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49 KIPLING PLAZAgcPZo/7- /Z 5"9G 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 Owner's Name CHARLES & VICKI PHANEUF Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 49 KIPLING PLAZA Company NAIC Number: City State ZIP Code CLEARWATER FLORIDA 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOTS 1 - 4, BLOCK 43, MANDALAY SUBDIVISION - PARCEL # 05-29-15-54666-043-0010 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, Lat. 27.9973° Long. Accessory, etc.) RESIDENTIAL -82.8253° Horizontal Datum: ❑ obtain flood insurance. 1.0 foot above adjacent above adjacent grade NAD 1927 grade x NAD 1983 16 2 photographs of the building if the Number 7 Certificate is being used to 1,924 sq ft 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 *SEE NOTES sq or enclosure(s) within in sq ft within 1.0 foot sq in N/A x Yes ❑ No garage: garage N/A openings in the attached garage in A9.b N/A ❑ 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 COUNTY B3. State FLORIDA B4. Map/Panel Number 12103C0102 B5. Suffix G B6. FIRM Index Date 8-18-2009 B7. FIRM Panel Effective/ Revised Date 9-3-2003 B8. Flood Zone(s) AE B9. Base Flood Elevation(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 (BFE) ❑ Community Determined for BFE in Item B9: Coastal Barrier Resources ❑ CBRS data ❑ NGVD System or base flood depth entered in Item B9: ❑ Other/Source: x FIRM datum used located in a N/A 1988 ❑ Other/Source: or Otherwise Protected 1929 x NAVD (CBRS) area ❑ OPA Area (OPA)? ❑ Yes x No FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 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. 49 KIPLING PLAZA Policy Number: City State ZIP Code CLEARWATER FLORIDA 33767 Company NAIC Number SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. 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 A1—A30, AE, AH, A (with BFE), VE, V1—V30, V (with BFE), AR, AR/A, AR/AE, AR/A1—A30, Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, Benchmark Utilized: CITY OF CLEARWATER BM J-03 Vertical Datum: N.A.V.D. 1988 x Finished Construction AR/AH, AR/A0. enter meters. Indicate elevation datum ❑ NGVD 1929 used x 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 a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 5.16 x the measurement used. feet ❑ meters b) Top of the next higher floor 15.48 x feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet ❑ meters d) Attached garage (top of slab) N/A ❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 11.82 x feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 4.4 x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 4.8 x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 4.7 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 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? X authorized by law the data available. 1001. Yes ❑ No to I understand x certify elevation information. that any false Check here if attachments. Certifier's Name License Number GEORGE A. SHIMP II 2512 , . ' , PieCQ4'' ,, -Y'V, ' . seat to #2512'•ae: 2'5-2}20 Title Job Number PRESIDENT 190003-A Company Name GEORGE A. SHIMP II & ASSOCIATES, INC. Address 3301 DeSOTO BOULEVARD, SUITE D City State ZIP Code PALM HARBOR FLORIDA 34683 (Not valid unless embossed with surveyor's original raised seal) Signatur ,digerj; Date Telephone 2-25-2020 727-784-5496 Copy 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) SEE ATTACHMENT PAGES 1 AND 2 FOR SURVEYOR'S NOTES AND COMMENTS. THIS DOCUMENT IS NOT VALID UNLESS SIGNED AND EMBOSSED WITH THE SURVEYOR'S ORIGINAL RAISED SEAL AND MUST CONTAIN ALL FORM PAGES AND ATTACHMENTS. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 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. 49 KIPLING PLAZA 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 certify 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 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 " REI. Lk am* WATER V ttachments. 49 KIPLING PLZ BCP2017-12659C ELEVATION CERTli CHARLES A PHANEUF Zoning: Low Medium Density Atlas #: 249A FEMA Form 086-0-33 (7/15) rs peaces all previous editions. Form Page 3 o 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. 49 KIPLING PLAZA 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 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. G1. ❑ 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 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 community floodplain management purposes. 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. FEMA 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. 49 KIPLING PLAZA 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. i ,aF `J AO Photo One NIVIN ill O Photo One Caption FRONT VIEW 2-25-2020 r ' (, , I 4.40,0 t a � "�. 3: .r • `i. 1 _ nib j Photo Two Photo Two Caption REAR VIEW 2-25-2020 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. 49 KIPLING PLAZA Policy Number: City State ZIP Code CLEARWATER 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 Photo Three Caption N/A N/A Photo Two Photo Two Photo Four Caption N/A N/A FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6 Surveyor's Notes Attachment Page 1 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. 49 KIPLING PLAZA Policy Number: City State ZIP Code CLEARWATER FLORIDA 33767 Company NAIC Number SECTION D — SURVEYOR'S CERTIFICATION (CONTINUED FROM PAGE 2) Al.) THIS ELEVATION CERTIFICATE, UNDER CONTRACT, WAS EXCLUSIVELY PREPARED FOR AND CERTIFIED TO THE PARTY SPECIFIED IN SECTION A, ITEM 1, FOR THE SPECIFIC PURPOSE OF OBTAINING FLOOD INSURANCE AND/OR VERIFYING FLOOD ZONE COMPLIANCE WITH THE LOCAL GOVERNING AUTHORITY. USE OF THIS DOCUMENT BY ANY OTHER PARTY OR FOR ANY OTHER PURPOSES SHALL BE AT THAT PARTY'S SOLE RISK AND GEORGE A. SHIMP II & ASSOCIATES, INC. ASSUMES NO LIABILITY AND DOES NOT PROVIDE ANY WARRANTY TO SAID PARTY. GEORGE A. SHIMP II & ASSOCIATES, INC. ASSUMES NO LIABILITY AND DOES NOT PROVIDE ANY WARRANTY FOR UNAUTHORIZED COPIES, IN ANY FORM OR BY ANY MEANS, INCLUDING PHOTOCOPYING OR OTHER ELECTRONIC OR MECHANICAL METHODS, AND USE OF SAID COPIES SHALL BE AT THE USER'S SOLE RISK. REQUESTS FOR ANY ADDITIONAL OFFICIAL SIGNED AND SEALED COPIES MUST BE DIRECTED TO GEORGE A. SHIMP II & ASSOCIATES, INC. A4.) THE BUILDING USE WAS DETERMINED BY PHYSICAL OBSERVATIONS MADE ON THE DATE OF SURVEY. A5.) THE LATITUDE AND LONGITUDE COORDINATES WERE OBTAINED USING A HAND HELD G.P.S. UNIT WHICH MEETS OR EXCEEDS FEMA'S REQUIRED ACCURACY OF 66 FEET. A7.) THE BUILDING DIAGRAM NUMBER WAS DETERMINED BY PHYSICAL OBSERVATIONS MADE ON THE DATE OF SURVEY. CERTAIN STRUCTURAL FEATURES NOT VISIBLE TO THE SURVEYOR (PILINGS, GRADE BEAMS, ETC.) OR USE OF ANY AREAS BELOW THE BASE FLOOD ELEVATION THAT DOES NOT COMPLY WITH FEMA REGULATIONS CAN AFFECT THIS DETERMINATION. A8.) FOR THE PURPOSE OF THIS DOCUMENT, A BUILDING ENCLOSURE IS DEFINED AS THAT PORTION OF AN ELEVATED BUILDING, BELOW THE LOWEST ELEVATED FLOOR, THAT IS EITHER PARTIALLY OR FULLY SHUT IN BY RIGID WALLS. A GARAGE BELOW OR ATTACHED TO AN ELEVATED BUILDING IS CONSIDERED AN ENCLOSURE. SUCH AREAS SHALL NOT CONTAIN MORE THAN 20 LINEAR FEET OF FINISHED INTERIOR WALLS (PANELING, ETC.) OR IT WILL BE CONSIDERED A FINISHED (HABITABLE) AREA. A8. & A9.) FOR THE PURPOSE OF THIS DOCUMENT, A FLOOD OPENING IS DEFINED AS A PERMANENT OPENING IN AN EXTERIOR WALL THAT IS NO HIGHER THAN 1.0 FOOT ABOVE THE HIGHER OF THE EXTERIOR OR INTERIOR GRADE OR FLOOR IMMEDIATELY BELOW THE OPENING. IN REGARD TO ENGINEERED FLOOD OPENING(S), IF APPLICABLE, THE SURVEYOR DOES NOT KEEP COPIES OF EITHER THE INDIVIDUAL ENGINEERED FLOOD OPENINGS CERTIFICATION OR THE EVALUATION REPORT ISSUED BY THE INTERNATIONAL CODE COUNCIL EVALUATION SERVICE (ICC ES) ON FILE. CURRENT COPIES OF THESE DOCUMENTS SHOULD BE AVAILABLE FROM THE MANUFACTURER OF THE ENGINEERED FLOOD OPENING(S). B8.) UNLESS OTHERWISE NOTED IN SECTION B, ITEM 10, THE FLOOD ZONE WAS DETERMINED BASED ON THE FLOOD INSURANCE RATE MAP. IN CERTAIN CASES WHERE AN ACCURATE DETERMINATION COULD NOT BE MADE FROM THE MAP, FEMA'S INTERACTIVE MAP OR THE COUNTY'S G.I.S. OVERLAY MAY HAVE BEEN UTILIZED TO DETERMINE THE FLOOD ZONE. NO SEARCH OF THE PUBLIC RECORDS WAS PERFORMED FOR LOMA'S, LOMR'S, ETC. WHICH MAY AFFECT THE SITE. B9.) IF APPLICABLE, WHEN THE BASE FLOOD ELEVATION IS SHOWN ASA WHOLE NUMBER ON THE FIRM, IT HAS BEEN CONVERTED TO A DECIMAL AND ENTERED TO THE NEAREST TENTH OF A FOOT AS REQUIRED BY FEMA. IF APPLICABLE, THE STRUCTURE CONTAINS: ❑ CRAWLSPACE ❑p ENCLOSURE ❑ ATTACHED GARAGE ❑ N/A IF APPLICABLE, THE BOTTOM FLOOR ENCLOSURE CONTAINS: GARAGE & STORAGE AREA IF APPLICABLE, DOES THE BOTTOM FLOOR ENCLOSURE APPEAR TO CONTAIN BREAK -AWAY WALLS? ❑ YES ❑p NO 0 N/A IF APPLICABLE, THIS ELEVATION CERTIFICATE WAS PREPARED USING THE "HISTORIC" FLOOD MAP DATA AND DATUM (N.G.V.D. 1929) FOR POSSIBLE "GRANDFATHERING" PURPOSES: 0 YES ❑X NO Attachment Page 1 of 2 Surveyor's Notes Attachment Page 2 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. 49 KIPLING PLAZA Policy Number: City State ZIP Code CLEARWATER FLORIDA 33767 Company NAIC Number SECTION D — SURVEYOR'S CERTIFICATION (CONTINUED FROM PAGE 7) IN REGARD TO ENGINEERED FLOOD OPENINGS, AS REFERENCED IN SECTIONS A8 AND A9 IF APPLICABLE, THE STRUCTURE'S: ❑ CRAWLSPACE CONTAINS N/A ENGINEERED FLOOD OPENING(S) CERTIFIED TO COVER N/A SQ. FEET PER OPENING (MANUFACTURER: N/A — MODEL: N/A ) FOR A TOTAL OF N/A SQ. FEET OF COVERAGE AND N/A NON -ENGINEERED FLOOD OPENING(S) WITH A NET AREA OF N/A SQ. INCHES, PROVIDING COVERAGE FOR A TOTAL OF N/A SQ. FEET. ENGINEERED FLOOD OPENING(S) ARE: ❑INSTALLED ❑UNDER CONSTRUCTION ❑ PER PLAN 0 N/A NOTES: N/A Q ENCLOSURE CONTAINS 16 ENGINEERED FLOOD OPENING(S) CERTIFIED TO COVER 200 SQ. FEET PER OPENING (MANUFACTURER: SMART VENT — MODEL: 1540-510 ) FOR A TOTAL OF 3,200 SQ. FEET OF COVERAGE AND 1 NON -ENGINEERED FLOOD OPENING(S) WITH A NET AREA OF 128 SQ. INCHES, PROVIDING COVERAGE FOR A TOTAL OF 3,328 SQ. FEET. ENGINEERED FLOOD OPENING(S) ARE: 0 INSTALLED ❑ UNDER CONSTRUCTION OPER PLAN 0 N/A NOTES: ENGINEERED FLOOD OPENING(S) ARE 8" x 16" AND CONTAIN A TOTAL PHYSICAL NET AREA OF 2,048 SQ. INCHES ❑ ATTACHED GARAGE CONTAINS N/A ENGINEERED FLOOD OPENING(S) CERTIFIED TO COVER N/A SQ. FEET PER OPENING (MANUFACTURER: N/A — MODEL: N/A ) FORA TOTAL OF N/A SQ. FEET OF COVERAGE AND N/A NON -ENGINEERED FLOOD OPENING(S) WITH A NET AREA OF N/A SQ. INCHES, PROVIDING COVERAGE FOR A TOTAL OF N/A SQ. FEET. ENGINEERED FLOOD OPENING(S) ARE: ❑INSTALLED ❑UNDER CONSTRUCTION ❑ PER PLAN ❑x N/A NOTES: N/A C2.e) AIR CONDITIONER IS INSTALLED ON AN ELEVATED WOODEN DECK. A8.b) THE ENCLOSURE CONTAINS 16 TOTAL ENGINEERED FLOOD VENTS, SEE ABOVE NOTES FOR DIMENSIONS, TYPES & COVERAGE. 6 OF THE 16 ENGINEERED FLOOD VENTS ARE NOT RECONIZED BY FEMA TO ALLOW WATER TO EXIT THE ENCLOSURE. THESE ARE FROM INTERIOR WALLS TO INTERIOR AREAS. NOTICE: THIS DOCUMENT SHALL NOT BE VALID OR BINDING AGAINST THE SIGNING SURVEYOR UNLESS IT IS SIGNED AND EMBOSSED WITH THE ORIGINAL RAISED SEAL OF THE FLORIDA LICENSED SURVEYOR AND MAPPER. Attachment Page 2 of 2 r I U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE ELEVATION CERTIFICI GUS S AFENDOULIS Zoning: Low Medium Density Important: Follow the instructions on pages 1• 49 KIPLING PLZ BCP2017-12659A Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) it Atlas #: 249A SECTION A — PROPERTY INFORMATION RECEIVED BY: M.J. MAY 0 2 2019 & DEVELOPMENT OF CLEARWATER Al. Building Owner's Name CHARLES & VICKI PHANEUF A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route a Box No. 49 KIPLING PLAZA City State PLANNING CLEARWATER FLORIDA CITY A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Descriptior LOTS 1 - 4, BLOCK 43, MANDALAY SUBDIVISION - PARCEL # 05-29-15-54666-043-0010 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, Lat. 27.9973° N. Long. Accessory, etc.) RESIDENTIAL 82.8253° W. Horizontal Datum: obtain flood insurance. 1.0 foot above adjacent above adjacent grade ❑ NAD 1927 grade x NAD 1983 - 10 2 photographs of the building if the Number 7 Certificate is being used to 1,924 sq ft 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 *SEE NOTES sq or enclosure(s) within in sq ft within 1.0 foot sq in N/A x Yes ❑ No garage: garage N/A. openings in the attached garage in A9.b N/A ❑ 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 COUNTY B3. State FLORIDA B4. Map/Panel Number 12103C0102 B5. Suffix G B6. FIRM Index Date 8-18-2009 B7. FIRM Panel Effective/ Revised Date 9-3-2003 B8. Flood Zone(s) AE B9. Base Flood Elevation(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 (BFE) ❑ Community Determined for BFE in Item B9: Coastal Barrier Resources ❑ CBRS data ❑ NGVD System or base flood depth entered in Item B9: ❑ Other/Source: x FIRM datum used located in a N/A 1988 ❑ Other/Source: or Otherwise Protected Area (OPA)? 1929 x NAVD (CBRS) area ❑ OPA ❑ Yes x No 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. 49 KIPLING PLAZA Policy Number: City State ZIP Code CLEARWATER FLORIDA 33767 Company NAIC Number SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. 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: CITY OF CLEARWATER BM J-03 x building (with Vertical Building Under Construction* ❑ Finished Construction is complete. BFE), AR, AR/A, AR/AE, AR/A1—A30, AR/AH, AR/A0. in Item A7. In Puerto Rico only, enter meters. Datum: N.A.V.D. 1988 Indicate elevation datum ❑ NGVD 1929 used x 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 a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 5.10 x the measurement used. feet ❑ meters b) of the next higher floor 15.48 x feet ❑ meters .Top c) Bottom of the lowest horizontal structural member (V Zones only) N/A x feet ❑ meters d) Attached garage (top of slab) N/A x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building NSA x feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 4.0 x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 4.7 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 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? x authorized by law the data available. 1001. Yes ❑ No to I understand x certify elevation information. that any false Check here if attachments. Certifier's Name License Number GEORGE A. SHIMP III 6137 ,;_: r.a A s `J 0 AP ': `� No. c : Jt #.6137 -D • : ; ,_ 5/,, t40 .: , 8137 _` lite;,`. . ',-15=2019 Title Job Number VICE PRESIDENT 190003 Company Name GEORGE A. SHIMP II &ASSOCIATES, INC. Address 3301 DeSOTO BOULEVARD, SUITE D City State ZIP Code PALM HARBOR FLORIDA 34683 e (Not valid unless embossed with surveyor's original raised seal) S' ture Date Telephone 4 ' 2IE 1-15-2019 727-784-5496 Copy all p ges of this Ele ation 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) SEE ATTACHMENT PAGES 7 AND 8 FOR SURVEYOR'S NOTES AND COMMENTS. THIS DOCUMENT IS NOT VALID UNLESS SIGNED AND EMBOSSED WITH THE SURVEYOR'S ORIGINAL RAISED SEAL AND MUST CONTAIN ALL 8 PAGES. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 8 1 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. 49 KIPLING PLAZA 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, B,and 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 certify 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 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 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. 49 KIPLING PLAZA 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 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. G1. ❑ 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 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 community floodplain management purposes. 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: ❑ feet ❑ feet ❑ feet meters Datum New Construction • Substantial Improvement basement) 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. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 8 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. 49 KIPLING PLAZA 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. • Ea AV Bill' t ij 1; fps, N z ' 41't: a Photo One Photo One Caption FRONT VIEW 1-15-2019 Photo Two Photo Two Photo Two Caption N/A 1-15-2019 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 8 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. 49 KIPLING PLAZA Policy Number: City State ZIP Code CLEARWATER 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. }i '/i 1 Airi prim. • in r. 1 - Photo One . 4£b # Photo Three Caption REAR VIEW 1 1-15-2019 014 1 1.0,1. 5 1.: j.� I h �,. t % _ � . ~ pin r's• Photo Two Photo Four Caption REAR VIEW 2 1-15-2019 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 8 ELEVATION CERTIFICATE Surveyor's Notes Attachment Page 7 OMB No. 1660-0008 Expiration Date: November 30, 2018 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. 49 KIPLING PLAZA FOR INSURANCE COMPANY USE Policy Number: City State CLEARWATER FLORIDA ZIP Code 33767 Company NAIC Number SECTION D — SURVEYOR'S CERTIFICATION (CONTINUED FROM PAGE 2) A1.) THIS ELEVATION CERTIFICATE WAS EXCLUSIVELY PREPARED FOR AND CERTIFIED TO THE PARTY SPECIFIED IN SECTION A, ITEM 1, FOR THE SPECIFIC PURPOSE OF OBTAINING FLOOD INSURANCE AND/OR VERIFYING FLOOD ZONE COMPLIANCE WITH THE LOCAL GOVERNING AUTHORITY. USE OF THIS DOCUMENT BY ANY OTHER PARTY OR FOR ANY OTHER PURPOSES IS STRICTLY PROHIBITED AND SHALL RENDER THIS DOCUMENT INVALID FOR THOSE PURPOSES. THIS DOCUMENT SHALL NOT BE VALID OR BINDING AGAINST THE SIGNING SURVEYOR UNLESS IT IS SIGNED AND EMBOSSED WITH THE ORIGINAL RAISED SEAL OF THE FLORIDA LICENSED SURVEYOR AND MAPPER. UNAUTHORIZED COPIES IN ANY FORM OR BY ANY MEANS, INCLUDING PHOTOCOPYING OR OTHER ELECTRONIC OR MECHANICAL METHODS, ARE STRICTLY PROHIBITED, SHALL NOT BE CONSIDERED AS SIGNED AND SEALED AND SHALL NOT BE VALID. REQUESTS FOR ANY ADDITIONAL OFFICIAL SIGNED AND SEALED COPIES MUST BE DIRECTED TO GEORGE A. SHIMP II & ASSOCIATES, INC. A4.) THE BUILDING USE WAS DETERMINED BY PHYSICAL OBSERVATIONS MADE ON THE DATE OF SURVEY. A5.) THE LATITUDE AND LONGITUDE COORDINATES WERE OBTAINED USING A HAND HELD G.P.S. UNIT WHICH MEETS OR EXCEEDS FEMA'S REQUIRED ACCURACY OF 66 FEET. A7.) THE BUILDING DIAGRAM NUMBER WAS DETERMINED BY PHYSICAL OBSERVATIONS MADE ON THE DATE OF SURVEY. CERTAIN STRUCTURAL FEATURES NOT VISIBLE TO THE SURVEYOR (PILINGS, GRADE BEAMS, ETC.) OR USE OF ANY AREAS BELOW THE BASE FLOOD ELEVATION THAT DOES NOT COMPLY WITH FEMA REGULATIONS CAN AFFECT THIS DETERMINATION. A8.) FOR THE PURPOSE OF THIS DOCUMENT, A BUILDING ENCLOSURE IS DEFINED AS THAT PORTION OF AN ELEVATED BUILDING, BELOW THE LOWEST ELEVATED FLOOR, THAT IS EITHER PARTIALLY OR FULLY SHUT IN BY RIGID WALLS. A GARAGE BELOW OR ATTACHED TO AN ELEVATED BUILDING IS CONSIDERED AN ENCLOSURE. SUCH AREAS SHALL NOT CONTAIN MORE THAN 20 LINEAR FEET OF FINISHED INTERIOR WALLS (PANELING, ETC.) OR IT WILL BE CONSIDERED A FINISHED (HABITABLE) AREA. A8. & A9.) FOR THE PURPOSE OF THIS DOCUMENT, A FLOOD OPENING IS DEFINED AS A PERMANENT OPENING IN AN EXTERIOR WALL THAT IS NO HIGHER THAN 1.0 FOOT ABOVE THE HIGHER OF THE EXTERIOR OR INTERIOR GRADE OR FLOOR IMMEDIATELY BELOW THE OPENING. IN REGARD TO ENGINEERED FLOOD OPENING(S), IF APPLICABLE, THE SURVEYOR DOES NOT KEEP COPIES OF EITHER THE INDIVIDUAL ENGINEERED FLOOD OPENINGS CERTIFICATION OR THE EVALUATION REPORT ISSUED BY THE INTERNATIONAL CODE COUNCIL EVALUATION SERVICE (ICC ES) ON FILE. CURRENT COPIES OF THESE DOCUMENTS SHOULD BE AVAILABLE FROM THE MANUFACTURER OF THE ENGINEERED FLOOD OPENING(S). B8.) UNLESS OTHERWISE NOTED IN SECTION B, ITEM 10, THE FLOOD ZONE WAS DETERMINED BASED ON THE FLOOD INSURANCE RATE MAP. IN CERTAIN CASES WHERE AN ACCURATE DETERMINATION COULD NOT BE MADE FROM THE MAP, FEMA'S INTERACTIVE MAP OR THE COUNTY'S G.I.S. OVERLAY MAY HAVE BEEN UTILIZED TO DETERMINE THE FLOOD ZONE. NO SEARCH OF THE PUBLIC RECORDS WAS PERFORMED FOR LOMA'S, LOMR'S, ETC. WHICH MAY AFFECT THE SITE. B9.) IF APPLICABLE, WHEN THE BASE FLOOD ELEVATION IS SHOWN AS A WHOLE NUMBER ON THE FIRM, IT HAS BEEN CONVERTED TO A DECIMAL AND ENTERED TO THE NEAREST TENTH OF A FOOT AS REQUIRED BY FEMA. IF APPLICABLE, THE STRUCTURE CONTAINS: ❑ CRAWLSPACE 0 ENCLOSURE ❑ ATTACHED GARAGE ❑ N/A IF APPLICABLE, THE BOTTOM FLOOR ENCLOSURE CONTAINS: GARAGE & STORAGE AREA IF APPLICABLE, DOES THE BOTTOM FLOOR ENCLOSURE APPEAR TO CONTAIN BREAK -AWAY WALLS? ❑ YES 0 NO ❑ N/A IF APPLICABLE, THIS ELEVATION CERTIFICATE WAS PREPARED USING THE "HISTORIC" FLOOD MAP DATA AND DATUM (N.G.V.D. 1929) FOR POSSIBLE "GRANDFATHERING" PURPOSES: ❑ YES 0 NO Attachment Page 7 of 8 ELEVATION CERTIFICATE Surveyor's Notes Attachment Page 8 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. 49 KIPLING PLAZA Policy Number: City State ZIP Code CLEARWATER FLORIDA 33767 Company NAIC Number SECTION D — SURVEYOR'S CERTIFICATION (CONTINUED FROM PAGE 7) IN REGARD TO ENGINEERED FLOOD OPENINGS, AS REFERENCED IN SECTIONS A8 AND A9 IF APPLICABLE, THE STRUCTURE'S: 0 CRAWLSPACE CONTAINS N/A ENGINEERED FLOOD OPENING(S) CERTIFIED TO COVER N/A SQ. FEET PER OPENING (MANUFACTURER: N/A — MODEL: N/A ) FOR A TOTAL OF N/A SQ. FEET OF COVERAGE AND N/A NON -ENGINEERED FLOOD OPENING(S) WITH A NET AREA OF N/A SQ. INCHES, PROVIDING COVERAGE FOR A TOTAL OF N/A SQ. FEET. ENGINEERED FLOOD OPENING(S) ARE: ❑INSTALLED ❑UNDER CONSTRUCTION ❑ PER PLAN El N/A NOTES: N/A Q ENCLOSURE CONTAINS 9 ENGINEERED FLOOD OPENING(S) CERTIFIED TO COVER 200 SQ. FEET PER OPENING (MANUFACTURER: SMART VENT — MODEL: 1540-570 ) FORA TOTAL OF 1,800 SQ. FEET OF COVERAGE AND 1 NON -ENGINEERED FLOOD OPENING(S) WITH A NET AREA OF 128 SQ. INCHES, PROVIDING COVERAGE FOR A TOTAL OF 1,928 SQ. FEET. ENGINEERED FLOOD OPENING(S) ARE: 0 INSTALLED 3I UNDER CONSTRUCTION OPER PLAN 0 N/A NOTES: ENGINEERED FLOOD OPENING(S) ARE 8" x 16" AND CONTAIN A TOTAL PHYSICAL NET AREA OF 1,152 SQ. INCHES O ATTACHED GARAGE CONTAINS N/A ENGINEERED FLOOD OPENING(S) CERTIFIED TO COVER N/A SQ. FEET PER OPENING (MANUFACTURER: N/A — MODEL: N/A ) FOR A TOTAL OF N/A SQ. FEET OF COVERAGE AND N/A NON -ENGINEERED FLOOD OPENING(S) WITH A NET AREA OF N/A SQ. INCHES, PROVIDING COVERAGE FOR A TOTAL OF N/A SQ. FEET. ENGINEERED FLOOD OPENING(S) ARE: ❑INSTALLED DUNDER CONSTRUCTION ❑ PER PLAN EIN/A NOTES: N/A C2.e) NO MACHINERY AND/OR EQUIPMENT HAS BEEN INSTALLED. Attachment Page 8 of 8 ELEVATION CERTIFICATE Surveyor's Notes Attachment Page 7 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. 49 KIPLING PLAZA Policy Number: City State ZIP Code CLEARWATER FLORIDA 33767 Company NAIC Number SECTION D — SURVEYOR'S CERTIFICATION (CONTINUED FROM PAGE 2) Al.) THIS ELEVATION CERTIFICATE WAS EXCLUSIVELY PREPARED FOR AND CERTIFIED TO THE PARTY SPECIFIED IN SECTION A, ITEM 1, FOR THE SPECIFIC PURPOSE OF OBTAINING FLOOD INSURANCE AND/OR VERIFYING FLOOD ZONE COMPLIANCE WITH THE LOCAL GOVERNING AUTHORITY. USE OF THIS DOCUMENT BY ANY OTHER PARTY OR FOR ANY OTHER PURPOSES IS STRICTLY PROHIBITED AND SHALL RENDER THIS DOCUMENT INVALID FOR THOSE PURPOSES. THIS DOCUMENT SHALL NOT BE VALID OR BINDING AGAINST THE SIGNING SURVEYOR UNLESS IT IS SIGNED AND EMBOSSED WITH THE ORIGINAL RAISED SEAL OF THE FLORIDA LICENSED SURVEYOR AND MAPPER. UNAUTHORIZED COPIES IN ANY FORM OR BY ANY MEANS, INCLUDING PHOTOCOPYING OR OTHER ELECTRONIC OR MECHANICAL METHODS, ARE STRICTLY PROHIBITED, SHALL NOT BE CONSIDERED AS SIGNED AND SEALED AND SHALL NOT BE VALID. REQUESTS FOR ANY ADDITIONAL OFFICIAL SIGNED AND SEALED COPIES MUST BE DIRECTED TO GEORGE A. SHIMP II & ASSOCIATES, INC. A4.) THE BUILDING USE WAS DETERMINED BY PHYSICAL OBSERVATIONS MADE ON THE DATE OF SURVEY. A5.) THE LATITUDE AND LONGITUDE COORDINATES WERE OBTAINED USING A HAND HELD G.P.S. UNIT WHICH MEETS OR EXCEEDS FEMA'S REQUIRED ACCURACY OF 66 FEET. A7.) THE BUILDING DIAGRAM NUMBER WAS DETERMINED BY PHYSICAL OBSERVATIONS MADE ON THE DATE OF SURVEY. CERTAIN STRUCTURAL FEATURES NOT VISIBLE TO THE SURVEYOR (PILINGS, GRADE BEAMS, ETC.) OR USE OF ANY AREAS BELOW THE BASE FLOOD ELEVATION THAT DOES NOT COMPLY WITH FEMA REGULATIONS CAN AFFECT THIS DETERMINATION. A8.) FOR THE PURPOSE OF THIS DOCUMENT, A BUILDING ENCLOSURE IS DEFINED AS THAT PORTION OF AN ELEVATED BUILDING, BELOW THE LOWEST ELEVATED FLOOR, THAT IS EITHER PARTIALLY OR FULLY SHUT IN BY RIGID WALLS. A GARAGE BELOW OR ATTACHED TO AN ELEVATED BUILDING IS CONSIDERED AN ENCLOSURE. SUCH AREAS SHALL NOT CONTAIN MORE THAN 20 LINEAR FEET OF FINISHED INTERIOR WALLS (PANELING, ETC.) OR IT WILL BE CONSIDERED A FINISHED (HABITABLE) AREA. A8. & A9.) FOR THE PURPOSE OF THIS DOCUMENT, A FLOOD OPENING IS DEFINED AS A PERMANENT OPENING IN AN EXTERIOR WALL THAT IS NO HIGHER THAN 1.0 FOOT ABOVE THE HIGHER OF THE EXTERIOR OR INTERIOR GRADE OR FLOOR IMMEDIATELY BELOW THE OPENING. IN REGARD TO ENGINEERED FLOOD OPENING(S), IF APPLICABLE, THE SURVEYOR DOES NOT KEEP COPIES OF EITHER THE INDIVIDUAL ENGINEERED FLOOD OPENINGS CERTIFICATION OR THE EVALUATION REPORT ISSUED BY THE INTERNATIONAL CODE COUNCIL EVALUATION SERVICE (ICC ES) ON FILE. CURRENT COPIES OF THESE DOCUMENTS SHOULD BE AVAILABLE FROM THE MANUFACTURER OF THE ENGINEERED FLOOD OPENING(S). B8.) UNLESS OTHERWISE NOTED IN SECTION B, ITEM 10, THE FLOOD ZONE WAS DETERMINED BASED ON THE FLOOD INSURANCE RATE MAP. IN CERTAIN CASES WHERE AN ACCURATE DETERMINATION COULD NOT BE MADE FROM THE MAP, FEMA'S INTERACTIVE MAP OR THE COUNTY'S G.I.S. OVERLAY MAY HAVE BEEN UTILIZED TO DETERMINE THE FLOOD ZONE. NO SEARCH OF THE PUBLIC RECORDS WAS PERFORMED FOR LOMA'S, LOMR'S, ETC. WHICH MAY AFFECT THE SITE. B9.) IF APPLICABLE, WHEN THE BASE FLOOD ELEVATION IS SHOWN AS A WHOLE NUMBER ON THE FIRM, IT HAS BEEN CONVERTED TO A DECIMAL AND ENTERED TO THE NEAREST TENTH OF A FOOT AS REQUIRED BY FEMA. IF APPLICABLE, THE STRUCTURE CONTAINS: 0 CRAWLSPACE I I ENCLOSURE 0 ATTACHED GARAGE 0 N/A IF APPLICABLE, THE BOTTOM FLOOR ENCLOSURE CONTAINS: GARAGE & STORAGE AREA IF APPLICABLE, DOES THE BOTTOM FLOOR ENCLOSURE APPEAR TO CONTAIN BREAK -AWAY WALLS? 0 YES ❑p NO 0 N/A IF APPLICABLE, THIS ELEVATION CERTIFICATE WAS PREPARED USING THE "HISTORIC" FLOOD MAP DATA AND DATUM (N.G.V.D. 1929) FOR POSSIBLE "GRANDFATHERING" PURPOSES: 0 YES I I NO Attachment Page 7 of 8 ELEVATION CERTIFICATE Surveyor's Notes Attachment Page 8 OMB No. 1660-0008 Expiration Date: November 30, 2018 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. 49 KIPLING PLAZA FOR INSURANCE COMPANY USE Policy Number: City State CLEARWATER FLORIDA ZIP Code 33767 Company NAIC Number SECTION D — SURVEYOR'S CERTIFICATION (CONTINUED FROM PAGE 7) IN REGARD TO ENGINEERED FLOOD OPENINGS, AS REFERENCED IN SECTIONS A8 AND A9 IF APPLICABLE, THE STRUCTURE'S: 0 CRAWLSPACE CONTAINS N/A ENGINEERED FLOOD OPENING(S) CERTIFIED TO COVER N/A SQ. FEET PER OPENING (MANUFACTURER: N/A — MODEL: N/A ) FOR A TOTAL OF WA SQ. FEET OF COVERAGE AND N/A NON -ENGINEERED FLOOD OPENING(S) WITH A NET AREA OF N/A SQ. INCHES, PROVIDING COVERAGE FOR A TOTAL OF N/A SQ. FEET. ENGINEERED FLOOD OPENING(S) ARE: ❑INSTALLED ❑UNDER CONSTRUCTION ❑ PER PLAN [ N/A NOTES: N/A Q ENCLOSURE CONTAINS 9 ENGINEERED FLOOD OPENING(S) CERTIFIED TO COVER 200 SQ. FEET PER OPENING (MANUFACTURER: SMART VENT — MODEL: 1540-570 ) FOR A TOTAL OF 1,800 SQ. FEET OF COVERAGE AND 1 NON -ENGINEERED FLOOD OPENING(S) WITH A NET AREA OF 128 SQ. INCHES, PROVIDING COVERAGE FOR A TOTAL OF 1,928 SQ. FEET. ENGINEERED FLOOD OPENING(S) ARE: 0 INSTALLED 0 UNDER CONSTRUCTION OPER PLAN 0 N/A NOTES: ENGINEERED FLOOD OPENING(S) ARE 8" x 16" AND CONTAIN A TOTAL PHYSICAL NET AREA OF 1,152 SQ. INCHES 0 ATTACHED GARAGE CONTAINS N/A ENGINEERED FLOOD OPENING(S) CERTIFIED TO COVER N/A SQ. FEET PER OPENING (MANUFACTURER: N/A — MODEL: N/A ) FOR A TOTAL OF N/A SQ. FEET OF COVERAGE AND N/A NON -ENGINEERED FLOOD OPENING(S) WITH A NET AREA OF N/A SQ. INCHES, PROVIDING COVERAGE FOR A TOTAL OF N/A SQ. FEET. ENGINEERED FLOOD OPENING(S) ARE: ❑INSTALLED ❑UNDER CONSTRUCTION 0 PER PLAN 0 N/A NOTES: N/A C2.e) NO MACHINERY AND/OR EQUIPMENT HAS BEEN INSTALLED. Attachment Page 8 of 8 U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL E'l}IERGENCY MANAGEMENT AGENCY National flood Insurance Program Important: Read the instructions on pages 1-9. ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION F Al Building Owner's Name MR & MS AFENDOULIS, MR & MS PI-IANEUF Pi A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 49 KIPLING PLAZA City CLEARWATER State FL ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) • 05-29-15-54666-043-0010 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) A5. Latitude/Longitude: Lat. 27°59'50.3" Long. 82°4911.1" Horizontal Datum: A6. Attach at least 2 photographs of the building if the Certificate is being used A7. Building Diagram Number 1A A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 0 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade Q c) Total net area of flood openings in A8.b 0 sq in d) Engineered flood openings? ❑ Yes ® No RESIDENTIAL ❑ NAD 1927 ® NAD 1983 to obtain flood insurance. A9. For a building with an attached garage: a) Square footage of attached garage 271 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? 0 Yes ® 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 B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12103C0102 G AUGUST 18, 2009 Effective/Revised Date Zone(s) AO, use base flood depth) SEPTEMBER 3, 2003 AE 11 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM ❑ Community Determined 0 Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 0 Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date: N/A 0 CBRS 0 OPA ❑ Yes ® No SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* 0 Building Under Construction* ® 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 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: CITY OF CLEARWATER, J-02 Vertical Datum: NAVD 88 Indicate elevation datum used for the elevations in items a) through h) below. 0 NGVD 1929 ® NAVD 1988 0 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 5.3 N/A. N/A. 4.0 4.9 3.8 4.9 4.8 Check the measurement used. ® feet ❑ feet ❑ feet ® feet ® feet ® feet ® feet ® feet ❑ meters ❑ meters ❑ meters ❑ meters ❑ meters ❑ meters ❑ meters ❑ 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. / 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. ® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a • 0 Check here if attachments. licensed land surveyor? ® Yes 0 No Certifier's Name DANIEL D. FERRANS License Number 3885 Title PROF LAND SURVEYOR Company Name POLARIS ASSOCIATES, INC. Address 2165 SUNNYDALE BLVD, STE D City CLEARWATER State FL ZIP Code 33765 Sign 1170:1W4'' :1 Date SEPTEMBER 17, 2015 Telephone 727-461-6113 7..a .6/5 FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. RECEIVED BY: T.V. DEC 2 8 2017 PLANNING & DEVELOPMENT CITY OF CLEARWATER 49 KIPLING PLZ BCP2017-12659 SFR CHARLES A PHANEUF Zoning: Low Medium Density Odd Atlas #: 249A ELEVATIQN CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the corresponding information from Section A. Build:ig Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 49 KIPLING PLAZA FOR INSURANCE COMPANY USE Policy Number. City CLEARWATER State FL ZIP Code 33767 Company NAIC Number: SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments 1. SURVEY MAP AND REPORT OR THE COPIES THEREOF ARE NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. ADDITIONS OR DELETIONS TO SURVEY MAPS OR REPORTS BY OTHER THAN THE SIGNING PARTY OR PARTIES IS PROHIBITED. 2. ITEM C2E DENOTES EQUIPMENT SERVICING THE BUILDING IS THE NC UNIT ON A CONC PAD. 3. POLARIS =4537-01 Signat Date SEPTEMBER 17, 2015 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, crawlspace, or enclosure) is 0 feet 0 meters 0 above or 0 below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is 0 feet ❑ meters ❑ above or 0 below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 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 0 feet 0 meters ❑ above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is 0 feet ❑ meters ❑ above or 0 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 0 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's or Owners Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments 0 Check here if attachments. 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. G1. 0 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. 0 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 community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: 0 New Construction 0 Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: G9. BFE or (in Zone AO) depth of flooding at the building site: ' G10. Community's design flood elevation: ❑ feet ❑ meters Datum ❑ feet ❑ meters Datum ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 Building Photographs 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. 49 KIPLING PLAZA City CLEARWATER State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Policy Number: 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. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 Building Photographs Continuation Page IMFSORTANT: 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. 49 KIPLING PLAZA City CLEARWATER State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Policy Number: 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. FEMA Form 086-0-33 (7/12) Replaces all previous editions.