669 BAY ESPLANADEU.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
ELEVATION CERTIFICA
Important: Follow the instructions on pages 1-1
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) ins
SECTION A — PROPERTY INFORMATION
Al. Building Owners Name
DE NUNZIO, DUSTIN J
A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route ani
Box No.
669 BAY ESPLANADE
City
Clearwater
State
Florida
RECEIVED BY: K.D.
MAY 31 2019
PLANNING & DEVELOPMENT
CITY OF CLEARWATER
669 BAY ESPLANADE
BCP2017-12667B
ELEVATION CERTIFICATE
DUSTIN J DE NUNZIO
?oning: Tourist
Atlas #: 258A
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, € ...,
PARCEL ID:05-29-15-54756-077-0080 Block 77, Lot 8
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 with
a) Square footage
b) Number of
c) Total net area
d) Engineered
Residential, Non -Residential, Addition,
Lat. 27-59'1677" Long. -82-49'2736"
Accessory, etc.) Residential
Horizontal Datum:
obtain flood insurance.
1.0 foot above adjacent
above adjacent grade
❑ NAD 1927
grade
x NAD 1983
12
2 photographs of the building if the
Number 7
Certificate is being used to
2,250 sq ft
with a crawlspace
of crawlspace
permanent flood
of flood openings
flood openings?
an attached
of attached
permanent flood
of flood openings
flood openings?
or enclosure(s):
or endosure(s)
openings in the crawlspace
in A8.b 2,400
sq
or endosure(s) within
in
sq ft
within 1.0 foot
sq in
0
x Yes ❑ No
garage:
garage 0
openings in the attached garage
in A9.b 0
❑ Yes x No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
Clearwater, Pinellas County, 125096
B2. County Name
Pinellas County
B3. State
Florida
B4. Map/Panel
Number
12103C0103
B5. Suffix
G
B6. FIRM Index
Date
09/03/2003
B7. F RM Panel
Effective/
Revised Date
09/03/2003
B8. Flood Zone(s)
AE11
B9. Base Flood Elevation(s)
(Zone AO, use Base
Flood Depth)
9.0
810. Indicate the source
0 FIS Profile
B11. Indicate elevation
B12. Is the building
Designation Date:
of the Base
Flood Elevation (BFE)
❑ Community Determined
for BFE in Item B9:
Coastal Barrier Resources
❑ CBRS
data
❑ NGVD
System
or base flood depth entered in Item B9:
❑ Other/Source:
x FIRM
datum used
located in a
1988 ❑ Other/Source:
or Otherwise Protected
1929 p NAVD
(CBRS) area
❑ 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
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.
669 BAY ESPLANADE
Policy Number.
City State ZIP Code
Clearwater Florida 33767
Company NAIC Number
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
❑ Finished Construction
AR/A1—A30, AR/AH, AR/AO.
Rico only, enter meters.
Cl. Building elevations are based on: ❑ Construction Drawings* x 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: 872 6724A TIDAL AG7196 Vertical Datum: NAVD 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) 2. 0
Check the measurement used.
x feet ❑ meters
b) Top of the next higher floor 13 0
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 n/a
x feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 5. 0
x feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 6. 0
x feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including 6 0
X 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 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.
Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes 0 No ❑ Check here if attachments.
Certifiers Name License Number
David P Graves LS 5392
.SA
;yam a a ,y . ,,... c0.,
d ..)1':44
Title
President
Company Name
AFN Consulting, Inc.
Address
PO Box 445
City State ZIP Code
San Antonio Florida 33525
Signature Date Telephone
David P Graves 01p"'"slimed °yDiN°"""'°
We 7014.04.2, Cl: 5e: 34 440.7 04/23/2019 (813) 503-3228
Copy all pages 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)
Building is built in flood zone "AE" only. Proposed A/C is on roof. Proposed Lowest electrical boxes are on first floor and are above flood
plain elevation.
First floor is in the enclosure that has the flood vents. Smart vent approval #FL 5822-R4
C2 a) is in the enclosure with the flood vents.
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.
669 BAY ESPLANADE
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 E1—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 endosure) 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
certify this information in Section G.
b) Top of bottom floor (including basement,
crawlspace, or endosure) 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? 0 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 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.
669 BAY ESPLANADE
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:
❑ feet
❑ feet
❑ feet
❑ meters Datum
New Construction ■ Substantial Improvement
basement)
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
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.
669 BAY ESPLANADE
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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Photo One
Photo One Caption North side view
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Photo Two
Photo Two Caption 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. 1660-0008
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.
669 BAY ESPLANADE
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.
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Photo One
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Photo One Caption South side view
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Photo Two
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Photo Two Caption Front view
FEMA Form 086-0-33 (7/15)
Replaces all previous editions.
Form Page 6 of 6