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810 ELDORADO AVEDEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency ELEVATION CERTIFICATE OMB Control Number: 1660-0008 _- IMP[')RT4NT� F(�LLOW THE INSTRUCTIONS ON PAGES 9-16 Expiration: 11/30/2018 opy 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 FORM INSURANCE COMPANY USE A1. Building Owner's Name KqREN A AND E�LIOT J PENNER Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Box No. 810 ELDORADO AVENUE Number: City CLEARWATER State FLORIDA Zip Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parce► Number, Legal Description, etc.) PARCEL 25-29-15-54666-005-0040, BLOCK 5, LOT 4, MANDALAY SUB, PB 014, PG 032, PINELLAS COUNTY, FLORIDA A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) A5. Latitude/Longitude: Lat. Long. Horizontal Datum: �, NAD 1927 (: NAD 1983 �7 99�q -82.8280 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number �+q A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) NA sq ft a) Square footage of attached garage 9� 8 sq ft b) Number of permanent flood openings in the b) Number of permanent flood openings crawlspace or enclosure(s) within 1.0 foot in the attached garage within 1.0 foot NA above adjacent grade NA above adjacent grade c} Total net area of flood openings in A8.b Nq sq in c) Total net area of flood openings in A9.b NA sq in d) Engineered flood openings? C�' Yes C�No d) Engineered fiood openings? i` Yes (i�No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name 63. State CLEARWATER CITY OF 125096 PINELLAS FL B4. Map/Panel Number 65. Suffix 66. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) B9. Base Flood Elevation(s) Revised Date (Zone AO, use base flood 12103C0102 G 08/18/2009 09/03/2003 VE depth 14.0 FEET B10. indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: {�' FIS Profile �' FIRM (` Community Determined C�` Other/Source: B11. Indicate elevation datum used for BFE in Item B9: {" NGVD 1929 � NAVD 1988 (�` Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ('` Yes ¢�`` No Designation Date: NA {" CBRS � OPA SECTION C- BUILDING ELEVATiON INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: �` Construction Drawings" C�` Building Under Construction` (R Finished Construction 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/AO. Complete Items C2.a -h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. A new Elevation Certificate wi{I be required when construction of the bui{ding is cosnplete. Benchmark Utilized: GPS Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. (`' NGVD 1929 � 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) 8�57 - {: feet {� meters b) Top of the next higher floor 17.43 - (: feet �"' meters c) Bottom of the fowest horizontal structural member (V Zones only) 14�9 - {:' feet (' meters d) Attached garage (top of slab) 7•91 - (: feet (`� meters e) Lowest elevation of machinery or equipment servicing the building 9 5 (Describe type of equipment and location in Comments) C�' feet (` meters fl Lowest adjacent (finished) grade next to buiiding (LAG) 7•74 - (: feet C meters g) Highest adjacent (finished) grade next to building (HAG) 7�94 - (: feet C' meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 7.74 ' t: feet (` meters PROVIDED BY BILL HYATT, PROFESSIONAL SURVEYOR FLORIDASURVEYOR@AOL.COM FEMA Form 086-0-33 (7/15) Replaces all previous editions. Page 3 of 15 ELEVATION CERTIFICATE OMB Control Number: 1660-0008 810 ELDORADO AVENUE, CLEARWATER, FL 33767 Expiration: 11/30/2018 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 thaf the information on this Certificate represents my best efforts to interpret the data available. l understand that any false statement may be punishable by �ne or imprisonment under 18 U. S. Code, Section 1001. Were latitude and longitude in Section A � Check here if attachments. provided by a licensed land surveyor? ti��,� �� "�' y r r (: Yes i` No :, i �.;''�� ,�'��'� Certifier's Name License Number �� BILL HYATT FLORIDASURVEYOR@AOL.COM LS 4636 �j � Title PRESIDENT Company Name KNOW IT NOW INC Address City State Zip Code `"�-� �� °�s �"�� t ; � t:�!?IL�'s 1497 MAIN ST #321 DUNEDIN FL 34698 � F "''c.,,, Signature fC�� Date Telephone ' .�:; � `�� 2-23-16 +1 (727) 415-8305 Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location , per C2(e), if applicable)" , EQUIPMENT LISTED IN C.2.E IS BASE OF AIR CONDITIONING UNIT 2-23-2016 Signature � � "� ' ' � � Date SECTION E- BUILDING ELEVATION INFORMATtON (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT Bf =or Zones AO and A(without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR-F request, comple 3ections A, B,and C. For ltems E 1-E4, use natural grade, if availabte. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is b) Top of bottom floor {including basement, crawlspace, or enclosure) is � feet C` meters � above or � below the HAG. (' feet ("' meters 0 above or ❑ below the �AG. 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 in the diagrams) of the building is - ("' feet (" meters � above or � below the HAG. Attached garage (top of slab) is Top of platForm of machinery and /or equipment �icing the building is (~ feet ('s meters (� feet (`' meters � above or � below the HAG. � 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 fioodplain 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 completes Sections A, B, and E for Zone A(without a FEMA-is: community-issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knc Property Owner or Owner's Authorized Representative's Name: Address City State ZIP Code Signature Comments FEMA Form 086-0-33 (7/151 Date Telephone Reqlaces all previous editions. or � Check here if attachments. Page 4 of 15 OMB Control Number: 1660-0008 Expi ration: 11 /30/2018 FEMR Form Q86-Q-33 (7/15) Replaces all previous editions. F'age 5 of 15 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS CONTINUATION PAGE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. ADDRESS: 810 ELDORADO AVE CLEARWATER, FL 33767 PICS TAKEN 02/23/2016 FRONT VIEW AND CONTINUING AROUND BUILDING .� __ ., , < , � _ � . ,_� � : . #-� � �- � � �� « -- . �.---- � _��..� � _y_______-�:-- ,. � �---�---�--�--,�.�-�' � �°_: � ��--- , � � � ��_ __. ., � � � �� .� ,� � r � �.. _.__.. `" � � � ;: �t _ �� n� ^�'&��•.i � �c v..�. __ . y..�': �� : f�iti $ r 3F ��,�.; �'�� .� m. �� t � �''_ F � �� _ � 3 � � �. , � �5 � � ��,..:. . . . . .s �'�� U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB NO. 166a0008 Federal Emergency Management Agency Expires March 31,2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION ,FOrJttsuran�e�ornpan�.11se-s� �� A1. Building Owner's Name KAREN A AND ELLIOT J PENNER Ppi�cy N�,mber; �r�., A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. ComperEy NAEC Number 810 ELDORADO AVENUE City CLEARWATER BEACH State FL ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) PARCEL 25-29-15-54666-005-0040, BLOCK 5, LOT 4, MANDALAY SUB, PLAT BOOK 014, PAGE 032, PINELLAS A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)RESIDENTIAL A5. Latitude/Longitude:Lat. 27.9939 Long. 82.8278 Horizontal Datum: ❑ NAD 1927 x NAD 1983 A6. Attach at least 2 photographs of the buiiding if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number SIX A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s)1975 INCLUDES GARAGE a) Square footage of ENCLOSED garage 918 sq ft b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? ❑Yes X No d) Engineered flood openings? ❑ Yes X No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name&Community Number B2.County Name 83.State CLEARWATER CITY OF 125096 PINELLAS FL 64.Map/Panel Number 65.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 12103C0102 G 08/18/2009 09/03/2003 VE 14.0 FEET B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑FIS Profile x FIRM ❑Community Determined ❑Other(Describe) B11. indicate elevation datum used for BFE in Item 69: _NGVD 1929 X NAVD 1988 ❑Other(Describe) B12. Is the buiiding located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes x No Designation Date ❑CBRS DOPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) 1. Building elevations are based on: ❑Construction Drawings' ❑Building Under Construction* x Finished Construction ��_..�.:__,._�:<:__._..:��----'---� -�-- , ._..-°-- -<.,_ � .�_�� i1 IIGW CICVAUVII I.CIIIIII:CLC WIII UC ItlI�UIICU WIICII I.UIIJIIUl:llUll UI llle UUIIUIfI(�IS(:Ufll()ICl(.''. 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/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized GPS Vertical Datum NAVD 1988 Conversion/Comments NONE Check the measurement used. a) Top of bottom floor(including basement,crawispace,or enclosure floor) 8.57 x feet ❑meters(Puerto Rico only) b) Top of the next higher floor 17.43 x feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) 14.9 x feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) 7.91 x feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building AC 7.94 x feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) � Lowest adjacent(finished)grade next to building(LAG) 7.74 X feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 7.94 x feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest eievation of deck or stairs,including 7.74 x feet ❑meters(PueRo Rico only) 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. 4a`��.,�tr,,,�..y R 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. �� L`-.�:H r'�.> XCheck here if comments are provided on back of form. Were latitude and longitude in Section A provided by a +;��G�k7�,c�.�� licensed land surveyor? x Yes ❑No f � yf,-`� Certifier's Name: BILL HYATT License Number: LS 4636 'c r ? �s � �Y =.�':,SnTqT f �� Title: PRESIDENT Company Name: KNOW IT NOW INC � 0� `•:-.��'•.,OR1 DA � Address: 1497 MAIN STREET#321 City: DUNEDIN State: FL ZIP Code: 34698 .��;^�/{��(�� Signature /o�-��'- Date: 5-31-12 Telephone: 727-415-8305 ��SY�- 5-31-2012 PLS 4636 FEMA Form 81-31, Mar 09 See reverse side for continuation. epiaces all previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. �or Insucance�ompany Use: Building StreetAddress(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. PotiCy,Number- 810 ELDORADO AVENUE City CLEARWATER BEACH State FL ZIP Code 33767 CQrnpanyNAIG',Nutt�ber? . SECTlON D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community officiai,(2)insurance agenUcompany,and(3)building owner. Comments EQUIPMENT ON PRIOR PAGE IS EXTERIOR AIR CONDITIONING UNIT ENCLOSED AREA=1975 SQUARE FEET,918 OF WHICH IS A GARAGE Signature �"—"-'7� Date 5-31-12 X Check here if attachments 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 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 elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or ❑below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or ❑below the LAG. 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 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 ❑below 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 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,8, and E are correct to the best of my knowledge. PropeRy Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Teleohone Comments ❑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. 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 following 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 G10.Community's design fiood elevation ❑ feet ❑meters(PR)Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑Check here if attachments FEMA Form 81-31, Mar 09 Repiaces all previous editions Building Photographs See Instructions for Item A6. For Insurance Company Use: Buiiding Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Poi�cy Number _ 810 ELDORADO AVENUE City CLEARWATER BEACH State FL ZIP COd@ 33767 C�npany NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at �east two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front VieW' and "Rear Viev✓'; and, if required, "Right Side View"and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the reverse. 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