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816 MANDALAY AVEU.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. OMB No. 1660-0008 Expiration Date: November 30, 2018 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance aaent/com SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Taralon Homes LLC Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 816 Mandalay Avenue Company NAIL Number: City State ZIP Code Clearwater Florida 33767-1324 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Parcel ID #05-29-15-54666-010-0130 A4. Building Use (e.g., A5. Latitude/Longitude: A6. Attach at least A7. Building Diagram A8. For a building a) Square footage b) Number of c) Total net area d) Engineered A9. For a building a) Square footage b) Number of c) Total net area d) Engineered Residential, Non -Residential, Addition, Accessory, etc.) Lat. 27deg59'38" Long. 82deg49'37" Residential Horizontal Datum: obtain flood insurance. 1.0 foot above adjacent above adjacent grade ❑ NAD 1927 grade x NAD 1983 9 2 photographs of the building if the Number 1B Certificate is being used to 1,473 sq ft with a crawlspace of crawlspace permanent flood of flood openings flood openings? with an attached of attached permanent flood of flood openings flood openings? or encosure(s): or enclosure(s) openings in the crawlspace in A8.b 1,800 sq or enclosure(s) within in sq ft within 1.0 foot sq in 3 x Yes ❑ No garage: garage 711 openings in the attached garage in A9. b 600 x Yes ❑ No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number City of Clearwater 125096 B2. County Name Pinllas B3. State Florida B4. Map/Panel Number 12103C0102 B5. Suffix G B6. FIRM Index Date 08/19/2009 B7. F RM Panel Effective/ Revised Date 09/03/2003 B8. Flood Zone(s) AE B9. Base Flood Elevation(s) (Zone AO, use Base Flood Depth) 11 B10. Indicate the source ❑ FIS Profile B11. Indicate elevation B12. Is the building Designation Date: of the Base Flood Elevation (BFE) ❑ Community Determined for BFE in Item B9: Coastal Barrier Resources ❑ CBRS data ❑ NGVD System or base flood depth entered in Item B9: ❑ Other/Source: x FIRM datum used located in a 1929 p NAVD 1988 MI Other/Source: (CBRS) area or Otherwise Protected ❑ OPA Area (OPA)? ❑ Yes x No orm 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 KCV IJCIJ r'LH1V� RECEIVED BY:M.J.= MAY 0 2017 PLACITY OF CLEARWATER DEVELOPMENT 816 MANDALAY AVE BCP2015-11493B RTC TARALON HOMES Zoning: Low Medium Density Atlas #: 249A 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. 816 Mandalay Avenue Policy Number City State ZIP Code Clearwater Florida 33767-1324 Company NAIC Number SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: 0 Construction Drawings* 0 Building Under Construction* 0 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, V1—V30, V (with BFE), AR, AR/A, AR/AE, AR/A14k30, AR/AH, AR/A0. Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: "F 3" PID AG0504 Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. 0 NGVD 1929 0 NAVD 1988 0 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, crawispace, or enclosure floor) 6, 6 0 feet 0 meters b) Top of the next higher floor 15 1 ' 0 feet 0 meters c) Bottom of the lowest horizontal structural member (V Zones only) n/a El feet 0 meters d) Attached garage (top of slab) 6 2 0 feet 0 meters e) Lowest elevation of machinery or equipment servicing the building 14 1 0 feet 0 meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 5. 5 0 feet 0 meters g) Highest adjacent (finished) grade next to building (HAG) 5. 7 0 feet 0 meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 5. 5 0 feet 0 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 information. / certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement 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? tEl Yes 0 No 0 Check here if attachments. Certifier's Name License Number Thomas J Monaweck LS5332 Plae : .. Title President Company Name Monaweck Surveying, Inc. Address 13902 N. Dale Mabry, Suite 108 e... _ 1.... .--.."' j/ 217/ City State ZIP Code Tampa Florida 33618 Signature Date Telephone 03/27/2017 (813) 240-6823 Copy all pag of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) Grades shown in section C-2 (e) are for air conditioner pad's, located on the southeast corner of the residence Sections A-8 & A-9 references Flood Smart Vents 1540-510, Flood Coverage is 200 sq. ft. each FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 CAIJII auui I vane. rvovemoer :Su, Yui tf 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. 816 Mandalay Avenue Policy Number: City State ZIP Code Clearwater Florida 33767-1324 Company NAIC Number 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—E5. If the Certificate is intended to support a complete Sections A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑feet ❑meters LOMA or LOMR-F request, used. In Puerto Rico only, the elevation is above or below ❑above or below the HAG. • b) Top of bottom floor (including basement, crawlspace, 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 the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters 9 (see pages 1-2 of Instructions), ❑ 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 floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify with the community's this information 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 or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. orm Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No1000-0008 ExukabonDate: November 302D18 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/oBldg. No.) or P.O. Route and Box No. 816 Mandalay Avenue Policy Number: City State ZIP Code Clearwater Florida 33767-1324 Company NAIC Number SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community'sfloodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable itern(s) and sign below, Check the measurement used in Items G8 -G10. In Puerto Rico only, enter meters. Gi. 0 The information in Section C was taken from other documentation that has been signed and sealed by a licensed 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. DI A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone A0. {;3. 0 The following information (Items G4—G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certifiof Compliance/Occupancy Issued G7. This permit has been issued for. []New G8. Elevation of as -built lowest floor (including of the building: G9. BFE or (in Zone A0) depth of flooding at the G10. Community's design flood elevation: Construction 0 Substantial Improvement basement) Flfeet 0 feet 0 meters Datum building site: Flfeet meters Datum 0 meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) 0 Check here if attachments. FEMA Form 086-0-33 (7/ 5) Replaces aall previous editions. Form Page 4 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS See Instructions for Item A6. 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. 816 Mandalay Avenue Policy Number: City State ZIP Code Clearwater Florida 33767-1324 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 flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. AM az Y of .� - ► ,a7G . i •33 Photo One Photo One Caption Front View A t ` 7. M w ,y � r.l� u :; 09 ' 38 Photo Two Photo Two Caption Side View FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 RECEIVED BY. J• •• APR 2 6 2017 PLANNING & DEVELOPMENT CITY OF CLEARWATER 10b0' FIR 11 /2 NO 1.D. LOT 12 34.90' 24.90' 816 MANDALAY AVE BCP2015-11493B ELEVATION CERTIFICATE TARALON HOMES Zoning: Low Medium Density D: o� to za 2U Z uj VII - Ow D: Atlas #: 249A o' 20' 40' GRAPHIC SCALE: 1" = 20' N 8718' 36"E 109.90' (F) 0) LOT 3 FIR I 1 /2" I NO II.D. N8718'36"E 110.00'(F) 1 STORY MASNORY RESIDENCE #808 35.59' LOT 14 SURVE'YOR'S NOTES.. 1) BEARINGS ARE BASED ON THE EAST BOUNDARY UNE OF LOT 13, SAID UNE SAID UNE BEARS 5.89'48'16"W. ASSUMED. 2) NO UNDERGROUND UTIUTIES, FOUNDATIONS OR ENCROACHMENTS WERE LOCATED EXCEPT AS SHOWN. NO DIGGING, PROBING, EXCAVATING BY HAND OR MACHINE OR SUBSURFACE EXPLORATION FOR ANY IMPROVEMENTS WAS PREFORMED FOR THIS SURVEY. THE SURVEYOR MAKES NO GUARANTEE THAT THE UNDERGROUND UTIUTIES SHOWN COMPRISE ALL SUCH UTIUTIES IN THE AREA, EITHER IN SERVICE OR ABANDONED. 3) THE SURVEY SHOWN HEREON WAS PREPARED WITHOUT THE BENEFIT OF AN ABSTRACT OF TITLE AND WITHOUT HAVING SEARCHED THE PUBUC RECORDS OF THE COUNTY IN WHICH THE PROPERTY IS LOCATED; THEREFORE, THE UNDERSIGNED MAKES NO GUARANTEES, WARRANTIES OR REPRESENTATIONS REGARDING INFORM— ATION AS SHOWN HEREON PERTAINING TO APPROXIMATE PROPERTY LINES, EASE— MENTS, RIGHTS—OF—WAY, SETBACK UNES, AGREEMENTS, RESERVATIONS AND OTHER SIMILAR MATTERS. 4) ADDITIONS OR DELETIONS TO SURVEY MAPS OR REPORTS BY OTHER THAN THE SIGNING PARTY OR PARTIES IS PROHIBITED W1111OUT WRITTEN CONSENT OF THE SIGNING PARTY OR PARTIES. 5) THE ABOVE DESCRIBED PARCEL APPEARS TO BE LOCATED IN ZONE "AE(11) & AE(12)" ACCORDING TO FEDERAL INSURANCE ADMINISTRATION FLOOD HAZARD RATE MAP NUMBER 12057CO205H, MAP REVISED DATE 8/28/2008, WITH A BASE FLOOD ELEVATION OF 12 FEET, NAVD 1988 DATUM. NO FIELD SURVEYING WAS PREFORMED TO DETERMINE THESE FLOOD ZONE. BOUNDARY SURVEY LECENi?• (F) c FIR I.D. Ila PP PER RECORD PLAT FIELD MEASUREMNET UTILITY POLE FOUND IRON ROD IDENTIFICATION WATER METER POOL PUMP/FILTER AIR CONDITIONER LEGAL DESCRIPTION.' O • r� F▪ asx Z a THE SOUTH 10 FEET OF LOT 12 AND ALL OF LOT 13, BLOCK 10, MANDALAY, ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 14, PAGES 32 THROUGH 35 INCLUSIVE, OF THE PUBLIC RECORDS OF PINELL(kS, GQI1INTY, FLORIDA. ..;7 P.S.M.4261^� i • c4 NOT VALID WITHOUT THE SIGNATURE',A1 fT1&„QRIGINAt 'RAISED SEAL OF A FLORIDA LICENSED SUI't LEYOR'A ►PPg ',ti DATE OF LAST FIELD WORK `3/27447; + , ; t } THOMAS J. MONAWECK, PSM IMSIDEN77AL. OOMMICrarAL. FLOOD naV, fl 4S. arAravtraroN PLAT7W , IOUNDAIrY. 00/4s7111.107)ON 41# 70"IXMIAI4/0 INNKY as7RNDrs 13902 N. DALE MABRY HWY. 7FLEPHOV£ (813) 240-6823 SUITE 108 FAX (813) 962-7575 TAMPA, FLORIDA 33618 DRAWN BY: T.J.M. CHECKED BY: T.M. FIELD BOO: nia SCALE: 1 - 20' DAZE .1A 7 PAGE: NIA P.C. T.J.M. W.O. NUMBER 15078.00 SHEET OF PREPARED FOR: TARALON HOMES 24714 State Road 54 Lutz, FL. 33559 REVISIONSI DATE i BY ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS Continuation Page OMB No. 1660-0008 Expiration Date: November 30 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. 816 Mandalay Avenue Policy Number: City State ZIP Code Clearwater Florida 33767-1324 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 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. i'� •. 1,^ ... F isF 41,, r ri t 'k '� 5, y '! t , ' {�'. Ohl, 7r/ - - i•. . ... _ ie ly. A. : iiiiil _ '- /,/ ' ,. .201.1. , 2?` e > ,, ti Photo One Photo One Caption Side View Fig Ii A� 4F.4041 ' ro t co -'74-'i 09to0 i. J •}4: Photo Two . .. Photo Two Caption Back View FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6 U.S.OEPAf2TMENTOFNOMELANDSECURITY ELEYATION CEFtTIFIGATE PEDEii/�ll EMERGENCY MANAGEMENT AGENCY dhlfg �jp ��{}_�(J(j$ ��ar,o,wt�loa�tr��r�c�Pr�rt,,,, ��ant: Read the instruetions on pages 1-9. Exprratio� Qate: July 31, 2015 SECTlON A - PROPERTY INFOFiMAT1t7N �'£�',1�t1. ,, � ��:t��'�i�' �5�� , A1. Buiiding OwnePs Name Taralon Homes, LIC. ��p,��-�� #� ��,. �� A2. Bui{ding Street Address (inciuding Apt., Unit„ Suite, and/or B1dg. No.} or P,O. Route and Box No. �carnip� � �` � 816 �landatay Avenue -� q � . � ....., __ _... . .. � City Gieanaater State FL ZIP Cale 33767-1324 A3. Property Description (Lot and Block Nurnbers, Tax Percei Number, Legai Description, etc.} �� v^ �'arcei #05-29�15-54666-610-fl130 A4. Build4ng Use {e,g., Residential, Nan-Residen#iai, Addition, Accessory, etc.) Residentiai A5. lat+#udelLorrgitude: Lat. 27de�59'38° Lang. 82deaA9'37'1N Hnrizontal Datum: ❑ NAD 1927 jg� NAD 1983 A6. Attach at least 2 photographs af the building if the Certificate is being used to obtain fiaod insurance. Ai. Building Diagram Numbet 1B A8. For a buildir�g with a crawispace or enclosure(s}: A9. For a building with an attached garage: a) Square footage of crawispace o� enciosut�s{s} n/a sq ft a) Square footage of attached garage A45 sq ft b) Number of psrmane�t flaod apenings in the crawispace b) Number of permanent flood apenings in the attached garage or enGosure(s} within 1.0 foot above adjacenY grade Na within 1.0 faot above adjacent grade t 2 e) Totaf net area of flood apenings in AB,b n/a sq in c) Total nei area ofi flovd apenings in A9.b 2 4� sq in d} Engineered flaod openings? ❑ Yes � No d} Engineered 800d openings? � Yes ❑ h10 SEC7IQN B- F1.00D INSURANGE RATE MAP (FIRM) INFORMATION B1. NFIP Gommunity Name & Gummunity Number � B2. Cou�ty Name City of St. Petsrsburg 125i48 Pinellas 64. MaplPanel Number 85. Suffix B6. FIRM Index Date 67. �IRM Panef 125098 0102 G 8119/09 EffectivelRevised Date 9J3I2003 B3. State FL 88. Flaod ( B9. Base Flaod Etevafion{s) (Zane Zo��(s) AO, use ba; �tiood dep#h} Bt Q. Indicate the source of the Base Flood Elevation {BFE) data or base flood depth entered in Item 89. ❑ FIS Profike � FIRM [j Community Determined ❑ Qtherl5ource: B11. lndicate elevatian datum used far BFE in item B�J: ❑ NGVD 1828 � h1AV0 198$ ❑ OtherlSource: 812. Is the buitding lacated ir� a Caastal Barrier Resaurces Systsm (CBf28) area or flthenmise Protected Area (4PA)? Designa#ion pa#e: Q CBRS ❑ OPA ■ � • SEGTIQN C- BUILDING E�EVATlf')N fNFORMATtQN (SURVEY REQUIREt�) C1. Building elevations are based on: ❑ Constructian Drawings` � Building Under Construdion` ❑ Finished Gonstructian �A new Elevation Certificate will be required when construciion of the building is camplete. C2. E�vations - Zones A1-�34, AE, AH, A(with BFE}, VE, V1-V30, V(with BF'E), At2, AWA, ARtAE, ARIAi A30, ARlAH, ARIAO, Complete items C2.a-h below according ta the huilding diagram specit'�d in Item A7. In Puerto Rica anly, enter meters. Benchmaric Utilized: "F 3" Plp AG05Q4 Vertical Daium: NAViJ 1988 Indicate elevation daturrs used for the elevatiorss in items a) through h� belaw. C) NGVD 1929 i� NAVQ 1988 C3 OtherlSaurce: Datum used for building elevations must be the same as that used for ihe BFE. a} Top af bottom floor (including basement, crawlspace, or enclosure flaor} b} Top of the ne� higher floor c) Bottorn of the lowest horizanta0 structural member {V 2ones ccniy) d) Atfacheci garage (top of siab} e) i�owest elevation of machinery or equipment servicing the building (Describe iype of equipment and location in Comments) � Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent kfinished) grade ne� ta buiiding (HAG) h} �owest adjacent grade at lowast elevation of deck or stairs, inciuding structural support Check the measurement used. &_.6_ � feet p meters 15,1 � feet ❑ meters nfa. ❑ feet ❑ meters 6.2 � feet ❑ meters nta. ❑ feet � meteis 5.5 � feet 3.Z � feet nla. p feet SEG7tON D- SURVEYC?R, ENGINEER, OR AE�CNlTECT GERTlFICATtOh! ❑ meters p meters C�`meters Thi� cettification is to be signed and seaied by a land sutv�yar, engineer, or arch�ect authorized t�y !aw ta certify elevation `� -a- �"`�- infarmation. t eerti{�r that fhe irrfomtation on this Cert�cata represenfs my besf et�orts to interpret fhe dafs availabte. ' I understand thaf any fatse statement may be punisheble by ftne or imprisorrmenf urrder 18 U.S. Code, Section f00i. ❑ Check here if comments are provided an back of form. Were iatit�de and longitude in Section A provided by a ❑ Chedc here if attachments. lieensed land surveyar? � Yes ❑ No �� ,�,. �^ ; Certifier's Name Thamas J Monaweck Title President Address 139q2 FI, Dale Mabry Hwy Signature License Number LS5332 Gompany Name M4naweck Surveying, Inc. City Tampa �� ~ State FL ZIP Code 33618 Date 411711 Telephone ($13) 240-&823 � �v� . 1 �.. `s. . � ;� . ..�'"'fi+f^:�� . �� (��(��, FEMA Form 086-0-33 (7112} See reverse side for continuation. Replaces all previous editions_ E�.EVATION CERTIFICATE, IMPORTANT: In these spaces, cppy the correspanding informatian from Section A. Building Street Address (including Apt., Unit, Suite, andlor Bldg. Na.} or P.O. Route and Box No. 896 Mandalay Avenue City Cteamater State FL 21P Code 33767-1324 SECTIOht O- SURVEYOR, ENGINEER, OR ARGHIiECT CERTIFICATIUN (CQNTINUED) Copy bath sides of this Eievation Certificate for (1 j community o�cial, {2} insurance agentJcompany, and {3) buiiding owner. Comments Sectian A8d refereneces smart vents 1540-510 Flood Coverage is 200 Sq. Ft. each Signature �,/ date 4tt7116 SECTiON E- BU{LDtNG ELEVATION INFC)RMATION (SURVEY NOT REQUIREDj FflR ZONE AO AND ZONE A(WI'THOUT BFEj For Zones AO and A(withaut BFE), camplete ftems E1-E5. If the Certificate is intended to suppo�t a LOMA or Lf7MFi-F request, complete Sectiuns A, B, and C. For Items E1-E4, use natural grade, if available. Chedc the measurement used. in Pue�to Rico oniy, enter meters. E1. Provide elevation infortnation for the faliowing a�d ah�ic the apprapriate boxes ta shaw whether the elevatiar� is above ar below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG}. a) Tap at bottom floor {including basement, crawispace, or endosure} is ❑ feet ❑ meters ❑ abave or � below the HAG. b} Top of bottom floor (including basement, crawlspace; or enciosure} is ❑ feet ❑ meters ❑ above or � befow the LAG. E2. For Building Oiagrams 6-9 with permanent flood openings prauided in Section A Items 8 andlor 9(see pages 8-9 of Instructiansj, the neact higher floor (elevation C2.t� in the diagrams} of the building is ❑ t�et ❑ meters ❑ above or ❑ below the HAG. E3. Attad�ed garage {top af sfab) is ❑ feet ❑ meters ❑ above or Q below the HAG. E4. Tap of piatform of machinery andlor equipment servicing the building is ❑ feet ❑ meters 0 above or Q be#aw the HAG. E5. 2one AO on3y: If �o flood depth number is avaiiable, is the top of the bottam floor elevated in accrardance with the cammunity's floodpiain ma�agement orclinanc�? ❑ Yes ❑ No ❑ Unknown. The focal officiai must certify this infiormation in Section G. SECTION F- PRbPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERT{�ICATIC7N + The property owner ar awner'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 a�e corr�ect to the best of my knowledge. Property Owner's ar Owner's Au#horized Representative's Name Address Signa#are Gamments City � State Teiephane ZIP Code Check here if attacl�ments. SECTtQN G- C4MMUNITY INFORMATtON 40PTIONAL} The Ipcal offiipal who is authorized by law ar ordinance to administer the communiry's floodplafn management ortiinance can camplete Sectians A, B, C(or Ej, and G of this Etevation Certificate. Camplete ttre appiicable ikem(s} and sign below. Chedc the measurement used in ftems G8-GiO. in f'uerto Ric:o onfy, enter meters. G1. ❑ The infarmation in Section C was taken from ather documentatian that has been signed and sealed by a lir,ensed surveyor, engineer, or archi�ect wha is authorized 6y law to certify e{evation information. (IndiCate the source and date of the elevation data in the Camments area beiow.) G2. ❑ A cammunity offficcial completed 5ection E for a buiiding located in Zane A{withaut a FEMA-issued or communi#y-issued BFE} or Zone AC1. G3. ❑ The fopowing informatian (Items G4-G1 Q} is provided for cammunity floodplain management purposes. G4. Permit Number � G5. Qate Permit Issued G8. Da#e Certificate Qf Compliar�celOccupancy Issued G7. This permit has been issued for: [] New Canstruction ❑ Substar�tiat lmpravement G8. Eievatian of as-buiit lox�st floor (including basernent} of the buitding: Q feet G9. B�E or (in Zo�e AO) deptb of flooding at the building-site: G1Q. Commu�ify's design flood elevaiian: Lacal Of�iaE's Name Community Name Signature Gommsnts Q fee# ❑ feet Title Telephone Date ❑ meters Datum � me#ers Oatum ❑ mete�s Datum Gheck here if atta�hments. _ __- FEMA Form 086-0-33 (7J12) Replaces all previous editians. ELEVATICIN CERTIFICATE, page 3 gu�lding Phc�tographs See instructions for Item A6. IMPORTANT: in these spaees, eopy the earresponding infarmation fram Section A. Ft�R Ih�SURANCE Cflt+ttPAN'� USE Bui{ding Street Address (including Apt., Unit, Suite, andlor Bldg. No.) ar P.O. Raute and Box Na. Fo(icy Number. 816 MandalayAvenue Ciry Giearvvater 5tate FL �IP C�de 33767-1324 �ompar�y NAIG hlurtber: If using the Elevatian Certificate to abtain NFIP flood ir�surance, affix at least 2 building phatographs below according te� the ir�struc#ions 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 represen#ative exampfes af ihe flood openings or vents, as indicated in Section A$. ff submitting more phatographs than will fit on this page, use the Continuation Page. -�; �' �.:�-�..�' � �::�r.�...� FEMA Form 086-4-33 (71'12j Replaces a!1 preaious editions. ELEVATtON CEFtTiF{CATE, page 4 guEldirtg Photographs Continuation Page IMRORTANT: In these spaces, capy the correspanding informatian fram Sectian A. Bu9lding 3treet Address (including Apt.> U�it, Suite, andior Bidg. Na.} or P.C7. Route and Box No. 816 Mandaiay Avenue FC}R CNSI�#2FtNCE C(?t�iFANY llSE Po(icy Number: City Ciearwater State FL ZIP Code 33767-1?,24 � Company hiAiC iV€,mt�er. If submitting more photographs than wili fit on the preceding page, affix the additionai phatographs below. Identify a!I phofographs with; date #aken; "Front View" and "Rear �ew"; and, if required, `Right S+de View" and "Left Sid� View." When appiicabie, photographs must shaw the foundation with representative examples of the flaod openings or vents, as indicated in Section A8. � `_.._�°'l �'` '�..rt€_.�,�..�' FEMA Forr� 086-0-33 (7/12) Replaces all previous editians. , U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 Federal Emergency Management Agency Expiration Date: November 30, 2018 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow 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: Taralon Homes, LLC A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 816 Mandalay Avenue Ciry State ZIP Code Clearwater Florida 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Parcel ID #05-2-15-54666-010-0030 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) Residential A5. Latitude/�ongitude: Lat. 27deg59'38" Long.82deg49'37" 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 1A A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enGosure(s) sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b sq in d) Engineered flood openings? ❑ Yes ❑ No A9. For a building with an 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 c) Total net area of flood openings in A9.b sq in d) Engineered flood openings? � Yes � No SECTION B— FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP Community Name & Community Number B2. County Name B3. State City of Clearwater 125096 Pinellas Florida 64. Map/Panel 65. Suffix B6. FIRM Index 67. FIRM Panel 68. Flood Zone(s) B9. Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 125096 G 09/03/2003 09/03/2003 AE 11 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: ❑ FIS Profile �x FIRM � Community Determined � Other/Source: 611. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 �x NAVD 1988 � Other/Source: 612. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? � Yes � No Designation Date: � CBRS ❑ OPA FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE Expiration Date: November 30, 20�8 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (inciuding Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. Policy Number: 816 Mandalay Avenue City State ZIP Code Company NAIC Number Clearwater Florida 33767 SECTION C— BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* � Building Under Construction* ❑ 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, 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: Vertical 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. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 6 6 �x feet ❑ meters b) Top of the next higher floor � 5. � ❑x feet � meters c) Bottom of the lowest horizontal structural member (V Zones only) n�a. x� feet � meters d) Attached garage (top of slab) 6. 2 ❑x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building n�a. � feet ❑ meters (Describe type of equipment and location in Comments) � Lowest adjacent (finished) grade next to building (LAG) 5 5 �x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 5. � Q feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including n�a. x❑ 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 information. 1 certify that 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 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑X Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number Thomas Monaweck LS5332 Title 't,`�`;: Y President ��, � i l�., ,'�, � Company Name `' �':;;�`,.�,� ��° `.'r r� Monaweck Surveying, Inc. ~ ; ; �al = �r Address ` i,;;� �� 13902 N Dale Mabry, Suite 108 �� ` ,� City State ZIP Code �%., �' �� ` '' ww Tama `' '. '•'' �� °. p Florida 33618 ; �3. ,.., �,- , � Signature Date Telephone ��, r��'�} ~��ti � 04/17/2016 (813) 240-6823 � 1 + ' � '° � 4 ' Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agenUcompany, and {3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) FEMA Form 086-0-33 (7l15) Replaces all previous editions. Form Page 2 of 6 OMB No. 1660-0008 � ELEVATION CERTIFICATE Expiration Date: November 30, 2o�s IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (inGuding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 816 Mandalay Avenue City State ZIP Code Company NAIC Number Clearwater 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—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 floor (including basement, crawlspace, or enclosure) is . ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is . ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams fr-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 OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E fo� 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 � OMB No. 1660-0008 ELEVATION CERTIFICATE Expiration Date: November 30, 2o�s 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.b. Route and Box No. Policy Number: 816 Mandalay Avenue City State ZIP Code Company NAIC Number Clearwater 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 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 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. Permit Number G5. Date Permit Issued G6. Date Ce�tificate of Compliance/Occupancy Issued G7. This permit has been issued for: � New Construction � Substantial Improvement G8. Elevation of as-built lowest floor (including basement) feet meters of the building: . ❑ ❑ 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 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 ' BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instru�tions for Item A6. 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: 816 Mandalay Avenue City State ZIP Code Company NAIC Number Clearwater Florida 33767 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 buiiding 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. ;i ►---..-.._ _ __ �---��.y_ _— ___ �� __. _- #.. ; � r Y� '� ,��.;,�... .. . _ , „;� , , f �. � ., s �., �� . � �.. .�T : §,:.�1 . , . . .. . ti. �: ,r w ' :. � "� � ��" � �i' ' � �' '`:� $�° , , e.. +- S' �� k ' �,� i � #� $ _ - �� A1i,r^'' 6 "f � ': �� c aw ._ „�,Ya ' ts �� . �� -" �.�y,. , . � ..,.., e . _ � � � . � �.� s�� - z� x . ' `' "" _ � � ��'�� '� �� . A,"� .t .... � Cd,t �.v��,e5'.n 4 �r . � . ryy Y" ISi_. � � .... ... s4"; . ty��.� ;�4' ��. `�M�i: d-0"drv,.�`'.�'y�`"d,��" �"„e�es f+� ^�'«. `�j��r�1�5"��r�p��k'�i"kp��d "`-,s,�� ,„ ': y y- �' y ti � � � � �� i � �� ¢ �r �' r� �r"-'EY' ^" �"�C �`'er �� , . � p � � „��J��.'�� }�?b ''� � �3�S�y e7° � � °� �,N ��r�� , P � 4 U!3 � � , . � Photo One Photo One Caption Front View � �� ; ,� �. . , , `. ,��..... , � • � �s � �1 ,.°k ?Pi," '� ��'T�� ,e. ,�y `��,�-.:. � T . � 4� p.✓ xa E .�., — �Yi � t'r"+�..,..'+Ry, ' U+. " ;. a +d�G,:,fir.� "s ' � � �,�``� f^ ?�: ,:a: � I O ' a ' Photo Two Photo Two Caption Side View FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 � HOMEBUYERS WARRANTY. LONG LIVE HAPPY HOMES` ICI�� F�e-'�- � � s- l(�- 13 ��o��- 2-SO.com �. �� - � �i ' �:, � ELEVATION CERTIFICATE onna No. �sso-000s F�cpiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding i�formation 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: 816 Mandalay Avenue C�tY State ZIP Code Company NAIC Number Clearwater Florida 33767-1324 SECTION C— BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings" � Building Under Construction" � 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, 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: "F 3" PID AG0504 Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 Ox NAVD 1988 ❑ 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) 6. 6 � feet � meters b) Top of the next higher floor � S. � Ox feet � meters c) Bottom of the lowest horizontal structural member (V Zones only) ��a. �x feet � meters d) Attached garage (top of slab) 6. 2 0 feet � meters e) Lowest elevation of machinery or equipment servicing the building 14. � �x feet � meters (Describe type of equipment and location in Comments) � Lowest adjacent (finished) grade ne�ct to building (LAG) 5. 5 �x feet � meters g) Highest adjacent (finished) grade next to building (HAG) 5 � �x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, inGuding 5 S �x feet ❑ meters structural support SECTION D— SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certi6cation is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I ce�tify that the information on fhis Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude in Sedion A provided by a licensed land surveyor? � Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number °'�=�., -- Thomas J Monaweck LS5332 �, y, � f,�,; ' af=1-r Title �° � �,`5C � -�,;,�, President ; � ��:��' ".�� •,• r'� Company Name ,. r�'�_�j, , P�e Y', ��.,��'_� 'r � „� .� Monaweck Surveying, Inc. .v .. .,, .' �� ., ; ;, Add�ess v :��UI�i��,�.��Z-- 13902 N. Dale Mabry, Suite 108 L,r.I�� •.�.: ti,: �_ City State ZIP Code ��. �` � Jq �, Tampa Florida 33618 �'�� ~' �° A � r`'iyG;' °� �%9711ti1� Signature Date Telephone 03/27/2017 (813) 24a6823 Copy all pag of this Elevation Cert�cate and all attachments for (1) communiry official, (2) insurance agenUcompany, and (3) building ow�er. Comments (including type of equipment and location, per C2(e), if applicable) Grades shown in section G2 (e) are for air conditioner pad's, located on the southeast comer of the residence Sections A-8 & A-9 references Flood Smart Vents 1540-510, Flood Coverage is 200 sq. ft. each rcmH rorm utsci-u-ss (in5) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE onna No. �ssa000s Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (inGuding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 816 Mandalay Avenue �� State ZIP Code Company NAIC Number Clearwater Florida 33767-1324 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—E5. If the Certificate is intended to support a LOMA or LOMR-F request, �mplete 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, crawlspace, 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 serviGng 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 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 or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. rcm� rorm vuu-u-S� �ii�SJ Replaces all previous editions. Form Page 3 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 (inGuding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 816 Mandalay Avenue City State ZIP Code Company NAIC Number Clearwater Florida 33767-1324 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 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 official completed Section E for a building located in Zone A(without a FEMA-issued or �mmunity-issued BFE) or Zone AO. 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/Occupancy 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 Oificial'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 BU�S ��iNGuP'�HOT�OGRAPHS OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. Polcy NumbeNCE COMPANY USE 816 Mandalay Avenue C�� State ZIP Code Company NAIC Number Clearwater Florida 33767-1324 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 A8. If submitting more photographs than wili fit on this page, use the Continuation Page. _ , u . . . . _ ,� .. w. _ 4 ,n, �.� ., ,. .... . _ , ,�� _ .M ,, _ _ _ .. � i�r��' _--_----- �--- ' ___+_-�__��_..----_-�°�'~' � -�<.•� �°� � * � � �.J� �� 3 � "�°� � �, , � �. .. � �,�� » � v r�_,._x ; , „, _ t�{ ' �� f -' � a � ` , � _. _.. . � S ,�� s�s��,�:... �� °� � -� �` 'x��NC�..�'�n"�.t�� . � . `';�� ,-., r �� ° "'�.[� xs3P-... $',� :,.,e ,� :-�„+°`x"s+ . . �� t �r�f : � ...'�. -. ... � � '- , c:. .,a .-. 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Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Polcy N mbeNCE COMPANY USE 816 Mandalay Avenue C�� State ZIP Code Company NAIC Number Clearwater Florida 33767-1324 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 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. � " � *+� �1�, � t �A�+ -' �A` �� `� $�` '�� .v��#� .�� - .4 �. � � ,; „;, . f., k . ��4 * trw�9 ' :+. "r. 't� �,.i P `�_.; � � � i�° � 7 �J�' r � _ �: ai i�. 1%'#' ! � i . ...'.�.'P.� . t i� t` "'°.� '�%� � a�'"� 3"� � �-t� . � M y s� �� ,� � �.� ,`9�: � , � :. . , .�,. ,�..� . 4 .�. - � � , �� . - � z � ..�� . � � �� , # ,� a' `� A v '� _� aa` ,€ { �°�- . ��t > � �a ,� � ` y ` �� ' . ` ►` "ep k 1 f ",�„ 'wy �y�/�.p�� y +'*� ?�-_ a At - � ��_ �d'�' - ,�� = '�� t ` � ` ,�' , y � � � � � �,� >�� . :� �°' . . � � �- � . �; �'". _ ,,� ► �, '� , � �• �`�� • _�,, " �, :. �+i► - .�. � � ,s�,. „, wii � � ' - .d �M � " Photo One � Photo One Caption Side View - � �; �. , ,�. _ — I a,�„�` � _ ` A��'� � �'" � ii !�' - � �- ,r �:,, � k _ �_�� : � �. � �,.,^�'', ,� <�, ,� ., . , ,- : '�.� �a l�� 4 t �� y ,. � �,, � � �" ` ° � :� � � °�:i �°;� ` � ,� � �� , fr�� r � �� y� � � � &� �� y��"' � '� / ''+,;� �� .~T � • r` �i``a„�� ` ^� a � r' t' y . � ��.� � ! �` ` 's�` r r=.. ' �s ` �� x . . . . . � . �. . eM;�`, �',��".a s:.,x.�. ' _. Photo Two Photo Two Caption Back View FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6 DIVISIQN: O8 QO QQ '=QPENINGS SECTION: 08 95 43-VENTS/FOU:NDATlQN ELOOD VENTS REPORT HOLDER: SMARNENT PRODUCTS 430 ANDBRO DRIUE, UNI7 PITMAN,'NEW JERSEY 0$0 EVALUATI�N SUBJECT: INC. l 1 SMART VENT� AUTOMATIC FQUNDATION FLOOD #1540-520; #1540-521; #1540-510;. �0-570; #1540-574; #1540-524; #15 tGC [CC � ICC 1�� Look for the trusted marks of Conformity! "2014 Recipient of Prestigious Western States Seismic Policy Council (WSSPC) Award in Excellence" 1; 14 '1►A"1r ' �Ei ■'t� A Subsidiary of � c� ICGES Evaluation Reports are not to be constraed as representing aesthetics or any other attributes not ,� specifically addressed, nor are they to be construed as an endorsement of the subject of the report or a� recommendation for its use. There is no warranty by ICC Evaluation Service, LLC, express or impliec� as � to arry finding or other matter in this re ort, or as to an roduct covered b the re r � �� P YP Y Po t. ,� ,�«�ewccM Copyright 0 2017 ICC Evaluation Service, LLC. All rights reserved. �c%c:-t5 Evaluation Report ESR-2074 Reissued Febn.iary 2017 This report is subject to renewal February 2019. www.icc-es.orq �(800) 423-6587 �(562) 699-0543 A Subsidiary of the Infernationa/ Code Council� DIVISION: 08 00 00—OPENINGS Section: 08 95 43—VentslFoundation Flood Vents REPORT HOLDER: SMARNENT PRODUCTS, INC. 430 ANDBRO DRIVE, UNIT 1 PITMAN, NEW JERSEY 08071 (877)441-8368 www.smartvent.com info(cDsmartvent.com EVALUATION SUBJECT: SMART VENT� AUTOMATIC FOUNDATION FLOOD VENTS: MODELS #1540�20; #15qpfi21; #1540�10; #1540�i11; #1540�70; #1540�674; #1540�24; #154pfi14 1.0 EVALUATION SCOPE Compliance with the following codes: ■ 2015, 2012, 2009 and 2006 /ntemationa! Building Code� (IBC) ■ 2015, 2012, 2009 and 2006 /ntemational Residential Code� (IRC) ■ 2013 Abu Dhabi Intemational8uilding Code (ADIBC)t tThe ADIBC is based on the 2009 IBC. 2009 IBC code sedions referenced in this report are the same sections in the ADIBC. Properties evaluated: ■ Physical operation ■ Water flow 2.0 USES The Smart Vent� units are engineered mechanically operated flood vents (FVs) employed to equalize hydrostatic pressure on walls of enclosures subject to rising or falling flood waters. Certain models also allow natural ventilation. 3.0 DESCRIPTION 3.1 General: When subjected to rising water, the Smart Vent� FVs internal floats are activated, then pivot open to allow flow in either direction to equalize water level and hydrostatic pressure from one side of the foundation to the other. The FV pivoting door is normally held in the closed position by a buoyant release device. When subjected to rising water, the buoyant release device causes the unit to unlatch, allowing the door to rotate out of the way and allow flow. The water level stabilizes, equalizing the lateral forces. Each unit is fabricated from stainless steel. Smart Vent� Automatic Foundation Flood Vents are available in various models and sizes as described in Table 1. The SmartVENT� Stacking Model #1540-511 and FloodVENT� Stacking Model #1540-521 units each contain two vertically arranged openings per unit. 3.2 Engineered Opening: The FVs comply with the design principle noted in Section 2.7.2.2 and Section 2.7.3 of ASCE/SEI 24-14 [Section 2.6.2.2 of ASCE/SEI 24-05 (2012, 2009, 2006 IBC and IRC)] for a maximum rate of rise and fall of 5.0 feet per hour (0.423 mm/s). In order to comply with the engineered opening requirement of ASCE/SEI 24, Smart Vent FVs must be installed in accordance with Section 4.0. 3.3 Ventilation: The SmartVENT� Mode� #1540-510 and SmartVENT'� Overhead Door Model #1540-514 both have screen covers with '/4-inch-by-'/4-inch (6.35 by 6.35 mm) openings, yielding 51 square inches (32 903 mm2) of net free area to supply natural ventilation. The SmartVEN'f� Stacking Model #1540-511 consists of two Model #1540-510 units in one assembly, and provides 102 square inches (65 806 mmZ) of net free area to supply natural ventilation. Other FVs recognized in this report do not offer natural ventilation. 4.0 DESIGN AND INSTALLATION SmartVENT'� and FloodVENT'� are designed to be installed into walls or overhead doors of existing or new construction from the exterior side. Installation of the vents must be in accordance with the manufacturer's instructions, the applicable code and this report. Installation clips allow mounting in masonry and concrete walls of any thickness. In order to comply with the engineered opening design principle noted in Section 2.7.2.2 and 2.7.3 of ASCE/SEI 24-14 [Sec6on 2.6.2.2 of ASCE/SEI 24-05 (2012, 2009, 2006 IBC and IRC)j, the Smart Vent� FVs must be installed as follows: ■ With a minimum of two openings on different sides of each enclosed area. ■ With a minimum of one FV for every 200 square feet (18.6 m2) of enclosed area, except that the SmartVENI'� Stacking Model #1540-511 and FloodVEN'T� Stacking Model #1540-521 must be installed with a minimum of one FV for every 400 square feet (37.2 m2) of enclosed area. ■ Below the base flood elevation. /CC-ES Eva[uation Reports are not to be construed as representrng aesthetics or any other attrrbutes not specifically addressecl, nor are they to be construed as an endorsement ojthe subject of the reporl or a recommendation for its use. There is na warranry by ICC Evaluation Service, LLC, erpress or implie� as ` to arryfrnding or other matter in this report, or as to a�ry product covered by the report. �,�� ,� Copyright � 2017 ICC Evaluation Service, LLC. AII rights reserved. Page 1 of 3 ESR-2074 � Most wdely Accepted and Trusted Page 2 of 3 ■ With the bottom of the FV located a maximum of are permitted for use in conjunction with breakaway 12 inches (305.4 mm) above the higher of the final walls in other areas. grade or floor and finished exterior grade immediately 6.0 EVIDENCE SUBMITTED under each opening. 5.0 CONDITIONS OF USE Data in accordance with the ICC-ES Acceptance Criteria for Mechanically Operated Flood Vents (AC364), dated The Smart Vent� FVs described in this report comply with, August 2015. or are suitable alternatives to what is specified in, those 7.0 IDENTIFICATION codes listed in Section 1.0 of this report, subject to the following conditions: The Smart VENT� models recognized in this report must 5.1 The Smart Vent� FVs must be installed in accordance be identified by a label bearing the manufacturer's name with this report, the applicable code and the (Smartvent Products, Inc.), the model number, and the manufacturer's installation instructions. In the event of evaluation report number (ESR-2074). a conflict, the instructions in this report govem. 5.2 The Smart Vent� FVs must not be used in the place of "breakaway walls" in coastal high hazard areas, but TABLE 1—MODEL SIZES ru� �r i �ncn =��.q mm; � square toot = m` ESR-2074 � Most �de/y Accepted and Trusted Page 3 of 3 FIGURE 1�MART VENT: MODEL 1540-510 FIGURE 2�MART VENT MODEL 1540-520 FIGURE 3—SMART VENT: SHOWN WITH FLOOD DOOR PIVOTED OPEN ICC-ES Evaluation Report ESR-2074 CBC and CRC Supplement Issued January 2017 This report is subject to renewal February 2019. www.icc-es.orq �(800) 423-6587 �(562) 699-0543 A Subsidiary of the Intemational Code Council� DIVISION: 08 00 00—OPENINGS Section: 08 95 43--Vents/Foundation Flood Vents REPORT HOLDER: SMARNENT PRODUCTS, INC. 430 ANDBRO DRIVE, UNIT 1 PITMAN, NEW JERSEY 08071 (877)441-8368 www.smartvent.com infoCaasmartvent.com EVALUATION SUBJECT: SMART VEN'i� AUTOMATIC FOUNDATION FLOOD VENTS: MODELS #1540�i20; #1540-621; #1540�10; #1540�11; #1540�670; #1540�674; #1540�?A; #1540�14 1.0 REPORT PURPOSE AND SCOPE Purpose: The purpose of this evaluation report supplement is to indicate that Smart Vent� Automatic Foundation Flood Vents, recognized in ICC-ES master evaluation report ESR-2074, have also been evaluated for compliance with codes noted below. Applicable code edition: ■ 2016 Califomia Building Code (CBC) ■ 2016 Califomia Residential Code (CRC) 2.0 CONCLUSIONS 2.1 CBC: The Smart Vent� Automatic Foundation Flood Vents, described in Sections 2.0 through 7.0 of the master evaluation report ESR-2074, comply with 2016 CBC Chapter 12, provided the design and installation are in accordance with the 2015 Intemational Building Code� (IBC) provisions noted in the master report and the additional requirements of CBC Chapters 12, 16 and 16A, as applicable. The products recognized in this supplement have not been evaluated under CBC Chapter 7A for use in the exterior design and construction of new buildings located in any Fire Hazard Severity Zone within State Responsibility Areas or any Wildland-Urban Interface Fire Area. 2.2 CRC: The Smart Vent� Automatic Founda6on Flood Vents, described in Sections 2.0 through 7.0 of the master evaluation report ESR-2074, comp� with the 2016 CRC, provided the design and installation are in accordance with the 2015 Intemational Residential Code (IRC) provisions noted in the master report. The products recognized in this supplement have not been evaluated under 2016 CRC Chapter R337, for use in the exterior design and construction of new buildings located in any Fire Hazard Severity Zone within State Responsibility Areas or any Wildland-Urban Interface Fire Area. The products recognized in this supplement have not been evaluated for compliance with the Intemational Wildland–Urban Interface Code�. This supplement expires concurrently with the master report, reissued February 2017. ICGES Evaluation Reports are no! to be construed as representing aesthetics or ony other attributes not spec�cally addressed, nor are they to be construed as an endorsement of the subject ojthe repor! or a recommendation jor its use. 7iiere is no warranry by ICC Evaluation Servrce, LLC, express or implied, as {' to arry frnding or other matter in thrs report, or as to any product covered by the report. �� „�„ � Copyright � 2017 ICC Evaluation Service, LLC. All rights reserved. Page 1 of 1 �c:c-E5 Evaluation Report ESR-2074 FBC Supplement Reissued February 2017 This report is subject to renewa! February 2019. www.icc-es.orq �(800) 423-6587 �(562) 699-0543 A Subsidiary of the lntemational Code Council� DIVISION: 08 00 00—OPENINGS Section: 08 95 43—Vents/Foundation Fiood Vents REPORT HOLDER: SMARNENT PRODUCTS, INC. 430 ANDBRO DRIVE, UNIT 1 PITMAN, NEW JERSEY 08071 (877)441-8368 www.smartvent.com info(aasmartvent.com EVALUATION SUBJECT: SMART VENT� AUTOMATIC FOUNDATION FLOOD VENTS: MODELS #1540�i20; #1540�21; #7540�10; #1540�11; #1540�70; #1540-674; #1540�24; #1540�b14 1.0 REPORT PURPOSE AND SCOPE Purpose: The purpose of this evaluation report supplement is to indicate that Smart Vent� Automatic Foundation Flood Vents, recognized in ICC-ES master report ESR-2074, have also been evaluated for compliance with the codes noted below. Applicable code editions: ■ 2014 Florida Building Code—Building (FBC) ■ 2014 Florida Building Code—Residential (FRC) 2.0 CONCLUSIONS The Smart Vent� Automatic Foundation Flood Vents, described in Sections 2.0 through 7.0 of the master evaluation report ESR-2074, comply with the FBC and the FRC, provided the design and installation are in accordance with the International Building Code� provisions noted in the master report. Use of the Smart Verrt� Automatic Foundation Flood Vents has also been found to be in compliance with the High-Velocity Hurricane Zone provisions of the FBC and the FRC. For products falling under Florida Rule 9N-3, verification that the report holder's quality assurance program is audited by a quality assurance entity approved by the Florida Building Commission for the type of inspections being conducted is the responsibility of an approved validation entity (or the code official when the report holder does not possess an approval by the Commission). This supplement expires concurrently with the master report, reissued February 2017. lCGES Evaluation Reports are not to be constnred as representrng aesthetics or a�ry other attrrbutes not specifrca!!y addressed, rror are they to be construed as an endorsement of the subject of the repnrt or a recommendation for iu use. There is no warranry by ICC Evaluadon Service, LLC, erpress or rmplied, as ` to any findrng or ottier matter in this report, or as to arry product covered by the report �� .��.�,;,a��«�:.,,�.,,,p. Copyright � 2017 ICC Evaluation Service, LLC. All rights reserved. Page 1 of 1 DETAIL DIAGRAM MODEL 1540-510 DUAL FUNCTION F1.00D AND VENTIlAT10N VENT Smart VENT 877— 441 — 8368 www.smartvent.com . _i., , r �•, iNSrn�v{noN iNSrRUCnoNs � o�� MODEL 1540-510 DUAL FUNCTION FLOOD AND VENTILATION VENT REV. 6-21-16 1. REMOVE VENT DOOR FROM VENT FRAME. (TURN UPSIDE DOWN, ROTATE BOTfOM OF DOOR OUTWARD AND SLIDE OUT) 2. PREPARE A CLEAN 16.25" WIUE BY 8.25" HIGH ROUGH OPENING (APPROX. 1 BLOCK WIDE X 1 BLOCK HIGH) FOR EACH VENT. ENSURE THE BOTTOM OF THE ROUGH OPENING IS NO MORE THAN 12" ABOVE THE FlNISHED GRADE. 3. APPLY A BEAD OF HURRIBOND GRIP dc SEAL OR EQUIVALENT ADHESIVE AROUND THE BACK OF THE FLANGE ON THE VENT FRAME. (FIG. 2) 4. INSERT INSTALLATION CLIPS INTO THE iW0 SLOTS ON THE TOP AND TWO SI.OTS ON THE BOTfOM OF THE PRAME. 5. THE SPRING ARM OF THE CLJPS SHOULD BE ON THE OUTSIDE OF THE VENT FRAME. COMPRESS THE BOTfOM TWO CLIPS AND BEGIN SLIPPING THE FRAME INTO THE OPENING. ENSURE THAT THE BOTTOM CUPS ARE IN THE OPENING BEFORE ALLOW THEM TO DECOMPRESS. 6. WITH THE FRAME NOW IN THE OPENING, AND THE BOTTOM SPRINGS IN PLACE, COMPRESS THE TOP SPRINGS AND PUSH THE VENT FRAME INTO THE OPENING COMPLEfELY UNTIL THE FRAME IS FLUSH WITH THE WALL. 7. RE—CHECK THAT FRAME IS SQUARE AND SLOTS ARE CLEAR OF DEBRIS, AND CAULK. 8. INSTALL THE DOOR INTO FRAME 8Y GRASPING THE BOTTOM OF DOOR (WITH FLOAT PINS DOWN) AND FRONT (SMALL SCREEN IN FRONT). SUDE DOOR INTO FRAME AND ROTATE UNTIL IT IS LATCHED. 9. INSERT THE TOP STR4PS INTO THE TOP 1W0 STRAP SLOTS ABOUT TWO CLICKS. 10. TO OPEN THE DOOR INSERT TWO CREDIT CARDS INTO THE FLOAT SLOTS AS SHOWN IN THE DIAGRAM. THIS WILL UNLATCH THE DOOR FOR REMOVAL AND CLEANING. DETAILED SPECIFlCATIONS: MATERIAL: STPJNLESS STEEL OPERATION FLOOD: AUTOMATIC NON—POWERED ACTIVATION AND OPERATION VENT REMAINS CLOSED AND LOCKED UNTIL ACTIVATED OPERATION AIR: AUTOMATIC LOUVERS FUILY OPEN AT 75 DEG. FULLY CLOSED AT 35 DEG. NO POWER REQUIRED INSTALLATION: SECURED W/ 4 STAINLESS STEEL INSTALLATION CLIPS INCLUDED AND AN ADHESIVE HYDROSTATIC RELIEF: 200 SQ. FT PER VENT VENTILATION: 51 SQ. IN. PER VENT NOTE: VAPOR BARRIER ALLOWS FOR REDUCED VENTIUITION REQUIREMENTS FLOOD: MINIMUM OF 2 VENTS PER ENCLOSEO AREA MOUNTEO ON AT LEAST TWO DIFFERENT WAL�S COLORS: STAINLESS (STANDARD) EXTERIOR POWDER COATED WHITE, WHEAT, GRAY, AND BLACK (AVAIIABLE) MEETS THE REQUIREMENTS FOR ENGINEERED OPENINGS AS SET FORTH BY: FEMA, NFIP, ICC, dc ASCE SUPPORTIVE DOCUMENTS, TB 1-08, 44CFR 60.3(C)(5), ASCE 24-14 ICC EVALUATION � ESR-2074 SHEEf 2 OF 2