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848 ISLAND WAYU.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 ALVAREZ NEW CONCEPTS A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route Box No. 848 ISLAND WAY City CLEARWATER State 848 ISLAND WAY BCP2017- 03376C ELEVATION CERTIFICATE MOSSMAN Zoning: Island Estates Atlas #: 249A RECEIVED BY: V.J.K FEB 21 2019 PLANNING & DEVELOPMENT CITY OF CLEARWATER FEMA Form 086 -0 -33 (7/15) Replaces all previous editions. Form Page 1 of 6 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 57, ISLAND ESTATES OF CLEARWATER, UNIT # 8, PLAT BOOK 64, PAGE 73 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 c) Total net area d) Engineered Residential, Non - Residential, Addition, Accessory, Lat. 27 °59'43 "N Long. 82 °49'14 "W etc.) RESIDENTIAL Horizontal Datum: ❑ NAD 1927 insurance. above adjacent grade grade 0 x NAD 1983 22 2 photographs Number with a crawlspace of crawlspace permanent flood of flood openings flood openings? with an attached of attached permanent flood of flood openings flood openings? of the building if the 7 Certificate is being used to obtain flood 2362.00 sq ft or enclosure(s): or enclosure(s) openings in the crawlspace in A8.b or enclosure(s) 2640.00 sq in within 1.0 foot 1.0 foot above adjacent in No 0.00 sq ft ❑ Yes X garage: garage openings in the attached garage within 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 84. Map /Panel Number 12103C0102 B5. Suffix G B6. FIRM Index Date 08 -18 -2009 B7. FIRM Panel Effective/ Revised Date 09 -03 -2003 88. Flood Zone(s) AE B9. Base Flood E evation(s) (Zone AO, use Base Flood Depth) 12.0' 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 N/A ❑ Other /Source: 1929 x NAVD 1988 (CBRS) area or Otherwise ❑ OPA Protected 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. 848 ISLAND WAY Policy Number: City State ZIP Code CLEARWATER Florida 33767 Company NAIC Number SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* x 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: PINELLAS Vertical Datum: NAVD 1988 Indicate elevation datum ❑ NGVD 1929 used for the elevations in items a) through h) below. x 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) 20.16 x the measurement used. feet ❑ meters feet ❑ meters feet ❑ meters feet ❑ meters feet meters ❑ feet ❑ meters feet ❑ meters feet ❑ meters b) Top of the next higher floor 30.10 x ❑ ❑ x x x x c) Bottom of the lowest horizontal structural member (V Zones only) N/A d) Attached garage (top of slab) N/A e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) 13.00 f) Lowest adjacent (finished) grade next to building (LAG) 8.30 g) Highest adjacent (finished) grade next to building (HAG) 9.12 h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 8.30 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. 1 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 x Check here if attachments. Certifier's Name License Number DONALD L. WILLIAMSON PSM# 5649 , 11 I I / / f,' `\� O L . W f 4 < i/, Ot.oe5 NG..."4tytP ,: �G O .., : �, 5649 6 ; Z ., : — ' .., STATE OF I `� �, '..,FLORIDA::' d /��'� '.' . C� \�` Z�� // 1 � ii;\``�� Title LAND SURVEYOR Company Name WILLIAMSON & ASSOCIATES, INC. Address 5020 GUNN HIGHWAY SUITE 220 A City State ZIP Code TAMPA n Florida 33624 Signature Date Telephone Ext. 02 -14 -2019 (813) 265 -4795 Copy all page 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) C2 e) LOWEST ELEVATION OF MACHINERY IS THE A/C UNIT AND IS LOCATED ON THE SIDE OF HOUSE JOB# 19 -4FNL 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 30 201 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. 848 ISLAND WAY 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 El—E4, use natural grade, if available. Check the measurement enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters LOMA or LOMR -F request, used. In Puerto Rico only, the elevation is above or below ❑ above or ❑below the HAG. ❑ above or ❑ below the LAG. 9 (see pages 1 -2 of Instructions), ❑ above or ❑ below the HAG. ❑ above or ❑ below the HAG. ❑ above or ❑ below the HAG. with the community's this information in Section G. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and /or the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters E3. Attached garage (top of slab) is ❑ feet ❑ meters E4. Top of platform of machinery and /or equipment servicing the building is ❑ feet ❑ meters E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA- issued or community- issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owners Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. orm 086 -0 -33 (7/15) Replaces all previous editions. Form Page 3 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. 848 ISLAND WAY 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 New Construction ❑ Substantial Improvement basement) ❑ feet ❑ feet ❑ feet ❑ meters Datum G7. This permit has been issued for: II 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: 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 BUILDING PHOTOGRAPHS ELEVATION CERTIFICATE 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. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. 848 ISLAND WAY FOR INSURANCE COMPANY USE Policy Number City CLEARWATER State Florida ZIP Code 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 VIEW DATE TAKEN 02 -14 -2019 Clear Photo One Photo Two Photo Two Caption REAR VIEW DATE TAKEN 02 -14 -2019 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. 848 ISLAND WAY 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 Three Photo Three Photo Three Caption RIGHT SIDE VIEW DATE TAKEN Cear Photo Three Photo Four Photo Four Photo Four Caption LEFT SIDE VIEW DATE TAKEN Clear Photo Four A Form 086 -0 -33 (7/15) Replaces all previous editions. Form Page 6 of 6