706 BAYWAY BLVD (2)U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
ELEVATION CERTIFICATE
OMB No. 1660 -0008
Expiration Date: November 30, 2018
Important: Follow the instructions on pages 1 -9.
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
SECTION A - PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
Al. Building Owner's Name
BAYWAY HOTEL HOLDINGS, INC.
Policy Number:
A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and
Box No.
706 BAYWAY BOULEVARD
Company NAIC Number:
City State ZIP Code
CLEARWATER Florida 33767
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOTS 25 AND 26, BLOCK A, BAYSIDE SUBDIVISION NO. 5; PARCEL ID #17- 29- 15- 06286- 000 -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, Accessory, etc.)
Lat 27 °58'02.1" N Long. -82 °49'23.7" W
RESIDENTIAL (CONDOMINIUM)
Horizontal
Datum: ❑ NAD 1927
insurance.
706 BAYWAY
BCP2017- 04049E
ELEVATION CERTIFICATE
SANDPIPER'S COVE
Zoning: Tourist
x NAD 1983
BLVD 1
Atlas #: 2I
2 photographs
Number
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
6
Certificate is being used to obtain flood
1373.11 sq ft
or enclosure(s):
or enclosure(s)
openings in the crawlspace
in A8.b
or enclosure(s)
0.00 sq in
within 1.0
foot above
in
0.00 sq ft
• Yes ❑ 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 COUNTY
B3. State
Florida
B4. Map /Panel
Number
12103C0104
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. Base Flood E evation(s)
(Zone AO, use Base Flood Depth)
11
B10. Indicate the source
❑ FIS Profile
811. Indicate elevation
B12. Is the building
Designation
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:
1929
(CBRS)
depth entered in Item B9:
x FIRM
datum used
located in a
Date:
❑ Other
Protected
/Source:
x NAVD 1988
area or Otherwise
Area (OPA)?
❑ Yes x No
•
• OPA
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.
706 BAYWAY BOULEVARD
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,
Complete Items C2.a —h below according to the building diagram specified in Item A7. In Puerto
Benchmark Utilized: AURAL A (PID AG0298) EL =11.82 Vertical Datum: NAVD 1988
x Finished Construction
AR /A1 —A30, AR /AH, AR /AO.
Rico only, enter meters.
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)
Check the measurement used.
5.06 x feet ❑ meters
b) Top of the next higher floor 15.08
x feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only)
N/A x feet ❑ meters
d) Attached garage (top of slab)
N/A x feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 1.06
(Describe type of equipment and location in Comments)
®feet ❑meters
f) Lowest adjacent (finished) grade next to building (LAG) 5.00
x feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 5.10 LI 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 authorized 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 18 U.S. Code, Section 1001.
law
to certify elevation information.
I understand that any false
Were latitude and longitude in Section A provided by a licensed land surveyor? ❑ Yes x No
x Check here if attachments.
Certifiers Name License Number
Elizabeth Kathleen Merta LS6113
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Title
Professional Surveyor & Mapper
Company Name
Deuel & Associates (WO #2017 -130)
Address
565 South Hercules Avenue
City State ZIP Code
Clearwater Florida 33764
Sig Date Telephone Ext.
12 -11 -2018 (727) 822 -4151 210
Copy p g this leva on irate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments (including type of equipment and location, per C2(e), if applicable)
A5: Latitude and longitude were determined using Google Earth.
A8a: Enclosures consist of an elevator shaft, stairwells and storage areas.
C2a: Elevation shown is the finish floor of the parking area;
C2e: Elevation shown is bottom of elevator shaft
Date shown is the date of the field work.
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.
706 BAYWAY BOULEVARD
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 El—E5. If the Certificate is intended to support a
complete Sections A, Band C For Items El—E4, use natural grade, if available. Check the measurement
enter meters.
E1. 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.
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
I above or ❑ below the HAG.
E4. Top of platform of machinery and /or equipment
servicing the building is ❑ feet al meters
• above or ❑ below the HAG.
with the community's
certify this information in Section G.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance
floodplain management ordinance? I/ 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 6
ELEVATION CERTIFICATE
OMB No. 1660 -0008
Expiration Date: November
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.
706 BAYWAY BOULEVARD
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: [j
❑ 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.
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 0 Route and Box No
706 BAYVVAY BOULEVARD
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 .
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s Tit
Photo One
Photo One Caption FRONT VIEW (SOUTH SIDE) - PHOTO TAKEN 12 -11 -2018 Clear Photo One
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III
Photo Two°
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Photo Two Caption REAR VIEW (NORTH SIDE) - PHOTO TAKEN 12 -11 -2018 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
706 BAYWAY BOULEVARD
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.
Oa
1Ii
\ ,,
.1 s
Photo Three
Photo Three Caption LEFT SIDE VIEW (WEST SIDE) - PHOTO TAKEN 12 -11 -2018 Clear Photo Three
}
Photo Four
Photo Four Caption SOUTH SIDE OF NORTH WALL - PHOTO TAKEN 01 -04 -2019 Clear Photo Four
FEMA Form 086 -0 -33 (7/15)
Replaces all previous editions.
Form Page 6 of 6