866 ISLAND WAY U,�S.DEPA�TMENT OF HOMELAND 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 INFORM I �E � ��� ;
A1. Building Owner's Name Andreas M.Wilson&Debra L.Wilson , � � �� �����,
.� � � ,���w ��;
A2. Building Street Address(including Apt.,Unit,Suite,andlor Bldg.No.)or P.O.Route and Box No ����� b� €.
886 lsland Way � � � ' .,�'��, �°;��'�w �. ��k:�._
City Clearwater State FL 21P Code 33767 J f�`, � �+• �dY„
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)
Lot 51,Island Estates of Clearwater Unit 8
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential � r�y(�` ���p(��/�/p R
A5. Latitude/Longitude:Lat.27d 59'47.33"N. Long.82d 49'14.00"W. HorizontaT��tur�f:��"l�D'192TT�'NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insur
A7. Building Diagram Number 1A
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 570.0 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 IVA within 1.0 foot above adjacent grade NA
c) Total net area of flood openings in AB.b NA sq in c) Total net area of flood openings in A9.b IVA sq in
d) Engineered flood openings? ❑ Yes � No
d) Engineered flood openings? ❑ Yes � No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name 8 Community Number B2.County Name B3.State
Clearwater 125096 Pinellas Florida
64.Map/Panel Number B5.Suffix 66.FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
12103C -0102 G Date Effective/Revised Date Zone(s) AO,use base flood depth)
9/3/03 9/3/03 AE 12.0
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑ FIS Profile � FIRM ❑ Community Determined ❑ Other(Describe)
B11. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 ❑ Other(Describe)
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes
Designation Date ❑ CBRS ❑ OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
a
C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' � Finished Cons N
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Etevations-Zones A7-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 �
below according to the building diagram specified in Item A7. Use the same datum as the BFE. c�
Benchmark Utilized Citv of Clwtr E.F.-3 Vertical Datum NAVD 1988 Q
Conversion/Comments � �
0
Check the measurement used. Q �
a) Top of bottom floor(including basement,crawlspace,or enclosure floor)10.5 �feet ❑meters(Puerto Rico only) S � z
b) Top of the ne�ct higher floor W.A �feet ❑meters(Puerto Rico only) Q �y u,
c) Bottom of the lowest horizonta�structural member(V Zones only) N.A �feet � �
❑meters(Puerto Rico only) �
d) Attached garage(top of slab) 9.9 �feet ❑meters(Puerto Rico only) Q �i Q w �
w
e) Lowest elevation of machinery or equipment servicing the building 9.9 �feet �meters(Puerto Rico only) N m Y �
(Describe rype of equipment and location in Comments) J O� � �
� Lowest adjacent(finished)grade next to building(LAG) 9.6 �feet ❑meters(Puerto Rico only) � N w Z�'
g) Highest adjacent(finished)grade next to building(HAG) 9.6 �feet ❑meters(Puerto Rico only) (p a 2 O a�
h) Lowest adjacent grade at lowest e�evation of deck or stairs,including N.A �feet U � c
❑meters(Puerto Rico only) QO V H _ c
structural support 0� m Y � N
SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION -
This certification is to be signed and sealed by a Iand surveyor,engineer,or architect authorized by law to certify elevation 1•�°� P
information. I certify that the informafion on this Certificate represents my best efforts to interpret the data available.l \�*ti�,,�;.: : ;' �,
undChec hte et if com/me ts aee prov d db n�back o�o��ne o�e�e lat t de and�ongi udesn Section Atp o ided b❑y a :��'�y�,=' A�� , f�.%_ ,-
licensed land surveyor? � Yes ❑ No . =,1'
Certifier's Name Edward D.Murphy "tl =�^ r
License Number 5333 �n ,� ; M1 �
Title Professional Land Surveyor Company Name Murphy's Land Surveying,Inc. � '�• .:,Z<+�
�f,��•. f^ii� � •\,� \.
Address 575011 Avenue City St.Petersburg State FL ZIP Code 33710 ��'� �� ��' �� ^J �
����/i�����i�'ti��ti��.���
Signature �'`V � Date 01/24/12 Telephone 727/347-8740
FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions
II�APORTANT: In these spaces, copy the corresponding information from Section A. ���r(��y�a�c�,�arr�p�r��t�sa� "_����;
Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No J or P.O.Route and Box No. �pJ� �(�ry �,� ���3 h;
886 Island Way ': ����,..%������,;...����: � r'a �s�: ���
�� -
City Clearwater State FL ZIP Code 33767 ~, �� �� � r
. ��' xa �� i� : '��.��:
�
x �
'' c � - u
�. ,., ....'�..� ._., �._.�`��.��....,s�a,..�.
SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION(CONTINUED)
Copy both sides of this Elevation Certificate for(1)community officiai,(2)insurance agent/company,and(3)building owner.
Comments C2e=A/C
Signature Date 01/24l12
❑ Check here if attachments
SECTION E-BUILDING ELE ATION I ORMATION(SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO and A(without BFE),comp te Items E1- 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 g de,if available. Ch k the measurement used. In Puerto Rico only,enter meters.
E1. Provide elevation information f the following and check he appropriate boxes to show whether the elevation is above or below the highest adjacent
grade(HAG)and the lowest a nt grade(LAG).
a)Top of bottom floor(including base ce,or enclosure)is ❑feet ❑meters ❑above or�below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enGosure)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 fioor
(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 o�cial 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.
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 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 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
+ . •
Buiiding 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. Poi�cy N�mber
886 Island Way
Clty Clearvvater Stat2 FL ZIP COde 33767 CompanyNAlCNumber
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least finro 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
submittin more hoto ra hs than w II
g p g p i fit on this page, use the Continuation Page,
fotlowing.
__ _.
�- " .. � ., t � �<�;,
{ �� > ��� ,��'
DATE: 01/20/12 �` � +}�� ��`'�""�
,i,��<���� ���� ,fi.
,
r � +�
i, '�i
�� �yY 3.� . k~'a &,+�"., i�+� -+�,,
- �"u � y,� *"��� °�"ir �° *' ��-� a w.
� =�� �-.�,�, # ;� �� ,� �,� ,
� �,. � ��_ ;__;;
�� � q � > a � .
� - ... . .. .... .... s'.� �' ` �i�'°'� H'��.,>_.. �
� �z* .-.a- w.0• :�c,,, �� 'ia�4�.$ ��r ry.��� ��.'..
� :. p s,�.AS.�� -'+�'t... A' y.�'„-"
,�g
_ r
.�x,�„� �,..� . `� �� �
,r �+,- {� �i rI' ' _ "4
" � '�R � � ;v
.�
. _
,
� � h
i. .
�
. . . . . ..v'n t,y � '
^.e
' �
'.... ., -.. . .. . _ 4�, ' - '�,•,
�_..�__ . . �fl'!� '�•
� ,_� ;
� �
�i�+� _.. r .�.� :� y �,..
=s:.. . _..-..Y�..._. ._.. . ''
�-'
FRONT VIEIN: " , .:_ �,__��
. •_ . 'S� . ... .
. . /� �'a��� ' , L
� " � , �. . - . . i'�i`s.',b,. � r�'"�.�� ,.
� -
. . ... . . , . . . � . :
. . , r . : � i �. ..:. -:. � `c
� _. ; . ..._._�._._.. _ .... -. .. _a '
�`:
; . . . . ... ._ . ', .'t..�.a > ,«.
t�;"
� .'
, � . .., „ < , �
,r
�, .4 .. . a..: , , :.�
.._ . #�'�_x§— _Y. ' _' . ��'"T� _.. �_...__ .�___..� _ `-_°
I
_
.� . . .,� .. .
�° __'
aa '
. �.�e�"3� ..�. �..�. � �'?r� _�
�.. . �►q,� �. ,�`:e����"
���.,� ,„,��'a "�w ; � � .�.~ .
^'i
+.� .�3'� � m
,�,�' .�M ��� .`tlr.6'+F :' .� ...� ,
,.., -".��' �_� .._ � :-
... .
�
y �`
�--� . �....�..
C.`
f � �.� _
_ �._ �____ � '� : ; ,� . Z
REAR VIEW: �, �, .� 'k, -�'
� ���^-� ���
�� �e `� ��'���{` , ;,�� �
`_ � .�'" _ �6r L �--:�ii
_
.��� � � _� ���k�1���"
t�� `� .,� i�7l1. Y ;
�.:< ` '- � � _ F _��
, �r:; i't� '� . I! .� ��
��.A`-� � �°�. ,
��... . t!• ���.
w. ,.,.:.. �' . "' " ' . ,,
. `' �-.
arr
.a a�"
. ,�� ,
c '.. ,rl: ���� '� • I
i w� {�L ` 9*`
��'�ij- ����� �''j`u"��� � `�� �� � _ " �_ �.
� �3 :�.*�% :�:�'.- � '� . �, � �..�'-
" I�� �'�,�° ,
_`"*_.. "" _`• .�_ , �.tA,: � a*'t c,�*��.
,
�:
r` ' ,I . :a. .., °�