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PLANNING & DEVELOPMENT DE�T
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1795 HARBOR DR
� �- BCP2016-10065 -
° CHIH-TANG LI - -
Zoning: Low Medium Density Atlas #: 280A
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U.S. DEPARTMENT OF HCIMELAND SECURITI' OMB No. 166q-0008
Federal Emergency Management Agency Expiration Date: November 30, 20� 8
National Flood Insurance Program
,
ELEVATIQN CERTI�ICATE
' Impartant: Foilow the instructions on pages 1-9.
Copy all pages of this Elevation Certificate and all attachments for (1) community official, {2) insurance agenUcompany, arrd (3} building owner.
SEGTIOPI A— PROPERTY INFOF2MATION FOR INSURANCE GOMPANY USE
A1. Building Owner's Name Policy Number:
Don Li
A2. Building Street Address (inciuding Apt., tlnit, Suite, and/or 81dg. Rto.} or P.O. Raute and e�mpany NAIC tVumber:
Box Na.
T95 Harbor Qrive
City State ZIP Cade
Ciearwater Florida 33702
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legai Qescription, etc.)
03-29-15-01926-005-OQ34
A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lai. �7°59'Q8.22"�N Lang. 82°47'30.43"W Horizontal Datum: � NAD 1927 � NAD 1983
A8. At#ach at least 2 photographs af the buiiding 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 faotage af crawlspace or enclosure(s} p sq ft
bj Number of permanent flood openings in the erawispace ar enclosure(s) within 1.0 foot abave adjacent grade 0
c} Total net area of flood openings in A8.b 0 sq in
d) Engineered flood openings? ❑ Yes ❑ No
A9. For a building with an attached garage:
a} Square footage of attached garage a sq ft
b) Number af perrnanent flood openings in the attached garage within 1.0 foot above adjacent grade 0
c) Total net area of fload openings in A9. b 0 sq in
d} Engineered flood ope�ings? (� Yes ❑ No
SEGTlON B— FLQOD iNSURANCE RATE MAP (FIRM) INFt)RMATIpN
B1. NFIP Community Name & Commun+ty Number B2. County Name B3, State
125096 City of St Clearwater Pineilas Florida
84. MaplPanel B5. Suffix B6. FIRM index B7. FIRM Penel B8. Flood Zone(s) B9. Base Fiood Elevation(s}
tVumber Date Effective/ (Zane AO, use Base
Revised Date Flood Depth}
12103C 0106H N 05l17I2005 05/17/2005 AE 11
B10. Indicate the source of the Base Flood Elevation {BFE) data or base flood depth entered in Item 69:
❑ FIS Profile Q FIRM ❑ Community Determined ❑ OtherlSource:
611. Indicate elavation datum used for BFE in Item B9: ❑ NGVD 1929 []x NAVQ 1988 �(�therlSource:
612. is the buiiding located in a Coastal Bar�ier Resources System (CBRS) area or Otherwise Protected Area (�PA)? [] Yes [�x No
Designation i�ate: C] CBRS [� OPA
FEMA Form 086-0-33 (7115) Replaces afl previous editions. Form Page 1 af 6
ELEVATION CERTIFfCATE onnB rvo. �sso-000s
Expiration Date: November 30, 2018
IMPORTAyNT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building StreetAddress (including Apt., Unit, Suite; andlor Bldg. No.} or P.O. Route and Box No. Palicy Number:
79� Harbor Drive
���' State ZIP Code Company NAIC Number
Glearwater Flarida 33702
SECTION C— BUILDING ELEVATION INFORMATION (SURVEY REQUIREDj
C1. Building elevations are based on: ❑ Constructian drawings* ❑ Building Under Construction' 0 Finished Construction
'A new Elevation Ce�tificate wili be required when construction of the buiiding is complete.
C2. Elevations — 2ones A1—A30, AE, AH, A{with BFE), VE, V1—V30, V(with BFE), AR, ARlA, ARfRE, AR/A1—A30, AR/AH, AR/AO.
Camplete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized: County Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a} th�augh h) below.
❑ NGVD 1929 � NAVD 1988 [] Other/Source:
Datum used %r building elevations must be the same as that used for the BFE.
a} Tap of bottom ftoor (inciuding basement, crawlspace, or enclosure floor}
b) Top of the next higher flaor
c} Bottom of the lowest horizontai structural member (V Zones only)
d) Attached garage (top of slab)
e} Lawest elevation of machinery ar equipment servicing the building
(Describe type of equipment and location in Camments)
Check the measurement used.
7 94 Q feet [] meters
n/a, xC] feet � meters
nJa, � feet [] meters
n�� � feet � meters
8 7 [] feet � meters
f} Lowesi adjacent {flnishedj grade next to building (LAG} � 7 � feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) � 3 � feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including ��a Q feet [] meters
structural support
SECTION D— SURVEYC?R, ENGINEER, OR ARCHITECT CERTIFIGATIQN
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law ta ce�tify elevation information.
t certify thaf the information on this Certificats represents my best effo�Cs to interpret the data avaiJabte. 1 understand that any faise
stafement may be punishable by fine or rmpnsonmenf under 18 U. S. Code, Secfion 1009.
Were latitude and longitude in Section A provided by a(icensed land surveyor? ❑ Yes � No � Ch+�c}c i`��a!#��h3�esr#S,
Certifier's Name
Patrick K. ireland
Professianal Land Surveyor
Company Name
LakeRidge 5urveying and Mapping, LLC
1399 Legendary Boulevard
Clermont
License
6637
State ZIP Code
Flarida 34711
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Signature Date t Telephone
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Copy al( pa es af this Eleva n Certificate and all attachments for (1 } community official, (2) insurance agenUcompany, and (3) building owner.
Comments (including type af equipment and iocation, per C2(ej, if appiicable)
C2e=alc unit
job number 16-2092
FEMA Form 086-0-33 (7115)
Replaces ali previous editions.
Form Page 2 of 6