229 PALM ISLAND SWU.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 a ent/com an and (3) buildinQ owner
SECTION A — PROPERTY INFORMATION
. _ . .
FOR INSURANCE COMPANY USE
Al. Building Owners Name
REDSTONE CAPITAL LLC
Policy Number.
A2. Budding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Box No.
229 PALM ISLAND S.W.
Company NAIC Number.
City State ZIP Code
CLEARWATER, Florida 33767
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
05-29-15-43416-000-0050
A4. Building Use (e.g.,
A5. Latitude/Longitude:
A6. Attach at least
A7. Building Diagram
A8. For a building with
a) Square footage
b) Number of permanent
c) Total net area
d) Engineered
A9. For a building with
a) Square footage
b) Number of permanent
c) Total net area
d) Engineered
Residential, Non -Residential, Addition,
Lat. 27 deg. 58' 59.8" Long. 82
Accessory, etc.) RESIDENTIAL
deg. 49 05.9"
Horizontal Datum:
obtain flood insurance.
1.0 foot above adjacent
above adjacent grade
0 NAD 1927
grade
MI NAD 1983
0
2 photographs of the building if the
Number 1A
Certificate is being used to
0 sq ft
a crawlspace
of crawlspace
flood
of flood openings
flood openings?
an attached
of attached
flood
of flood openings
flood openings?
or enclosure(s):
or endosure(s)
openings in the crawlspace
in A8.b 0 sq
or enclosure(s) within
in
sq ft
within 1.0 foot
sq in
0
0 Yes 0 No
garage:
garage 487
openings in the attached garage
in A9.b 0
0 Yes 0 No
, SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community
Name & Community Number
B2. County Name
PINELLAS
63. State
Florida
CLEARWA i Eli / 125096
B4. Map/Panel
Number
12103 C 0102
65. Suffix
G
66. FIRM Index
Date
08/18/2009
B7. FIRM Panel
Effective/
Revised Date
09/03/2003
B8. Flood Zone(s)
AE
B9. Base Flood Elevation(s)
(Zone AO, use Base
Flood Depth)
11' & 12'
B10. Indicate the source
0 FIS Profile
B11. Indicate elevation
B12. Is the building
Designation Date:
of the Base Flood Elevation (BFE)
0 FIRM 0 Community Determined
datum used for BFE in Item B9:
located in a Coastal Barrier Resources
0 CBRS
data
0 NGVD
System
or base flood depth entered in Item B9:
0 Other/Source:
1929 0 NAVD 1988 0 Other/Source:
(CBRS) area or Otherwise Protected
0 OPA
Area (OPA)? 0 Yes 0 No
FEMA Form 086-0-33 (7/15)
Replaces all previous editions.
Form Page 1 of 6
ELEVATION CERTIFICATE
OMB No. 1660-0008
Ex irati
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.
229 PALM ISLAND S.W.
Policy Number:
City State ZIP Code
CLEAR WATER, Florida 33767
Company NAIC Number
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
complete Sections A. B,and C. For Items El—E4, use natural grade, if available. Check the measurement
enter meters.
El. Provide elevation information for the following and check the appropriate boxes to show whether
the highest adjacent grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement,
crawlspace, or enclosure) is 0 feet 0 meters
LOMA or LOMR-F request,
used. In Puerto Rico only,
the elevation is above or below
0 above or 0 below the HAG.
0 above or 0 below the LAG.
9 (see pages 1-2 of Instructions),
0 above or 0 below the HAG.
0 above or 0 below the HAG.
0 above or 0 below the HAG.
with the community's
certify this information in Section G.
b) Top of bottom floor (including basement,
crawlspace, or enclosure) is 0 feet 0 meters
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or
the next higher floor (elevation C2.b in
the diagrams) of the building is 0 feet EI meters
E3. Attached garage (top of slab) is 0 feet 0 meters
E4. Top of platform of machinery and/or equipment
servicing the building is 0 feet 0 meters
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance
floodplain management ordinance? 1::] Yes • No 0 Unknown. The local official must
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, E3, and E are correct to the best of my knowledge.
Property Owner or Owner's Authorized Representatives 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 30
ELEVATION CERTIFICATE
OMB No, 1660-0008
Expiration Da
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.
229 PALM ISLAND S.W.
Policy Number
City State ZIP Code
CLEARWATER, Florida 3376
Company NAIC Number
s
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. 0 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. 0 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. 0 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 0
G8. Elevation of as -built lowest floor (including
of the building:
G9. BFE or (in Zone AO) depth of flooding at the
G10. Community's design flood elevation:
New Construction 0 Substantial Improvement
basement)
feet
0 feet
El feet
Ei meters Datum
building site:
0 meters Datum
El meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments (includingtype of equipment and location, per C2(e), if applicable)
0 Check here if attachments.
FEMA Form 086-0-33 (7/15)
Replaces all previous editions.
Form Page 4 of 6
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
See Instructions for Item A6.
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.
229 PALM ISLAND S.W.
Policy Number:
City State ZIP Code
CLEARWATER, Florida 33767
Company NAIC Number
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.
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Photo Two Caption REAR VIEW / 2/09/2017
FEMA Form 086-0-33 (7/15)
Replaces all previous editions.
orm Nage 5 0
U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30, 2018
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Foilow the instructions on pages 1-9.
Copy all pages of this Elevation Ce�tificate and atl attachments for (1) community official, (2) insurance agenUcompany, and (3) building owner.
SECTION A— PROPERTY INFORMATION FOR INSURANCE COMPANY USE
A1. Buiiding Owners Name Policy Number.
REDSTONE CAPITAL, LLC
A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number.
Box Na
229 PALM IStAND S.W.
City State ZIP Code
CLEARWATER, Florida 33767
A3. Property Description (Lot and Bfock Numbers, Tax Parcel Number, Legal Description, etc.)
05-2&15-43416-000-0050
A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. LatitudelLongitude: Lat 27 deg. 58' 59.8" Long. $2 deg. 49' 05.9" 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 1A
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or endosure(s) p sq fi
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b 0 sq in
d) Engineered flood openings? ❑ Yes 0 No
A9. For a building with an attached garage:
a) Square footage of attached garage �7 sq ft
b) Number of permanerrt flood openings in the attached garage within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A9.b 0 sq in
dj Engineered flood openings? � Yes �x No
r SECTION B— FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number 62. County Name B3. State
CLEARWATER / 125096 PINELLAS Florida
B4. Map/Panel B5. Suffix 66. .FIRM Index 67. FIRM Panel B8. Flood Zone(s) B9. Base Flood Elevation(s)
Numioer Date Effecctive/ (Zone AO, use Base
Revised Date Flood Depth)
12103 C 0102 G 08/18/2009 09/03/2003 AE 11' & 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. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ❑x NAVD 1988 � Other/Source:
612. Is the building located in a Coastal Barrier Resources System (CBRS) area or Othervvise Protected Area (OPA)? � Yes �x No
Designation Date: � CBRS ❑ OPA
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6
OMB No. 1660-0008
ELEVATION CERTIFICATE Expiration Date: November30, 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:
229 PALM ISLAND S.W.
City State ZIP Code Company NAIC Number
CLEARWATER, Florida 33767
SECTION E— BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED)
FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO and A(without BF�, complete Items E1—E5. If the Gertificate 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 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 endosure) is . ❑ feet ❑ meters ❑ above or ❑ below the HAG.
b) Top of bottom floor (inGuding basement,
crawlspace, or endosure) 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
servic�ng 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 managemerrt ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this i�ormation in Section G.
SECTION F— PROPERTY OWNER (OR OWNER'S REPRESENTATNE) CERTIFICATION
The properly owner or owner's authorized represerrtative who completes Secaons 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 corred 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.
FEMA Form 086-0-33 (7/15) Replaces all previous editions. rorm rage :� or ci
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 (inGuding Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number:
229 PALM ISLAND S.W.
C�tY State ZIP Code Company NAIC Number
C�EARWATER, Fiorida 3376
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) a�d sign below. Check the measu�ement
used in Items G8—G10_ In Puerto Rico only, enter meters.
G1. ❑ The information in Section C was taken ftom other documentation that has been signed and sealed by a licensed surveyor,
engineer, or archited 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 loqted 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/Ocxupancy Issued
G7. This permit has been issued for. � New Construction ❑ Substantial Improvement
G8. Elevation of as-built lowest floor (inGuding basement)
of the building: . ❑ feet ❑ meters Datum
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 Offiaal's Name TiUe
Community Name Telephone
Signature Date
Comments (inGuding 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
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:
229 PALM ISLAND S.W.
City State ZIP Code Company NAIC Number
CLEARWATER, Florida 33767
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to #he
instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear vew' ; and, if required, "Right Side Vew" and
"Left Side Vew." When applipble, 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.
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Photo Two Caption REAR VIEW / 2/09/2017
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6