965 BRUCE AVEU.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
965 BRUCE AVENUE REALTY TRUST
Policy Number:
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Box No.
965 BRUCE AVENUE
Company NAIC Number:
City State ZIP Code
CLEARWATER Florida 33767
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 1, BLOCK 264, CARLOUEL SUB., PLAT BOOK 20, PAGE 60, PINELLAS COUNTY, FL. AND PORTION VACATED ROAD.
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 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. 28°00'02.0" Long. 82°49'31.1"
RESIDENTIAL
Horizontal
Datum:
insurance.
above
❑ NAD 1927
adjacent grade
grade 0
x NAD 1983
0
2 photographs
Number
with 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
1A
Certificate is being used to obtain flood
0.00 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
foot above adjacent
in
308.00 sq ft
❑ Yes x 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
12103C0064
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
B11. 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:
depth entered in Item B9:
x FIRM
datum used
located in a
Date:
❑ Other/Source:
Protected
1929 x NAVD 1988
(CBRS) area or Otherwise
❑ 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 r
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.
965 BRUCE AVENUE
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 Al 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: CITY OF CLEARWATER J-03 Vertical Datum: ELEV. 2.595' NAVD
x Finished Construction
AR/A1—A30, AR/AH, AR/AO.
Rico only, enter meters.
1988
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.
4.58 x feet ❑ meters
b) Top of the next higher floor N/A ❑ feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only)
N/A ❑ feet ■ meters
d) Attached garage (top of slab) 3.33
x feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 4.65
(Describe type of equipment and location in Comments)
x feet meters
❑
f) Lowest adjacent (finished) grade next to building (LAG) 4.00
x feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 4.10
x feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including feet meters
structural support N/A ❑ ❑
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
❑ Check here if attachments.
Were latitude and longitude in Section A provided by a licensed land surveyor? x Yes ❑ No
Certifier's Name License Number
GUY D. HALE 4626'q`,`
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Title
PROFESSIONAL LAND SURVEYOR
Company Name
COMPLETE SURVEYING SOLUTIONS, LLC
Address
406 SO. ARCTURAS AVENUE SUITE ONE
City State ZIP Code
`y
CLEARWATER Florida 33765
Signature Date Telephone Ext.
04-27-2018 (727) 734-4266
Copy all pages of this El 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)
THE LOWEST MACHINERY IS THE AIR CONDITIONER.
FEMA Form 086-0-33 (7/15)
Replaces all previous editions.
Form Page 2 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.
965 BRUCE AVENUE
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.
Photo One Caption FRONT ( WEST SIDE ) TAKEN 04/27/2018 Clear Photo One
Photo Two
Photo Two Caption REAR ( EAST SIDE ) TAKEN 04/27/2018 Clear Photo Two
FEMA Form 086-0-33 (7/15)
Replaces all previous editions.
Form Page 5 of 6
4 ♦1
965 BRUCE AVE
BCP2020-030123
REMODEL
CLARKE, PATRICIA L
Zoning: Low Medium Density Atla
RECEIVED BY: M.J.
MAR 1 1 2020
PLANNING & DEVELOPMENT
CITY OF CLEARWATER