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830 BAYWAY BLVDU.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 aqenUcomoanv. and (31 buildinn nwnar SECTION A— PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Building Owner's Name Policy Number. CLEARWATER YACHT CLUB, INC. � BoxdNo Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number. 830 BAYWAY BOULEVARD City State ZIP Code CLEARWATER, Florida 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) 17-29-15-05022-0040050 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) NON-RESIDENTIAL A5. Latitude/Longitude: Lat. 27deg. 58' 01.7" Long. 82deg. 49' 15.8" 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 7 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enGosure(s) 3,744 sq ft b) Number of permanent flood openings in the crawlspace or endosure(s) within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in d) Engineered flood opening`s? ❑ Yes � No A9. For a building with an attached garage: a) Square footage of attached garage 0 Sq {� b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade p c) Total net area of flood openings in A9.b 0 sq in d) . Engineered flood openings? � Yes 0 No SECTION B— FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community. Name & Community Number B2. County Name B3. State - GITY.OF CLEARWATER / 125096 PINELLAS Florida B4. t�ilap/Pare! - B5. Suf�x B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) 69. Base Flood Eleva6on(s) Nurraber Date Effective/ Zone AO, use Base ' Revised Date �lood Depth) 12103 C Q1t�4 G OS/18/2009 09/03/2003 AE �� B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69: ❑ FIS Profile 0 FIRM � Community Determined � Other/Source: 811. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 �x NAVD 1988 � Other/Source: B12. �s the building located in a�oastal Barcier Resources System (CBRS) area or Othervvise Protected Area (OPA)? � Yes � No Designation Date: 0 CBRS ❑ OPA FEMA Form 086-0-33 (7/15) Replaces all previous editions. . Form Page 1 of 6 �� ELEVATiON CERTIFICATE IMPORTANT: In these spaces, copy the corresponding information from Section A. Buiiding Street Address (inGuding Apt, Unit, Suite, and/or Sldg. No.) or P.O. Route and Box No. 830 BAYWAY BOULEVARD onne No. �ssa000s Expiration Date: November 30, 2018 FOR INSURANCE COMPANY USE Policy Number. ""y 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_ b) Top of bottom floor (including basement, ' � feet_ � mster.s ❑ above or ❑ below the. HAG. crawlspace, or endosure) is feet � • ❑ ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood oPenings provided in Sedion A Items 8 and/or 9(see pages 1-2 of Instructions); � the next highe� floor (elevation C2.b in - the diagrams) of the building is . ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top ofslab) is . ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery, �{�d/or equipment servicing the building is __;, . ❑ feet � ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood deptfi number is available, is the top of the bottom floor elevated in accocdance with the c�mmunity's floodplain management ordinahce? Yes „�, ❑ ❑ No � Unknown. The local offiaal must certify this information in Section G. SEGTION F— PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION -- The property owner or owne�'s authprized representative who completes Sections A, B, and E fw Zone A(without a FEMA-issued or commurnty-issued BFE) or Zone q0 must sign here. The statements in Sections A, B, and E are corred to the best of my kno�Medge. Property Owner or Owner's - Address Signature Comments FEMA Form 086-0-33 (7/15) ,. :S. , :� i- �r . , i,; ��:��I� ;� i �, �ir� �.� . ,' � Representative's Name City Replaces all previous editions. State T� ZIP Code ❑ Check here if attachments. Form Page 3 of 6 ELEVATION CERTIFICATE onn6 rva isso-000s r.'_'--•. cnNuauun ua[e: IvOVeRIDe� 3p, Z018 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. 830 BAYWAY BOULEVARD C�ty 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 GS—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 Certifiqte of . Compliance/Occupancy Issued G7. This permit has been issued for. � New �onstruction ❑ Substantial Improvement G8. Elevation of as-built lowest�floor (indudi�g 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.flaod eleuatian: _ ❑ feet ❑ meters Qatum. Locaf Offiaal's Name TiUe Community Name Telephone Signature Date , Comments (including: typ.e of. equipment and. Iocation,. pec C2(e), if. applicable� � Check here ifattachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS oMB No. �ssa000a ELEVATION CERTIFICATE See Instructions 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: 830 BAYWAY BOULEVARD City State ZIP Code Company NAIC Number CLEARWATER, Florida 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 vew" and "Left Side �ew." 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�� ty NYn . ' l '�, ��s�;� .*, s.. _ R � � !. , . �1 ,��: a ,� �� '� >:; � ��M� k �:�'� � a��, �k � „+��` : `�� ` � `i,r � t�-�' --Y- -.,� ` a ,,� 4 Photo One Photo One Caption RIGHT FRONT VIEW / 10/07/2016 � .�.,. ---�- �': - � ., � � � '�`� ►f % 1 �� • ,�� {�� , �[��.� � � � �, ;�� _ ,� ?�. ..�,,;. �� - � �� k t : ,� " � �� , �� , F;� Photo Two Photo Two Caption LEFT REAR VIEW / 10/07/2016 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE Continuation Page 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: 830 BAYWAY BOULEVARD City State ZIP Code Company NAIC Number CLEARWATER, Florida 33767 If submitting more photographs than will fit on the preceding page, a�x the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear Vie�nl; and, if required, "Right Side Vew" and "Left Side Vew." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. _-�`''1 I u , ,, f � rnrrr�'� � � � � � �� .� �� µ,� � � ��- �� ` � � ��,z. .. .�t�' �r� �. �, � � � uf' i Photo One Photo One Caption LEFT FRONT VIEW / 10/07/2016 iF � . `i` ;±�? , `i � . . � � .� �� . . .._.. � ��+ �•� `� � � ' '� `�a i ! ,y _, . -� �. � � r� . . , i �r� : �p . �' z , {,. , Y � � �'{4 r _:3 �,'. "� �'�� liiilf � �, � II� F� �� ,�� 1 � � 'illlll � � _ � �- . �� :� .�� ,� � ��. �� .w.. �� Photo Two Photo Two Caption RIGHT REAR VIEW / 10/07/2016 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6