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752 ELDORADO AVE O � U� 15 lf 1!I L5 FEDERAL EM�RGENCY MANAGEMENT AGENCY O M.B. No. 3067-0077 N A T I O N A L F L O O D I N S U R A N C E P R O G R A M Expires December 31, 2005 FEB 2�� 2� . ELEVATION CERTIFICATE • j Im ortant: Read the instructions on a es 1 -7. EN?�SE�1v�CES OEIn SECTION A-PROPERTY OyVNER INFORMATION F or Insurance Company Use: UILDI F'olfcy Number ' ROBERT BASHANI ' BUIIDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROWTE AND BOX NO. Company NAIC Number 752 ELDORADO AVE. , CITY CLEARWATER BEACH STATE , Z�P CoDE FLORIDA 33767 PROPER7Y DESCRIPTION(Lol and Biock Numbers,Tax Parcei Number,Legal Description,etc.) LOT 1 AND THE SOUTH 5 FEET OF LOT 2, BLOCK 4, MANDALAY SUBDIVISION BUILDING USE(e. Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,ii necessary.) RESIDE�TIAL - IATITUDE/LONGITUDE(OPTIONAI) HORIZONTAL DATUM: SOURCE: �_�GPS(Type): ( ##°-##'-##.##" Of ##.#####� �_�NAD 1927 �_�NAD 19$,'i I_I USGS Quad Map �_�Other SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME � B3. STATE � CITY OF CLEARWATER/125096 PINELLAS FLORIDA 84.MAP AND PANEL 65.SUFFIX B6.FIRM INDEX B7.FIRM PANEL 68.FLOOD 139.BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO,use depth of tlooding) 1�,10�C 0102 � 09/03/03 06/18/71-09/03/03 "VE" 14.00' NAVD 1988 DAT B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9. �_) FIS Profile � X� FIRM �_) Community Determined �_�Other(Describe): B11. Indicate the elevation datum used for the BFE in B9: �_) NGVD 1929 �X � NAVD 1988 �_�Other(Describe): 612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? (_�Yes �X � No Designation Date: SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) :1. Building elevations are based on: �_�Construction Drawings* �X�Building Under Construction' �_�Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 6 (Select the building diagram most similar to the building for which this certificate is being compieted-see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. 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/AO Complete Items C3.a-i below according to the building diagram specified in Item C�. State the datum used if the datum is different from the datum used for the BFE in Section B,conve�t the datum to that used for the BFE. Show field measurerrients and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate,to document the datum conversion. Datum NAVD 1988 Conversion/Comments CITY OF CLEARWATER BENCHMARK "I�-OZ" ELEVATION: 9.68' NAVD ADJ. Elevation reference mark used CITY "I-02" Does the elevation reference mark used appear on the FIRM? �_�Yes �X� No !� a)Top of bottom floor(including basement or enclosure) GRADE BEA1�I5 7..02 ft.(@b) � C:I b)Top of next higher floor �.OWEST LIVING FINISHED FLOOR:16..98 ft.(�b) � GUY D. HALE _ ❑ c)Bottom of lowest horizontal structural member(V zones only) 15..02 ft.(�b) �o P•L.S. ��4626 U d)Attached garage(top of slab) UNDER CONSTRUCTION _ft•(m) E� Ll e)Lowest elevation of machinery and/or equipment W `° UNDER CONSTRUCTIO � ; servicing the building(Describe in a Comments area.) �. m U Lowest ad'acent finished rade LAG ` ) E � � ) � )9 � ) 5.•Q—�) mv,' / U g)Highest adjacent(finished)grade(HAG) st .p_ft�i i) y � U h)No. of permanent openings(flood vents)within 1 ft. above adjacent grade 0 � � U i)Total area of all permanent openings(flood vents)in C3.h � sq. in.(sq. cm) J FEB RY 21, 2006 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 certi/y Ihaf the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data availab/e. I understand that any false statement may be punishable by�ne or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME ' LICENSE NUMBER GUY D. IiAT.F. P L S �f4626 TITLE COMPANY NAME PROFESSIONAL LAND SURVEYOR GUY D. HALE, LAND SURVEYING ��DDRESS 1110 OVERCASH DRIVE, SUITE "C" CITY �}UNEDIN STATE FLORID�i�P COOE 34698 SIGNATURE DATE TELEPHONE � FEMA Form 81-31,J ary 2003 See reverse side for continuation. Replaces all previous editions r�-�p Q��D� - a�(�� ' . . . , ... . � .._.+.. . �...q... . � . . '� . . . � �� . t IMPORTANT: In these spaces,copy the corresponding in�ormation from Section A. F��r insurance Company Use:, - BUILDING STREET ADDRESS(�nduding ApL,Unit,Suite,and/or Bidg.No.)OR P.O. ROUTE AND BOX NO. Policy Number 752 Er,DORan� avF CITY S7A7E ZIP CODE Company NAIC Number CLEARWATER BEACH FLORIDA 33767 ' � SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTIPJUED) Copy both sides of this Elevation Certificate for(1)community official, (2)insurance agent/company, and(3)b�iilding owner. COMMENTS -- I I Check here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zone AO and Zone A(without BFE), complete items E1.through E5. If the Elevation Certificate is intended for use as supporting information for a LOMA or LO�MR-F, Section C must be completed. E1. Building Diagram Number• (Select the building diagram most similar to the building for which this certificate is being completed– see pages 6 and 7. If no diagram accurately represents the building,provide a sketch or photograph.) E2. The top of the bottom floor(including basement or enclosure)of the building is I—I—I�• (m)I_I—I�� (��) I—I above or�_�below (check one)the highest adjacent grade. (Use natural grade, if available.) E3. For Building Diagrams 6-8 with openings(see page 7), the next higher floor or elevated floor(elevation b)of the building is I_I_I ft (►n)I—I—I�n. (cm) above the highest adjacent grade. Complete Items C3.h and C3.i on front of f��rm. E4. The top of the platform of machinery and/or equipment servicing the building is �_�_I ft• �m)I—I_I�n. (cm)�_� above or�_� below (check one)the highest adjacent grade. (Use natural grade, if available.) E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's f►oodplain manaqement ordinance?� � Yes I I No � I Unknown. The local official must certify this information in Section G SECTION F-PROPER7Y OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B,C(Items C3.h and C3 i only), and E for Zone A (without a FEMA-issued or community-issued BFE)or Zone AO must sign here. The stafements in Secfions A, 8, C, and E are correct to U�e best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME • ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS � � I Check here if attachments 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. Gt. �_) The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, ;- engineer,or architect who is authorized by state or loca�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 fol�owing inFormation(Items G4-G9)is provided for community floodplain management purposes. G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIF�CATE OF COMPLIANCE/OCCUPANCY � ISSUED G7. This permit has been issued for: �_� New Construction �_� Substantial Improvement G8. Elevation of as-built lowest floor(including basement)of the building is: ft. (m) Datum:_ G9. BFE or(in Zone AO)depth of flooding at the building site is: _ft. (m) Datum: LOCAL OFFICIAL'S NAM[ TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE • COMMENTS ��Check here if aftachments FEMA Form 81-31,January 2003 Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: Building StreeS Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number 752 ELDORADO AVENUE City State ZIP Code Company NAIC Number CLEARWATER BEACH FLORIDA 33767 SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for(1)community official, (2)insurance agent/company,and(3)building owner. Comments THIS IS A FOUR STORY BUILDING THAT IS BUILT WITH THREE STORIES BEING LIVING AREAS ABOVE THE GARAGE AND STORAGE STORY ON THE FIRST FLOOR. THE GARAGE LEVEL IS:8.27';THE FIRST LIVING FINISHED FLOOR ELEVATION IS: 17.04';THE A/C'S ARE RAISED TO AN ELEVATION OF: 17.0 ' THER RE O IOOD VENTS OR CRAWL SPACE. THE FIRST STORY HAS BREAKAWAY WAILS. Signature Date OCTOBER 24,2007 ❑ Check here if attachments SECTION E-BUI NG 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 Sections A,B, and C. For Items E1-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only,enter meters. E1. Provide eievation information for the fotlowing and check the appropriate boxes to show whether the elevation is above or be�ow the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawl space,or enclosure)is _ feet meters above or below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is _ feet meters above or below the LAG. E2. For Building Diagrams 6-S with permanent flood openings provided in Section A Items 8 and/or 9(see page 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is _ feet meters above or below the HAG. E3. Attached garage(top of slab)is feet meters above or beiow the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _ feet meters above or below the HAG. 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 floodplain management ordinance? Yes No 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 compietes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The sfatements in Sections A, 8, and 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 SECTION G -COMMUNITY INFORMATION (OPTIONAL) The locai official who is authorized by law or ordinance to administer the community's floodpiain 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.and G9. 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 foilowing information(Items G4.-G9.)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: � New Construction ❑Substantial Improvement G8.Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters(PR) Datum G9. BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR) Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poiicy rvumber 752 ELDORADO AVENUE City State ZI P Code Company NAIC Number CLEARWATER BEACH FLORIDA 33767 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two 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." If submitting more photographs than will fit on this page, use the Continuation Page, following. 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Zoos Federal Emergency Management Agency National E(�od insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1. Building Owner's Name Policy Number RDB WATERFRONT, LLC A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Company NAIC Number 752 ELDORADO AVENUE City State ZIP Code CLEARWATER BEACH FLORIDA 33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) �OT 1 AND THE SOUTH 5.0 FEET OF LOT 2,BLOCK 4,MANDALAY SUBDIVISION,PARCEL NO:05/29/15/54666/004/0020 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27°59'30"N. Long. 82°49'41"W. Horizontal Datum: NAD 1927 [x]NAO 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 6 A8. For a building with a crawl space or enclosure(s),provide: A9. For a building with an attached garage,provide: a) Square footage of crawl space or enciosure(s) 0 sq ft a) Square footage of attached garage 2152.8 sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enciosure(s)walls within 1.0 foot above adjacent grade 0 walls within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in c) Totai net area of flood openings in A9.b 0 sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 61. NFIP Community Name&Community Number 62.County Name 63.State CITY OF CLEARWATER/125096 PINELLAS FLORIDA B4.Map/Panel Number B5.Suffix 66.FIRM Index B7. FIRM Panel 68. Flood 69.Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 12103 C 0102 G 09/03/2003 09/03/2003 VE 13.00 NAVD 1988 DATUM 810. Indicate the source of the Base Fiood Elevation(BFE)data or base flood depth entered in Item 69. ❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe) 611. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 �NAVD 1988 ❑Other(Describe) 812. Is the building located in a Coastal Barrier Resources System(CBRS)area or Othervvise Protected Area(OPA)? � Yes � No Designation Date N/A �CBRS �OPA SECTION C -BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑Construction Drawings" ❑ Building Under Construction' � 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/Ali,ARlAO. Complete Items C2.a-g below according to the building diagram specified in Item A7. Benchmark Utilized CITY OF CLEARWATER BENCHMARK"I-02: Vertical Datum NAVD 1988 DATUM Conversion/Comments PUBLISHE�ON CITY OF CLEARWATER ENGINEERING WEBSITE AS:4.98 NAVD 1988 DATUM Check the measurement used. a) Top of bottom floor(including basement,crawl space,or enclosure floor) 827 �feet �meters(Puerto Rico only) b) Top of the next higher floor 17.04 �feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) 15.02 �feet ❑meters(Puerto Rico only) d) Attached garage(top of siab) 8.27 �feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 17.02 �feet ❑meters(Puerto Rico only) (Describe type of equipment in Comments) � Lowest adjacent(finished)grade(LAG) 8.1 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade(HAG) 8.2 .�feet �meters(Puerto Rico oniy) 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 fo interpret the data available. 1 understand that any false statement may be punishabie by fine or impnsonment under 18 U.S. Code, Section 1001. " �UY D:`hI/4LE P L.S."#46� Check here if comments are provided on back of form. � , � �' . Certifier's Name License Number �� GUY D.HALE P.L.S.#4626 Title Company Name PROFESSIONAL LAND SURVEYOR GUY HALE LAND SURVEYING � Address City State ZIP Code 1110 OVERCA IVE UITE C DUNEDIN FLORIDA 34698 ��:{O� OBER 24, 2007 Signature Date Telephone NOVEMBER 24 2007 727 73�3-4266 FEMA Form 81-31, ebruary 2006 See reverse side for continuation. Replaces all previous editions