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1409 HIBISCUS STU.S. DEPAI -MENVOF 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 Mitchell Evan Cruit and Rebecca Lynn Cruit Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1409 S. Hibiscus Street Company NAIC Number: City State ZIP Code Clearwater FLORIDA 33755 A3, Property Description (Lot and Block numbers, Tax Parcel Number, Legal Description, etc.) Lot Number:16 A4. Building Use (e.g., A5. Lattitude/Longitude: A6. Attach at least A7. Building Diagram A8. For a building a) Square footage b) No. of permanent c) Total net area d) Engineered A9. For a building a) Square footage b) No. of permanent c) Total net area d) Engineered Residential, Non -Residential, Addition, Lat. N 27°58'33.79 Long. Accessory, Etc.) Residential W 82°46'44.12 Horizontal Datum: ❑ NAD grade 0 1927 X NAD 1983 133 2 photographs of the building if the number 8 Certificate is being used to 1217 Sq. Ft. obtain flood insurance foot above adjacent adjacent grade with a crawlspace of crawlspace flood openings of flood openings flood openings? with an attached of attached flood openings of flood openings flood openings? or enclosure(s): or enclosure(s) in the crawlspace in A8.b 2152 or enclosure(s) within 1.0 Sq. in. Sq. Ft. within 1.0 foot above Sq. In. ❑ Yes X No garage: garage 400 in the attached in A9.b 0 garage ❑ Yes X No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number 125096 B2. County Name Pinellas County B3. State FLORIDA B4. Map/Panel Number 12103C0107H B5. Suffix G B6, FIRM Index Date 09/03/2003 B7. F RM Panel Effective/Revised Date 09/03/2003 B8. Flood Zone(s) A B9. Base Flood elevation(s) (Zone AO, use base flood depth) 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: Barrier Resources ❑ CBRS data ❑ NGVD System ❑ or base flood depth ❑ Other (Describe) entered in item B9: X FIRM datum used locaed in a Costal N/A 1988 ❑ Other (Describe) Otherwise protected Area (OPA)? 1929 X NAVD (CBRS) area or 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. 1409 S. Hibiscus Street Policy Number: City State ZIP Code Clearwater FLORIDA 33755 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 Benchmark Utilized: N/A Vertical Datum: NAVD 1988 X only, Finished Construction AR/AH, AR/AO. enter meters. Indicate elevation datum ❑ NGVD 1929 used In 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) 18 . 88 the X measurement used. feet ❑ meters b) Top of the next highest floor 21 55 © feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A . ❑ feet ❑ meters d) Attached Garage (top of slab) 19 . 07 X feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 19 87 X feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 18 52 El feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 18 88 X feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs including N/A . ❑ 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 authorized I certify that the information on this Certificate represents my best efforts to interpret the data statement may be punishable by fine or imprisonment under 17 U.S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑ Yes X by law to certify available. I understand No X elevation information. that any false Check here if attachments. Certifier's Name License number JOSE ROCHE 5935 ;b.6•„ *-VG Title PROFESSIONAL SURVEYOR & MAPPER Company Name ME LAND SURVEYING* Address 10665 SW 190th STREET SUITE 3110 City State ZIP Code MIAMI FL 33157 Signature Date Telephone 10/16/2019 (305) 740-3319 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2)insurance agent/company, (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) LATITUDE LONGITUDE PER GOOGLE, ATTACHMENTS = BUILDING PICTURES Crown of Road, is located directly in front of the property in question, on S. Hibiscus Street is used as assumed elevation. Natural Grade is assumed to be lower than Crown of Road. Machinery/Equipment is an A/C Pad. This elevation certificate is for flood insurance rating purposes only and may not be used for building permitting purposes due to measurement precision issues. 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. 1409 S. Hibiscus Street Policy Number: City State ZIP Code Clearwater FLORIDA 33755 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 LOMA or LOMR-F request, complete Sections A, Band C. For Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. El. 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, 2 67 X feet ❑ meters X above or ❑ below the HAG crawlspace, or enclosure) is b) Top of bottom floor (including basement, 3 03 I feet ❑ meters X above or ❑below the LAG 9 (see pages 8-9 of instructions), ❑above or below the HAG crawlspace, or enclosure) is 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❑feet ❑meters in the diagrams) of the building is E3. Attached garage (top of slab) is 0 19 X feet ❑ meters X above or ❑ below the HAG E4. Top of platform of machinery and/or equipment 0 99 X feet ❑ meters X above or ❑ below the HAG with the community's this information in Section G. servicing the building is 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 X 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, abd E are correct to the best of my knowledge. Property Owner's 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. 1660-10008 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. 1409 S. Hibiscus Street Policy Number: City State ZIP Code Clearwater FLORIDA 33755 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 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 Complicance/Occupancy Issued G7. This permit has been issued for: G8. Elevation of as -built lowest floor of the building: G9. BFE or (in Zone AO) depth of site: G10. Community's design flood elevation ❑ New Construction ❑ Substantial Improvement (including basement) ❑ feet ❑ meters Datum flooding at the building ❑ feet ❑ meters Datum ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑ 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 1409 S. Hibiscus Street Policy Number City State ZIP Code Clearwater FLORIDA 33755 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. • .' r� PJ. RECEIVED { MAY PLANNING CITY OF BY: S.L. 1 1 2020 &DEVELOPMENT CLEARWATER BCP2020-040522 CURRENT ELEVATION CERT !1:IL11409 S HIBISCUS ST CRUIT. REBECCA Zoning: Low Medium Density Atlas #: 270A Photo One Photo One Caption Photo Taken 10/15/2019 "Front View' • ,. Photo Two Photo Two Caption Photo Taken 10/15/2019 "Rear View" FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS Continuation Page OMB No, 1660-1)008 Expiration Date: Nove 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. 1409 S Hibiscus Street Policy Number - City State ZIP Code Clearwater FLORIDA 33755 Company NAIC Number If submitting more photographs than will fit on the preceding page, affix the date taken, "Front View" and "Rear View"; and, if required, "Right Side View" show the foundation with representative examples of the flood openings or additional photographs below. Identify all photographs with and "Left Side View." When applicable, photographs must vents, as indicated in Section A8 fi 4j Photo One Photo One Caption Photo Taken 10/15/2019 "Left View" Photo Two Photo Two Caption Photo Taken 10/15/2019 "Right View" FEMA Form 086-0-33 (7/15) Replaces all previous editions Form Page 6 of 6