2229 SPRINGRAIN DRU.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency OMB No. 1660-0008
National Flood Insurance Program Expiration Date: November 30, 2018
ELEVATION CERTIFICATE
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
Al. Building Owner's Name FOR INSURANCE COMPANY USE
Jacqueline Kautz Policy Number.
A2. Building Street Addresi (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Box No. Company NAIC Number:
2229 Springrain Drive'
City State
Clearwater ZIP Code
Florida 33763
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 27, SPRING LAKE OF CLEARWATER
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. 28d 00'05.86" N. Long. 82d 45'42.36" W.
Horizontal Datum: ❑ NAD 1927 x❑ NAD 19$3
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
AT Building Diagram Number 1A
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s)
NIA sq ft
b) Number of permanent Rood openings in the crawlspaoe or enclosure(s) within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A8.b
N/A sq in
d) Engineered flood openings? ❑ Yes 0 No
A9. For a building with an attached garage:
a) Square footage of'attached garage 400.00 sq It
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade NIA
c) Total net area of flood openings in A9.b N/A sq in
d) Engineered flood openings? ❑ Yes x❑ No
SECTION B — FLOOD INSURANCE RATE MAP (FIRII
131. NFIP Community Name & Community Number B2. County Name
Clearwater 125096
Pinellas
84. Map/Panel 85. Suffix 136. FIRM Index B7. FIRM Panel B8. Flood
Number Date Effective/ Zone(s)
12103C / 0069C Revised Date
09-03-2003 09-03-2003 X & AE
INFORMATION
B3. State
Florida
Bg. Base Flood Elevations)
(Zone AO, use Base Flood Depth)
47.0' (See Comments)
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 89:
❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 0 NAVD 1988 ❑ Other/Source:
1312. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes 2 No
Designation Date: ❑ CBRS ❑ OPA
FEMA Form 086-0-33 (7/15) Replaces all previous editions.
Farm Page 1 of 6
ELEVATION CERTIFICATE
IMPORTANT: In these spaces, copy the corresponding information from Section A.
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
2229 Springrain Drive
Clearwater
Jame ZIP C1
Florida 33763
OMB No. •1660-0008
Expiration Date: November 30, 2018
FOR INSURANCE COMPANY USE
Policy Number.
Ompany NAIC Num
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: [❑ Construction Drawings" ❑ Building Under Construction' ❑x Finished Construction
`A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations —Zones Al—A30, AE, AH, A (with 8FE). VE, V1—V30, V (with SFE), AR, AR/A, ARAE, AR/A1—A30, AR/AH, AR/AO.
Complete items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized: City of St. Pete BM J-10 Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a) through h) below.
❑ NGVD 1929 0 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) _ 48 90he x t feet measurement meters used.
❑ ❑meters
b) Top of the next higher floor feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) N/A feet ❑ meters
d) Attached garage (top of slab) 48.34 0 feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment and location in Comments) 48.611 ❑x feet ❑ meters
f) Lowest adjacent (finished) grade next to building (LAG) 47.90 Q feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 48.00 x feet
[J meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
structural support NIA x feet
❑ [_1 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.
I cerfify that the information on this Certirrcate represents my best efforts to interpret the data available. J understand that any false
statement may be punishable by Erne or imprisonment under 18 U.S. Code, Soctron 1001.
Were latitude and longitude in Section A provided by a licensed land surveyor? R Yes ❑ No
El Cheek here If attachments.
Edward D. Murphy
Professional Land Surveyor
Company Name
Murphy's Land Surveying, Inc
Address
576011 th Avenue N.
City - -
St. Petersburg
Signature ,
Copy all pages of this Elevation Certificate and
Comments (including type of equipment
C2e = A/C
or
#5333
Place
Sed C
Here
aaare ZIP Cc
Florida 33710
Date Telephone Ext,
11-01-2017 (727) 347-8740
tm-0 s for (1) community official, (2) insurance agenticompany, and (3) building owner.
per C2(e , if applicable)
NOTE: Flood Zone and Base Flood Elevation are per Pinellas llas County Engineering Department
FEMA Form 086-0-33 (7/15) (Replaces all previous editions.
Form Page 2 of 6