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907 LANTANA AVEU.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 Federal Emergency Management Agency Expiration Date: November 30, 2018 National Fload Insurance Program ELEVATION CERTIFICATE Important: Foilow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for t1) communiN officiaL (21 insurance aaent/com�anv anri !31 h� �ilrlinn nwnc� . - - -- -�-- - --.._. .� .,..,,,.,. SECTION A— PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Building Owner's Name Policy Number: John Trapuuano AZ. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box Na Company NAIC Number. 907 Lantana Avenue C�tY State ZIP Code Ciearwater Florida 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Tax Parcel ID # 05-29-15-54666-045-0070 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat. N27-59-52.15 Long. W82-49-29.56 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): 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 AS.b N/A sq in d) Engineered flood openings? ❑ Yes � No A9. For a building with an attached garage: a) Squa�e footage of attached garage 495.00 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade W/A c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes �x No SECTION B— FLOOD INSURANCE RATE MAP (FiRM) INFORMATION B1. NFIP Communiry IVame & Community Number 62. County Name B3. State City of Clearvvater 125096 Pinellas Florida 64. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel 68. Flood B9. Base Flood Elevation(s) Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth) Revised Date 12103C0102G G 0&18-2009 09-03-2003 AE 11' B10. Indicate the source of the Base Flood Eleva6on (BFE) data or base flood depth entered in Item B9: ❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source: 811. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: 612. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? � Yes Ox No Designation Date: ❑ CBRS ❑ OPA rtnnA rorm utss-o-3s �msJ Replacas all previous editions. Form Page 1 of 6 ELEVATlON CERTIFICATE onnB No. �ssa000s Expiration date: November 30, 2018 IMPOR7ANT: In these spaces, copy the corresponding informatlon 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: 907 Lantana Avenue ��tY 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' �x Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. E�evations — 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: See Comments Vefical Datum: IVAVD 1988 Indicate etevation datum used for the elevations in items a) through h} below. ❑ NGVD 1929 0 NAVD 1988 ❑ Other/Source: Datum used for buitding 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) 4.44 �x feet ❑ meters b) Top of the next higher floor N/A ❑ feet ❑ meters c) Bottom of the Iowest horizontal structural member (V Zones only) N/A � feet ❑ meters d) Attached garage (top of slab) 3.82 ❑x feet � meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) 6.18 �x feet ❑ meters � Lowest adjacent (finished) grade next to building (LAG) 3.70 Ox feet � meters g) Highest adjacent (finished) grade next to building (HAG) 3.90 �x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 3.80 �x feet ❑ meters SECTION O— SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a tand surveyor, engineer, or architect authorized by law to certity elevation information. l certify that the information on this Cartificate repiesents my best efforfs to inferpret the data available. I understand that any fa/se 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? 0 Yes ❑ No Qx Check here if attachments. Certifiers Name License Number Mark S. Lischalk, PLS LS 5727 Title ` :� President Y =�� •*b;'� ' � 'w� � ��, Company Name ��+ , � . �. ? Zarra Boyd, Inc. � � s � � �� F �� ".� Address � ;� • '�� ' � 1480 Beltrees Street, Suite 3 �'r �`r�f�t� �'�� City State ZIP Code �r��'� �� Dunedin Florida 34690 �L..S ��►Z� . , Signature�`, Date Telephone Ext 03-21-2017 (727) 73&9010 Capy all pages of vation Certificate and all attachments for (1) community offiaal, (2) insurance agenUcompany, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) The elevation listed in item C2.e is the bottom of the air conditioning unit. Vertical control is based upon L-Net Global Navigation Satellite System {GNSS) Network within the State of Florida. FEMA Form 086-0-33 (7I15) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IAAPORTANT: 1� 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. 907 Lantana Avenue ��tY State ZIP Code Company NAIC Number Clsarwater Florida 33767 SECTION E— BUILDING ELEVATION INFORMATION (SURVEY NOT REQUtREDj FOR ZONE AO AND ZONE A(WITiiOUT BFE) For Zanes 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, it 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 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 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 menagement ordinance? � Yes ❑ No ❑ Unknown. The local official must certify this inforrnation in Section G. SECTlON F— PROPERTY OWNER (OR OWNER'S REPRESENTAT{VE) CERTIFICATION The property owner or owners authorized representative who completes Sections A, B, and E for Zone A(without a FEMA-issued or commurnty-issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are corcect to the best of my knowledge. Prope►ty Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signatur�e Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces aN previous edftions. Form Page 3 of 6 ELEVATfON CERTIFICATE OMB No. 1660-0008 Expiratian Date: November 30, 2018 IMPORTAWT: !n 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. 907 Lantana Avenue City State ZIP Code Company NAIC Number Ciearwater Florida 33767 SECTION G — COMMUNITY INFORAAATION (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 appiicable item(s) and sign below. Check the measurement used in ltems G8—G10. !n Puerto Rico only, enter meters. G 1. ❑ 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 infoRnation. (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 cammunity 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 AOj 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 (7/15j 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, 201s IMPORTANT: In these spaces, copy the corresponding infonnation from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. Policy Number: 907 Lantana Avenue 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 the instructions for Item A6. Identify atl photographs with date taken; "Front View" and "Rear vew"; and, if required, "Right Side Vew" and "Left Side vew." 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 #his page, use the Continuation Page. ..-,�,,e. 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Photo Two Photo Two Caption Front & Side View 03-21-2017 Clear Photo 7wo FEMA Form 086-0-33 (7/15} Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE Continuation Page Expira6on 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: 907 Lantana Avenue ��tY State ZIP Code Company NAIC Number Clearwater Florida 33767 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. 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. ��..� ,��f ,� ' i .� _ � � i i� _---- �� +s;; ` �. `° .� .� 'k f � � �,�-, . - .°��6 .. ,: . . ... � : � ..�..�.:1 Pholo Three Photo Three Caption Rear View 03-21-2017 Clear Phato Three , r, ; � � � �- , �: ��,. � �� :� � ��;� k �rP� �E � 4�, r f �. �, � �;:. .: �s . - ,. �....., �. .. ..� - �w.�,�, . � � �. �",� �`�,� � =:: `''Q ��.�� = � .,� . Photo Four Photo Four Caption Side View from rear 03-21-2017 Clear Photo Four FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6