Loading...
1004 BRUCE AVEU.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFIC Important: Follow the instructions on pages Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) SECTION A — PROPERTY INFORMATION Al. Building Owner's Name Kathy Marques A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route Box No. 1004 Bruce Avenue City Clearwater Beach State Florida 1004 BRUCE AVE BCP2017-02176A AMENDMENT A KATHERINE L MARQUES Zoning: Low Medium Density Atlas #: 238A RECEIVED BY: M.J. NOV 1 5 2017 PLANNING & DEVELOPMENT CITY OF CL EARWATER A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 14, Block 67, MANDALAY SUBDIVISION 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 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, Accessory, etc.) Lat. 28d 00' 07.88" N. Long. 82d 49' 29.84" Residential W. Horizontal Datum: 0 NAD 1927 insurance. above adjacent grade grade N/A 0 NAD 1983 N/A 2 photographs of the building if the Number 1A Certificate is being used to obtain flood N/A sq ft with a crawlspace of crawlspace flood of flood openings flood openings? an attached of attached flood of flood openings flood openings? or enclosure(s): or enclosure(s) openings in the crawlspace in A8.b or enclosure(s) N/A sq in within 1.0 foot foot above adjacent in 237.20 sq ft • Yes 0 No garage: garage openings in the attached garage within 1.0 in A9.b N/A sq 0 Yes 0 No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number Clearwater 125096 B2. County Name Pinellas 63. State Florida 64. Map/Panel Number 12103C 0064 65. Suffix G B6. FIRM Index Date 09-03-2003 B7. FIRM Panel Effective/ Revised Date 09-03-2003 68. Flood Zone(s) AE B9. Base Flood E evation(s) (Zone AO, use Base Flood Depth) 11.0' B10. Indicate the source D FIS Profile B11. Indicate elevation B12. Is the building Designation of the Base Flood Elevation 0 FIRM 0 Community Determined datum used for BFE in Item 69: located in a Coastal Barrier Resources Date: 0 (BFE) data or base flood 0 Other/Source: 0 NGVD 1929 System (CBRS) CBRS 0 OPA depth entered in Item B9: 0 NAVD 1988 area or Otherwise 0 Other/Source: Protected Area (OPA)? 0 Yes 0 No FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 CERTIFICATE OMB No. 1860'0000 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. 1004 Bruce Avenue Policy Number City State ZIP Code Clearwater Beach Florida 33767 Company NAIC Number SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: 0 Construction Drawings* 0 Building Under Construction* EI 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 BFEVE, V1—V3U.V(with BFE).AR, AR/A.AR/AE.AR/A1—A3o.AR/AM.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: Aural RM -3 Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. 0 NGVD 1929 0 NAVD 1988 0 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) 3.50 0 feet 0 meters b) Top of the next higher#uor 4.90 �[� � feet ^� Fl meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A x feet meters d) Attached garage (top of slab) 3.50 IM feet • meters e) Lowest elevation of machinery or equipment servicinthe�ui/ding (Daunrbatypeufequipmentand|ouadonmComme�5.00 0 feet 0 meters 0 Lowest adjacent (finished) grade next to buil3.40 [�feet 0 meters (LAG>�� g) Highest adjacent (finished) grade next to building (HAG) 3.50 x feet 0 meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A 0 feet 0 meters SECTIOND—SORVEYOR.ENGINEER'OR ARCHITECT CERTIFICATION This rUfioob is be i d and sealed by a land surveyor, engineer,r architect authi d by I certify that the information on this Certificate represents my best efforts to interpret the data available. statement may be punishable by fine or imprisonment under /8 U.S. Code, Section 1001. law to certifyevation information. I understand that any false D Check here if attachments. ^,. Were latitude and longitude in Section A provided by a licensed land surveyor? xYea 0 No Certifiers Name License Number Edward D. Murphy #5333 ```"/,o^ '- n;- ` SM'''' Professional Land Surveyor Company Name W1uqphyoLandSumoy|ng. Inc Address 576011\bAvenue N. City State ZIP Code St. Petersburg _ Florida 8871U Signatuva � DateTelephone Ext. 4� ,�0o���'11-08-2017 (727) 347-8740 Copy all pages of this Elevation Certificate and al 'ttouh - ts for(1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipmen ''^ location, per C `.ifapplicable) C2a=A/C FEMA Form 086-0-3 7Y15) Replaces all previous editions. Form Page 2 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. 1004 Bruce Avenue Policy Number: City State ZIP Code Clearwater Beach 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. ,`t , F,lF:f eay i - i , At • ....sem_ .d.'- ,.ra- Photo One • Photo One Caption FRONT VIEW Clear Photo One t:h _ A.die T Photo Two Photo Two Caption REAR VIEW Clear Photo Two FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 ' ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS Continuation Page 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. 1004 Bruce Avenue Policy Number: City State ZIP Code Clearwater Beach 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. sa �. 7 � $ r Photo Three Photo Three Caption SIDE VIEW Clear Photo Three .,g> tee, - L e+q Photo Four Photo Four Caption SIDE VIEW Clear Photo Four FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6 U.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/n compa SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Kathy Marques Policy Number. A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1004 Bruce Avenue Company NAIL Number. City State ZIP Code Clearwater Beach Florida 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 14, Block 67, MANDALAY SUBDIVISION 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 a) Square footage b) Number of permanent c) Total net area d) Engineered Residential, Non -Residential, Addition, Accessory, tat 28d 00' 07.88" N. Long. 82d 49' 29.84" eta) Residential W. Horizontal Datum: insurance. above grade • NAD 1927 adjacent grade N/A p NAD 1983 N/A 2 photographs Number with a crawlspace of crawlspace permanent flood of flood openings flood openings? with an attached of attached flood of flood openings flood openings? of the building if the 1A Certificate is being used to obtain flood N/A sq ft or enclosure(s): or enclosure(s) openings in the crawlspace in A8.b or enclosure(s) N/A sq in within 1.0 foot 1.0 foot above adjacent in No 237.20 sq ft ■ Yes © garage: garage openings in the attached garage within in A9.b N/A sq • Yes IM No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number Clearwater 125096 62. County Name Pinellas B3. State Florida B4. Map/Panel Number 12103C / 0064 B5. Suffix G B6. FIRM Index Date 09-03-2003 B7. FIRM Panel Effective/ Revised Date 09-03-2003 B8. Flood Zone(s) AE 89. Base Flood Elevation(s) (Zone AO, use Base Flood Depth) 11.0' B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood 0 Other/Source: depth entered in Item B9: • FIS Profile p FIRM ■ Community Determined B11. Indicate elevation B12. Is the building Designation Date: datum used located in a for BFE in Item B9: Coastal Barrier Resources 0 Other/Source: Protected ■ NGVD 1929 III NAVD 1988 System CBRS (CBRS) area or Otherwise Area (OPA)? ■ Yes p No ■ ■ OPA Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 • IMPORTANT: In these spaces, copy the corresponding information from Section A. �MII ammo 1 va1.0. IYVY0111YOI JV, CU 10 FOR INSURANCE COMPANY USE Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1004 Bruce Avenue Policy Number: City State ZIP Code Clearwater Beach Florida 33767 Company NAIC Number SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: *A new Elevation Certificate will be required C2. Elevations - Zones A1 -A30, AE, AH, Complete Items C2.a-h below according Benchmark Utilized: Aural RM -3 • A Construction Drawings' when construction of the (with BFE), VE, V1 -V30, V to the building diagram specified Vertical • building (with Datum: Building Under Construction' p Finished Construction is complete. BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. in Item A7. In Puerto Rico only, enter meters. NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. • NGVD 1929 El NAVD 1988 ■ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check a) Top of bottom floor (including basement, crawispace, or enclosure floor) 3.50 E the measurement used. feet • meters b) Top of the next higher floor 4.90 p feet ■ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A El feet ■ meters d) Attached garage (top of slab) 350 ID feet ■ meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) 5.00 p feet ■ meters f) Lowest adjacent (finished) grade next to building (LAG) 3.40 p feet ❑ meters g) Highest adjacent (finished) grade next to budding (HAG) 3.50 p feet ■ meters h) Lowest aldjacengrade at lowest elevation of deck or stairs, including N/A © feet ■ meters 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 may be punishable by fine or imprisonment under 18 U.S. Code, Section Were latitude and longitude in Section A provided by a licensed land surveyor? © authorized by law the data available. 1001. Yes ■ No to I understand ■ certify elevation information. that any false Check here if attachments. Certifier's Name License Number Edward D. Murphy #5333 Title Professional Land Surveyor Place Company Name Murphy's Land Surveying, Inc Seal Address 5760 11th Avenue N. Here City State ZIP Code St. Petersburg Florida 33710 Signature i Date Telephone 411 11-08-2017 (727) 347-8740 Ext. Copy all pages of this Elevation Certificate and al = - is for (1) community official, (2) insurance agenticompany, and (3) building owner. Comments (including type of equipment - r location, per C - , if applicable) C2e = NC Replaces all previous editions. Form Page 2 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. 1004 Bruce Avenue Policy Number: City State ZIP Code Clearwater Beach 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. i r .. ..fit .. rr�. s- :. a t ► s. Photo One Photo One Caption FRONT VIEW Clear Photo One PhC o Two Photo Two Caption REAR VIEW Clear Photo Two FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS Continuation Page 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. 1004 Bruce Avenue Policy Number: City State ZIP Code Clearwater Beach 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. 0 Photo Three Photo Three Caption SIDE VIEW Clear Photo Three � r vS 9 I • Photo Four Photo Four Caption SIDE VIEW Clear Photo Four FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6 U.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 Owners Name Kathy Marques Policy Number. A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1004 Bruce Avenue Company NAIC Number City State ZIP Code Clearwater Beach Florida 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 14, Block 67, MANDALAY SUBDIVISION 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 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, Accessory, tat 28d 00' 07.88" N. Long. 82d 49' 29.84" etc.) Residential W. horizontal Datum: insurance. above grade ■ NAD 1927 adjacent grade N/A DI NAD 1983 N/A 2 photographs Number with a crawlspace of crawlspace flood of.flood openings flood openings? an attached of attached flood of flood openings flood openings? of the building if the 1A Certificate is being used to obtain flood WA sq ft or enclosure(s): or enclosure(s) openings in the crawlspace in A8.b or enclosure(s) N/A sq in within 1.0 foot 1.0 foot above adjacent in 237.20 sq ft • Yes i3 No garage: garage openings in the attached garage within in A9.b WA sq • Yes p No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Community Name & Community Number Clearwater 125096 B2. County Name Pinellas B3. State Florida B4. Map/Panel Number 12103C / 0064 65. Suffix G B6. FIRM Index Date 09-03-2003 B7. FIRM Panel Effective/ Revised Date 09-03-2003 88. Flood Zone(s) AE B9. Base Flood Elevation(s) (Zone AO, use Base Flood Depth) 11.0' B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood ❑ Other/Source: depth entered in Item B9: • FIS Profile p FIRM datum used located in a • Community Determined for BFE in Item 89: Coastal Barrier Resources 811. Indicate elevation 612. Is the building Designation Date: • NGVD 1929 p NAVD 1988 • Other/Source: Protected System CBRS (CBRS) area or Otherwise Area (OPA)? • Yes p No • • OPA FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 8 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. 1004 Bruce Avenue Policy Number: City State ZIP Code Clearwater Beach Florida 33767 Company NAIC Number SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: • Construction Drawings* 'A new Elevation Certificate will be required when construction of the C2. Elevations - Zones A1 -A30, AE, AH, A (with BFE), VE, V1 V30, V Complete Items C2.a-h below according to the building diagram specified Benchmark Utilized: Aural RM -3 Vertical ■ building (with Datum: Building Under Construction* is complete. BFE), AR, AR/A, AR/AE, AR/A1-A30, in Item A7. In Puerto Rico only, NAVD 1988 Di Finished Construction 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 bulking elevations must be the same as that used for the BFE. Check a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 3.50 p the measurement used. feet • meters b) Top of the next higher floor 4.90 DI feet • meters c) Bottom of the lowest horizontal structural member (V Zones only) WA P feet ■ meters d) Attached garage (top of slab) 350 Di feet • meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and Iocabon in Comments) 5.00 © feet • meters f) Lowest adjacent (finished) grade next to building (LAG) 3.40 p feet ■ meters g) Highest adjacent (finished) grade next to building (HAG) 330 © feet • meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including WA structural support p feet • meters SECTION 0 - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect 1 certify that the irdnrmatfon on this Certificate represents my best efforts to interpret statement may be punishable by fine or imprisonment under 18 U.S. Code,00nn Were latitude and longitude in Section A provided by a licensed land surveyor? In authorized by law the data available. 1001. Yes • No to I understand ■ certify elevation information. that any false Check here if attachments. Certiffer's Name License Number Edward D. Murphy #6333 Place Seal Hr, e Title Professional Land Surveyor Company Name Murphy's Land Surveying, Inc Address 5760 11th Avenue N. City State ZIP Code St. Petersburg Florida 33710 Signature I Date Telephone Ext. 1.11°,.� 4 v 11-08-2017 (727) 347-8740 Copy all pages of this Elevation Certificate and al ttac is for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment location, per C - , if applicable) C2e = A/C FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 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. 1004 Bruce Avenue Policy Number: City State ZIP Code Clearwater Beach Florida 33767 Company NAIL 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. Photo on. Photo One Caption FRONT VIEW Clear Photo One l ,a l - r 1 yy 7 xr S + R- • Ptoto Two Photo Two Caption REAR VIEW Clear Photo Two FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS Continuation Page 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. 1004 Bruce Avenue Policy Number: City State ZIP Code Clearwater Beach 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. •7 Photo Theo Photo Three Caption SIDE VIEW Clear Photo Three i . --• y' t Photo Far Photo Four Caption SIDE VIEW Clear Photo Four orm -0- Replaces all previous editions. Form Page 6 of 6 U.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 ow SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Kathy Marques Policy Number. A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1004 Bruce Avenue Company NAIL Number. City State ZIP Code Clearwater Beach Florida 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 14, Block 67, MANDALAY SUBDIVISION 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, Lat. 28d 00' 07.88" N. Long. 82d 49' 29.84" etc.) Residential W. Horizontal Datum: insurance. above grade ❑ NAD 1927 adjacent grade N/A p NAD 1983 N/A 2 photographs Number with a crawlspace of crawlspace permanent flood of flood openings flood openings? an attached of attached permanent flood of flood openings flood openings? of the building if the 1A Certificate is being used to obtain flood N/A sq ft or enclosure(s): or enclosure(s) openings in the crawlspace in A8.b or enclosure(s) N/A sq in within 1.0 foot 1.0 foot above adjacent in 237.20 sq ft • Yes © No garage: garage openings in the attached garage within in A9.b N/A sq ❑ Yes x No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number Clearwater 125096 82. County Name Pinellas B3. State Florida B4. Map/Panel Number 12103C 0064 B5. Suffix G B6. FIRM Index Date 09-03-2003 B7. FIRM Panel Effective/ Revised Date 09-03-2003 B8. Flood Zone(s) AE B9. Base Flood E evation(s) (Zone AO, use Base Flood Depth) 11.0' B10. Indicate the source ❑ FIS Profile B11. Indicate elevation B12. Is the building Designation Date: of the Base Flood Elevation ❑ Community Determined for BFE in Item B9: Coastal Barrier Resources ❑ (BFE) data ❑ NGVD System CBRS or base flood ❑ Other/Source: depth entered in Item B9: x FIRM datum used located in a ❑ Other/Source: Protected 1929 x NAVD 1988 (CBRS) area or Otherwise ❑ OPA Area (OPA)? ❑ Yes x No orm U2iii-U- Replaces all previous editions. Form Page 1 of 6 • OMB No. 1660-0008 ELEVATION CERTIFICATE 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. 1004 Bruce Avenue Policy Number. City State ZIP Code Clearwater Beach Florida 33767 Company NAIC Number SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: *A new Elevation Certificate will be required C2. Elevations — Zones A1—A30, AE, AH, Complete Items C2.a—h below according Benchmark Utilized: Aural RM -3 • A Construction Drawings* when construction of the (with BFE), VE, V1—V30, V to the building diagram specified Vertical • building (with Datum: Building Under Construction* is complete. BFE), AR, AR/A, ARAE, AR/A1—A30, in Item A7. In Puerto Rico only, NAVD 1988 p Finished Construction AR/AH, AR/AO. enter meters. Indicate elevation • datum NGVD 1929 used p for the elevations NAVD 1988 • in items a) through h) below. Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 3.50 p the measurement feet • used. meters b) Top of the next higher floor 4.90 x feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A p feet ■ meters d) Attached garage (top of slab) 3.50 MI feet • meters e) Lowest elevation of machinery or equipment servicing the building 5.00 (Describe type of equipment and location in Comments) x feet ■meters f) Lowest adjacent (finished) grade next to building (LAG) 3.40 x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 3.50 p feet ■ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A 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 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 the data available. 1001. Yes ❑ No to I understand • certify elevation information. that any false Check here if attachments. Certifiers Name License Number Edward D. Murphy #5333 Place Seal Title Professional Land Surveyor Company Name Murphy's Land Surveying, Inc Address 5760 11th Avenue N. City St. Petersburg State ZIP Code Florida 33710 Signature�,I ■ Date Telephone Ext. 11-08-2017 (727)347-8740 Copy all pages of this Elevation Certificate and al -ttach - is for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment _ -d location, per C - , if applicable) C2e = A/C FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 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. 1004 Bruce Avenue Policy Number. City State ZIP Code Clearwater Beach 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. / ' , t • ,!t � . �' f ...-4_ .4 -:'ice l _ �_ Photo One Photo One Caption FRONT VIEW Clear Photo One - _ - _ .. .. 4. • li • T,-- --C,: aS .. Photo Two Photo Two Caption REAR VIEW Clear Photo Two FEMA Form 086-0-33 (7/15) Replaces at previous editions. Form Page 5 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS Continuation Page 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. 1004 Bruce Avenue Policy Number. City State ZIP Code Clearwater Beach 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. \ 1 Photo Three Photo Three Caption SIDE VIEW Clear Photo Three T _ � Photo Four Photo Four Caption SIDE VIEW Clear Photo Four FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6