRS ❑ Yes � No ❑ OPA SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings" ❑ Building Under Construction' *A new Elevation Certificate will be required when construction of the building is complete. � Finished Construction 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: CITY OF CLEARWATER E-17 Indicate elevation datum used for the elevations in items a) thro gh h�b owm� NGVD 19 9�5NAVD 1 88 ❑ Datum used for building elevations must be the same as that used for the BFE. OtheNSource: a) Top of bottom floor (inGuding basement, crawlspace, or enclosure floor) 6 2 Check the measuremerrt used. b) Top of the next higher floor -- ��eet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) 9�1 ��t ❑ meters d) Attached garage (top of slab) N�'4�- ❑ feet ❑ m�e� e) Lowest elevation of machine or N�'4'- ❑�t ❑ meters Describe ry equipment servicing the building 9 � � feet ( type of equipment and location in Comments) ❑ meters fl Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished s'� � feet ❑ meters ) grade next to building (HAG) � � h) Lowest adjacent grade at lowest elevation of dedc or stairs, including structural support 6.7 ��et ❑ meters - � feet p meters 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. l certify that the infomration on this Ce�cate represenfs my best efforts to interpret the data available. � l understand that any fa/se statement may be punishable by fine or imp�sonment under 18 U. S. Code, Section 1001. :'�'' � i� �' °+� )'f' �• � Check here if comments are provided on badc of form. Were latitude and longitude in Section A provided by a ',,���'. '`��• ❑ Check here if attachments. licensed land surveyor? � Yes • . ' ❑ No „ ; �r����A,. ' � .. Certifier's Name DANA A. WYLUF Title SURVEY MANqGER Address 565 FEMA Form 086-0-33 (7/12) _ J License Number LS 5874 Company Name DEUEL & ASSOCIATES See reverse side for continuation. . � � c� ��r �F��t �^ � � �. : � , ,: ; �;�� � �. �,: . , ���. _ -��t*-�. . � ELEVATtON 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. 3141 GULF TO BAY BLVD (EAST WASTE TREATMENT CONTROL ROOM) City CLEARWATER State FL ZIP Code 33759-4506 SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) +� Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner. Comments A5: Latitude and longitude were determined by using Google Earth. C2a) Elevation is floor of entry foyer on south side of building. C2b) Elevation is floor at west door of building C2e) Elevation is top of air conditioner platform. Lowest electrical outlet elevation = 10.3 feet. C2h is bottom of stairs on south side of building. Generator: top of slab elevation = 13.6 feet. Lowest horizontal member elevation = 11.0 feet. Bottom of stairs to generator elevation = 6.7 feet. Signature �+ 7/ / Date G.�c (� (�/ � /9 zO�S SECTION E- BUILDING EL ATION 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. Chedc the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation infortnation 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 enGosure) is ❑ feet ❑ meters b) Top of bottom floor (including basement, crawlspace, or enGosure) is ❑ above or 0 below the HAG. • ❑ 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 community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local 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 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 Ciry Date State ZIp Code Telephone ❑ Check here if attachmenffi 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 Certficate. Complete the applicable item(s) and sign below. CheGc the measurement used in Items G8-G10. In Puerto Rico only, enter meters. G1. ❑ The infortnation 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. Perrnit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Oxupancy 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 Title Telephone Date Check here ff attachments FEMA Form 086-0-33 (7/12) Replaces all previous editions. ',EL'E'VATION CERTIFICATE, page 3 guiiding 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. 3141 GULF TO BAY BLVD (EAST WASTE TREATMENT CONTROL ROOM) City CLEARWATER State FL ZIP Code 33759-4506 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 flc�od openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. � �� _ �e- .;. k�4. �� � -•� �, , ;°, ,� k � , �� #r A.�- � i { '; �� �r � ;��'4�. _ M.� :'f.•. F. I. .,.. � ig .. 1. �i' "'-� �?��� :. .. . 1 _ . .. i � a z „ f � 'n.� •.. ,� . . v f • `� � ' :.: . . � �'�7- , -' . , . 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FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 3141 GULF TO BAY BLVD (EAST WASTE TREATMENT CONTROL ROOM) City CLEARWATER State FL ZIP Code 33759-4506 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 Vie+nj' 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. T � � . �. �µ �. �G t � s � ru � I: ��...,;� a ...�a„a„ernw.x�m �� �B}p zz�... ` �.� � - .. � «�^� ° ,;. ` � �;�. _ __ � �:' r �r�; �:� �.� t �;r;. � �� � GENERATOR (WEST SIDE OF BUILDING) 6-17-2015 FEMA Form 086-0-33 (7/12) Y�`. ..�..,. ...: ._. `.::�+ ��: �. . x .` �'x :£:.. „� ��� GENERATOR PLATFORM 6-17-2015 Replaces all previous editions.