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984 ELDORADO AVEU.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. OMB No. 1660-0008 Expires March 31, 2012 SECTION A - PROPERTY INFORMATION ComptlnY Al, Building Owner's Name Michael Cavil! t Nurr A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 984 Eldorado Avenue Cornpari NAIC Number City Clearwater State FL ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Parcel ID # 05-29-15-54666-069-0040 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longltude: Lat. 28.0013999 Long. -82.826927 Horizontal Datum: AB. Attach at least 2 photographs of the building if the Certificate Is being used to obtain flood insurance. A7. Building Diagram Number 7 A8. For a building with a crawtspace or enclosure(s): a) Square footage of crawlspece or enclosure(s) b) No. of permanent flood openings in the crawtspace or enclosure(s) within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b d) Engineered flood openings? 0 Yes ® No NL Q 2 sq ft sq In 0 NAD 1927 CEI NAD 1983 A9. For a building with an attached garage: a) Square footage of attached garage 2482 sq ft b) No. of permanent flood openings in the attached garage within 1.0 foot above adjacent grade Q c) Total net area of flood openings In A9.b Q sq In d) Engineered flood openings? 0 Yes ISI No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Community Name & Community Number City of Clearwater 62. County Name Pinellas B3. State FL 64. Map/Panel Number B5. Suffix 66, FIRM Index 87. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12103C0064 G Date Effective/Revised Date Zone(s) AO, use base flood depth) 8-18-09 9-3-03 VE 13' B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered In Item B9. 0 FIS Profile ® FIRM 0 Community Determined 0 Other (Describe) B11. Indicate elevation datum used for BFE in Item 89: 0 NGVD 1929 :1 NAVD 1988 0 Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes No Designation Date N/A 0 CBRS 0 OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 0 Construction Drawings' ® Building Under Construction' 0 Finished Construction 'A new Elevation Certificate will be required when construction of the building Is complete. C2. Elevations - Zones A1 -A30, AE, All, 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 ARUEL Vertical Datum ELEV= 5.40' (N.A.V.D.) Conversion/Comments N/A a) Top of bottom floor (including basement, crawispace, or enclosure floor) ¢.¢¢ b) c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servidng the building (Describe type of equipment and location in Comments) Lowest adjacent (finished) grade next to building (LAG) Highest adjacent (finished) grade next to building (HAG) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support Top of the next higher floor L. 1 14.11 14.8 `3•¢ ¢•1 f) g) h) Check the measurement ® feet 0 meters (Puerto Ri ® feet 0 meters (Puerto R ® feet 0 meters (Puerto R ® feet 0 meters (Puerto R Ca feet 0 meters (Puerto R a ® feet 0 meters"(Puerto Rico only) ® feet 0 meters (Puerto Rico only) feet 0 meters (Puerto Rico only) \ 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. / certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. 181 Check here if comments ere provided on bade of form. Were latitude and longitude in Section A provided by a licensed land surveyor? ® Yes ❑ No Certifler's Name Philip C. Stock License Number RLS#3035 Title President Company Name Target Land Surveying, Inc. Address 516 Lakeside Place City Largo State FL ZIP Code 33771 Signature Date 12-23-11 Telephone (727) 784-0573 FEMA Form 81=31, Mar 09 See reverse side for continuation. Replaces all previous editions 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. 984 Eldorado Avenue Fof tittru►onos-Compeny.Ues: • City Clearwater State FL ZIP Code 33767 Compaty.NAIC Number 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 Job # 111115.02 C.2.e) = NC Unit Building has break -a -way walls Date 12-23-11 Q Check here If attachments SECTION UILDING 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 0 feet 0 meters 0 above or 0 below the HAG. b) Top of bottom floor (including basement. crawlspace, or enclosure) is 0 feet 0 meters 0 above or 0 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 0 feet 0 meters 0 above or 0 below the HAG. E3. Attached garage (top of slab) is 0 feet 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is 0 feet 0 meters ❑ above or 0 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? 0 Yes 0 No 0 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 ere correct fo the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments 0 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, 8. C (or E). and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items 08 and G9. G1. 0 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. 0 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. 0 The following Information (Items G4-09) is provided for community floodplain management purposes. G4. Permit Number 05. 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 09. BFE or (in Zone AO) depth of flooding 010. Community's design flood elevation 0 New Construction 0 Substantial Improvement basement) of the building: 0 feet 0 meters (PR) Datum at the building site: 0 feet 0 meters (PR) Datum 0 feet 0 meters (PR) Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑ Check here If attachments FEMA Form 81-31, Mar 09 Replaces all previous editions Building Photographs See Instructions for Item A6. I Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 984 Eldorado Avenue City Clearwater State FL ZIP Code 33767 For Insurance C p ny Use: j Policy Number CompanyNAJC Nu 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 on the reverse. Building Photographs Continuation Page For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 984 Eldorado Avenue Policy Number City Clearwater State FL ZIP Code 33767 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." "Ri • ht Side View" - Pictures Taken 12-23-11 "Left Side View" — Pictures Taken 12-23-11 U.S.DEPARTMENT OF HOMELAIJD SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency Expires March 31,2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION `sa�`or�t�lsu�ce Cotnpany U�e: A1. Building Owner's Name Michael Cavill ''1�tlIICy1�f7Ribet A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. l;c�fCipghy NAIC NUrtlber 984 Eldorado Avenue City Clearwater State FL ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Parcel ID#05-29-15-54666-069-0040 A4. Building Use(e.g.,Residential,Non-Residentlal,Addition,Accessory,etc.)Residential A5. Latitude/Longitude:Lat.28.0013999 long.-82.826927 Horizontal Datum: ❑ NAD 1927 � 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 7 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) N/A sq ft a) Square footage of attached garage 2482 sq ft b) No.of peRnanent flood openings in the crawlspace or b) No.of pertnanent flood openings in the attached garage enGosure(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 � No d) Engineered flood openings? ❑ Yes � No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 61.NFIP Community Name 8 Community Number 62.County Name 83.State City of Clearvvater Plnellas FL 64.Map/Panel Number 65.SufBx B6.FIRM Index 67.FIRM Panel BS.Flood B9.Base Flood Elevatlon(s)(Zone 12103C0064 G Date Effective/Revised Date Zone(s) AO,use base flood depth) &18-09 9-3-03 VE 13' B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑ FIS Profile � FIRM ❑ Community Detertnined ❑ Other(Describe) 611. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other(Describe) B12. 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/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 ARUEL Vertical Datum ELEV=5.40'(N.A.V.D.) ConversionlComments N/A ��-�'� L�� , Check the measuremenl a) Top of bottom floor(inGuding basement,crawlspace,or enclosure floor)¢.�6 �feet ❑meters(Puerto Ri ��"�� b) Top of the next higher floor 17.69 �feet ❑meters(Puerto Ri c) Bottom of the lowest horizontal structural member(V Zones only) 14.�3 �feet ❑meters(Puerto Ri :��.-,t F� �_��„F�� d) Attached garage(top of slab) 6.66 �feet ❑meters(Puerto R� e) Lowest elevation of machinery or equipment servicing the building N.A �feet ❑meters(Puerto Ri (Describe rype of equipment and location in Comments) .x � Lowest adjacent(finished)grade next to building(LAG) 5.9 �feet ❑meters�'(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 6.1 �feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,inGuding IV.A �feet ❑meters(Puerto 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 infortnation. I certify that the infamation on this Certiftcate represents my best elforts to interpret the data available. '�X'. I understand that any false statement may be punishable by�ne or impNsonment under 18 U.S. Code,Section 1001. � ?"' "* '�' r;,, �,"'� i.. � � � Check here if comments are provided on badc of fortn. Were latitude and longitude in Section A provided by a '� x�,-£i, '� licensed land surveyor? � Yes ❑ No *'s: ��'� `�"� F _ �+ :. Certifier's Name Philip C.Stock License Number RLS#3035 I `�j�`''�!��+�. � t. ' y Title President � � r-�_ �: Company Name Target Land Surveying,Inc. � � . ��,,�1�`� �+'�p'✓ p .!`;, �` ; �'i Address 516 Lakeside Place City Largo State FL ZIP Code 33771 � ,�"� '� .��.��Q..3�- � , � Signature�G��Cc� �L�� Date 12-23-11 Telephone (727)7840573 r4.,r 4'�r��,�a�• ,;.E FEMA FoRn 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In thes�spaces,copy the corresponding information from Section A. �+'FDI`Ihbu[an0e Compshy,Ube: Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. PdICy,NtNnbel' 984 Eldorado Avenue City Clearvvater State FL ZIP Code 33767 Corllpaf�y NAIC NumMM' SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)building owner. Comments Job#111115.02 C.2.e)=A/C Unit Building has break-a-way walls Signature Date 12-23-11 :'�.1��`'..__��j_ ❑ Check here if attachments SECTION F�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 ET-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters. E 1. 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,crawispace,or endosure)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 pemianent flood openings provided in Section A Items 8 and/or 9(see pages&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 platforrn of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or 0 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 infortnation in Secdon 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. Properry 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 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 infortnaBon in Secbon 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 communiry official completed Section E for a building located in Zone A(without a FEMA-fssued 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 peRnit 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 flood elevation ❑feet ❑meters(PR)Datum Local O�cial's Name Title Community Name Telephone Signature Date Comments ❑Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions Building Photographs See Instructions for Item A6. For Insurance Company Use: I Building Street Address(including Apt., Unit,Suite, and/or Bldg. No.)or P.O. Route and Box No. Poucy Nu'mber 984 Eldorado Avenue � � f . City Clearwater State FL ZIP COde 33767 CompanyNAlCNumber i I� � __ __ ----_ ', � If using the Elevation Certificate to obtain NFIP flood insurance, a�x 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 on the a reverse. ��rzf �_`EEYv:'�� F�it�l�rrE°� '��kF€ � �_,. i 1 w e .�"�._� _. -� IR�er Ri`-- —�-, �� ■��_ — �_ W:�+�r,� _ , � � ' �- ' �i i) � , , ,; �� k �� i . .. ., �� r . � —w r a�� ,.� � � � ��r „. 1 j �, �_ ..# .. �_ ,�M � ,' 4 1 � � ♦ Y � w1.. �'. _ � °- � �4.*N'.., {2t „n•., �� +¢ ��h { �R� � �� ' ,' �� i �:: .�:,�, r.rc�. x � �� . . a. . �-_��:��. . . -�.� i�, . . ; . ;� �� r�� ,,,_., "Rear View"— Pictures Taken 12-23-11 � , � ,/ p � ` i �� !,; : ..� � �i ' tF,�r{ , ;, , � , A � �� „�� 4 _ '• � � . � _.w- Building Photographs Continuation Page For Insurance Company Use: __-- ------ _,� Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number , 984 Eldorado Avenue I . ; City C�earwater State FL ZIP COde 33767 CompanyNAlCNumber 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." , ------ - ------ ---- � "Ri ht Side View" - Pictures Taken 12-23-1'E -« �. ,.,� �. �; � , ,,�«`�� { °�s � ��_ /;'✓� i �.� � i��l -�� , II� �� `� � �� h � ,•. � �` � � �, y'^ .��`+' , _ �� ,, ' � ��,��` F„�.. , � .�� 'r � > w� ��' �' ' � ° , ,., ; � � �..__., . - � � � � _. . �v., ; °� ��::� �� h� . I '�Y'+f �. y v�'j,� ^b�' ..ay �� . rs��-+M,'��.I �:'� .x'��A'e�'3�'tlg ./+ .�� ' �. � "Left Side View" - Pictures Taken 12-23-11 � . .. li' 1 � � I � � � . - _.._..�_.� � � � G l-' l ,� ...Y . . . .. .. . ..... '°� U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program EL�VATION CERTIFICATE Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION A1. Huildin Owner'sName MI�HAEL CAVILL A2. Building Street Address (inGuding Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. 984 ELDORADO BLVU OMB No. 1660-0008 Expires March 31, 2012 �tY State ZIP Code CLEARWATER FL 33767 A3. Property Description (l.ot and Block Numbers, Tax Parcel Number, Legal Description, etc.) A PORTION OF LOT 3, ALL OF LOT 4, AND A PORTION OF LOT 5, BLOCK 69, MANDALAY, PLAT BOOK 14, PAGES 32-35. A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDEN�� IAL A5. Latitude/Longitude: Lat. 28 DEG. 00�05.63"N Long. 8z DEG. a9�37.o2°w Horizontal Datum: ❑ NAD 1927 ❑� NAD 1983 A6. Attach at least 2 photographs of the building 'rf the Certificate is being used to obtain flood insurance. A7. Building Diagram Number SEVEN 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) � soo.o Sq ff a) Square footage of attached garage N�'0` 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 � within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N�A sq in c) Total net area of flood openings in A9.b N�A sq in d) Engineered flood openings? � Yes �✓ No d) Engineered flood openings? � Yes Q No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION CITY OF CLEARWATER 125096 64. Map/Panel Number 65. Suffix 12103C0064 c; � PINELLAS 66. FIRM Index 67. FIRM Panel Date Effective/Revised Date 08/18/09 09/03/03 � FL 38. Flood 69. Base Flood Elevation(s) (2 Zone(s) AO, use base flood depth) VE �a n B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile Q FIRM � Community Deterrnined ❑ Other (Describe) 611. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 �✓ NAVD 1988 ❑ Other (Describe) 612. Is the building located in a Coastal Barrier Resources System (CB❑RS) area o� therwise Protected Area (OPA)? � Yes �✓ No Designation Date 'NiA ' 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/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 NGS BENCHMARK ID:AL0119 ELEVATION 5.40� Vertical Datum NAVD 1988 Conversion/Comments NONE Check the measurement used. a) Top of bottom floor (inGuding basement, cravNspace, or enclosure floor) . 6.66 ❑� feet � meters (Puerto Rico only) b) Top of the next higher floor 17.66 � feet meters (Puerto Rico only) c) Bottom of the low�est horizontal structural member (V Zones only) �4•$3 � feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) 6.66 IN A8. AREA a feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building !'JC 15.66 �✓ feet ❑ meters (Puerto Rico only) (Describe type of equipment and location in Comments) � Lowest adjacent (finished) grade next to building (LAG) 6.03 Q✓ feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) 6.23 �✓ feet � meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including 6.03 �✓ feet � meters (Puerto Rico only) structural support SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land survevor, enqineer. or architect authorized bv law to certifv Piavatinn rtmA rorm si-3�, Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, cop;� the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, andJor Bldg. No.) or P.O. Route and Box No. 984 E�DORADO BLVD City CLEARWATER State FL ZIP Code 33767 SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) � G Copy bofh sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. AIR CONDITIONING UNIT ON CONCRETE SLAB-NOT TO BE USED FOR CONSTRUCTION OR DESIGN, FLOOD INSURANCE USE ONLY Signature �"" �� °� �o�z9��2 ❑ 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, crawispace, or enclosure) is ❑feet ❑meters �above or ❑below the LAG. E2. For Building Diagrams 6-9 with permanent flood openinqs provided in Secti n A Items 8 and/or 9(see a es 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 Q 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 A0 only: If no flood depth number is available, isthe top of the bottom �or elevated in accordancewith the community's -oodpl�n m�agement 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 owners 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 know/edge. Roperty Owner's or Owner's Authorized F�presentative's Name Address Signature Comments The local official who is authorized and G of this Elevation Certificate. City Date State ZIP Code Telephone ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL► or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C(or E), ete 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. (Indica te 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 Pertnit 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 flood elevation ❑ feet ❑ meters (PR) Datum Local Official's Name Community Name Signature Comments Title Telephone Date ❑ Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions - Building Photographs See Instructions for Item A6. Building Street Address (including Apt., Unit, Su�te, and/or Bldg. No.) or P.O. Route and Box No. Poiicy Numbec 984 ELDORADO BLVD CitY State ZI P Code Company ruvC rvumbe� CLEARWATER FL 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 on the reverse. Front 10/29/12 Rear 10/29/12 � Building Photograprls Continuation Page ng Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 9&4 ELDORADO BLVD City State CLEARWATER ZIP Code �� FL 33767 If submitting more photographs than will fit on the preceding page, affix `he additional photographs below. Identify all photographswith: datetaken; "Front �/ew" and "F�arUi�v"; �d, if required, "Right Side�lew° and "Left 8de�lew" Left 10/29/12 Right 10/29/12 M �� r�,��„ � ,y,,,, �,,.,.� �w� ,, ; __ _ _.., ,. ..._ .._ .. .. , . _ _ �: V ZONE DESIGN CERTIFICATE Name /� � 1�t � �/ L- Policy Number (lnsurance Co. Use) Building Address or Other Descxiption c"+ fl`"� �G.. rJ612 p��j0 ,�.� PermitNo. �� { � City__G��,o�t2�,�,ry.-1rCtZ. State l. Zi Code ofl354 -� p 337h7 SECTlON I: Flood Insu�anoe Rate Map (FIRM) Information Community No. IZ 'J� Q� �o Panel No.06� Suffix � FIRM Da'.e � 3 d 3 FIRM Zone(s) �� SECTION il: Elevation Information Used for Design jNOTE: This section documents elevafions used in the design - it does not substitute fnr an Elevatfon Certificate.J 1. Elevation of the Bottom of Low�est Horizontai Structural Member ...... ......... ...... .........../� $feet (NAVD88j 2.BaseFloodElevation(BFE) .............................................................................../_-5=0{eet (NAVD88) 3. Eievation oi Lowest Adjacerrt Grade .. .... ..... ... . .... .......�. _ .....6 =�eet (NAVD88) .....................•-•••....... _ 4. Approximate Depth of Mtkipated SoouNErosion used for Foundation Design ......... ......� eet (NAVD88) 5. Embedment Depth of Pilings or Foundation Below Lawest Adjacent Grade ........ .... .-�.: �.Ofeet {NAVD88) SECTION 111: V Zone Design Certification Statement (NOTE. This section must be oertified by a registe�d engfneer or arrhrted. j 1 certify that: { 1) I have developed or reviewed the structural design, pians, and specif�cations for construction and (2) that the design and methods of construdion to be used are in accordance with accepted standards of practice for meeting the ' following provisions: • The bottom of the lowest horizo�al structufal member of the lowest floo� (exduding piles and columns) is elevated to or above the BFE; and • The pile and column foundation and strudure attached thereto is anchored to resist flotation, collapse, and lateral movemerrt due to the effects of the wind and water loads acting sirtwftaneously on all building comp�eMs. Water loading values used are those associated with the base ftood. Wnd toading values used are those required by the applicable State or local building code. The potential for scour and erosion at the foundation has been anticipated for conditions associated with the base flood, including wave action. SECTION IV: 8reaicaway Wall Design Certification Statement [NOTE. This sectio» must a/so be certifred by a registered engrneer or architect when breakaway walls exceed a design safe loading resistmrce of 20 poundr per square foot.J I certify that (1)1 have developed or reviewed the structural design, plans, and speafications for construction and (2) that the design and methods of oonstruction to be used for the breakaway walls are in accordance with accepted standards of practice for meeting the follawing provisions: • Breakaway wall collapse shall result from a water bad less than that which would oa;u� during the base flood; and • The elevated pation of the building and supporang Toundation system shall not be subject to collapse, displacement, or other strtactural damage due to the effects of wind and water bads ac�ing simuftaneously on all building components (wind and water loading vatues to be used are defined in Sectio� IU). SECTI�N V: Certificafion and Seal This certiflcation is to be sgned and sealed by a registered professional engineer or archRect author¢ed by law to certify structural designs. I oertify the V 2one Design Certification Statement in Section !ll and the Breakaway Wall Design Ce�tification Statemeni in Section 1 V('�f appNcable). . .. !7 � / , r�Au� �• ( 1aC� ��tZ. � P� 2GSt5'8 - �v,,;:�.., Certtfier's Name License Number ,�� .. r,�',�fi; � i u�� PA��'E. f-�aCacF�2 , CoNsu �-t c A� �uGra E�Q, �•` pMce 5� T�� Company Name ' ; -� : _��D„ �EA'r NE2 Ie10GE !0l[�70. _ Dt�.�� /.0 _ C. si tl/�4 O l�� L � � -73�- 9o�s elephone 984 ELDORADO AVE BCP 2011-08354 . !� CAVILL, MIKE p � Za�ing: Low Medium Density Re Atlas #: 238A :s;� �[ • ��.�-��a�' � _ ;' . ; _ �{ . O.•.,' 0}�;1 ;�,�'": � `` .... .:••'' �, pN''�t1A! E��C