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325 GULFVIEW BLVD S' � ' DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency ELEVATION CERTIFICATE IMPORTANT: FOLLOW THE INSTRUCTIONS ON PAGES 9-16 OMB Control Number: 1660-0008 Expiration: 11 /30/2018 opy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agenUcompany, and (3) building owner. SECTION A- PROPERTY INFORMATION FORM INSURANCE COMPANY USE A1. Building Owner's Name Polic Number: KER BEACHVIEW HOLDINGS LLC Y A2. Building Street Address (including Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. Company NAIC 325 S GULFVIEW BLVD Number: City CLEARWATER State FL 2ip Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LLOYD-WHITE-SKINNER SUB LOTS 63 THRU 66 AND LOTS 113 THRU 117 AND S 1/2 OF LOT 112 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTIAL GROUP R-1 A5. Latitude/Longitude: Lat. 27.972486 Long. -82.829034 Horizontal Datum: �-, NAD 1927 (''; 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): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) Sq ft a) Square footage of attached garage Sq {� b) Number of permanent flood openings in the b) Number of permanent flood openings crawlspace or enclosure(s) within 1.0 foot in the attached garage within 1.0 foot above adjacent grade above adjacent grade c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in d) Engineered flood openings? � Yes (� No d) Engineered flood openings? C` Yes (`, No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name 63. State FL CLEARWATER, CITY OF 125096 PINELLAS COUNTY 64. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) B9. Base Flood Elevation(s) 12103C0102G G Revised Date VE (Zone AO, use base flood SEPTEMBER 3, 2003 depth 14.0 610. Indicate the source of the Base Floo.d Elevation (BFE) data or base flood depth entered in Item B9: {"° FIS Profile (: FIRM ("' Community Determined (�:Other/Source: 611. Indicate elevation datum used for BFE in Item B9: (": NGVD 1929 (: NAVD 1988 (",`, Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? (�` Yes {: No Designation Date: ('` CBRS {"`� OPA SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ("; Construction Drawings'` (` Building Under Construction" �:; Finished Construction 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. A new Elevation Certificate will be required when construction of the building is complete. Benchmark Utilized: CITY OF CLEARWATER BM F-02 Vertical Datum: NAVD 1988 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) 7.34 - C:; feet % meters b) Top of the next higher floor 19.34 - (.` feet ("` meters c) Bottom of the lowest horizontal structural member (V Zones only) 17.34 - {` feet ("` meters d) Attached garage (top of slab) N/A - (`; feet (" meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) 6.45 - (:' feet (�` meters fl Lowest adjacent (finished) grade next to building (LAG) 6.45 - (: feet (�' meters g) Highest adjacent (finished) grade next to building (HAG) 7.50 - (:' feet ("` meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 6.45 - {:; feet (" meters �C V�" o�-d l�" d�� 3�% FF�AA Fnrm (1RR_f1_�� l7/151 Ranlaccc all nravin�ic ariitinnc Paae 3 of 15 , 1 � 325 S GULFVIEW BLVD ELEVATION CERTIFICATE CLEARWATER OMB Control Number: 1660-0008 Expiration: 11 /30/2018 FL 33767 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. I understand that any false statemenf may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. Were latitude and longitude in Section A qA;RO?:��;3p�.. � Check here if attachments. provided by a licensed land surveyor'? ��a4� i-`, `� . . • Yes (:; No ,�,� , a�,' Certifier's Name License Number `tl ;�;' 9 x�` ... •, �� . MARK A. JONNATTI AR 10778 ° ° F`w 'r' ry' Title PRESIDENT Address 21021 USHWY19N Signature Company Name JONNATTI ARCHITECTURE, INC. City CLEARWATER Date MAY 2, 2016 State Zip Code FL 33765 Telephone +1 (727) 725-2724 � 2., �'� � • . �, E.: ^, , 4 ,� ' . ,��,; . �; � . ° ��' , _ . .ay }�. , 'x .�� f` s� e,gmqase!'o''� Copy bpth sides �is Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comme ' uding type of equipment and location , per C2(e), if applicable)" (3) AIR CONDITIONING UNITS ON CONCRETE SLAB - WEST SIDE OF BUILDING (2) ELECTRICAL POWER TRANSFORMERS - EAST SIDE OF BUILDING Signatu�e �`� Date MAY 2, 2016 SEC ON - 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, crawlspace, or enclosure) is (` feet (` meters 0 above or � below the HAG. (` feet (` meters ❑ above or � below the LAG. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions), the next her floor (elevation C2.b in the diagrams) of the building is - (� feet (` meters � above or ❑ below the HAG. Attached garage (top of slab) is ' (�'� feet i 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 Signature Comments City Date State Telephone ZIP Code ❑ Check here if attachments. FFMA Fnrm (1RR_(1_�A (7/151 Ranlacae all nrauini ic oriitinnc Paae 4 of 15 , � , OMB Control Number: 1660-0008 Expiration: 11 /30/2018 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 Section 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 Certificate of Compliance/Occupancy Issued This permit has been issued for: (`: New Construction ('; Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: G9. BFE or (in Zone AO) depth of flooding at the building site: G10. Community's design flood elevation: Local Official's Name Community Name Signature Comments ' C�'? feet {^3 meters Datum ' (`=feet {`' meters Datum - (` feet {` meters Datum Title Telephone Date ❑ Check here if attachments. FFIIAA Fnrm f1RR_(1_�'� (7/1�i1 Ranlarcc all nrP��in�� prlitinnc Paae 5 of 15 Bt11LDING PHOTOGRAPHS See instructions for Item A6 OMB Control Number: 1660-0008 Expiration: 11 /30l2018 FFMA Fnrm t1RR_fl_�� !7/1Fl Ranlaroc all nraviniic ariitinnc Paoe 6 of 15 BUILDING PHOTOGRAPHS Continuation Page OMB Control Number: 1660-0008 Expiration: 11 /30/2018 FFMA Fnrm (1RR_!1_3R (7/151 Ranlacac all nrF+vini�c arlitinnc Paae 7 of 15