The URL can be used to link to this page

801 PHILLIES DR - CLUBHOUSE� DEPARTMENT OF HOMELAND SECURITY � ' Federal Emergency Management Agency ELEVATION CERTIFICATE OMB Control Number: 1660-0008 IMPORTANT: FOLLOW THE INSTRUCTIONS ON PAGES 9-16 Expiration: 11/30/2018 opy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agenUcompany, and (3) building owner. SECTION A- PROPERTY INFORMATION FORM INSURANCE COMPANY USE A1. Building Owner's Name CITY OF CLEARWATER FLORIDA Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number: 801 PHILLIES DRIVE - CLUBHOUSE BUILDING City CLEARWATER State F� Zip Code 33755 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) TAX PARCEL #10-2915-59796-004-0007 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) NON-RESIDENTIAL A5. Latitude/Longitude: Lat. 27°58'25.9" Long.-82°47'19.4" Horizontal 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 1A A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawispace 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 b) Number of permanent flood openings crawlspace or enclosure(s) within 1.0 foot in the attached garage within 1.0 foot above adjacent grade N�q above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? %T° Yes �''< No d) Engineered flood openings? � Yes �" No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. Gounty Name B3. State CLEARWATER 125096 PINELLAS FL 64. Map/Panel Number 65. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ 68. Flood Zone(s) B9. Base Flood Elevation(s) Revised Date (Zone AO, use base flood depth 12103C0106 H AUGUST 18, 2009 MAY 17, 2005 AE 20 B10. 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: B11. Indicate elevation datum used for BFE in Item B9: �"' NGVD 1929 � NAVD 1988 �°` Other/Source: 612. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? f""" Yes ��" No Designation Date: �'°' CBRS �`°' OPA SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: �°" Construction Drawings* {`''' Building Under Construction* t�' 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. A new Elevation Certificate will be required when construction of the building is complete. Benchmark Utilized: CITY OF CLEARWATER BM G-06 Vertical Datum: 26.98 NAVD'88 Indicate elevation datum used for the elevations in items a) through h) below. �' NGVD 1929 �` NAVD 1988 tr`" 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 (including basement, crawlspace, or enclosure floor) 22 ' 39 (: feet � meters b) Top of the next higher floor 36 - 01 �: feet � meters c) Bottom of the lowest horizontal structural member (V Zones only) N�A► ' �`� feet �'"' meters d) Attached garage (top of slab) N/A - �°" feet � meters e) Lowest elevation of machinery or equipment servicing the building 22 _ 03 (Describe type of equipment and location in Comments) � feet � meters f) Lowest adjacent (finished) grade next to building (LAG) 21 - 7 � feet �"'" meters g) Highest adjacent (finished) grade next to building (HAG) 22 � 2 {� feet � meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 22 � structural support t`" feet ��" meters FFMA Fnrm �RR-(1-'�3 (7/151 Ranlar.ac all nravinu� a�iitinnG Paae 3 of 15 • ' ELEYATION CE�'tTIFICATE . . OMB Control Number: 1660-0008 . Expiration: 11/30/2018 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. ! certify thaf the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1009. � � Check here if attachments. Certifier's Name JAMES R. McMATH Title ONAL SURVEYOR 565 . H RCU S AVE. Si atur � „ Were latitude and longitude in Section A provided by a licensed land surveyor? �" Yes �" No License Number LS 5126 Company Name DEUEL & ASSOICIATES City State Zip Code CLEARWATER FL 33764 Date Telephone ��`�� 6/7/2016 727-822-4151 y'�µ .,.��.,,..,, � .�;: . . ' ,. r�� . - `";.?, - l .;' =�.': ' �� ; '� ` � + 4 y i � s� �,,,, � . ,, C % � �' sij ~ � s` -''� � "a ?� }�` � � ti; , �.�'� 6 :%1 . � �'`` � Lh . . .. � ., ,�� , .�. ��; // � � A �,py� ('"1 LY ' � 1 } ��/. f., .��.�':.. �opy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner. Comments (including type of equipment and location , per C2(e), if applicable)" ITEM C2e ELEVATION OF PLATFORM SUPPORTING AIR CONDITIONING EQUIPMENT LOCATED ON THE NORTH - REAR SIDE OF BUILDING. ITEM C2bELEVATION OF 2ND STORY FLOOR. Signature Date SECTION E- BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BF For Zones AO and A(without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR-F request, comple 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, crawispace, or enclosure) is b) Top of bottom floor (including basement, crawlspace, or enclosure) is ;" feet � meters ❑ above or � below the HAG. C"' 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 - E� ` feet C°` 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 t'�` Unknown. The local official must certify this information in Section G. SECTION F- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION rhe property owner or owner's authorized representative who completes Sections A, B, and E for Zone A(without a FEMA-issued or �ommunity-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 Telephone ZIP Code � Check here if attachments. FFMA F�rm (1RR-(1-:i� /7/1.ril Ranlar.as all nravinii� P�iiti�nc Paqe 4 Of 15 OMB Control Number: 1660-0008 Expiration: 11 /30l2018 FFMA Fnrm (1RR-(1-�'� /7/1.ril Ranlar.aG all nravirnic ariitinn� Paae 5 of 15 , � 1 BUILDING PHOTOGRAPHS See Instruction for Item A6 OMB Control Number: 1660-0008 Expiration: 11l30/2018 IMPORTANT: In these spaces, copy the corresponding information from SectionA. FOR INSURANCE COMPANY USE 801 PHILLIES DRIVE, CLUBHOUSE BUILDING Policy Number: City State Zip Code Company NAIC CLEARWATER FL 33755 Number: It 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. PHOTOS TAKEN MAY 25, 2016 �, �'�' � �; FRONT VIEW (SOUTH SIDE) ,x .�� a � �, �e� � � 4` � : , _�� __.,:�;,.4' � , -. � i . .i _ , �� ' �?x ��_�. na�,,,.,,,,..-�-'�'-.• .�-• �*�.^... �;.,�� ,-�'.�� 5,;,....; r+�^^"_ . �.." . ....r . . '�W�- .. � . . FEMA FORM 086-0-33 (7/15) 4i�*�*'l"'! fi';�:;: a3r ; . :: ��'.,,�t,k�,`'a"'�''�9P j"��„ a�'»�a-.� * v .. �„ ,:�.""� . �t � ,�te'�:,_..�.,.,., _,..�,.,.�.,,_.._ . .. .. . . REAR VIEW (NORTH SIDE) Replaces all previous editions. Page 6 of 15 . ,� , , , ' � BUILDING PHOTOGRAPHS Continuation Page IMPORTANT: In these spaces, copy the corresponding information from Section A. 801 PHILLIES DRIVE, CLUBHOUSE BUILDING OMB Control Number:1660-0008 Expi ration: 11 /30/2018 INSURANCE COMPANY USE Policy Number: City State Zip Code ompany NAIC Number: CLEARWATER FL 33755 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date :aken; "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 SectionAB. PHOTOS TAKEN MAY 25, 2016 � k � ��#� � ` � �?� � ' ^�.. a 1 t 4. -^+ �� , , W , $ � r � � , �ii�� i + i; 4{��" ` ;� ?`�rr gP( �� 9 - f �� ,�.::�:�,<:; � ,.:s : , . _ .. '? ^•-�; .,., I . ' $ ~ ~. Y , �;;.. ° ��",q� p�� 1 �,. .,,,,.� . �� $ . ��,,�_ -� • . . 4 ..u' SH �.. . e� 3 y �r Y� 5,�,,..�..,� d�k .., � �e� � �,a f . � �'�� . ^r . . , . � . .. I:T[eL'��YI»91� FEMA FORM 086-0-33 (7/15) Replaces all previous editions. Page 7 of 15 �� U ��U ��LnJ�� RECEIVED JUN 1 0 2016 PLANNING 8� DEVELOPMENT DEPT CITY �F CLEARWATER 801 PHILLIES DR �, ��, BCP2016-04426 �" 2ND FLOOR RENO JACK RUSSELL STADIUM 2ND FLOOR CLUBHOUSE Zoning: Open Space/Recreation Atlas #: 278A