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387 MANDALAY AVEU.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency iVational Flood Insurance Program ELEVATION CERTIFIC�4TE 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 attachmen4s for (1) community official, (2) insurance agent/companv, and (3) buildina owner. SEGTION A— PROPERTY INFORAAATION FOR INSURANCE COMPANY USE A1. Building Owner's Name Policy Number: 387 - 391 IVIANDALAY AVENUE, LLC A2. Building Street Address (including ApY., Unit, Suite, and/or Bldg. IVo.) or P.O. Route and Company NAIC Number: Box No. 387 MANDALAY AVENUE City State ZIP Code CLEARUVATER FLORIDA 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel IVumber, Legal Description, etc.) LOTS 23, 24 & 25, BLOCK A, BARBOUR - nAORROW SUBDIVISION - PARCEL # 08-29-15-02592-001-0230 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) iVON-RESIDENTIAL A5. Latitude/Longitude: Lat. 27.9784° N. Long. 82.8273° 1/V. Horizontal Datum: ❑ NAD 1927 � NAD 1983 A6. Attach a4 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 enclosure(s) y��,q sq ft b) iVumber of permanen4 flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade �y/q c) To4al net area of flood openings in A8.b �y/p, sq in d) Engineered fiood openings? ❑ Yes ❑� No A9. For a building with an attached garage: a) Square footage of attached garage N/A sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade �y/p� c) Total ne4 area of flood openings in A9.b �y/q sq in d) Engineered flood openings? � Yes �x iVo SECTION B— F�OOD 9N�fl�li�4N�� 9�TE III�P QEBR9�) 98dFORAA�lgI�IV 61. �fFIP Community Rlame & Community iVumber B2. County Name 63. State CITY OF CLEARWATER - 125Q96 PIRIELLAS COUNTY FLORIDA B4. iViap/Panel B5. Suffix 66. FIRM Index 67. FIRM Panel B8. Flood Zone(s) 69. Base Flood Elevation(s) IVumber Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 92103C0102 G 8-18-09 9-3-03 AE 12' B10. 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: B11. Indica4e elevation datum used for BFE in Item 69: ❑ NGVD 1929 Ox NAVD 1988 ❑ Other/Source: 612. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? � Yes ❑x No Designation Date: �y/p, � CBRS ❑ OPA FEIVIA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 OIVIB No. 1660-0008 ELEVATION CERTIFICAT'E Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the �orresponding information from Section A. FOR IIVSURAIVCE COMPANY USE Building Street Address (including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. Policy Number: 387 MANDALAY AVEIVUE City State ZIP Code Company NAIC Number CLEARWATER FLORIDA 33767 SECT90BV �—��98LDBNCa ELEVATION INFORMATION 4S11I2VE� ff8E2�U9liED) C1. Building elevations are based on: ❑ Construction Drawings� ❑ Building Under Construction" QQ Finished Cons4ruction �A new Elevation Certificate uvill be required when construction of the building is complete. C2. Elevations — Zones A1—,430, AE, P,H, A(with BFE), VE, V1—V30, V(with BFE), AR, AR/A, ,4R/AE, ,4R/A1—A30, AR/AH, AR/AO. Complete Items C2.a—h below according to the building diagram specifled in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: CLEARWATER "G-03" Vertical Datum: N.A.V.D. 1988 Indicate elevation datum used for the elevations in items a) through h) below. � NGVD 1929 � NAVD 9988 ❑ 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 basemenY, crawlspace, or enclosure floor) 5. 64 � feet ❑ meters b) Top of the next higher floor �1 .� 0 feet ❑ meters c) Bottom of the lowest horizontal struc4ural member (V Zones only) �. A � feet ❑ meters d) Attached garage (top of slab) �.� ❑x feet ❑ meters e) Lowest elevation of machinery or equipment senricing the building �. 38 ❑x feet ❑ meters (Describe type of equipment and location in Comments) fl Lowest adjacent (finished) grade next to building (LAG) 5. 3 � fee4 ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 5. 6 ❑x feet ❑ meters h) Lovvest adjacent grade at lowest elevation of deck or stairs, including �.� 0 feet ❑ meters structural support ���TB�9� � — SU�9299���R, EN('x9i�EER, �R ARC�B9TEC� ��9��@�9�AgB�B� This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by lauv to certify elevation informa4ion. 1 certify that the information on this Certificate represents my best effo►ts to interpret the data available. l understand that any fa/se statement may be punishable by fine or imprisonment under 98 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 iVumber GEORGE A. SH111�P I11 6137 Title Job fVumber place VICE PRESIDEIVT 100043-C sea� Here Company Rlame GEORGE A. SHIMP II & ASSOCIATES, INC. ,�jj�� �� n-�� "- � � � Address 3301 DeSOTO BOULEVARD, SUITE D # 6137 Date: 8-15-2016 City State ZIP Code (Not valid unless embossed with PALM HARBOR FLORIDA 34683 surveyor's original raised seal) Sjgr�ature Date Telephone �' 8-15-201� 727-784-5496 Copy all pages of this Ele ation 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) SEE ATTACHIIAENT PAGE 7 OF 7 FOR SURVEYOR'S NOTES AND COMIVIENTS. THIS DOCUMENT IS NOT �/AL9D 11NLESS SIGNED AND EIVIBOSSED 1/VITH THE SIJRVEYOR'S ORIGINAL RAISED SEAL AND 11A11ST CONTAIIV ALL 7 PAGES. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the coa�responding 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: 387 MANDALAY AVENUE ��tY State ZIP Code Company FJAIC Number CLEARWATER FLORIDA 33767 SECTION E—�U9LD9NQa ELE�/ATION INFORMATION (SURVEY IVOT REQUBRED) FOR �OIVE p►O AND �ONE 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. Chedc the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for 4he 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 basemenf, 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 ❑ me4ers ❑ 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: Ifi 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 Sec4ion G. SE�T6�N � 0�680PE8�T1( 01f�9E9� Q09� �!N/N9E9t°S REPRESENT,�T9�/E, CE9�TBEIC,�TION The property owner or owner's authorized representative vuho completes Sections A, B, and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO mus4 sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Au4horized 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 OIUIB No. 1660-0008 ELEVATION CERTIFICATE Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Sect6oa� e4. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 387 IVIAFIDALAY AVENUE City State ZIP Code Company NAIC Number CLEARWATER FLORIDA 33767 SECTION G — C�OIIAMIINYITY BNF09211A�eTIOR1(O(�TI�1�7I4L) 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 suroeyor, 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 FEfilIA-issued or community-issued BFE) or Zone AO. G3. ❑ The followring information (Items G4—G10) is provided for community fioodplain 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. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 • BIJIL.DING PFiOiOG PHS EL �9��@�R9 ���3°�9F9CATE see Instructions gor �tem �,6. BN1P��1°�V�'P: 9�0 ��0��� spac�s, �opy t9ae ���r�spondirag inforrraa�ion f��m S���s�ro �4. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. RouYe and Box fVo 387 M,4iVD,4L�4�Y ,4VEiVUE CLEARWAiER State ZIP Cc FLORIDA 33767 OiUIB No. 1660-0008 Expiration Date: November 30, 2018 FOR INSURAIVCE COMPAiVY USE Policy �lumber: Company IV,41C Number If using 4he Elevafiion Certiflcate 40 obtain RIFIP flood insurance, affix at leas4 2 building pho4ographs below according fio fhe ins4ructions for Ifiem A6. Idenfiify all photographs with date taken; "Fron4 View" and "Rear View"; and, if required, "Righ4 Side View" and "Left Side View." UVhen applicable, phofiographs musY show fhe fioundation with represen4aiive examples of 4he flood openings or vents, as indicafed in Section ,48. If submitting more photographs 4han will ft on this page, use 4he Confinuation Page. Photo One Caption FROiVT VIEW Photo One 8-15-2016 �.. , .3 ; �. Pho4o Two Cap4ion REAR VIEW -- --- �� °` •--- . __ �. � ;-� . - ' �. ._ �.�,_.�---- � - � - . _ _ � r� 3�� � saa . �.� � � � � � } � � � � �= r � � �,; # .. -: - � �: �� ���� �'. �, ��._ _ � , �. - _�.-:---a � �..:. .P� '��., . . . . _'.__.__._'--- .. f�YIaCC I'WO � 8-15-2016 FEfVIA Form 0�6-0-33 (7/15) Replaces all previous edi4ions. For�� Page 5 of 6 �U�LD9f�� �H�T�G PHS ONiB �lo. 1660-0008 ELEVA►iIOIV CEFtTIFICAiE Continua4ion Page Expiration Date: i�ovember 30, 2018 9NIPORTANT: Bn these spac�s, ��py �9�� ���o'e��ooa�eoaJ aa�$�a�a�o�$a�o� f��at� Se�t°�s� A° FOR IRISURARICE CO�/IPANY USE Building Street Address (including Apt., Unit, Suifie, and/or Bldg. �lo.) or P.O. Route and Box Rlo. Policy Number: 387 MARIDALAY AVENUE City S#afe ZIP Code Company FJAIC fVumber CLEARW,4TER FLORIDA 33767 If submitiing more photographs than will fit on 4he preceding page, affix the additional photographs below. Idenfify all photographs wifh: date taken; "Fronf View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs musf show the foundation with representa4ive examples of fihe flood openings or vents, as indica4ed in Section A8. �?��� i , i � )J�,b.-::• Photo One Photo One Caption N/A ,'i; . � �j', y: ; Photo Two Photo Two Caption �!/,4 FEfVi�1 Form 086-0-33 (7/1 b) Replaces all previous ediiions. Form Page 6 of 6 ELEV�►TION CERTIFICATE IMPORTANT: In these spaces, copy the Surveyor's Notes Attachment Page 7 inforrnatao� f�orra Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 387 iVIAIVDAWY AVENUE City State ZIP Code C�EARWATER FLORIDA 33767 onnB rvo. �ssa000s Expiration Date: November 30, 2018 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number SECTION D— SURVEYOR'S CERTIF'9�A'TYON (�ONTIFJl9ED FROM PAGE 2) A1. ) THIS ELEVATIO(V CERTIFICATE WAS PREPARED EXCLUSIVELY FOR THE USE AND BENEFIT OF THE PARTY SPECIFIED IN SECTIOfV A, ITEIVI 1, FOR THE SPECIFIC PURPOSE OF OBTAINIIVG FLOOD INSURANCE AfVD/OR VERIFYING FLOOD ZONE COMPLIAiVCE WITH THE LOCAL GOVERNING AUTHORITY. THIS DOCUAAENT SHALL NOT BE VALID AND BINDING AGAINST THE SIGNING SURVEYOR WITHOUT THE ORIGINAL RAISED SEAL AfVD SIGiVATURE OF THE FLORIDA LICENSED SURVEYOR AND MAPPER. USE OF THIS DOCUMENT BY ANY OTHER PARTY OR FOR ANY OTHER PURPOSES IS STRICTLY PROHIBITED AIVD SHALL REIVDER THIS DOCUIIAENT INVALID FOR THOSE PURPOSES. UNAUTHORIZED COPIES ARE STRICTLY PROHIBITED AND SHALL NOT BE VALID. REQUESTS FOR ANY ADDITIONAL OFFICIAL SIGNED AIVD SEALED COPIES MUST BE DIRECTED TO GEORGE A. SHIi1AP II & ASSOCIATES, INC. A4.) THE BUILDIiVG USE WAS DETERIVIIIVED BY PHYSICAL OBSERVATIONS MADE ON THE DATE OF SURVEY. A5.) THE LATITUDE AIVD LONGITUDE COORDINATES WERE OBTAINED USING A HAiVD HELD G.P.S. UIVIT WHICH MEETS OR EXCEEDS FEIVIA'S REQUIRED ACCURACY OF 66 FEET. A7.) THE BUILDING DIAGRA�/I NUWIBER WAS DETERMINED BY PHYSICAL OBSERVATIONS flAADE ON THE DATE OF SURVEY. CERTAIN STRUCTURAL FEATURES NOT VISIBLE TO THE SURVEYOR (PILIfVGS, GRADE BEAMS, ETC.) OR USE OF ANY AREAS BELOVN THE BASE FLOOD ELEVATIOfV THAT DOES fVOT COMPLY WITH FEMA REGULATIOIVS CAiV AFFECT THIS DETERfVIINATlO(V. A8.) FOR THE PURPOSE OF THIS DOCUMEIVT, A BUILDING EfVCLOSURE IS DEFIiVED AS THAT PORTIOIV OF AiV ELEVATED BUILDING, BELOW THE LOWEST ELEVATED FLOOR, THAT IS EITHER PARTIALLY OR FULLY SHUT IiV BY RIGID WALLS. A GARAGE BELOW OR ATTACHED TO AN ELEVATED BUILDI(VG IS COIVSIDERED AN ENCLOSURE. SUCH AREAS SHALL NOT CONTAIIV iViORE THAN 20 LINEAR FEET OF FINISHED IIVTERIOR WALLS (PAMELIfVG, ETC.) OR IT WILL BE CONSIDERED A FINISHED (HABITABLE) AREA. IF APPLICABLE, THE STRUCTURE CONTAINS: ❑ CRAWLSPACE ❑ ENCLOSURE ❑ ATTACHED GARAGE ❑# fV/A IF APPLICABLE, THE CRAWLSPACE CONTAIfVS �1�� EfVGINEERED FLOOD OPENING(S) CERTIFIED TO COVER �1�A SQ. FT. PER OPENIIVG (MANUFACTURER: N/A — MODEL: N/A ). IF APPLICABLE, THE BOTTOM FLOOR EIVCLOSURE CONTAIMS I�/A ENGINEERED FLOOD OPENIIVG(S) CERTIFIED TO COVER N/A SQ. FT. PER OPEIVING (IVIANUFACTURER: iV/A — IVIODEL: IV/A ). IF APPLICABLE, THE BOTTONI FLOOR EfVCLOSURE CONTAINS: N/A IF APPLICABLE, DOES THE BOTTOM FLOOR ENCLOSURE APPEAR TO COiVTAIN BREAK-AVUAY WALLS? ❑ YES ❑ NO OO fV/A A9.) IF APPLICABLE, THE ATTACHED GARAGE CONTAINS N/A ENGIIVEERED FLOOD OPEfVING(S) CERTIFIED TO COVER iV/A SQ. FT. PER OPEfVIIVG (MANUFACTURER: fil/A — MODEL: N/A ). A8. & A9.) FOR THE PURPOSE OF THIS DOCUIIAENT, A FLOOD OPEiVIiVG IS DEFIfVED AS A PERIVIANENT OPENIfVG IN AN EXTERIOR WALL THAT IS fV0 HIGHER THAN 1.0 FOOT ABOVE THE HIGHER OF THE EXTERIOR OR INTERIOR GRADE OR FLOOR IMMEDIATELY BELOW THE OPENIIVG. B8.) UIVLESS OTHERWISE IVOTED IN SECTIOiV B, ITEM 10, THE FLOOD ZOfVE WAS DETERMINED BASED ON THE FLOOD INSURANCE RATE NIAP. IIV CERTAIN CASES WHERE AfV ACCURATE DETERAnIfVATIOfV COULD NOT BE MADE FROIVI 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 PERFORiVIED FOR LOfVIA'S, LOWIR'S, ETC. WHICH MAY AFFECT THE SITE. C2.e) ELECTRICAL BOX MOUNTED TO REAR OF BUILDIIVG (AIR CONDITIONER IS ON THE ROOF). Attachment Page 7 of 7