228 PALM ISU.S. DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-9.
OMB No. 1660-0008
Expiration Date: July 31, 2015
SECTION A - PROPERTY INFORMATION
F,OR
Al. Building Owner's Name Charles M. Popa, Ill; Jamie J. Popa
4--
A2, Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No,
228 Palm Island Northwest
City Clearwater
State FL ZIP Code 33767
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Parcel ID: 05-29-15-43452-000-0660
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. 27°5906" Long. 82*49'08" Horizontal Datum: 0 NAD 1927 0 NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 1B
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 0
c) Total net area of flood openings in A8.b 0 sq in
d) Engineered flood openings? 0 Yes No
A9. For a building with an attached garage:
a) Square footage of attached garage 506+- sq ft
b) Number of permanent flood openings in the attached garage
within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A9.13 N/A sq in
d) Engineered flood openings? 0 Yes El No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
81. NFIP Community Name & Community Number
CITY OF CLEARWATER-125096
B2. County Name
PINELLAS
B3. State
FL
B4. Map/Panel Number
85. Suffix
B6. FIRM Index Date
87. FIRM Panel
B8. Flood
B9. Base Flood Elevation(s) (Zone
12103C0102
G
09/03/2003
Effective/Revised Date
Zone(s)
AO, use base flood depth)
09/03/2003
AE
11;12;13
810. Indicate the source of he Base Flood Elevation (BFE) data or base ttood depth entered in Item 89.
0 FIS Profile El FIRM 0 Community Determined 0 Other/Source:
B11. Indicate elevation datum used for BFE in Item 89: 0 NGVD 1929 NAVD 1988 0 Other/Source:
812, Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)?
Designation Date: !L 0 CBRS 0 OPA
0 Yes El No
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: 0 Construction Drawings* 0 Building Under Construction* El Finished Construction
"A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations - Zones A1 -A30, AE, AK. 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-Ii
below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized: PCBM Vertical Datum: 1988
Indicate elevation datum used for the elevations in items a) through h) below. 0 NGVD 1929 El 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) 6.54
b) Top of the next higher floor N/A.
c) Bottom of the lowest horizontal structural member (V Zones only) N/A.
d) Attached garage (top of slab) 5.94
e) Lowest elevation of machinery or equipment servicing the building 7.24
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG)5.8 feet 0 meters
g) Highest adjacent (finished) grade next to building (HAG) 6.1 10 feet 0 meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A. 0 feet 0 meters
Check the measurement used.
El feet
0 feet
0 feet
ca feet
(23 feet
0 meters
0 meters
0 meters
o
m eters
0 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. 1 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.
El Check hele-if co ments are pro ded on back of form.
0 Check here if att chm ts. licensed land surveyor? 0 Yes
Were latitude and longitude in Section A provided
Certifiers Name Ral h S e dlo
ttle Surveyor
Address 370 Wa o t Court
Signature
FEMA Form 086- -
7
2
License Number #3411
Company Name Swerdloff & Perry Surveying, Inc.
City Lake Mary
Date 2/15/2016
014
No /
State FL ZIP Code 32746
Telephone (407)-688-7631
See reverse side for continuation. Replaces all previous editions.
228 PALM ISLefai
BCP2019-080606A
ADDITIONAL REMODELING
MOULTON, LIZ
Zoning: Island Estates
Atlas #: 258B