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351 HARBOR PSGEU.S. D�PARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 �ederal Emergency Management Agency Expiration Date: November 30, 2018 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for (11 communitv offir.ial_ (�l i�� a��p a�o.,ri��.,,.,�.,,, ,.,a �� ,,,�a, .... .......... ' ' _ • . , - - -"---...r_..,, .... �.,, ..,.��..��y ,...��c�. SECTION A— PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Building Owner's Name Policy Number: SUSAN M NEWELL A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 351 HARBOR PASSAGE City State ZIP Code CLEARWATER Florida 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) PARCEL 05-29-15-43456-071-0110 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27.987452 Long. -82.817123 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 enclosure(s) N/A sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in d) Engineered flood openings? ❑ Yes � No A9. For a building with an attached garage: a) Square footage of attached garage 546.00 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? � Yes � No SECTION B— FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State CITY OF CLEARWATER 125096 PINELLAS COUNTY Florida B4. Map/Panel B5. Suffix B6. FIRM Index 67. FIRM Panel B8. Flood B9. Base Flood Elevation(s) Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth) Revised Date 12103C0102 G 08-18-2009 09-03-2003 AE 11.0 FEET 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: � FIS Profile � FIRM � Community Determined � Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 Ox NAVD 1988 � Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? � Yes �x No Designation Date: ❑ CBRS ❑ OPA rtnnH rorm uuti-u-ss ��i� 5� Replaces all previous editions. Form Page 1 of 6 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 (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 351 HARBOR PASSAGE C�� State ZIP Code Company NAIC Number CLEARWATER Florida 33767 SECTION C— BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings" ❑ Building Under Construction* 0 Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. 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. Benchmark Utilized: GPS Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. � NGVD 1929 Qx 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) 7.66 �x feet ❑ meters b) Top of the next higher floor N/A � feet � meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A Ox feet ❑ meters d) Attached garage (top of slab) 6.93 � feet � meters e) Lowest elevation of machinery or equipment servicing the building 7.50 x feet meters (Describe type of equipment and location in Comments) ❑ ❑ f) Lowest adjacent (finished) grade next to building (LAG) 6.80 Ox feet � meters g) Highest adjacent (finished) grade next to building (HAG) 6.90 � feet � meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 6.01 �x feet � meters 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 informafion on this Certificate represents my besf efforts to inferpret the data avai/ab/e. / understand that any false statement may be punishable by fine or imprisonmenf under 18 U. S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑X Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number BILL HYATT FLORIDASURVEYORa�j40L.COM LS 4636 �� :a r �.�� • r � � Title ��°`'f � �',�f� PRESIDENT ti �t+3r, Company Name KNOW IT NOW INC Address w 1497 MAIN ST #321 '-r tir:tir[ +►r t��ttt>� ,: S' Cilry DlgrcalrysignedbyelLL State ZIP Code ��, � DUNDEIN DNAm=61LLHYATf,�KNOW Florida 34698 '�': �, xti� `'µ _,/ RNOW,INC.,ou=SURVEYOR, \7J^ Signature "r a��+,�s Date Telephone Ext. Date: 2017.69.07 08:4522 �•oa' 04-07-2017 (727) 415-8305 Copy all pages of this Elevation 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) C2E ELEVTION IS AIR CONDITIONER UNIT TOP OF BASE THIS IS NOT TO BE USED FOR CONSTRUCTION, IS FOR HOME INSURANCE USE ONLY rcmr� rorm uun-u-��s (ii�oJ 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 corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. Policy Number: 351 HARBOR PASSAGE C�tY 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 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 ❑ 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 Cr9 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 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 � �i A s City State ZIP Code -� � S �Z °�.�✓ � Z � �'I Y 30 � Sign re Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 �ELEVATION CERTIFICATE OMB No. 1660-0008 �xNuauon vaie: rvovemper 3U, Z01S 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: 351 HARBOR PASSAGE C��' State ZIP Code Company NAIC Number CLEARWATER Florida 33767 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. ❑ 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 G7. This permit has been issued for: � New Construction � Substantial Improvement G8. Elevation of as-built lowest floor (including 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 O�cial'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 0 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS CONTINUATION PAGE REPLACES PAGES 5 AND 6 AND ALLOWS FOR ADDITIONAL PAGES Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. ADDRESS: 351 HARBOR PASSAGE CLEARWAETR, FL 33767 PICS TAKEN 04-05-17 FRONT OF BUILDING AND GOING AROUND IT �"��s �:.a: s �� ..-_.--^�" ' .- � � � � � ,.. _. ::�` , ' ..�' Y..Yl. .,��:�:�� t''� �i ` a � f - . � - �� .� r �-*� <, °� .,� r, �� t,;� _ �1� , � ;,, - � ��,�:� - : ._ � ��' 2'- ��I I�"� � R�� ,�. ��_�` _ �, k� - l �� .�� ' � � � y,--' � � i , ` t ry � ' �i1�..6 � r � y �,� 4 �� HI K� Y + �� , �� .... . .� � : .�l�f .� !. �� _� k 1 ., v 8 t. !!4 � �y . iwl� „ . � ��." �:. � �� ;�i' _ ' � �� *., { ,�k �� S�^ !. �< ,� � � �4'L