302 SEMINOLE ST4 U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
ELEVATI
Important: Follow t
Copy all pages of this Elevation Certificate and all attachments for (1)
E IFICATE
ctions on pages 1-9.
. 1660-0008
n Date: November 30, 2022
insurance agent/company, and (3) building owner.
SECTION A — PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
Al. Building Owner's Name
City of Clearwater
Policy Number:
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Box No.
302 Seminole Street
Company NAIC Number:
City State ZIP Code
Clearwater Florida 33755
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Parcel Tax ID # 09-29-15-02718-000-0190
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. N27-58-26.58 Long. W82-48-08.07
Non -Residential
Horizontal
Datum:
insurance.
above
❑ NAD 1927
adjacent grade
grade 0
x NAD 1983
0
2 photographs of the building if the
Number 6
Certificate is being used to obtain flood
63.00 sq ft
with a crawlspace
of crawlspace
flood
of flood openings
flood openings?
an attached
of attached
flood
of flood openings
flood openings?
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
N/A sq ft
❑ Yes x No
garage:
garage
openings in the attached garage within 1.0
in A9.b N/A sq
❑ Yes x No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
City of Clearwater
B2. County Name
Pinellas County
B3. State
Florida
B4. Map/Panel
Number
12103C0106
1
B5. Suffix
H
B6. FIRM Index
Date
08-18-2009
B7. FIRM Panel
Effective/
Revised Date
05-17-2005
B8. Flood
Zone(s)
VE
B9. Base Flood Elevation(s)
(Zone AO, use Base Flood Depth)
14.0'
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 or base flood
❑ Other/Source:
❑ NGVD 1929
System (CBRS)
CBRS ❑ OPA
depth entered in Item B9:
x FIRM
datum used
located in a
Date:
❑ Other/Source:
Protected
x NAVD 1988
area or Otherwise
Area (OPA)?
❑ Yes x No
FEMA Form 086-0-33 (12/19)
Replaces all previous editions.
Form Page 1 of 6
ELEVATION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2022
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.
302 Seminole Street
Policy Number:
City State ZIP Code
Clearwater Florida 33755
Company NAIC Number
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* x
*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, ARAE, AR/A1—A30,
Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only,
Benchmark Utilized: City of Clearwater G-06 El. 26.98 Vertical Datum: NAVD 1988
Finished Construction
AR/AH, AR/AO.
enter meters.
Indicate elevation datum
❑ NGVD 1929
used
x
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) 1.0 x
the measurement used.
feet ❑ meters
b) Top of the next higher floor 17.9 x
feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) 16.5 x
feet ❑ meters
d) Attached garage (top of slab) N/A ❑
feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment and location in Comments) 18.0 x
feet meters
❑
f) Lowest adjacent (finished) grade next to building (LAG) 4.9 x
feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 5.0 x
feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
structural support 5.0 x
feet ❑ meters
SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect
I certify that the information on this Certificate represents my best efforts to interpret
statement may be punishable by fine or imprisonment under 18 U.S. Code, Section
Were latitude and longitude in Section A provided by a licensed land surveyor?
x
authorized by law to certify elevation information.
the data available. I understand that any false
1001.
Yes ❑ No ❑ Check here if attachments.
Certifier's Name License Number
Mark S. Lischalk, PLS LS 5727
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President & Owner
Company Name
Zarra Boyd, Inc.
Address
1480 Beltrees Street, Suite 3
City State ZIP Code
Dunedin Florida 34698
Signatu'C'� Date Telephone Ext.
01-07-2021 (727) 738-9010
Copy all pages'bf 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)
The elevation listed in item C2.a is the bottom of the elevator shaft. The elevator shaft is listed as the enclosure in item A.8. The bottom
of the elevated deck elevation is 17.2'. Zone V design certificate will be submitted with the Finished Construction Elevation Certificate.
The elevator design will follow ASCE 24-14 per approved plans section 7.5.1. The elevation listed in item C2.e is the bottom of an
electric panel located on the wall of the building. See photos.
FEMA Form 086-0-33 (12/19)
Replaces all previous editions.
Form Page 2 of 6
ELEVATION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2022
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.
302 Seminole 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
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 enclosure) 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 enclosure) 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? ❑ 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 (12/19)
Replaces all previous editions.
Form Page 3 of 6