805 BRUCE AVE805 BRUCE �4YE
BcP2o�s-osa4o
SEP 0 2 2�!�
p�N C`ITY O�CLEARWATER DEPT
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Natioha! Flood I»numrce Progrm�
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1--9.
SECTION A — PROPERTY tNFORMATION
A2• Buildi�g Street Address (mdudinp qpt, Unit, Suite, and/or Bldg_ Na� or P.O. Route and Box No.
805 &uce Avenue
City CleanNeter State FL ZFP Code 33767
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OMB No. 1660-0008
Expiration Datie: July 31, 2013
FOR IIVSURANCE COMPANY U$E
A4. Building Use (e.g., Resideraial, hton-Residential, IQddition� Aoc�ory, e�.) Aaoessorv (AoartrneM)
A5. Latk�elLongfiide: L.at. ,�7 �' 3T�65" N Long. $� 49' 32.8p" W Horizartal Datum: ❑ NAD 1927 � MAD 1983
A6. A� at I�st 2 phatographs ot tde build'uig if q� Csrtific�te is being used to obtain flood insurance.
A7. Buiidinp Diagram Number �
A8. For a budding wdh a.crawkpaoe � endosure(s)= A9. For a building with an attached garage:
e) Square fooh+ge of c�awlapao�or erx9osure(s) WA sq R a) Square f�oota�e of a� 9ar�e ►J� s4 ft
b) Number d pem�anent Aood c�enings in the crawlspaoe b) Number of pennanent flood oponings in the atfad�ed gara�e
or enclosure(s) wkhin 1.0 ioa�bove adjaoeM 8rade Q wdhin 1.0 foot above adjaoern grade Q
c) Total net ar� of flood openir�s in A8.b Q sq in c) Total rret area of flood openirgs in A9.b g sq in
t� Engir�eted flood openYgs4 ;; ❑ Yes � No d) Engineered flood openings? ❑ Y� � No
$ECTION B— FIOOD INSURANCE RA7E MAP (FIRM) INFORMAT{ON
61. NFIP Communiry Name & Communiiy Number B2. County Name g3. y�
City of ClearMrat� 125�6 � Pinellaa �
84. Map�Panel N� I 85. S�fix I B6. FIRM lndex Da�e B7. FIRM Panei Bg, F�ppd gg.(� p�ppd �
12103C0102 G 8/18/09 Effective/Revised Dabe Z�s) J�;'tise 'bgge�
8�3/03 J�i�
B10. Indicate the souroe of the Base Fiqod Elevation (BFE) data w base tbod depth eniered in Itern 69.
❑ FlS Proflle � FlRM ❑ Community Detertnined ❑ OthedSource: WA
611. Indicffie elevation datum t�sed for$FE in Item 69: ❑ NGVD 1929 � NAVp 1888 ❑ OtheNSouroe: N!A
B12. ts ihe buiiding locattd � a� Barrier Resour�pes Sys�m (CgRS) aroa or Otherwise Protscbsd Area (OPA)� ❑ Yes � No
Designa6on Da�: �A ❑ CBRS ❑ OPA
C1
C2.
Building elevetiorls s
*A new Elevatioa Ce
Elevations — Zones �
below accoNing to t
Benchmark Ub'Cized:
IndicabB elavatlon dg
Datum ueed fo► buik
a) Top of bottom floag(inc
b) Top of the ne�Q hiy�er �
c) Bottom o# the towea! M
� Attached 9arage (toP a
e) Lowest olevation of ma
(� tYPe � �9��P
� Lowest adjacerrt (flnish
9) Highest adjxeM (ftnisF
h) Lowest adjaoer�t grede
C - BUILDING ELEVATION INFORMATION
❑ Constru�tion Drawings" ❑ Building Undmt Construcxion* � Fmished Conatruction
required when conshudbn of the building is canplebe.
i, A(with BFE7, VE, V1 V30, V(wlth BFE), AR, AR/A, AR/�, AR/A1—A30, AF21AF1, AR/AO. Corr�leb Iterris
pam speciRed in Item A7. In Puer�o Rk:o ony, enter metens
�r "�-�" Verdcal Datum: NA�
� ebvations in items a) tfirough h) below. ❑ NGVD 1929 NAVD 1988 ❑ OtherlSouroe: 1�1
must be the same as that wed for the BFE.
Chedc the measureme� used.
�eme�, crawlspace, w erx�osure floor) 3. � feet ❑ meaers
_ � feet ❑ met�s
rucburel member (V Zones onb) N19- � feet ❑ meters
wa_ � reet ❑ meters
e4u�Wr�er� aervicin9 the building 4.4 � feet ❑ meters
location in Corm��eMs)
neaa to buiiding (tAG) �•$ � feet ❑ meters
ne�Q bo bui�in9 (tfi°►G) 4.Q � fcet ❑ meters
elevation of dedc or stairs, induding strudural suppert '�_ � feet ❑ me�ers
:T10N D— SURVEYOR, ENGINEER, OR ARCHtTECT CERTIFICATION
This oertlfiCation is to be signed �1u►d by a la�d surveyor, eng'meer� or archited authormed by law to certify el�vatiai
infortnation. I cerbiy ih� the �, an thes Cerdl�cate �e,presents my best effarts tn inte�puet Lf�e deha sva,7eWe.
�e
� u.rderstand u►at any talse �nent r Ne pu,xshebl�e 6y fine or �nprrsa►►.►►ent under 1s u.S codf�, sectiar� 1001.
� Chedc hero if c�onttr�er� alib P on badc af form. Were I�tude and long�ude in Section A provided by a
p cnec� n� ���.' � ��d �oa sor�yorr � Yes ❑ na
Cerdfiefs Neme Donaid E. Arm� Jr.
ir,��•.. ��'-T!i
License Number 5083
CompanY Name Don Armsirong l.and Surveying, LLC
Aaaress Z7 87 N. Gro@n Ridge Pleo@ �# City Palm Harbor State FL ZJP Code 34G83
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nste �ti�a�s reiepnooe rz�-�-a��
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FEMA Form 086-0-33 (7H2) ' See reverse side for oorrtinuation. Replaces aN pr+evious edilbns.
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VA 1 IVM � VCK I IrI�A 1
: In iheae spsces,
L
the correspondMg information from 3ectlon A
Building Street Address (induding Apt., Unit, Suite, and/o� B�dg. NoJ w P.O. Route and Bwc No.
805 Bruos Aveoue
CitY CleanKaier State FL ZIP Code 33767
FOR INSUR/WCE COMPANY USE
PdiCy Number.
Company WUC Nurnber.
SECT'ION D- SURVEYOR, ENGINEER, OR ARCHtTECT CERTIFiCNTION (CONT'INUED)
Copy both sides of this Ebvation C,ertificc�te for (1) commiuu'ly olficial, (2) inaura�ce a9errt/oompanY, and (3) buddirg ovn'ier.
Commants Latldide and Longitude ware dee�mi�ed usin9 Coogle Maps. Lawest Mad+inery in roem C2 (e is a Fiat vVater Weaber adjaoer►t to the southeeat
comer of tha Apathr�ent
Signature
Date 12/1 QH 5
SECTION E- BUILDIN�3 ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO and A(witl�out BFE). oorr�pleEe 16ams E1-E5. If the Certifi�Ee is ir�bet�ded to suppott a LOMA or LOMR-F request, comPiebe Se�O� 1°�, 8,
and C. For Items E1-E4, we natural grsde, if available, Chadc the measu�erner►t used. In Puerbo Rico only, erMer meters.
E1. Provide eJevation inFormation far the iollowing and check the aPProPriate box� to ahow whether the elevatio� is above or below the highest adjaoerrt
9r�la (FIAG) and the b�rest adjaoent grade (LAG).
a) Top of bot6om floor fndudin9 ba�err�nt. �aw�Pace� or endoswe) is ❑ feet ❑ meters ❑ above or 0 below the HAG.
b) Top of borttom 11oor pndudin9 botemeM, aaw�aoe� of endosure) is ❑ feet ❑ meters ❑ above or ❑ below ihe LAG.
E2. For B�Idinp Diapr�ns 6-9 wkh pennaneM 11ood openir�ps provkkd m ge�ian A Items 8 andfor 9(see 8-9 of Ir�strucdons), the �d higher floor
(elevati� C2.b in the diagrmns) of the buildin9 is • ❑ feet ❑ meteis ❑ abore or � the HAG.
E3. Attad�ed 9arage (t� of slab) � ❑ feet ❑ meGers ❑ abov�e or ❑ babw the HAG.
E4. Top of platinon of machinery and/or equiprr�errt senricing the building is ❑ feet ❑ meGera ❑ above or [] below the HAG.
E5. Zor� AO ony: If no flood depth number is available, is the bop of the bottom floor elevated in axordanoe with the oommunitys floadplain management
ordkianoe? ❑ Yes ❑ No ❑ Unknown. The bcal oficial muat oertiy this intortnation in Sedion G.
SECTION F- PROPERTY OWNER (OR OWNER'3 REPRESENTATIVE} CERTlFICATION
The property aMmer or o�a aulfwriaod reprmaentadve who completes Sectbns q, B, and E fior Zone A(wnFrout a FEAAA�ssusd or coornmunky-issued BFE)
or Zwie AO must sipn here. The statemerhs in Sedions A, B, and E are oonect to the best oi my knowled�e.
Property Owner'a a Owners Authorized Repr�senffitive's Name
Address
Signature
Corrirr�en6s
�Y
Date
State ZIP Code
Telephone
n cn� na� �r �,�
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The bcal o�icial who is autlw�d by law or o�dinanoe to adm�iater the corrun�m�ys floodphain manage�r�ent ordinanoe can oomple6e Sections A, B, C(or �, �d G
of th� Elevation Certificate. Corr�le6e the epplie�bfe ih�nis) and sign below. Check the rr►easurerr�nt uaed in Iterns GB-f 10. In Puerto Rico oniy, e�er meEers.
G1. ❑ The �fortnatlwi in Secdon C w� taken from other documentation that haa been signed aniJ sealed by a lioenaed sun�eyor. ergkber, or archited who
is auithorized by lew to certiy elevati� iMortnation. pndicate the sour+ce and date of tl�e elevation data in the Commer�Ls ar� below.)
G2. ❑ A communily offioial aanpteted Sed'an E tor a building Mc�ad in Zone A(wkhout a FE11AA-isaued or c�nmunity-'ssued BFE) cr Z.one AO.
G3- ❑ The follawing iMom�atia� pbar� G4-.G10) is provided tor oommundy floodplain management purpcses•
G4. Pertnit Numb� � G5. Date Pertnit lasued
G6. Date Certificste Of Complian�ancy I�aued
G7. This pertnit hsa been issued �r. ❑ New Construcbon ❑ Substantial Improvement
G8. Elevation of as-buiit b�west fl�r (induding besemeM) of the building: ❑ feet ❑ me�s
G9. BFE or (in 2ane AO) de�th d flooding et tl�e bu�ding site: ❑ feet ❑ meters
G10. Canmunil�s design flood elevatlon: �{,� ���
Lopl OffidaPs Narrre
CommunUy Name
Signature
Commen�s
Title
Telephone
Date
..�•
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C'1 Chedc here if attachmer�_
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FEMA Fortn 086-0-33 (7N 2) • Replaoes all previous edidons.