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841 BAY ESPLANADEU.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 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 WADE HAMILTON Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 841 BAY ESPLANADE Company NAIC Number: City State ZIP Code CLEARWATER FLORIDA 33764 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 1, BLOCK 40, MANDALAY - PARCEL # 05-29-15-54666-040-0010 A4. Building Use (e.g., A5. Latitude/Longitude: A6. Attach at least A7. Building Diagram A8. For a building with 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, Lat. 27.9957° Long. Accessory, etc.) RESIDENTIAL -82.8236° Horizontal Datum: obtain flood insurance. 1.0 foot above adjacent above adjacent grade ❑ NAD 1927 grade x NAD 1983 N/A 2 photographs of the building if the Number 1A Certificate is being used to N/A sq ft 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 N/A sq or enclosure(s) within in sq ft within 1.0 foot sq in 0 ❑ Yes x No garage: garage 572 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 CITY OF CLEARWATER -125096 B2. County Name PINELLAS COUNTY B3. State FLORIDA B4. Map/Panel Number 12103C0102 B5. Suffix G B6. FIRM Index Date 8-18-2009 B7. F RM Panel Effective/ Revised Date 9-3-2003 B8. Flood Zone(s) AE B9. Base Flood Elevation(s) (Zone AO, use Base Flood Depth) 11.0' B10. Indicate the source ❑ FIS Profile 811. Indicate elevation B12. Is the building Designation Date: of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: x FIRM datum used located In a N/A ■ Community Determined for BFE in Item B9: Coastal Barrier Resources ❑ NGVD System • Other/Source: 1929 x NAVD (CBRS) area 1988 ■ Other/Source: or Otherwise Protected Area (OPA)? M Yes © No ■ CBRS ■ OPA 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, 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. 841 BAY ESPLANADE Policy Number: City State ZIP Code CLEARWATER FLORIDA 33764 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, Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Benchmark Utilized: N.G.S. Vertical Datum: N.A.V.D. 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) 7.10 Check the measurement used. x feet ❑ meters b) Top of the next higher floor 16.55 x feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet ❑ meters d) Attached garage (top of slab) 5.69 x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 5.09 x feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 5.2 El feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 5.9 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 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 Were latitude and longitude in Section A provided by a licensed land surveyor? x Yes ❑ No x Check here if attachments. Certifier's Name License Number GEORGE A. SHIMP II 2512 , , ` pC® ..` ,"" :Se`at" - tire '/ / 2512 Dafe" -22-2021 Title Job Number PRESIDENT 210062 Company Name GEORGE A. SHIMP II & ASSOCIATES, INC. Address 3301 DeSOTO BOULEVARD, SUITE D City State ZIP Code PALM HARBOR FLORIDA 34683 (Not valid embossed with surveyor's original raised seal) Signa Date Telephone 2-22-2021 727-784-5496 rfi Co all pthis evati icate 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) SEE ATTACHMENT PAGES 1 AND 2 FOR SURVEYOR'S NOTES AND COMMENTS. THIS DOCUMENT IS NOT VALID UNLESS SIGNED AND EMBOSSED WITH THE SURVEYOR'S ORIGINAL RAISED SEAL AND MUST CONTAIN ALL FORM PAGES AND ATTACHMENTS. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 3 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. 841 BAY ESPLANADE Policy Number: City State ZIP Code CLEARWATER FLORIDA 33764 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, Band C. For Items E1—E4, use natural grade, if available. Check the measurement enter meters. E1. 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), 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 • 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. 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 RECEIVED BY: K.D. MAR 0 1 2021 PLANNING & DEVELOPMENT CITY nF ri r P ,,\A,ATFR 841 BAY ESPLANADE BC P2021-020093 RTC D K C WETLAND PRESERVE LLC Zoning: Low Medium Density Atlas #: 24'. ......,..., ,,,,.,, ., ,.dachments. 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, 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. 841 BAY ESPLANADE Policy Number: City State ZIP Code CLEARWATER FLORIDA 33764 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: New Construction ❑ Substantial Improvement basement) ❑ feet ❑ feet ❑ feet ❑ meters Datum 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, 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. 841 BAY ESPLANADE Policy Number: City State ZIP Code CLEARWATER FLORIDA 33764 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. -.. 16% `.: \,.,.JJ en".ta. •i ,[ i . vim. I. - . . ms`s,$ 5 . _ .'V. - t,y 5;,„w.t- Photo One of , `am Ste" .•,z,•„. .. '..a .'• OA. Photo One Caption FRONT VIEW 2-22-2021 • Nvi e ,. :Ic TyvQk Tyvek-_ Ty vet — C` ! ; s ht �r ... -_ r' _ A Photo Two Photo Two Caption REAR VIEW 2-22-2021 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, 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. 841 BAY ESPLANADE Policy Number: City State ZIP Code CLEARWATER FLORIDA 33764 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. Photo One Photo One Photo Three Caption N/A N/A Photo Two Photo Two Photo Four Caption N/A N/A FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6 Surveyor's Notes Attachment Page 1 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. 841 BAY ESPLANADE Policy Number: City State ZIP Code CLEARWATER FLORIDA 33764 Company NAIC Number SECTION D — SURVEYOR'S CERTIFICATION (CONTINUED FROM PAGE 2) Al.) THIS ELEVATION CERTIFICATE, UNDER CONTRACT, WAS EXCLUSIVELY PREPARED FOR AND CERTIFIED TO THE PARTY SPECIFIED IN SECTION A, ITEM 1, FOR THE SPECIFIC PURPOSE OF OBTAINING FLOOD INSURANCE AND/OR VERIFYING FLOOD ZONE COMPLIANCE WITH THE LOCAL GOVERNING AUTHORITY. USE OF THIS DOCUMENT BY ANY OTHER PARTY OR FOR ANY OTHER PURPOSES SHALL BE AT THAT PARTY'S SOLE RISK AND GEORGE A. SHIMP II & ASSOCIATES, INC. ASSUMES NO LIABILITY AND DOES NOT PROVIDE ANY WARRANTY TO SAID PARTY. GEORGE A. SHIMP II & ASSOCIATES, INC. ASSUMES NO LIABILITY AND DOES NOT PROVIDE ANY WARRANTY FOR UNAUTHORIZED COPIES, IN ANY FORM OR BY ANY MEANS, INCLUDING PHOTOCOPYING OR OTHER ELECTRONIC OR MECHANICAL METHODS, AND USE OF SAID COPIES SHALL BE AT THE USER'S SOLE RISK. REQUESTS FOR ANY ADDITIONAL OFFICIAL SIGNED AND SEALED COPIES MUST BE DIRECTED TO GEORGE A. SHIMP II & ASSOCIATES, INC. A4.) THE BUILDING USE WAS DETERMINED BY PHYSICAL OBSERVATIONS MADE ON THE DATE OF SURVEY. A5.) THE LATITUDE AND LONGITUDE COORDINATES WERE OBTAINED USING A HAND HELD G.P.S. UNIT WHICH MEETS OR EXCEEDS FEMA'S REQUIRED ACCURACY OF 66 FEET. A7.) THE BUILDING DIAGRAM NUMBER WAS DETERMINED BY PHYSICAL OBSERVATIONS MADE ON THE DATE OF SURVEY. CERTAIN STRUCTURAL FEATURES NOT VISIBLE TO THE SURVEYOR (PILINGS, GRADE BEAMS, ETC.) OR USE OF ANY AREAS BELOW THE BASE FLOOD ELEVATION THAT DOES NOT COMPLY WITH FEMA REGULATIONS CAN AFFECT THIS DETERMINATION. A8.) FOR THE PURPOSE OF THIS DOCUMENT, A BUILDING ENCLOSURE IS DEFINED AS THAT PORTION OF AN ELEVATED BUILDING, BELOW THE LOWEST ELEVATED FLOOR, THAT IS EITHER PARTIALLY OR FULLY SHUT IN BY RIGID WALLS. A GARAGE BELOW OR ATTACHED TO AN ELEVATED BUILDING IS CONSIDERED AN ENCLOSURE. SUCH AREAS SHALL NOT CONTAIN MORE THAN 20 LINEAR FEET OF FINISHED INTERIOR WALLS (PANELING, ETC.) OR IT WILL BE CONSIDERED A FINISHED (HABITABLE) AREA. A8. & A9.) FOR THE PURPOSE OF THIS DOCUMENT, A FLOOD OPENING IS DEFINED AS A PERMANENT OPENING IN AN EXTERIOR WALL THAT IS NO HIGHER THAN 1.0 FOOT ABOVE THE HIGHER OF THE EXTERIOR OR INTERIOR GRADE OR FLOOR IMMEDIATELY BELOW THE OPENING. IN REGARD TO ENGINEERED FLOOD OPENING(S), IF APPLICABLE, THE SURVEYOR DOES NOT KEEP COPIES OF EITHER THE INDIVIDUAL ENGINEERED FLOOD OPENINGS CERTIFICATION OR THE EVALUATION REPORT ISSUED BY THE INTERNATIONAL CODE COUNCIL EVALUATION SERVICE (ICC ES) ON FILE. CURRENT COPIES OF THESE DOCUMENTS SHOULD BE AVAILABLE FROM THE MANUFACTURER OF THE ENGINEERED FLOOD OPENING(S). B8.) UNLESS OTHERWISE NOTED IN SECTION B, ITEM 10, THE FLOOD ZONE WAS DETERMINED BASED ON THE FLOOD INSURANCE RATE MAP. IN CERTAIN CASES WHERE AN ACCURATE DETERMINATION COULD NOT BE MADE FROM THE MAP, FEMA'S INTERACTIVE MAP OR THE COUNTY'S G.I.S. OVERLAY MAY HAVE BEEN UTILIZED TO DETERMINE THE FLOOD ZONE. NO SEARCH OF THE PUBLIC RECORDS WAS PERFORMED FOR LOMA'S, LOMR'S, ETC. WHICH MAY AFFECT THE SITE. B9.) IF APPLICABLE, WHEN THE BASE FLOOD ELEVATION IS SHOWN AS A WHOLE NUMBER ON THE FIRM, IT HAS BEEN CONVERTED TO A DECIMAL AND ENTERED TO THE NEAREST TENTH OF A FOOT AS REQUIRED BY FEMA. IF APPLICABLE, THE STRUCTURE CONTAINS: 0 CRAWLSPACE 0 ENCLOSURE ❑O ATTACHED GARAGE 0 N/A IF APPLICABLE, THE BOTTOM FLOOR ENCLOSURE CONTAINS: N/A IF APPLICABLE, DOES THE BOTTOM FLOOR ENCLOSURE APPEAR TO CONTAIN BREAK -AWAY WALLS? 0 YES 0 NO 0 N/A IF APPLICABLE, THIS ELEVATION CERTIFICATE WAS PREPARED USING THE "HISTORIC" FLOOD MAP DATA AND DATUM (N.G.V.D. 1929) FOR POSSIBLE "GRANDFATHERING" PURPOSES: 0 YES ❑O NO Attachment Page 1 of 2 Surveyor's Notes Attachment Page 2 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 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. 841 BAY ESPLANADE FOR INSURANCE COMPANY USE Policy Number: City CLEARWATER State FLORIDA ZIP Code 33764 Company NAIC Number SECTION D — SURVEYOR'S CERTIFICATION (CONTINUED FROM PAGE 7) IN REGARD TO ENGINEERED FLOOD OPENINGS, AS REFERENCED IN SECTIONS A8 AND A9 IF APPLICABLE, THE STRUCTURE'S: E CRAWLSPACE CONTAINS N/A ENGINEERED FLOOD OPENING(S) CERTIFIED TO COVER N/A SQ. FEET PER OPENING (MANUFACTURER: N/A — MODEL: N/A ) FOR A TOTAL OF N/A SQ. FEET OF COVERAGE AND N/A NON -ENGINEERED FLOOD OPENING(S) WITH A NET AREA OF N/A SQ. INCHES, PROVIDING COVERAGE FOR A TOTAL OF N/A SQ. FEET. ENGINEERED FLOOD OPENING(S) ARE: ❑INSTALLED ❑UNDER CONSTRUCTION ❑ PER PLAN E N/A NOTES: N/A 0 ENCLOSURE CONTAINS N/A ENGINEERED FLOOD OPENING(S) CERTIFIED TO COVER N/A SQ. FEET PER OPENING (MANUFACTURER: N/A — MODEL: N/A ) FOR A TOTAL OF N/A SQ. FEET OF COVERAGE AND N/A NON -ENGINEERED FLOOD OPENING(S) WITH A NET AREA OF N/A SQ. INCHES, PROVIDING COVERAGE FOR A TOTAL OF N/A SQ. FEET. ENGINEERED FLOOD OPENING(S) ARE: ❑ INSTALLED ❑ UNDER CONSTRUCTION OPER PLAN E N/A NOTES: N/A El ATTACHED GARAGE CONTAINS N/A ENGINEERED FLOOD OPENING(S) CERTIFIED TO COVER N/A SQ. FEET PER OPENING (MANUFACTURER: N/A — MODEL: N/A ) FOR A TOTAL OF N/A SQ. FEET OF COVERAGE AND N/A NON -ENGINEERED FLOOD OPENING(S) WITH A NET AREA OF N/A SQ. INCHES, PROVIDING COVERAGE FOR A TOTAL OF N/A SQ. FEET. ENGINEERED FLOOD OPENING(S) ARE: ❑INSTALLED ❑UNDER CONSTRUCTION 0 PER PLAN EN/A NOTES: N/A C2.e) AIR CONDITIONER IS LOCATED ON THE NORTH SIDE OF THE BUILDING ON AN ELEVATED CONCRETE SLAB. NOTICE: THIS DOCUMENT SHALL NOT BE VALID OR BINDING AGAINST THE SIGNING SURVEYOR UNLESS IT IS SIGNED AND EMBOSSED WITH THE ORIGINAL RAISED SEAL OF THE FLORIDA LICENSED SURVEYOR AND MAPPER. Attachment Page 2 of 2