2740 TERRACE DRU.S. �ARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emer9ency Management Agency Expiratmn Oate: November 30, 2018
Fbod Msurance Program
E1.EVATION CERTlFICATE
�npoKant: Follow the ins cui pages 1-9.
Cop�r � p�ea o# this Elevation Gertificate and aN attachments for (1) cbrnmur�ity oi�ciai, (2) insurance agenUcomp�y, and {3) building owner.
SECTfON A—PROPERTY INFOi2MAT10N FOR 1NSURANCE COMPANY USE
A1. 8�d�g Owners Name Policy tVumber.
Nicau
A2. 8�di� Sireet A�iress {induding Apc., tinit, Suite, and/or Bldg. No.) � P.O. Route and
Srnc No.
2740 Terrace Dr.
City Stste
Ci�rwater Fltuida
A3. Property Description (Lot ar�d Bfoc�c Numbers, Tax Parcel Number, Leg� Description, etc.)
Lot 9. B�c 3. Y�nia Grove Terrace 2rad Add Pl� OS-29-16-94356-003-0090
Company NAIC Number:
ZIP Code
33759
A4. 8t�siing Use (e.g_. Residential, Nor�-Residential. Addition, Ac�ssory, e4c.) Residentiat
A5. �itude: Lat �°��'�-31" N long. 82°43'23.44' V1l Horizontal Datum; ❑ NAD 192T �x NAD 1983
A6. Att� at Ieasi 2 photographs of tt�e buildng if the Certifica3e is beir�g u�ti to abtain flood insurance.
A7. " ing Diagram Numbe� �A
A8. Por a building with a craw{spa� or encl�ufe(s):
a) Square footage of crawlspace or enclasurs(s) sq fc
b) Wumber of pennanent 800d openir�s in the crawlspace or endosure{s) within 1.0 foot above adjacent grade 0
c) Taral net arsa of flood openings in A8.b sq in
d) Engineer�d flood openings4 ❑ Yes ❑ No
A8. For a buikiing with an attached gsrage:
a) Square #ootage of attad�ed garage 414.71 Sq �
b) Number of pem►anent flood openings in the attached garage within 1 A foot above adjacent grade
c) Tatal net area of flood openings in A9.b sq in
d) Engsnsered flood openings? � Yes ❑ No
SECTION B— FLOOD INSURANCE RATE MAP �FiRM) INFORMATION
81. NFIP Cammunity Name 8 Community ldumbe� B2. CouM�r Name
Ciiy of C�arwater 125496 Pinellas
0
B3. State
Florida
84. MapJPan� 85. Suffix 86. FlRM Index 87. FIRM P�nel 68. Flood Zone(s) B9. Base Flood Eleva6on(s)
Nisnber Date EifectiveJ (Zone AO, use Base
Revised Dais Flood Depth)
12103C 0126 G 08/18/2009 09/03/2003 X 8 AE 54.00
810. indicate t�e sourr,8 of the Base Fk�od Elewation (BFE) data or base flood dep�► entered in Item B9:
❑ FtS Profile Qx FIRM ❑ Community Detetmined ❑ OtherlSa.irc�:
B91_ Indicads elevation datum useci f� 8FE � Item 88: ❑ NGVD 1929 xQ NAVD 1988 ❑ OtheNSource:
B12. Is � buildi� loc�ted in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? � Yes �x No
Oesignation Date: � CBRS ❑ OPA
FEMA Fcum 086-0-33 (7/15)
Replaces al! previous ediUOns.
f
�
Fonn Page 1 of 6
EI�EVATIOM CERTIFICATE
OMB No. i860-0008
Exnirati� Date� Navemher 30. 2d18
I�TANT: in thess spaces, copy tl�e comespo�ding information from Sectioo A. FOR INSURANCE COMPANY USE
Street Address (inGuding A�., Unit, Suite, and/or Bldg. No.j ar P.O. Rtwte and Box No. Policy Number:
2740 T+arrac�e br.
Cit�r State ZIP Code ompany NAI Ntxnber
Florida 337�
SECTtON C— BUlLDiNG ELEYATION 1FIFORMATiON (SURVEY REQUIRED►
C1.. 8uikd'mg eiev�tions are based an_ ❑ Construction Drawings• � Under Construdion' []x Finished Construction
A raew Elevation Certiflcaie wifl be required when construction of t� bu�ng is comp►ete.
C2. Elevations—Zones A1—A30, AE, AH, A{with BFE), VE, V1—V30, V{with SFE), AR, AR/A, AR/AE, ARJA1 A30, AR/AH, AR/AO.
Complete ttems C2.a—fi below accordir� to the buitding diagram spec�%ed � Item A7. In Puerto Rico only, enter meters.
8enchmark Utilized: NC3SBM Courfiey V Vertical flatum: NAVO 1988
in�q� elevafia� datum used for � elevations fn items a) throug#� h) beloar.
� NGVD 1929 Q NAVD 'f988 � Other/Source;
flaiwn used for buitding elevations must be the same as that used brthe BFE.
Chedc the measurement used.
a� Top of bottom floor {indudinc� basement, crawlspace, or endosurs fioor) 55 49 ��t ❑ meters
b) Top cf the next higlter tbor . Qx feet � meters
c) Soitom of the lowest t�iza�tal sflnacxural member (v Zones or�y) . �x feet ❑ meters
d) Attached garage (top of slab) �. � Q�t ❑ meters
e) Lawest elsvatian of machir�ery or equipment servicing the building 55 2 x❑ feet ❑ meters
{Describe type of equipment and locat+on in Comments)
� l�vest adjacent (finished) grade next to building (LAG) 54 57 � feet ❑ meters
g) Hghest adjacent (finished) grade ne�ct to building (HAG) 55, 90 �{�t ❑ meters
h) Lawest adjacent grade at lowest e�vation of deck or stairs, induciing Q fest ❑ meters
sCructural suppo�t
SECTION D— SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
Th� c�rti�icadon is ta be signed and sealed by a land surveyor, engineer, or ar�itect authorized by law to cerGiy elevation information.
! c�rii/y+ that the information on this Ce�ti�"' rcate r+epresents my bes? e� to inteqo�t the data available. ! undersfand that any false
sta#ernenf may be punishable by ffne or imprisonment under 78 U. S. Code, Section 1001.
Were latihuie and longitude in Section A provided by a licensed tand sunreyor? � Yes ❑ No ❑ Check here if attachments.
Cerrtiifners Name Lic�ense Number
Denrris J Eyr�e 2865
T�
Land 5urveyor
Campany N�ne Place
Geoda#a Servic�s. Inc. Seal
,q�� Here
11C36 !{a�p flrive
��h' State tIP Code
Clearw�ter Florida 33765
S�gn � Date Telephone
04/10l201� (727) 447-1763
Copy �s E tion rtificate and ap attachments br (1) c�nmuniiy official. {2) insurance agenUcompany, and (3) building owner.
Ccxtunerrts {indud of equipment and location, per C2{e), if applicabie)
B 8 8 9 Praperiy i in flood zone X 8 AE. Structure is in flood zone X
C2 ej Lowest elevation of machinery serviang the building, is the air oondition.
FEMA Famt 088-0-33 {7/15)
Replaces aG previous editia�s.
Fonn Page 2 of B
ELEYATION CERTIFICATE
onna No. �sso-000s
t_.
cwNuauw� vai�a. rvwemDer 3U, LU'Itf
I�APt�tTANT: In thase apaces, copy the carresponding information from Section A. FOR INSURANCE COMPANY USE
8uilc�ng Straeet Address (induding Apt., Unit. Suite, andlor Bldg. No.) or P O Rou� and Box No. Paficy N�mber.
27� Terraoe �r.
�� State ZIP Code Company NAIC Number
Florida 33759
SECTiO�I E- BUILDING ELEVATION INFORMAT1pN (gURVEY NOT REQt1iRED)
�OR ZONE AO AND 20WE A�MIT#�UT BFE)
F� Z�nes AO and A(witfiout BFE), �mpiete )tems E1-E5. if the Cer� Es ir�ended to support a IOMA or IOMR-F request,
car►pMeLe Sections A, B,and C. For Items E1-E4, use natural grade, if avai�le. Cl�eck the measurement used. in Pusrto Rico only,
eM�sr me�ers.
E1. ProvKie elevation information fo� the following and check the apprc�iaEe boxes to show whether the elevaiion is above or below
4he highest adjaceM grade {HAG) ar�d the lawest adjacent grade {LAG).
a) T� of bottom floor (including bas8me�t,
cxawlspace, or enclosure) is , ❑ feet ❑ meters ❑ above or ❑ below the HAG.
b) Top of bottom fl�r (induding basement,
c�wlspace, or endosure) is . ❑ f�t ❑ meters
❑ above o� ❑ below the LAG.
E2. �� Bui�ing Diagrams 6-9 with permanent flood openings provideti in Se�n A Items 8 and/or 9(see pages 1-2 of Instructions),
ii�e �xt higl�er floor {elevation C2.b in
the diagrams) of the building is . ❑ fest ❑ meters ❑ aboye or ❑ below the HAG.
E3. A#tached garage {top of siab) is , ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4- Top o# platform of machinery andJar equipment
serviar►g the building is . ❑ feet
❑ meters ❑ above or ❑ below the HAG.
E5. Zons AO only: If no flood depU� number is available, is the top of the tx�tom fbor elevated in accordance with the community's
fbodplain managemenl ordinance? � Yes ❑ No ❑ Unknown. The it�al official must certify this information in Section G.
SECT#ON F- PROPERTY OWNER (OR ONMfR'S REPRESENTATIVEj CERTIFICATION
The �operty owner or owr�r's autt�orized representative who c�mpbtes Sections A, B, and E for Zone A{withoui a FEMA-issued or
ocunmtt�y-issued BFE) or Zone A� m�t sign here. The statemen#s in Sedions A, 8, and E are conect to the best of my knowledge.
Property Owner or Owners Authorizsd Representative's Name
�S C�+ State ZIP Code
Signature Date Telephone
Cornments
❑ Check here if attachments.
FEMA Form 086-0-33 {7/15) Replat�s all previous eciitions. Form Page 3 of 6
E�EYATION CERTIFICATE oMB nro. �ssa000s
Expiration Oate: November 30, 2018
I�APC?RTANT: In thase spaces, copy the cornasponding iniormadon from Ssction A. FOR IMSURANCE COMPANY USE
Building Str�eei Adc�ess (inciuding A�., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy N�ber:
2740 Terrace Or.
��Y • State �� ��
C� Company NAIC Number
Ftorida 33759
SECTION G - COMMUNITY iNF�1T�N {OPTIONAL)
The iocal Mfidal who is authorized by law or ardinance to adminiater tt►e �unitys floodplain management ordinar�e can complete
Sediar�s A, B, C(or E), and G of this Elevafion Certificate. Complete ihe item{s) and sign below. Chedc the rt�easurement
used in tbems GS-G10. In Puerto Ri� �iy, eMer meters.
(31. ❑ The information in Sedion C was taken hom other documen#ation tt�at has been signed and sealed by a licensed surveyor,
engineer, or architect who is authorized by law to certify elevation inf�mation. (Indicate the source and date of the elevation
data in the Comments area below.)
G2 ❑ A communiry official �npleted Section E for a building located in Za�e A{without a FEMA-issued or cbmmunity-issued BFE)
or Z�e AO.
Gg. ❑ The foliowing information (IUems G4-G10) is provided for cornmur�ty floodplain management purposes.
G4. Pemnit Number G5. Date Pertnit Issued G6. Date Certifipte of
CompliancelOccupancy Issued
G7. This permit has been issued far. � New Construction � Substantia� Improvement
t38. Eievation of as-buift lowest floor (inGuding basement)
of the twildin9� . ❑ feet ❑ meters Datum
G9. BFE or (in 2one AO) depth of flooding at the building site: _ ❑ feet ❑ meters Datum
G10. �ammunity's design flood eievadon: , � feet ❑ meters Datum
Local Offiaais Name 1-�
Community Mame Telephone
Signature Date
Comments (i�luding type of equipment and loca6on, per C2(e), if a�licable)
❑ Check here if attachments.
FEMA Form 086-0-33 {7/15j Replaces all previous editions. Form Page 4 of 6
BUILDING PHOTOGRAPHS OMB No. 1660-000$
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 Streei Address (inctuding Apt.. Unit. Suite. and/or Bldg. No.) or P.O. Route and Box No. Policy Number:
2740 Terrace Dr.
City State ZIP Code Company NAIC Number
C learwater Florida 33758
If using the Elevation Certificate to obtain NF1P flood insu�ance, affix at least 2 building photographs below according to the
instructions for ftem A6. Identify all photographs with date taken; "Front View" and "Rear VievJ'; and, if required. "Right Side View" and
"Left Side View." "lVhen applicable, photographs must show the foundation wim representative examples of the flood openings or
vents, as indicated in Section A8 If submittinp more photographs than will fit on this page use the Continuation Page.
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FEMA Form 086-0-33 (7l15) Replaces alI previous edit+ons Form Page 5 of 6
BUILDING PH�TflGRAPHS OMB No 1660-0008
ELEVATiON CERTIFICATE Continuat�on s�age Expiration Date: November 30, 2018
IMPt?KTANT: In these spaces, copy the corresponding information frvm Sectian A. FOR INSUf�ANCE COMPANY USE
8uilding Stresi Address (inciuding Apt . Uni#, Suite. and/vr Bldg. No. ) or P O. i2oute and Box No. Policy Number
274(3 Te.�race Dr.
C��Y State Z1P Code Company NAIC Number
Clearwa#er Florida 33759
If submitting more photographs than wil! fit on the preceding page. affix tlie additional photographs below. identify ali photographs
with date #aken; "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 af the flood openings or vents as indicated in Section A8.
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FEMA Form 086-0-33 (7/15) Replaces all previous editions Farm Page 6 of 6