821 MANDALAY AVE•
ELEVATION CERTIFICATE
IMP6RTANT: 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 B
821 MANDALAY AVENUE
City
CLEARWATER
State
Florida
ZIP Code
33767
SECTION C — BUILDING ELEVATION INFORMATION (SI
C1. Building elevations are based on: ❑ Construction Drawings* N Building Unc
*A new Elevation Certificate will be required when construction of the building is cor
C2. Elevations — Zones A1—A30, AE, AH, A (with BFE), VE, V1—V30, V (with BFE), AR,
Complete Items C2.a—h below according to the building diagram specified in Item
Benchmark Utilized: CITY OF CLEARWATER 1-2 Vertical Datum: ELEV. 4.87' NAVD 1988
gso-ago- /'90
821 MANDALAY AVE
BCP2017-06458
ELEVATION CERTIFICATE
JAMES E DEES
Zoning: Low Medium Density Atlas #: 249
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.
a) Top of bottom floor (including basement, crawlspace, or enclosure floor)
b) Top of the next higher floor
c) Bottom of the lowest horizontal structural member (V Zones only)
d) Attached garage (top of slab)
e) Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG)
g) Highest adjacent (finished) grade next to building (HAG)
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
structural support
Check the measurement used.
6.20 x❑ feet ❑ meters
17.35 ❑x feet ❑ meters
N/A ❑ feet ❑ meters
6.20 ❑x feet ❑ meters
N/A ❑x feet ❑ meters
4.50 ❑x feet ❑ meters
5.20 x❑ feet ❑ meters
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 authorized by law to certify elevation information.
I certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false
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? ❑x Yes ❑ No ❑ Check here if attachments.
Certifier's Name License Number
GUY D. HALE 4626
Title
PROF. LAND SURVEYOR
Company Name
GUY HALE, LAND SURVEYING
Address
406 SO. ARCTURAS AVENUE, SUITE ONE
City
CLEARWATER
Signature
State
Florida
Date
01-10-2018
ZIP Code
33765
Telephone
(727) 734-4266
Ext.
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)
THE FLOOD VENTS HAVE NOT BEEN INSTALLED YET. BUILDING UNDER CONSTRUICTION.
FEMA Form 086-0-33 (7/15)
Replaces all previous editions. Form Page 2 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 30,4018
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
CATHY AND JAMES DEES
Policy Number:
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Box No.
821 MANDALAY AVENUE
Company NAIC Number:
City State ZIP Code
CLEARWATER Florida 33767
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 5 AND 6 AND NO. 56 FT. LOT 7, BLOCK 16, MANDALAY SUB., PLAT BOOK 14, PAGE 32, PINELLAS COUNTY, FLORIDA.
A4. Building Use (e.g.,
A5. Latitude/Longitude:
A6. Attach at least
A7. Building Diagram
A8. For a building with
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. 27°59'39.0" Long.82°49'36.6"
RESIDENTIAL
Horizontal
Datum:
insurance.
above
❑ NAD 1927
adjacent grade
grade 0
x NAD 1983
2 photographs of the building if the
Number 6
Certificate is being used to obtain flood
367.00 sq ft
0
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)
0.00 sq in
within 1.0 foot
foot above adjacent
in
1387.00 sq ft
❑ Yes x No
garage:
garage
openings in the attached garage within 1.0
in A9.b 0.00 sq
❑ Yes x No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
CITY OF CLEARWATER/125096
B2. County Name
PINELLAS
B3. State
Florida
B4. Map/Panel
Number
12103C0102
B5. Suffix
G
B6. FIRM Index
Date
08-18-2009
B7. FIRM Panel
Effective/
Revised Date
09-03-2003
B8. Flood
Zone(s)
AE
B9. tood AO, use evation(s)
Flood Depth)
(Zonep )
11
B10. Indicate the source
❑ FIS Profile
B11. Indicate elevation
B12. Is the building
Designation
of the
Base Flood Elevation
❑ Community Determined
for BFE in Item 69:
Coastal Barrier Resources
❑
(BFE) data or base flood
❑ Other/Source:
❑ NGVD 1929
System (CBRS)
CBRS ❑ OPA
depth entered in Item B9:
x FIRM
datum used
located in a
Date:
❑ Other/Source:
Protected Area (OPA)?
x NAVD 1988
area or Otherwise
❑ Yes x No
FEMA Form 086-0-33 (7/15)
Replaces all previous editions.
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.
821 MANDALAY AVENUE
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.
Photo One
Photo One Caption FRONT (WEST SIDE) TAKEN 01/10/2018 Clear Photo One
Photo Two
Photo Two Caption REAR (EAST SIDE) TAKEN 01/10/2018 Clear Photo Two
FEMA Form 086-0-33 (7/15)
Replaces all previous editions. Form Page 5 of 6