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912 NICHOLSON STELEVA gJ .4 CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMP: 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. 912 Nicholson Street Policy Number: City State ZIP Code Clearwater Florida 33755 Company NAIC Number SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: *A new Elevation Certificate will be required C2. Elevations—Zones A1—A30, AE, AH, Complete Items C2.a—h below according Benchmark Utilized: City of Clearwater ■ A Construction Drawings* when construction of the (with BFE), VE, V1—V30, V to the building diagram specified Map #G-06 Vertical x building (with Datum: Building Under Construction* ❑ Finished Construction is complete. BFE), AR, AR/A, ARAE, AR/A1—A30, AR/AH, AR/A0. in Item A7. In Puerto Rico only, enter meters. NAVD 1988 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) 23.0 x the measurement used. feet ❑ meters b) Top of the next higher floor N/A 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) 21.9 x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building N/A (Describe type of equipment and location in Comments) x feet ❑meters f) Lowest adjacent (finished) grade next to building (LAG) 21.5 x feet p meters g) Highest adjacent (finished) grade next to building (HAG) 21.9 x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A 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 1 certify that the information on this Certificate represents my best efforts to interpret statement maybe 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 the data 1001. Yes • by law to certify elevation information. available. / understand that any false No ❑ Check here if attachments. Certifier's Name License Number John O. Brendla 4601 0 .../limuli Place Seal i7 Here Q.' 2 1 / 0 ). WC3 is 2.1)2.-v Title Surveyor Company Name John C. Brendla & Associates, Inc. Address 4015 82nd Avenue North City State ZIP Code Pinellas Park Florida 33781 Signature Date Telephone Ext. . 0612-28-2020 (727) 576-7546 None Copy all pa' - • this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments ,ding type of equipment and location, per C2(e), if applicable) C2) e. N/A Benchmark: City of Clearwater Map #G-06 Elev. 26.98' NAVD - MSL = 0.00 FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 2 of 6 U.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: Nov ber 30, 2022 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 EMERGE COMMUNITY ECONOMIC DEV. CORP. Policy Number. A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 912 Nicholson Street Company NAIC Number. City State ZIP Code Clearwater Florida 33755 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 7 and 1/2 of Vacated Alley adj on North, Block 2 - Pine Crest -Plat Book 1, Page 66 - Parcel #10-29-15-69138-002-0070 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 a) Square footage b) Number of c) Total net area d) Engineered Residential, Non -Residential, Addition, Accessory, Lat. 27.97483°N Long. -82.79386°W etc.) Residential Horizontal Datum: insurance. above grade ❑ NAD 1927 adjacent grade 0 p NAD 1983 0 2 photographs Number with a crawlspace of crawlspace permanent flood of flood openings flood openings? with an attached of attached permanent 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 1.0 foot above adjacent in 253.00 sq ft ■ Yes x No garage: garage openings in the attached garage within in A9.b 0.00 sq ❑ Yes x No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number Clearwater -125096 B2. County Name Pinellas B3. State Florida B4. Map/Panel Number 12103C0106 B5. Suffix H 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) 21.0' B10. Indicate the source ❑ FIS Profile B11. Indicate elevation B12. Is the building Designation Date: 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 ❑ Other/Source: Protected 1929 x NAVD 1988 (CBRS) area or Otherwise ❑ OPA Area (OPA)? II 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 IMPORTFT�T: 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. 912 Nicholson 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 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. F MPS FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 912 Nicholson Street Policy Number. City State ZIP Code Clearwater Florida 33755 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) 912 NICHOLSON ST BCP2020=070625A ucEc' EMERGE Zoning: Medium DensityAtlas # 278A i ❑ Check here if attachments. FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 4 of 6 U.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, 2022 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 EMERGE COMMUNITY ECONOMIC DEV. CORP. Policy Number: A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 912 Nicholson Street Company NAIC Number City State ZIP Code Clearwater Florida 33755 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 7 and 1/2 of Vacated Alley adj on North, Block 2 - Pine Crest -Plat Book 1, Page 66 - Parcel #10-29-15-69138-002-0070 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 permanent c) Total net area d) Engineered Residential, Non -Residential, Addition, Accessory, Lat. 27.97483°N Long. -82.79386°W etc.) Residential Horizontal Datum: insurance. above grade ❑ NAD 1927 adjacent grade 0 x NAD 1983 0 2 photographs Number with a crawlspace of crawlspace permanent 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 1.0 foot above adjacent in 253.00 sq ft ❑ Yes x No garage: garage openings in the attached garage within in A9.b 0.00 sq ❑ Yes x No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP Community Name & Community Number Clearwater -125096 62. County Name Pinellas B3. State Florida B4. Map/Panel Number 12103C0106 B5. Suffix H 66. FIRM Index Date 08-18-2009 B7. FIRM Panel Effective/ Revised Date 09-03-2003 B8. Flood Zone(s) AE 69. Base Flood E evation(s) (Zone AO, use Base Flood Depth) 21.0' 610. Indicate the source of the Base Flood Elevation ❑ Community Determined for BFE in Item 69: Coastal Barrier Resources ❑ (BFE) data ❑ NGVD System CBRS or base flood ❑ Other/Source: depth entered in Item B9: • FIS Profile B11. Indicate elevation B12. Is the building Designation Date: x FIRM datum used located in a ❑ Other/Source: Protected 1929 (CBRS) x NAVD 1988 area or Otherwise Area (OPA)? ❑ Yes x No ■ OPA 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. 912 Nicholson Street Policy Number: City State ZIP Code Clearwater Florida 33755 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, ARAE, Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Benchmark Utilized: City of Clearwater Map #G-06 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. Check a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 23.0 the measurement used. x feet ❑ meters b) Top of the next higher floor N/A 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) 21.9 x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) N/A x feet ❑meters f) Lowest adjacent (finished) grade next to building (LAG) 21.5 x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 21.9 x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A 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 authorized by I certify that the information on this Certificate represents my best efforts to interpret the data available. statement maybe 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 John O. Brendla 4601 0 PINAS Place. Seal , / �� �A Here �i ,2, 2 p'" 2.6217 Title Surveyor Company Name John C. Brendla & Associates, Inc. Address 4015 82nd Avenue North City State ZIP Code Pinellas Park Florida 33781 Signature -11 ©-6 ji Date Telephone Ext. 12-28 2020 (727) 576-7546 None this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Copy all pa1111 Comments ding type of equipment and location, per C2(e), if applicable) C2) e. N/A Benchmark: City of Clearwater Map #G-06 Elev. 26.98' NAVD - MSL = 0.00 FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 2 of 6 ti • / 4 I 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. 912 Nicholson 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 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. 912 Nicholson Street Policy Number: City State ZIP Code Clearwater Florida 33755 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) 912 NICHOLSON ST BCP2020-070625A UC EC EMERGE Zoning: Medium Density Atlas #: 278A ❑ Check here if attachments. FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 4 of 6