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1025 SUNNYDALE DRU.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 aaenUcom�anv. and (31 huilrlinn nwr,pr SECTION A— PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Building Owner's Name Policy Number: CUSTOM CREATIONS OF TAMPA BAY, INC. A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number: 1025 SUNNYDALE DRIVE C�tY State ZIP Code CLEARWATER FLORIDA 33755 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) A PART OF THE EAST 58 FEET OF LOT 5, SUNNYDALE SUBDIVSION - PARCEL # 03-29-15-86778-000-0050 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27.9913° N. Long. 82.7939° W. 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 16 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawispace or enclosure(s) N�q sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in d) Engineered flood openings? ❑ Yes ❑x No A9. For a building with an attached garage: a) Square footage of attached garage 457 sq ft 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 p sq in d) Engineered flood openings? ❑ Yes ❑x 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 COUNTY FLORIDA 64. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) 69. Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 12103C0106 H 8-18-09 5-17-05 AE 11' B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69: � FIS Profile Ox FIRM � Community Determined � Other/Source: B11. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? � Yes �x No Designation Date: N/q � CBRS � OPA r�rvw rorm uao-u-3.s (ii ia) Keplaces all previous editions. Form Page 1 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.O. Route and Box No. Policy Number: 1025 SUNNYDALE DRIVE City State ZIP Code Company NAIC Number CLEARWATER FLORIDA 33755 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: MAC DILL AFB 6 CORS ARP Vertical Datum: N.A.V.D. 1988 Indicate elevation datum used for the elevations in items a) through h) below. � NGVD 1929 ❑x 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) 12 . 17 � feet ❑ meters b) Top of the next higher floor 23 , 29 �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) 11 , 40 � feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 11 . 27 �x feet ❑ meters (Describe type of equipment and location in Comments) � Lowest adjacent (finished) grade next to building (LAG) 10 , 8 �x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 11 . 3 ❑x 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. I certify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any fa/se 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? 0 Yes ❑ No � Check here if attachments. Certifier's Name License Number GEORGE A. SHIMP III 6137 Title Job Number Piace VICE PRESIDENT 150190-E sea� Here Company Name � (^ GEORGE A. SHIMP II & ASSOCIATES, INC. �i/id,l %�� •v��/�- ! V Address � 3301 DeSOTO BOULEVARD, SUITE D # 6137 Date: �-25-2016 City State ZIP Code (Not valid unless embossed with PALM HARBOR FLORIDA 34683 surveyor's original raised seal) S�ature Date Telephone � 7-25-2016 727-784-5496 Copy all pages of this Eleva ion 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) SEE ATTACHMENT PAGE 7 OF 7 FOR SURVEYOR'S NOTES AND COMMENTS. THIS DOCUMENT IS NOT VALID UNLESS SIGNED AND EMBOSSED WITH THE SURVEYOR'S ORIGINAL RAISED SEAL AND MUST CONTAIN ALL 7 PAGES. C..�... o�nc 7 nf R FEMA Form 086-0-33 (7/15) Replaces aii prewous eaitions. 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: 1025 SUNNYDALE DRIVE City State ZIP Code Company NAIC Number CLEARWATER FLORIDA 33755 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 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 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. r�rvi„ �V<«l V60-V-33 (//l5) Keplaces 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.O. Route and Box No. Policy Number: 1025 SUNNYDALE DRIVE City State ZIP Code Company NAIC Number CLEARWATER FLORIDA 33755 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.) GZ � 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 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) � feet ❑ meters Datum of the building: � 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. C.....�. D.�nc il nf R FEMA Form 086-0-33 (7/15) Replaces au previous eamons. BUILDING PHOTOGRAPHS OMB No. 1660-0008 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: 1025 SUNNYDALE DRIVE City State ZIP Code Company NAIC Number CLEARWATER FLORIDA 33755 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. � �� :� � . ��a,� :._ � , r ,�� .�f Y�: � . � _ � � � � �� m� '::� �: K� E 't' '� .,�. . �: � a'S ��'+4 Pt j B 1 a'n� ,:§. � � � ,n� ., .a. '� r, o- . - � �- "" g ' „ . � ,r�. _ �. ...P- .�� '.m — �. .� ,{ .,, .. ._ . _ , _ �_ - . _— — �� _ .. __ _��„�.,. :',��' .!: � , � ��'.� �� .._.� ��.. , � £ �. �- -�°' ,�'�.-+�` -� �� e iG� �A��t '�`` .. . .x Photo One Photo One Caption FRONT VIEW 7-25-2016 �r � ��- :,� :'� °� . �' �� ;a �� = �: x �� ,�y ,e +� �,, g� , �� ^Y' �� ■ � _t a�� r �. ' ;�, '> .. .-. � r s � SS :; * , ��4 t A . �_ .tJ� ..: �,;� ' �.. a � � , . � ? :; t... � - » �z . � _ s A g = -_.. . #y � �,��;��:. j€ � _ $ . .�-. ¢ + .. �� . ' V � � " n."� ' - ' • '' ?M+H a �i�_.`+.�7 t �� '` :. °�. — � ..ss se_ r # �-�- "• �c. 3 - ` ��' S � �"�� •kr:... ^r- f ^�. :.,..x ��., a.'�,._. , �*>p?.s�' . - ' 2d`�a�. .�. ?� ,�, 5- � P .,, . r,< . . . ,. � , :. � <.. . . .... ,. � . - .t �� v.-.- . i � �� _ '� . � ' . . � . ; � zc p.: �t +f �' � y,� �..: ,� ' � � .r �S,�txr 4`,"n'-�y� _ . . _ .... . � .. .,h.��S , a.R ._� .. Pnoto Two Photo Two Caption REAR VIEW 7-25-2016 rtmH rorm Utt�i-o-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: 1025 SUNNYDALE DRIVE City State ZIP Code Company NAIC Number CLEARWATER FLORIDA 33755 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. �� ra� Photo One Photo One Caption N/A � y'' � C�:^ �4�iR? Photo Two Photo Two Caption N/A FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6 ELEVATION CERTIFICATE IMPORTANT: In these Surveyor's Notes Attachment Page 7 the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1025 SUNNYDALE DRIVE City State ZIP Code CLEARWATER FLORIDA 33755 OMB No. 1660-0008 Expiration Date: November 30, 2018 FOR INSURANCE COMPANY USE Pdicy Number: Company NAIC Number SECTION D— SURVEYOR'S CERTIFICATION (CONTINUED FROM PAGE 2) A1. ) THIS ELEVATION CERTIFICATE WAS PREPARED EXCLUSIVELY FOR THE USE AND BENEFIT OF THE PARTY SPECIFIED IN SECTION A, ITEM 1, FOR THE SPECIFIC PURPOSE OF OBTAINING FLOOD INSURANCE AND/OR VERIFYING FLOOD ZONE COMPLIANCE WITH THE LOCAL GOVERNING AUTHORITY. THIS DOCUMENT SHALL NOT BE VALID AND BINDING AGAINST THE SIGNING SURVEYOR WITHOUT THE ORIGINAL RAISED SEAL AND SIGNATURE OF THE FLORIDA �ICENSED SURVEYOR AND MAPPER. USE OF THIS DOCUMENT BY ANY OTHER PARTY OR FOR ANY OTHER PURPOSES IS STRICTLY PROHIBITED AND SHALL RENDER THIS DOCUMENT INVALID FOR THOSE PURPOSES. UNAUTHORIZED COPIES ARE STRICTLY PROHIBITED AND SHALL NOT BE VALID. REQUESTS FOR ANY ADDITIONAL OFFICIAL SIGNED AND SEALED COPIES MUST BE DIRECTED TO GEORGE A. SHIMP II & ASSOCIATES, INC. A4.) THE BUILDING USE WAS DETERMINED BY PHYSICAL OBSERVATIONS MADE ON THE DATE OF SURVEY. A5.) THE LATITUDE AND LONGITUDE COORDINATES WERE OBTAINED USING A HAND HELD G.P.S. UNIT WHICH MEETS OR EXCEEDS FEMA'S REQUIRED ACCURACY OF 66 FEET. A7.) THE BUILDING DIAGRAM NUMBER WAS DETERMINED BY PHYSICAL OBSERVATIONS MADE ON THE DATE OF SURVEY. CERTAIN STRUCTURAL FEATURES NOT VISIBLE TO THE SURVEYOR (PILINGS, GRADE BEAMS, ETC.) OR USE OF ANY AREAS BELOW THE BASE FLOOD ELEVATION THAT DOES NOT COMPLY WITH FEMA REGULATIONS CAN AFFECT THIS DETERMINATION. A8.) FOR THE PURPOSE OF THIS DOCUMENT, A BUILDING ENCLOSURE IS DEFINED AS THAT PORTION OF AN ELEVATED BUILDING, BELOW THE LOWEST ELEVATED FLOOR, THAT IS EITHER PARTIALLY OR FULLY SHUT IN BY RIGID WALLS. A GARAGE BELOW OR ATTACHED TO AN ELEVATED BUILDING IS CONSIDERED AN ENCLOSURE. SUCH AREAS SHALL NOT CONTAIN MORE THAN 20 LINEAR FEET OF FINISHED INTERIOR WALLS (PANELING, ETC.) OR IT WILL BE CONSIDERED A FINISHED (HABITABLE) AREA. IF APPLICABLE, THE STRUCTURE CONTAINS: ❑ CRAWLSPACE ❑ ENCLOSURE � ATTACHED GARAGE ❑ N/A IF APPLICABLE, THE CRAWLSPACE CONTAINS N/A ENGINEERED FLOOD OPENING(S) CERTIFIED TO COVER N/A gQ, FT. PER OPENING (MANUFACTURER: N/A — MODEL: N/A ). IF APPLICABLE, THE BOTTOM FLOOR ENCLOSURE CONTAINS N/A ENGINEERED FLOOD OPENING(S) CERTIFIED TO COVER N/A SQ. FT. PER OPENING (MANUFACTURER: N/A — MODEL: N/A ). IF APPLICABLE, THE BOTTOM FLOOR ENCLOSURE CONTAINS: N/A IF APPLICABLE, DOES THE BOTTOM FLOOR ENCLOSURE APPEAR TO CONTAIN BREAK-AWAY WALLS? ❑ YES ❑ NO ❑X N/A A9.) IF APPLICABLE, THE ATTACHED GARAGE CONTAINS N/A ENGINEERED FLOOD OPENING(S) CERTIFIED TO COVER N/A SQ. FT. PER OPENING (MANUFACTURER: N/A — MODEL: N/A ). A8. & A9.) FOR THE PURPOSE OF THIS DOCUMENT, A FLOOD OPENING IS DEFINED AS A PERMANENT OPENING IN AN EXTERIOR WALL THAT IS NO HIGHER THAN 1.0 FOOT ABOVE THE HIGHER OF THE EXTERIOR OR INTERIOR GRADE OR FLOOR IMMEDIATELY BELOW THE OPENING. B8.) UNLESS OTHERWISE NOTED IN SECTION B, ITEM 10, THE FLOOD ZONE WAS DETERMINED BASED ON THE FLOOD INSURANCE RATE MAP. IN CERTAIN CASES WHERE AN ACCURATE DETERMINATION COULD NOT BE MADE FROM THE MAP, FEMA'S INTERACTIVE MAP OR THE COUNTY'S G.I.S. OVERLAY MAY HAVE BEEN UTILIZED TO DETERMINE THE FLOOD ZONE. NO SEARCH OF THE PUBLIC RECORDS WAS PERFORMED FOR LOMA'S, LOMR'S, ETC. WHICH MAY AFFECT THE SITE. C2.e) AIR CONDITIONER LOCATED ON A CONCRETE SLAB. Attachment Page 7 of 7