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225 LEEWARD ISLANDU; 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 agent/company, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name MICHELLE & RICHARD MARCATOS Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 225 LEEWARD ISLAND Com an p y NAIC Number: City State ZIP Code CLEARWATER Florida 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 31, ISLAND ESTATES OF CLEARWATER UNIT 1 A4. Building Use (e.g., A5. Latitude/Longitude: A6. Attach at least A7. Building Diagram A8. For a building a) Square footage b) Number of c) Total net area d) Engineered A9. For a building with a) Square footage b) Number of c) Total net area d) Engineered Residential, Non -Residential, Addition, Accessory, etc.) Lat. 27.97965 Long. -82.81418 RESIDENTIAL Horizontal Datum: obtain flood insurance. 1.0 foot above adjacent above adjacent grade ❑ NAD 1927 grade x NAD 1983 N/A 2 photographs of the building if the Number lA Certificate is being used to N/A sq ft with a crawlspace of crawlspace permanent flood of flood openings flood openings? an attached of attached permanent flood of flood openings flood openings? or enclosure(s): or enclosure(s) openings in the crawlspace in A8.b N/A sq or enclosure(s) within in sq ft within 1.0 foot sq in 0 ❑ Yes 3 No garage: garage 400 openings in the attached garage in A9.b 0 ❑ Yes x No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number CITY OF CLEARWATER - 125096 62. County Name PINELLAS B3. State Florida B4. Map/Panel Number 12103C0102 B5. Suffix G B6. FIRM Index Date 05/17/2005 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 B10. Indicate the source ❑ FIS Profile B11. Indicate elevation B12. Is the building Designation Date: of the Base Flood Elevation (BFE) ❑x FIRM ❑ Community Determined datum used for BFE in Item B9: located in a Coastal Barrier Resources N/A ❑ CBRS data or base flood depth entered in Item B9: ❑ NGVD System • Other/Source: 1988 ❑ Other/Source: or Otherwise Protected 1929 x NAVD (CBRS) area Area (OPA)? ❑ Yes x No ■ OPA FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 S "REVISED" FLAN RECEIVED BY J.A.VN MAY 222017 ttiVi BCP2017-03763 Rc RICK MARCATOS, Zoning: Island Estates Atla ELEVATION CERTIFICATE OMB No. 1660-0008 • 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. 225 LEEWARD ISLAND Policy Number: City State ZIP Code CLEARWATER Florida 33767 Company NAIC Number SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations — Zones Al—A30, AE, AH, A (with BFE), VE, V1—V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, Benchmark Utilized: FDOT PERM REF NETWORK Vertical Datum: NAVD 1988 x Finished Construction A30, AR/AH, AR/AO. enter meters. Indicate elevation datum ❑ NGVD 1929 used p for the elevations in items a) through h) below. 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) 6. 2 ❑x feet ❑ meters b) Top of the next higher floor N/A x feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A x feet ❑ meters d) Attached garage (top of slab) 5 5 x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 7 1 x feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 5. 5 x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 5. 7 x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A. x feet ❑ meters structural support SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect I certify that the information on this Certificate represents my best efforts to interpret statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section Were latitude and longitude in Section A provided by a licensed land surveyor? x authorized by law to certify elevation information. the data available. I understand that any false 1001. Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number JONATHAN S. BRANSON FL PLS 6845 Digitally signed '. -'', by = Jonathan 5 02":x^""—"'' :�, > ___ Branson 'Date: """"".' 2017.05.19 11:51:55 -04'00' Title PRESIDENT Company Name ACROMIC, INC. LB 8094 Address 50 LAKEVIEW RESERVE BOULEVARD City State ZIP Code WINTER GARDEN Florida 34787 Signature n p Date Telephone �hd 05/19/2017 (321) 312-0787 Copy all page f this Elevan 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) A5. COORDINATES WERE DETERMINED USING GEOREFERENCED IMAGERY. C2. ELEVATIONS ARE REFERENCED TO THE FLORIDA DEPARTMENT OF TRANSPORTATION PERMANENT REFERENCE NETWORK, AS OBSERVED WITH A LEICA GS14 GPS SENSOR. C2e. IS ELEVATION OF TOP OF SLAB SUPPORTING AIR CONDITIONING UNIT. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 • 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. 225 LEEWARD ISLAND Policy Number: City State ZIP Code CLEARWATER 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, Band C. For Items E1—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 feet meters LOMA or LOMR-F request, used. In Puerto Rico only, the elevation is above or below ❑above or below the HAG. ❑ above or ❑ below the LAG. 9 (see pages 1-2 of Instructions), ❑ above or ❑ below the HAG. ❑ above or ❑ below the HAG. ❑ above or ❑ below the HAG. with the community's this information in Section G. • b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ 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 ❑ feet ❑ meters E3. Attached garage (top of slab) is ❑ feet ❑ meters E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ 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? ❑ Yes ❑ No ❑ Unknown. The local official must certify 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 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 3 of 6 • ELEVATION CERTIFICATE OMB No. 1660-0008 .._.. .—.sr......v.. vuao. INV,/ VII WWI )V, GU 10 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. 225 LEEWARD ISLAND Policy Number: City State ZIP Code CLEARWATER Florida 33767 Company NAIC Number SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance Sections A, B, C (or E), and G of this Elevation used in Items G8—G10. In Puerto Rico only, enter G1. ❑ The information in Section C was taken engineer, or architect who is authorized data in the Comments area below.) to administer the community's floodplain management ordinance can complete Certificate. Complete the applicable item(s) and sign below. Check the measurement meters. from other documentation that has been signed and sealed by a licensed surveyor, by law to certify elevation information. (Indicate the source and date of the elevation E for a building located in Zone A (without a FEMA -issued or community -issued BFE) is provided for community floodplain management purposes. G2 ■ A community official completed Section or Zone AO. G3. ❑ The following information (Items G4—G10) G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ 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 ❑ Substantial Improvement basement) ❑ feet ❑ feet ❑ feet ❑ meters Datum building site: ❑ meters Datum • 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. MA 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. 225 LEEWARD ISLAND 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. -.1111111111111pW 111.111.1 rrNMIRa4x x.. /. Photo One Photo One Caption FRONT VIEW - 05/16/2017 - . y Photo Two Photo Two Caption REAR VIEW - 05/16/2017 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS OMB No. 1660-0008 Continuation Page 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. 225 LEEWARD ISLAND Policy Number: City CLEARWATER State ZIP Code Florida 33767 Company NAIC Number 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. Photo One Photo One Caption RIGHT SIDE VIEW - 05/16/2017 Photo Two Photo Two Caption LEFT SIDE VIEW - 05/16/2017 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6 U.S. DEf7ro4RTMENT OF HOMELAND SECURITY OMB No. 1660-0008 Federal 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 (1) community official, (2) insurance agent/company, and (3) building owner. SECTION A— PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Building Owner's Name Policy Number: MICHELLE & RICHARD MARCATOS A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 225 LEEWARD ISLAND City State ZIP Code CLEARWATER Florida 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 31, ISLAND ESTATES OF CLEARWATER UNIT 1 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: �at. 27•97965 Long. -$2•81418 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 crawispace or enclosure(s) N/A sq fl 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 NIA sq in d) Engineered flood openings? ❑ Yes � No A9. For a building with an attached garage: a) Square footage of attached garage 400 sq ft b) Number of permanent 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 d) Engineered flood openings? � Yes 0 No SECTION B— FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name 63. State CITY OF CLEARWATER - 125096 PINELLAS Florida B4. Map/Panel 65. Suffix 66. FIRM Index 67. FIRM Panel B8. Flood Zone(s) B9. Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 12103C0102 G 05/17/2005 09/03/2003 AE 11 610. 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: 611. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 � Other/Source: B12. Is the buiiding located in a Coastal Barrier Resources System (CBRS) area or Othervvise Protected Area (OPA)? � Yes � No Designation Date: N/A � CBRS ❑ OPA rtMA t-orm o86-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 ,�REVI��'° i-�'` �►4�iS �ECEI\/�� B� .� .A.�t1i MAY222017 � , _iG�R��r�� gCP2017-03763 �� MARCATOS, RICK qtl� Zoning: Island Estates �LEVATION CERTIFICATE � pBa on1Da e�No8ember 30, 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: 225 LEEWARD ISLAND City State ZIP Code Company NAIC Number C�EARWATER 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 Gertificate 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: FDOT PERM REF NETWORK Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. � NGVD 1929 �x 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, crawtspace, or enclosure floor) 6 2 _ Ox feet ❑ meters b) Top of the next higher floor N�A. _ ❑x feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N�A. _ �x feet ❑ meters d) Attached garage (top of slab) 5. 5 � feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building �. � ❑x feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 5 5 �x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 5� �x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including N�A ❑x feet � meters structural support 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. 1 certify that the information on this Certificate represenfs my best efforts to interpret the dafa available. I understand that any fa/se statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? � Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number JONATHAN S. BRANSON FL PLS 6$45 Title PRESIDENT , , Digitally signed ,'��'�" �BR+;�;�- by Jonathan 5 Company Name �02"��^"'4�`so= ° _�: _- 8ranson ACROMIC, INC. LB 8094 �Date: RORCA '�� Address ��' - - '��' 2017.05.19 . SLrveya ,�.• 50 LAKF_VIEW RESERVE BOULEVARD 11:51:55 -04'00' City State ZIP Code WINTER GARDEN Florida 34787 Signature �,� ;�, � �._- %%' Date Telephone �,� "�� l � ___..__ 05/19/2017 (321) 312-0787 Copy all page f this Eleva`' n Certificate and all attachments for (1) community official, (2) insurance agenUcompany, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) A5. COORDINATES WERE DETERMINED USING GEOREFERENCED IMAGERY. C2. ELEVATIONS ARE REFERENCED TO THE FLORIDA DEPARTMENT OF TRANSPORTATION PERMANENT REFERENCE NETWORK, AS OBSERVED WITH A �EICA GS14 GPS SENSOR. C2e. IS ELEVATION OF TOP OF SIAB SUPPORTING AIR CONDITIONING UNIT. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 � OMB No. 1660-0008 �LEVATION CERTIFICATE Expiration Date: November 30, 20�8 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: 225 LEEWARD ISLAND 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 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, crawispace, 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 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 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 3 of 6 ' OMB No. 1660-0008 ELEVATION CERTIFICATE Expiration Date: November 30, 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: 225 LEEWARD ISLAND City 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. G�. [] 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 officiai 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 Compiiance/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 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 (7l15) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS �LEVATION CERTIFICATE See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 225 LEEWARD ISLAND City CLEARWATER OMB No. 1660-0008 Expiration Date: November 30, 2018 FOR INSURANCE COMPANY USE Policy Number: State ZIP Code I Company NAfC Number 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 all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicabie, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submiiting more photographs than will fit on this page, use the Continuation Page. Photo One Caption FRONT VIEW - 05/16/2017 �r�=' �� k a �i�� ! � e'x �<rt. � x� . Photo One �:� . ., . , , m: ,. � � Photo Two Caption REAR VIEW - 05/16/2017 �� 4< , 1i ' �� . . � R�,M ... �•�,.. �, . . , , . +i� ' . �. r ��_� � t F � 9� �s � �;; x � �� .t � ..,a� r � �' �� y ,r � `. �. t , .' �^ I �h �'� k, 4 -0,�, „�s ' 74� �r�. Photo Two 1 ;2w i � �, � � �� ' �'y ' �� ' , ��`�� .. . . b ��' S A � :M, ��Y',.� �� ..��t; � .,5� ��:. M. �. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 . BUILDING PHOTOGRAPHS ELEVATION CERTIFICATE Continuation Page IMPORTANT: In these spaces, copy the corresponding information from Section A. , Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No 225 LEEWARD ISLAND City State ZIP Code CLEARWATER Florida 33767 OMB No. 1660-0008 Expiration Date: November 30, 2018 FOR INSURANCE COMPANY USE Policy Numl�er: Company NAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: d�te 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. -� " `�4� � � y . s A;: ��; , _, .��: �� , � _� � � �� ' `� � x=.s � ..•.,� m ..`m'",*� �. ' .::z� ;3" # , � ._...__._....... � . . , � ' w .. ,p .�.. �'�� .+:. Fr ; d?�.�n,. . � � ..r_u.:w kC� �� ', i•ik•� 2kk",; Photo One Photo One Caption RIGHT SIDE VIEW - 05l16/2017 s :"$ i � �f5 � � � '";� ��"- : � � � �� '�� } ' �� .. . Photo Two Photo Two Caption LEFT SIDE VIEW - 05/16/2017 FEMA Form 086-0-33 (7115) Replaa�s all previous editions. .,,W �� Y $� � `g � �� ' 0 Form Page 6 of 6