Loading...
400 MANDALAY AVEU.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY Nationa! Flood Inmrance Program IMPORTANT: F011ow the i�StruCtiOnS on pegBS 1-9. SECTION A — PROPERTY INFORMATION OMB No. 1660-0008 Expiration Date: July 31, 2015 A1, Building Owner's Name �OHN S. TAYLOR AND C/O CLEARWATER-SURFSIDE TR PolicyNumber. A2. Building Street Address (including Apt., Unit, Suite, and/or Bidg. No.) or F0. Route and Box No. CompaFry NAIC Number. 400 MANDALAY AVENUE ��Ty CLEARWATER State F� ZIP Code A3. Property Description (LOt and Block Numbers, Tax Parcel Number, Legal Description, etc.) 33767 PARCEL 08-29-15-00000-230-0100, PINELLAS COUNTY, FLORIDA A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) HOTEURETAIL SHOPS A5. Latitude/Longitude: Lat. -27•978945° North Long. $2.827990° West Horizontal Datum: A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. ❑ NAD 1927 �x NAD 1983 A7. Building Diagram Number 6 A8. For a building with a crawispace or enclosure(s): A9. For a buiiding with an attached garage: a) Square footage of crawispace or enclosure(s) 8900 Sq ft a) Square footage of attached garage N/A s ft b) No. of permanent flood openings in the crawlspace or 4 enclosure(s) within 1.0 foot above adjacent grade NA b) Number of permanent flood openings in the attaChed garage c) Total net area of flood openings in A8.b NA within 1.0 foot above adjacent grade 0 sq in c) Total net area of fiood openings in A9.b � sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B— FLaOD INSURANCE RATE MAP (FIRM} INFORMATION 61. NFIP Community Name & Community Number 62. County Name CITY OF CLERRWATER -125096 (UNINCORPORATED AREAS) F� State B4. Map/Panei Number 85. Suffix 86. FIRM Index Date 87. FIRM Panel Effective/ B8. Flood Zone(s) 89. Base Flood Elevation(s) (Zone Revised Date A0, use base flood depth) 12103C0102 G 09/03l2003 09/03/2003 "VE" 8"AE" '1JE"=13 & "AE"=12 810.Indicate the source Of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69: ❑ FlS Profile � FlRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes � No Designation Date: / / ❑ CBRS ❑ OPA SECTIaN C— BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Ci. Building elevations are based on: ❑ Construction Drawings* ❑ Buiiding Under Construction* *A new Elevation Certificate will be required when construction of the building is compiete. � finished Construction C2. Elevations — 2ones A1—A30, AE, AH, A(with BFE), VE, V1—V30, V(with BFE), AR, AR/A, AR/AE, AR/Ai—A30, AR/AH, AR/A0. Complete Items C2.a—h below according to the buiiding diagram specified in Item A7. In Puerto Rico only, enter meters. eenchmark Util¢ed: ELEVATIONS BASED ON L-NET REFERENCE FRAME PROVIDED BY LENGEMANN NAVD 1988 VerUCal Datum: 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 (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) � Lowest adjacent (finished) grade neM to building (LAG) g) Highest adjacent (finished) grade next to buiiding (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structurai suppor[ Check the measurement used. -� - 2 � feet ❑ meters 6 • 2 � feet ❑ meters 15 , 4 � feet ❑ meters 5 3 � feet ❑ meters 6 - 2 � feet ❑ meters 5 , 3 � feet ❑ meters � - 2 � feet p meters NA , ❑ feet ❑ meters SECTION D— SURVEYOR, ENGINEER, OR ARCHITECT CERTIFlCATION This certlfication 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 6esi efforts to interpret the data avaiiable. I undersiand thai any false stafemeni 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 /�'J ❑ Check here if attachments. licensed land surveyor? ❑ Yes � No /J / "°' " """" James D. Bray essional Surveyor & Ma� :ss '. East Robinson Street ture �- Form 086-0-33 (7/12) License Number PSM 6507 Company Name Accuri ht Surve s of Orlando, Inc. Cfty State ZIP Code Orlando FL 32803 Date�/ /Z� /� Telephone � 407 894-6314 See reverse side for continuaii0n, E all previous editions. � 4QQ MANDALAY AVE BCP2015-08363 REMODEL HILTON CLEARWATER Zoning: Tourist Atlas #: , � � ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the corresponding information ftom Section A. Building Street Address (including Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. 400 MANDALAY AVENUE c�cy CLEARWATER State ZIP Code FOR INSURANCE COMPANY USE Policy Number: ny SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) communfty official, (2) insurance agent/company, and (3) buiiding owner. Comments C2.a (The top of bottom floor is located inside the elevator shaft) C2.b (Ground level enclosures include a lobby, shops, storage areas and a snack bar) C2.d (Elevation shown is for ground levei parking garage) C2.e (Air conditioning unit on pad outside of structure) A5 (Latitude and Longitude derived from Google Earth) oignawre Date ��/� � S'�CTION E— BUILDING ELEVATIO INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND 20NE 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 fioor (including basement, crawlspace, or enclosure) is . ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enciosure) 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 E3. Attached garage (top of slab) is ❑ below the HAG. • ❑ 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 managemen ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certity this inforrnation in Section G. SECTION F- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFlCATION The property owner or owner's author¢ed 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 21P Code Teiephone ❑ 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 applicabie 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 officiai completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE) or Zone A0. G3. ❑ The foliowing information (Items G4-G9) is provided for community floodplain management purposes. G4. Perrnit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy I u%. i nis peRnii nas 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) TUe Telephone Date ❑ Check here if attachments. Replaces all previous editions. �LEViA'iION CERTIFICATE, page 3 BUiLDING PHOTOGRAPHS See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. Bullding Street Address (including Apt., U�it. Suite, and/ar Bidg. No.} or P.O. Raute and Eox No. 400 MANDALAY AVENUE City State ZIP Code CLEARWATER FI._ 33767 FOR tNSURANCE COi�1PANY USE Policy Number: NAIC Number: if using the Elevation Certificate to obtain NFIP fiood 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 subrnitting more photographs than will fit on this page, use the Continuation Page. Date of Photos : 11/20/2014 �� � �� � FRONT VIEW r , _ ,. a�%' G. � % .;�`✓�. � '��� ��t�. ,� � ..� � �'` € :: PARKING GARAGE VIEW FEMA Form 036-0-33 (7/12) �" .,� g �. . -�: .�� ` � � �_ � �`� ,�` `� ����.� r�: �'-° ��_ `� � ;� :�` �, � '� �'� < � � _ � ��� REAR VIEW ;'°s'; f � �� � �� :.x i� 9 :�� SIDE VIEW u �� :�: Replaces all previous editions.