840 BAY ESPLANADE�.S.������ ELEVATION CERTIFICATE
�EDERRS ENER(a'ENCY MANAGEAAENT AGENCY
,Nadonal Fload lrrsw�xae Pmgrom �mportanr Read the instructions on pages 1�.
SECTION A - PROPERTY INFORMATION
A1. Suildiny Owners Name Richard Slone
A2. Building Street Address Cmcludin9 Apt. Unit, Suite. and/or Bkig. No_) or P.O. Route and Box No. .._.'..° ._._._ �..
840 BaY EsPlanade ��` �: �; I
City Clearyrater
Lot 3, Block 32,�Matidelay Sub. - PFat Book 14 Pg. 32
State FL
OMB No_ 1660-0008
Expirati�on Date: July 31, 2015
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A4. Budd'mg Use (e.g.. Residential, Non-Residential. AddiGon. A�ssorY. �c.) Reside�rtial ! Ul. 1 C� �V c-�
A5. 1.atitudeJLongdude: Let �7.9.957'N Long. 82.8238`W HorQOntal Datum: ❑ NAD 1927 � ` 1983 _.. _... _.
or on
A6. Attach at � 2 phdographs of tl�e building ff the Certificate is being used to obtain flood �sura .
n�_ s„'atrg n�rarn Nwn� � PLANNING � OEVE'.::�'!':'ui�Cl�i DEPT
A8. For a build'mg wkh a�oe or endoswe(s): A9. For a bu' in9 with �IF�4�� ��;;r�'•iER
a) Square footage Cf cx8w�paoa or e�losure(s) 1937 sq ft a) Sq 600fage of al�ched yarege �A
b) Number of permaneM flood openings in the crawlspaoe b) Nu
or endo�ure(s) wi@im 1.0 took above a�aoent grade 19 vMtl�in LD foot sbove 98�
c) Total net ar� of flood openirgs in A8•b 2_Q,�7, sq in c) Total net a�ea of fbod �� !L
d) Engineered flood openings? � Y� � No ��^ A9b WA sq in
� Engk�eered Ilood openirgs? � Yes � No
. SECTION B- FLOOD INSl1RANCE RATE MAP (FIRM� INFORMATION .
B1. t+IFlP Cammunity Name d� Gommun�ly Number B2,County Name
Cleanwater -�125096 . Pinellaa �
84. Mep/Penet Number 65. Surtix B6. FlRM index Da6e 67: FlRM Pane!
12103C0102 � G � 8/18109 Eft�ivelRevisad Daee
9/3/0:i
B3. State
Florida
88. F1AOd 69. Base Flood Elevation(s) (Zone
Z� s) AO, use ba � flood depth)
610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FlS Profile � FIRM ❑ Community Determined ❑ OthedSource:
811. indicate alevatbn datum used 4or BFE in Item 69: ❑ NGVD 1929 � NAVD 1888 ❑ OthedSouroe:
812. Is the budding bcated � a Coastal8amer Rssou�oes Sjrstem (CBR&) area or Othervvise Pro�cEed A�ea (OPA)? � Yes
. oesr�naaon nate: ❑ c�xs O oPA
� SECTION C- BI�iLOiNG ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevafions are based on: ❑ Coi�shudion Drawing�' � Buildiry Under Construction' � Finished Con,
-`A �riew Elevation Certlflcate will be requireit when conshuc#idn of the tiuildirrg is c�mplete.
C2 Elevatlons - Zaies /C1-A30� AE� AH� A iwilh BF�, VE. V1�d0, V(wdh BFE�, AR AWA, AR/AE, AR/A1-A30� ARG4H. AWAO. Cornpk
below acoad'mp to tlie buudU!9.di�9r�n $Pedfied in t�n A7. in Puerto�Rico only. enlsr mebers. .
Benchmark Ut�mad: �148 fF� ). Vertical Datum: 1988
Ind'rc:ate ebvatioe datum used for the elevations in ilems aj through h) below. ❑ NGyp 1929 � NAVD 1986 ❑ Othe�/Sou►ce:
Datum used tor buNd'mg elevations •rrnist be the aame as that used tor tl�e BFE_
a). Top of boltcm floor ('mckd'm9 basemeM, aawlspace� or enCbsure floo� . 4.� �-r
b) Top of the riext higher floor • . I B•73
c)'Bottom of the lovvest 1wr¢o�d structurel member (V Zones ony) NA '
d) A�aChed 9� (�P � �) N-�
e) Lowest.edevation of machinery orepuipment serviCing ifie building. g.�
(Desaibe type of equiprt�ent and location in Commerrts)
� Low�sf adjacent (fioished) 9rade ne�Q to bu�ding (LAG) 4.7�
9) Highesf adjacent (finished) grade next to buildin9 (Fb°�G) $.00
h) Lovve,st adjaoent grade_at bvrest elevation of dedc or stairs, indudiqg struc3ural support NA
. Chedc tlie measu�ner►t ut
� fest ❑ meter
�� o�
� reec ❑ rne�
� feet ❑ me�er
� Teet ❑ metar
� fe� ❑ metet
� feet ❑ meEe�
� ieet ❑ meten
SECTION D- SURYEYOR, ENGINEER. OR /1RCHi'fECT CERTIFICATION
This oertific�tion is to be signed and sealed by a Nand surv�ey�r, engineer. a archiEec:t ai�tNormed by law to oertlfy elavation
infonnation. ! oerHfy that H�e inAnrmabion on this Ce�tr�:afe rr�presents my best el�orts io inle�pvet U�e dats avaaebJe.
i tmderstend tl�et arry faf�e sKetement maY be ptnislrable by fine or imprisonn�ent ta�der !8 U.& C.ode. Sec�nn 1001.
� Check hene if oomrt� ar�e provided on back of torm. Were lat�ude and long�ude � Section A pmvided by a
� Chedc here if athadimerds. Goensed land surveYon � Yes ❑ No
Certifie�'s Name John C. Brendla
North
Company Name John C.
City Pinelfas Park
Date 08/01/13 /
Lioer�e Nurt�bet 12�
AssociaEes. Inc.
State Fl ZIP Code 33781
TelePhone i72� 57Cr7546
See 1+e�lerse Sic� iOt COntinuatlon.
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all previous edi6ons.
E�.EVATiON CERTfFiCATE, page 2
IMPORTANT: In these spaces, copy the caresponding infonnation from Section A.
Building Street /�ddtess ('induding Apt. Unit, Sui6e, and/or Bldg- No-) or P.O. Route and Baoc No.
840 Bay Espianade
City Clearwater State R ZIP C.ode 33767-1301
FOR IN$URANCE�GOMP/tidY USE `.
Policy Numbar
Cort�a�Y.NA1C Number
SECTION D— SURVEYOR. ENGINEER, OR ARCHITECT CERTIFlCATION (CONTII�lUED} •
Copy of this ' Cettificafe fior (1) communily orfificiel, (2) insurance a9eMicomPanY. and (3) building owner. �_ _
c2e: A/C P
�Th is tfie g�rage at Elev. 4.89' C� b. Thig is the floa� at 8.77' NAVD -,
Coiuity #148 (F-3) . 3.508' NG1ID a�ustad . 2.72' NAVD - MSL = 0.00
- — � r'� .
Dabe 08/Di/13
SECTION E—,BUILDING ELEVATION INFORMATION
FOR ZONE AO AND ZONE A(WITHOUT BFE)
� For Zones AO and A iwitho�d BFE). compiebe ibert�s E7-E5. ff fhe Certificabe is inEended to support a LOMA or LOMR-F nequest, oomPlele Sedions A, B.
and C. For t6ems E1-E4, �e n�ural grade, if airaiable. Chedc the meas�rrernent used. In Pue��o Rkko ony. e�er rt�e6ers.
E1. Provide elevation ir�fonnation for the forovdng and cffeck the appr�opriate bo�aes to show rMeth� tbe elevation is above or below the highest �adjacent
grade (HAG� and the lowest adjaoerrt gtade (LAG).
a) ToP .of bottom floor fu�ciudin9 bssement, crawlsPece. ar endosure) is ❑ ieet ❑ me�rs ❑ abwre or ❑ belo�w tha IiAG.
b) T� of bottom floor (indudin9 �ment, cra�wlspaoa. a��os��e) � ❑ reec ❑ mero� O ano� or p ee�, n� iac.
E2. For Building Diagrams 6-9 witfi pertnanent flood openirgs provided in Section A items a and/or 9(see 8-9 of Instrudior►s>; tfie ne�d nigher floor
(elevation C2.b in the diagtams).of the building� is . ❑ feet ❑ meters ❑ above or � the HAG. Y,�:ya'� "
E3. Attac�ed 9arage (toP of slab) is O �eet ❑ meters ❑ above or ❑ below tl�e HAG. ,.
E4. TOp of plat�ortn of madli�letp andlor equipmeM 9ervi�n9.the buid�9 fs ❑ �eec ❑ mece±s ❑�e a p t�ow u,� w�c. '�` .
E5. Zone AO only: If no Rood depth r�xnber is availaWe, is the top of the boltom tioor elevated in acxwdanoe wRh the oort�mun�s floodplain rnanagemeM
� ordinance? � Yes � No 0 Unknown. The bcal o�iCial muat oettify this k�F�madon in Sedion G.
SECT.ION F— PROPERT1f d11MNER (OR OYYNER'S REPRESENTATIVE) CERTiF�ATION
The property awrier or o�wnefs autlro�iaed � who oomplelas Sectiona A, B, aod E for Zoae A(witho�d a FEMA-issued or conunur�ty-�d gF�
or Zone� AO�must s� liere. The �err�enffi in Sedlons I►. B. and"E are conect to tlie best of my knowkdge.
Property Owner's or Owr�s Autlior¢ed �'s Nartie . .
'�� ' - �Y Siafe Z!P Code
Signature . p� T�
Commerrts
6a Chedc 6gte � �tadxnents_
SECT�ON G — CO�AUNIIY INPORMATION (OPTIONAL)
The locai alridal who.is ault�adasd by law or and�anos 10 admi�isEa� ihe aortrra�s tloodplain manapemeM andinanoe can camplele Sec�ions �►, B� C(a' �. arW G
af tlNs Elav�fon Ce�. Compleh� the aPP� ��'Ks) �md sign below. Chedc tlie meaa�nemdx used in pems G@-G1Q In Puerlo Rioo only, enlar n�e0ets.
G1, ❑ The iMortnation in Sectfon C was taken irom otl� documeMatlon that has been sipned and saaled by a Ycensed 9urveyor. engineer, or arahibed who
� autho� by law to oertify elevatbn iM�nr�lion. pndicale the aouroe and daie of the elevation data in the Conuiients a� below.)
G2: ❑. A communA�t offic3al i�mpleEed SecGon E for a building loc�ied rt� Zone A(wlthout a FEMA-Issued or cammunNy-issue0 BFE) or Zone AO. .
G3. ❑ The folbwing ir�ortnation (ICems G4-�10) is provided for oommunity floodplain management purposes,
G4. Pertnd Number
Oate F�enn't Issued
G6. D�e Catlfic�e Of ��
G7: This permR I�as baen issued fa: ❑ New Cor�struction ❑ Substar�ial lmprovement
ca. elevadon of as-buRt 1� noor finch�rg be�) or the bu�aing: ❑ reet � mete�s �atum
G9. BFE or ('n Zone AO) depfh of floo�ng at the buNd�g site: ❑ feet ❑ meters Datum
G10. Cammunitys design flood elevation: ❑ feet -❑ m�ers Datum
Local O(ficiei's Neme T�
�m� �� Tebpha�e
Signature D�
Commerns
! .i.>«, :_i- , .i�r-,ei �i.- ���:
FEnM F«m oas-o-33 (7nz� Repla�s al� pevious eaitions.