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137 MARINA DEL REY CT• 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 SHARPE, EDWARD M SHARPE, NATALIE M Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 137 MARINA DEL REY CT Company NAIC Number: City State ZIP Code CLEARWATER Florida 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) MARINA DEL REY AT SAND KEY UNIT B LOT 55 PB 81/54 PARCEL # 19-29-15-55303-000-0550 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, Accessory, etc.) Lat, 27.93972 N Long. -82.83488 W RESIDENTIAL Horizontal Datum: insurance. above ❑ NAD 1927 adjacent grade grade 0 Q NAD 1983 N/A 2 photographs of the building if the Number 7 Certificate is being used to obtain flood 2150.00 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 or enclosure(s) N/A 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 0.00 sq ❑ Yes F,9 No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number CITY OF CLEARWATER 125096 B2. County Name PINELLAS B3. State Florida B4. Map/Panel Number 12103C0104G B5. Suffix G 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) 11.0 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: Q FIRM datum used located in a Date: ❑ Other/Source: Protected Q NAVD 1988 area or Otherwise Area (OPA)? ❑ Yes .0 No FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 1 of 6 137 MARINA DEL REY C BCP2021-030606 ec SHARPE EDWARD M Zoning: Medium Density Atlas #: 31' 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. 137 MARINA DEL REY CT Policy Number: City State ZIP Code CLEARWATER Florida 33767 Company NAIC Number SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. 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 A1—A30, AE, AH, A (with BFE), VE, V1—V30, V (with BFE), 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: FDOT PRN Vertical Datum: NAVD 88 GEOID 12B Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 a NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 5.1 a feet (■ meters b) Top of the next higher floor 13.9 a feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A a feet ❑ meters d) Attached garage (top of slab) N/A a feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) 5.4 Q feet meters f) Lowest adjacent (finished) grade next to building (LAG) 4.5 VA feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 5.1 a feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A 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 law to certify elevation information. I certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement maybe 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? i, Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number LAWRENCE E. POWERS LS 5505 N Title j� N FLORIDA LICENSED LAND SURVEYOR q +"F` Company Name IP LAWRENCE E. POWERS LS t AddressT 4996 MIRAMAR DR # 6207 ki • IDA City State ZIP Code 46 fitavirte ST PETERSBURG Florida 33708 n Signature / Date Telephone Ext. LarryPowpJ/i Mortallygoad by Larry Powers Date 20 07 2d1129 07-14-2021 (727) 537-9895 Copy all pages of this ev ion 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) ITEM C2a GARAGE/STORAGE/UTILITY AREA ITEM C2b LIVING SPACE. ITEM C2d NOT APPLICABLE FOR A TYPE 7 BLDG (SEE ITEM C2a). ITEM C2e NC UNIT SOUTHWEST (BACK) SIDE OF BLDG. SUBJECT IS A TOWNHOME WITH SHARED EASTERLY PARTY -WALL SUBJECT BUILT IN 1982, ITEM A8a (PER ASSESSOR'S OFFICE) A8b SUBJECT DOES NOT HAVE FLOOD VENTS THIS ELEVATION CERTIFICATE IS ONLY VALID FOR THE PERSON OR PERSONS NAMED ON THIS CERTIFICATE AND IT'S USE IS LIMITED TO FLOOD INSURANCE APPLICATION 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. 137 MARINA DEL REY CT 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, 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), ❑ 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 Q 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. 137 MARINA DEL REY CT 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: 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) 137 MARINA DEL REY CT B BCP2021-030606 ec SHARPE EDWARD M Zoning: Medium Density Atlas #: 311B ❑ Check here if attachments. FEMA Form 086-0-33 (12/19) 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. 137 MARINA DEL REY CT 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. i%: aro- 4 1 Photo One Photo One Caption FRONT VIEW JULY 14, 2021 Clear Photo One I ..• 1- r rint lirwm-rrn i �r�� Ali tT t f M,.i L_4.6yM l i 1' I i'•I‘'i, 711 11 I Photo Two Photo Two Caption BACK VIEW JULY 14, 2021 Clear Photo Two FEMA Form 086-0-33 (12/19) 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. 137 MARINA DEL REY CT 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. Photo Three li- !tom . .. Photo Three Caption RIGHT SIDE VIEW JULY 14, 2021 Clear Photo Three Photo Four Photo Four Caption NO LEFT SIDE VIEW (SUBJECT IS A TOWNHOME WITH SHARED PARTY -WALL ON E. SIDE Clear Photo Four FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 6 of 6 Fo? •1=;..c - ch, 44 c. P -20 2 I - O W (o O ( ' RECEIVED JUL I5 2021 PLANNING & DEVEL! tAk CLE: CITY OF / F FEMA NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE AND INSTRUCTIONS 2019 EDITION OMB No. 1660-0008 Expiration Date: November 30, 2022 U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE AND INSTRUCTIONS Paperwork Reduction Act Notice Public reporting burden for this data collection is estimated to average 3.75 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting this form. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C Street SW, Washington, DC 20742, Paperwork Reduction Project (1660-0008). NOTE: Do not send your completed form to this address. Privacy Act Statement Authority: Title 44 CFR § 61.7 and 61.8. Principal Purpose(s): This information is being collected for the primary purpose of estimating the risk premium rates necessary to provide flood insurance for new or substantially improved structures in designated Special Flood Hazard Areas. Routine Use(s): The information on this form may be disclosed as generally permitted under 5 U.S.C. § 552a(b) of the Privacy Act of 1974, as amended. This includes using this information as necessary and authorized by the routine uses published in DHS/ FEMA -003 — National Flood Insurance Program Files System or Records Notice 73 Fed. Reg. 77747 (December 19, 2008); DHS/ FEMA/NFIP/LOMA-1 — National Flood Insurance Program (NFIP) Letter of Map Amendment (LOMA) System of Records Notice 71 Fed. Reg. 7990 (February 15, 2006); and upon written request, written consent, by agreement, or as required by law. Disclosure: The disclosure of information on this form is voluntary; however, failure to provide the information requested may result in the inability to obtain flood insurance through the National Flood Insurance Program or the applicant may be subject to higher premium rates for flood insurance. Information will only be released as permitted by law. Purpose of the Elevation Certificate The Elevation Certificate is an important administrative tool of the National Flood Insurance Program (NFIP). It is to be used to provide elevation information necessary to ensure compliance with community floodplain management ordinances, to determine the proper insurance premium rate, and to support a request for a Letter of Map Amendment (LOMA) or Letter of Map Revision based on fill (LOMR-F). The Elevation Certificate is required in order to properly rate Post -FIRM buildings, which are buildings constructed after publication of the Flood Insurance Rate Map (FIRM), located in flood insurance Zones A1—A30, AE, AH, A (with BFE), VE, V1—V30, V (with BFE), AR, AR/A, AR/AE, AR/A1—A30, AR/AH, and AR/AO. The Elevation Certificate is not required for Pre -FIRM buildings unless the building is being rated under the optional Post -FIRM flood insurance rules. As part of the agreement for making flood insurance available in a community, the NFIP requires the community to adopt floodplain management regulations that specify minimum requirements for reducing flood losses. One such requirement is for the community to obtain the elevation of the lowest floor (including basement) of all new and substantially improved buildings, and maintain a record of such information. The Elevation Certificate provides a way for a community to document compliance with the community's floodplain management ordinance. Use of this certificate does not provide a waiver of the flood insurance purchase requirement. Only a LOMA or LOMR-F from the Federal Emergency Management Agency (FEMA) can amend the FIRM and remove the Federal mandate for a lending institution to require the purchase of flood insurance. However, the lending institution has the option of requiring flood insurance even if a LOMA/LOMR-F has been issued by FEMA. The Elevation Certificate may be used to support a LOMA or LOMR-F request. Lowest floor and lowest adjacent grade elevations certified by a surveyor or engineer will be required if the certificate is used to support a LOMA or LOMR-F request. A LOMA or LOMR-F request must be submitted with either a completed FEMA MT -EZ or MT -1 package, whichever is appropriate. This certificate is used only to certify building elevations. A separate certificate is required for floodproofing. Under the NFIP, non- residential buildings can be floodproofed up to or above the Base Flood Elevation (BFE). A floodproofed building is a building that has been designed and constructed to be watertight (substantially impermeable to floodwaters) below the BFE. Floodproofing of residential buildings is not permitted under the NFIP unless FEMA has granted the community an exception for residential floodproofed basements. The community must adopt standards for design and construction of floodproofed basements before FEMA will grant a basement exception. For both floodproofed non-residential buildings and residential floodproofed basements in communities that have been granted an exception by FEMA, a floodproofing certificate is required. Additional guidance can be found in FEMA Publication 467-1, Floodplain Management Bulletin: Elevation Certificate, available on FEMA's website at https://www.fema.gov/media-library/assets/documents/3539?id=1727. FEMA Form 086-0-33 (12/19) Replaces all previous editions. F-053 U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program OMB No. 1660-0008 Expiration Date: November 30, 2022 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 FOR INSURANCE COMPANY USE Al. Building Owner's Name Edward M. Sharpe and Natalie M. Sharpe Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 137 Marina del Rey Court Company NAIC Number: City State ZIP Code Clearwater FLORIDA 33767 A3. Property Description (Lot and Block numbers, Tax Parcel Number, Legal Description, etc.) TAX PARCEL ID: 19-29-15-55303-000-0550 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, Etc.) Residential A5. Lattitude/Longitude: Lat. N 27°56'22.50 Long. W 82°50'5.80 Horizontal Datum: Q NAD 1927 3 NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance A7. Building Diagram number 1A A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 0 Sq. Ft. b) No. of permanent flood openings in the crawlspace or endosure(s) within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 Sq. in. d) Engineered flood openings? A9. For a building with an attached a) Square footage of attached garage II garage: Yes 3 400 No Sq. Ft. b) No. of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 0 Sq. In. d) Engineered flood openings? ❑ Yes 3 No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number PINELLAS COUNTY/ 125096 82. County Name Pinellas County B3. State FLORIDA B4.Map/Panel Number 12103C0104G B5.Suffix H B6.FIRM Index Date B7.FIRM Panel Effective /Revised Date B8.Flood Zone(s) AE B9.Base Flood elevation(s) (Zone AO, use base flood depth) 11.0' B10.Indicate the source El FIS Profile of the Base Flood Elevation (BFE) data or base flood depth entered in item B9: 3 FIRM Community Determined D Other (Describe) B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 © NAVD 1988 D Other (Describe) 612.1s the building located in a Costal Barrier Resources System (CBRS) area or Otherwise protected Area (OPA)? Q Yes Designation Date N/A CBRS OPA 3 No FEMA Form 086-0-33 (12/19) Replaces all previous editions. "REVISED" PLANS RECEIVED BY: S.L JUN 0 8 2021 PLANNING & DEVELOPMENT CITY OF CLEARWATER 137 MARINA DEL REY CT B BCP2021-030606 RTC SHARPE EDWARD M 0 Zoning: Medium Density Atlas #: 311B 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. 137 Marina del Rey Court Policy Number: City State ZIP Code Clearwater FLORIDA 33767 Company NAIC Number: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Complete items C2.a-h below according to C1. Building elevations are based on: ❑ Construction Drawings* i Building Under Construction* 3 Finished 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, AR/A1-A30, AR/AH, AR/A0. the building diagram specified in item A7. IN Puerto Rico only, enter meters. Benchmark Utilized: FDOT GPS NETWORK Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. NGVD 1929 3 NAVD 1988 D Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a)Top of bottom floor (Including basement, crawlspace, or enclosure floor) 5 • 53 3 feet 0 meters b)Top of the next highest floor 14 . 53 3 feet D meters c)Bottom of the lowest horizontal structural member (V Zones only) N/A . feet • meters d)Attached Garage (top of slab) 5 08 ® feet meters e)Lowest elevation of machinery or equipment servicing the building 5 38 3 feet meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 4 . 40 3 feet meters g)Highest adjacent (finished) grade next to building (HAG) 4 . 50 3 feet D 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 law to certify elevation information. I certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement imprisonment under 18 U.S. Code, Section 1001. may be punishable by fine or Were latitude and longitude in Section A provided by a licensed land surveyor? Q Yes 3 No 3 Check here if attachments. Certifier's Name JOSE ROCHE License number 5935 Title PROFESSIONAL SURVEYOR & MAPPER Company Name ME LAND SURVEYING Address 10665 SW 190th STREET SUITE 3110 City MIAMI State FL ZIP Code 33157 Signature Date 11/05/2020 Telephone (305) 740-3319 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2)insurance agent/company, (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) LATITUDE LONGITUDE PER GOOGLE, ATTACHMENTS = BUILDING PICTURES C2E= AC UNIT, LOCATED IN THE SIDE OF THE HOUSE. This elevation certificate is for flood insurance rating purposes only and may not be used for building permitting purposes due to measurement precision issues. FEMA Form 086-0-33 (12/19) Replaces all previous editions. T 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. 137 Manna del Rey Court 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 LOMA or LOMR-F request, complete E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the lowest adjacent grade (LAG). Sections A, B,and C. For Items El— the highest adjacent grade (HAG) and the HAG the LAG HAG HAG the HAG floodplain management ordinance? a) Top of bottom floor (including basement, . feet MI meters above or • below crawlspace, or enclosure) is b) Top of bottom floor (including basement, . feet meters 0 above or II below crawlspace, or enclosure) is E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of instructions), the next higher floor (elevation C2.b [J feet NI meters 0 above or below the in the diagrams) of the building is E3. Attached garage (top of slab) is . • feet meters above or below the E4. Top of platform of machinery and/or equipment . ❑ feet 0 meters above or below servicing the building is E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's Yes ❑ No 3 Unknown. The local official must certify this information in Section G. 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, abd E are correct to the best of my knowledge . Property Owner's 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 Pan* 1 of 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. 137 Marina del Rey Court 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 Elevation Certificate. Complete the applicable ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this item(s) and sign below. Check measurement used in items G8 - G10. In Puerto Rico only, enter meters. from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by (Indicate the source and date of the elevation data in the Comments area below.) E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. -G10) is provided for community floodplain management purposes. 01. II The information in Section C was taken law to certify elevation information. G2.11 A community official completed Section G3. Q The following information (Items G4 G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Complicance/Occupancy Issued G7. This permit has been issued New for: G8. Elevation of as -built lowest floor (including G9. BFE or (in Zone AO) depth of flooding G10. Community's design flood elevation Construction ❑ Substantial Improvement basement) of the building: feet 1111 meters Datum at the building site: . feet II meters Datum Dfeet NI meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments Check here if attachments. FEMA Form 086-0-33 (12/19) Replaces all previous editions. Fnrm Pan. A of R 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. 137 Marina del Rey Court 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. gra? ` fig r - • SIS! Photo One Photo One Caption Photo Taken "Front View" Pl,o o TWO is r r r 17 r7 1 II I ■ J — Photo Two Caption Photo Taken "Rear View" FEMA Form 086-0-33 (12/19) Replaces all previous editions. Fnrm Pana a of R 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. 137 Marina del Rey Court 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. Photo One Photo One Caption Photo Taken "Left View" el 0 a Two Photo Photo Two Caption Photo Taken "Right View" FEMA Form 086-0-33 (12/19) Replaces all previous editions