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766 ELDORADO AVE� ELEVATION CERTIFICATE �—� �� �C�' l.y�� ! O� O pg tion1Da e�November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (inciuding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 766 EI Dorado Avenue City State ZIP Code Company NAIC Number Clearwater Beach Florida 33767 SECTION C– BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* �x Building Under Construction` � Finished Construction *A new Elevation Certificate wili 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: Citv of Clearwater I-02 Vertical Datum: NAVD - 1988 Indicate elevation datum used for the elevations in items a) through h) below. � NGVD 1929 �x NAVD 1988 � OthedSource: 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) 8?� b) Top of the next higher floor 17. 34 c) Bottom of the lowest horizontal structurai member (V Zones only) 15. 71 d) Attached garage (top of siab) N/A. _ e) Lowest elevation of machinery or equipment servicing the building � �?S (Describe type of equipment and location in Comments) Check the measurement used. _ ❑x feet ❑ meters _ �x feet � meters _ �x feet ❑ meters _ ❑x feet ❑ meters _ �x feet ❑ meters fl Lowest adjacent (finished) grade next to building (LAG) � 48 Ox feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) � 86 � feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including N�A � feet � meters structural support 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 info atior 1 certify that the information on this Certificate represenfs my best efforts to interpret fhe data availab/e. I understand that any fa! statemenf may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes ❑ No ❑ Check here'i� attachm nts. John C. Brendla Title Surveyor Company Name John C. Brendla & Associates, Inc. A ess 015 8 d Avenue North C ity Pinel s Park Sig atur �. � opv all aaes of thi � erti um 1269 01 /26/2017 ZIP Code 33781 Telephone (727)576-7546 all attachments for (1) community official, (2) insurance . _ �- � � f� a1� .,- p� � S �l�H,e V' � '� 1� �c � \ , and (3) building owner. Comyfients (including type of equipment and location, per C2(e), if applicable) C2) a. Parking and Storage area C2) b. The Lowest Living Floor C2) c. Bottom of Beam C2) e. A/C Landing t the North side of the house Benchmark:City of Clearwater I-02, Atlas Page 249A Elev. 4.98' NAVD - MSL = 0.00 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency � piBr tion1Da e�NoBember 30, 2018 National Flood Insurance Program ' ELEVATION CERTIFICATE Important: Foilow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agenUcompany, and (3) building owner. SECTION A— PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Building Owner's Name Policy Number: Michael J. Williams AZ. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 766 EI Dorado Avenue City State ZIP Code Clearwater Beach Florida 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) ' Lot 4, Block 4- Mandalay - Plat Book 14, Pages 32-35 - Parcei #05-29-15-54666-004-0040 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) Residentiai A5. Latitude/Longitude: Lat. 27.99228° Long. -82.82792° Horizontal Datum: � NAD 1927 ❑x 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 6 A8. For a building with a crawispace or enclosure(s): a) Square footage of crawispace or enclosure(s) 2,335 sq ft b) Number of p�rmanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 0 c) Totai net area of flood openings in A8.b 0 sq in d) Engineered flood openings? ❑ Yes ❑x No A9 F�r � buildi�y with �n attached garage: a) Square footage of attached garage � sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) 7otal net.area of flood openings in A9.b 0 sq in d) Engineered floo� openings? � Yes ❑x No SECTION B— FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Communiry Name & Community Number 62. County Name 63. State � City of Clearwater $ 125096 Pinellas Florida B4. MaplPanel B5. Suffix B6. FIRM Index 67. FIRM Panei B8. Flood Zone(s) B9. Base Fiood Elevation(s) Number ' Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 12103C0102 G 08/18/2009 09/03/2003 VE 13' 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 B9: ❑ NGVD 1929 Ox NAVD 1988 � OtheNSource: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? � Yes �x No Designation Date: � CBRS � OPA FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 �. . ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 766 EI Dorado Avenue City State ZIP Code Company NAIC Number Clearwater Beach Florida 33767 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 GS—G10. In Puerto Rico only, enter meters. G1. ❑ The information in Section C was taken from other documentation tFiat 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 foilowing information (Items G4—G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compiiance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the buiiding: , ❑ feet ❑ meters patum 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 Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 ELEVATION CERTIFICATE � �. OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 766 EI Dorado Avenue City State ZIP Code Company NAIC Number Clearwater Beach Florida 33767 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—c5. 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, crawispace, 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 1-2 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 OYVNER'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 or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 Page 1 of 3 not valid without all three pages , s U.S. DEPARTMENT OF HOMELAND SECURI7Y F@ERAL EMERGENCY MANAGEMENT AGENCY Nati�al Flood Insurma Progmm A1. A2. Building SVeet Address (inciuding Apt., Unit, ELEVATION CERTIFICATE IMPORTANT: Follow the insVuctions on pages 1-9. SECTION A - PROPERTY INFORMATION , and/or Bldg. No.) or PO. Route and Box No. OMB No. 1660-0008 Expiration Date: July 31, 2015 FOR INSURANCE COMPANY USE Policy Number: Company A3. Property Descri on Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) 7 Pt� ( LOT 4. B CK 4 MANDA wv s�pRDIP rn naF MAP OR PLAT THEREOF AS RECORDE� !N PWT BOOK 14 PAGES � 3+ P� tni ir RECOR0.S OF PIN LoS C�UMTY Fl nRIDA A4 Build�ng Use (e.g., Res�der�tial, Non-ResidenUal, Addrtaon, Accessory, etc.) �SIDENTI� A5. Latitude/Longitude: Lat. ?7 99 25.2 N Long. €�? 8 7 W Horizontal Datum: ❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photogaphs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1A 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) � sq ft a) Square footage af attached garage 290 b) Number of Sq ft permanerrt flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enciosure(s) within 1.0 foat above adjacent gade 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 n d) Engineered flaod openings? ❑ Yes Q No ��n d) Engineered flood openings? ❑ Yes � No SECTION B- FLOOD INSURANCE RATE MAP iFlRM1 INFORMATION NFIP Community Name & B4. Map/Panel Number 12103C - 0102 Suffix � B6. FlRM Index S/18l2009 B2. County Name PINELLAS B7. FlRM Panel Effective/ B8. Flood Zone(s} Revised Date � 63. State Base Flood Elevation(s) {Zone A0, use base flood depth) 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth eMered in Item 69: �J ❑ FlS Profile � FlRM ❑ Communi[y Determined ❑ Other/Source: B11.Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: B12.Is the building loca#ed in a Coastai Barrier Resources System (CBRS) area or Othenvise Protected Area (OPA}? ❑ Yes � No Desig�ation Date: / / ❑ CBRS ❑ OPA SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Buiidir�g Under ConsVuction* [� 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, Vi-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 ftem A7. In Puerto Rico only, eMer meters. Benchmark Utilized: !-N T PS N M�ORK � Vertical Datum: NAVD 88 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: Datum used for buiiding 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 higt►er floor c) Bottom of the lowest horizonial structural member (Y 2ones onty) d) Attached garage {top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe Type of equipment and location in CommeMs) fl Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade ne�R to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support -S_ . 3.L__ -�- - 5�- 7 .3fi+1- 7 86 9 , �_ -Z_ . Z�_ -$- . 3-i-- 5 . 72 Check the measuremerrt used. �1 teet ❑ meters �] feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters SECTION D- SURYEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor; er�ineer, or architect authorized by law to certify elevation information. 1 certify thai ihe information on this Certificate represents my best efforts to interpret the data available. 1 understand thai any false staiement may be punishable by frne or imprisonment under 18 U.S. Code, Section 1001 � Check here if commerrts are provided on back of form. Were latitude and Iongitude in Section A provided by a �' �E�T � F IcqTF ❑ Check here if attachmenis. licensed land surveyor? ❑ Yes [� No N�. ��3 Certifier's Name Title Address 11940 FAIRWAY LAKES DRIVE SUITE 1 Signature p A � ��_ 1I,s�^�++�'�L Company Name City Date License Number State � ZIP Code Telephone ���. STATE OF ��oxtoi FEM/> Form 086-0-33 {Revised 7/12) See reverse side for continuation. Re laces all (RE1/.1 9/302013) (RE1/.1 9/30/2013j P previous edftions. Page 2 of 3 not valid without all three pages , ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copp the corr�p���g ����� �m Sectlon A. Buiiding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. �e� r� ni.e�.'... ....- C1� �e ZIP Code FL1309.2513EC FOR INSURANCE COMPANY USE Policy IVumber. Company NAIC Number; SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFlCATION (CONTINUED) CoPy both sides of this Elevation Certificate for (1) community officiai, (2) insurance ageni/cornpany, and (3) building owner. Comments NOTE: C2.E =AC UNIT PAD. NOTE: THIS ELEVATION CERTIFICATE IS ONLY VALID FOR THE PERSON OR PERSONS NAMED ON THIS ('FRTIFIC'ATF THI4 ('FRTIFIC`ATF IS FnR F( ()On INSURAN('F Pl IRPnSFS p1�1 Y TF;F II�FnRIIAATION ON! 71,IS ('FRTIFIC'ATF � inr oc USED FOR CONSTRUGTION OR PLANNING. C2G APPROX. BOTTOM OF SLAB. Signature W,� Date 9/30l2013 CENTERLINE ROAD ELEVATION: 7.25 SECTION E- BUIIDING ELEYATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT SFE) For Zones AO and A(without BFE}, complete ftems Ei-E5. If the Certificate is intended to support a LOAM or LOMR-F request, complete Sections A, B,and G. For Items E1-E4, use naturai grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation informatiai 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) Tap of bottom floor (induding basement, crawlspace, or encbsure) is _.l1/� . � feet ❑ meters ❑ above or ❑ below the HAG. b} Top of bottom floor (including basement, crawispace, or encbsure) is _�IlA_ . � feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams Fr9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions), the next higher floor (e�evation C2.b in the diagrams} of the building is N�A � feet ❑ meters E3. Attached garage (top of slab) is ❑ above or ❑ below the HAG. N�A � feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipmerrt servicing the building is _�. � feet ❑ meters ❑ abo� 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 ❑ Unlmown. The local official must certify this infortnation in Section G. SECTION F- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIF,CATION 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 laiowlec�e. Property Owner or Owner's Authorized Representative's Name Address Signature Comments City Date State ZIP Code Tetephone ❑ Check here if attachments. SECTION G - COMMUNITY INFORMATION (OPTIONAL) The Iocal official who is authorized by law or ordinance to administer the community's floodplain management ordina�ce 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 Sec[ion 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.y G2• ❑ A community official completed Section E far a building located in Zone A(without a FEMA-issued or communiry-issued BFE) or Zone A0. 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/Qccupancy Issued G7. This permit has been issued for: ❑ New ConsVuction ❑ Substantial Improvemerrt G8. Elevation of as-buift 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 dfficial's Name Community Name S�nature Commerrts Title Telephone Date ❑ Check here if attachmerrts. FEMA Form Og6.p-33 (Revised 7/12) Replaces alt previous editions. ELEVATION CERTIFICATE, page 3 BUILDING PHOTOGRAPHS Page 3 of 3 not valid without all ihree pages See In structions for Item A6. FL1309.2513EC IMPORTANT: In these spaces, copy the corresponding InformaRlon irom Section A. FOR INSURANCE COMPANY USE Building SVeet Address (inciuding Apt., Unit, Suite, and/or Bkig. No.) or P.O. Route and Box No. 766 ELDORADO AVE Policy Number: City State ZIP Code CLEARWATER �mPa�Y NAIC Number. FL 33767 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 ,48. If submitting more photographs than will fit on this page, use the Continuation Page. � "�` �} � , x�� , �P� -�-. __ � �. ��; '{ ���+;� � ��� �? � ,� If �fi�f�rdf��il� �'�G`��y� .,,._ � ��' � � � I �►- � FRONT PROPERTY PICTURE 9/28/2013 -t:, ..�"� �a W + � � °��� _.. LG � � �A.� } €"�a.ti � Y' .� '.r �"- . � �,; � � 4 � N�l , � �� �'� t � 1 . ." � A - - ilR, "'`"� � y`-� �.� .r y �p'�A..�� �''��iy .A. ��� . , . . � i^- . . ' x . . fi .a° � RIGHT PROPERTY PICTURE 9/28/2013 � �� � � y�` � +� , �'�'`•�'� � �K ""� ." 4�;,.'�Ml►,arw �!� �' ' � x,�l, � � � '' � REAR PROPERTY PICTURE 9/28/2013 � ;. "�H,y: _ _., � �. �.„�, .ya A' �wya• ?; � `'�t,.` . P'J' � . r ..ty � .yL' � r� r'' � "E� t �. ^ �, .. LEFT PROPERTY PICTURE 9/28/2013 �p �!`.; FEMA Form 08C�33 {Revised 7/12) Replaces all previous editions. ; �. . , .: v�..� , �:..� � . , „ . . .:.. ELEVATION CERTIFICATE, page 4 BUILDING PHOTOGRAPHS Continuation Page FEMA Form OBFrp-33 (Revised 7/12) Re laces all P previous editions.