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1160 MANDALAY POINT RD� , �' ; ��•� � 1'�, �t � .�� ,. t� � ; -`` t 1 'a �,,._...> � \i, � d» � 1 e �� .� 4 ,�� `:��y v.. 1 ,�O,�y =, �:.��. ��eM � �`' " `� � s;tihi:-`�� 4� i ��,E°'� r, k �� t %w'' .`�,J,�' �F�s./ � ��\N•� r�� <: 1 �'�`l�' r��`�.,�is � .,.,,.• °- _ __ _ __- _---------- � 1160 MANDALAY POINT RC gCP2009-07079 '� �IEW SFR ' �ILLS, JAMES '?oning: Low Density Residentiai Atlas #: 227A e U.S. DEPARTNYENT OF HOMELAND SECURITY ELEVATION CERTI FICATE FEDERAL EMERGENCY MANAGEMENT AGENCY NationalFloodlnsuranceProgram Important: Read the instructions on pages 1-9. A1 Name JAMES P. GILLS III & SECTION A - PROPERTY INFORMATION OMB No. 1660-0008 Expiration Date: July 31, 2015 A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box Na �� 1160 MANDAI..AY POINT ROAD City CLEARWATER State FL ZIP Code 33767 i °'" - A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOTS 14, 14A, 15, 15A, 16, 16A, 17 & 17A, FIRST ADDITION TO MANDALAY POI(VT SUBDIVISIOPI (PARCEL ID # 32-28-15-54702-000-0160) A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 28°00'21.1"N Long. 82°49'37.9"W Horizontal Datum: ❑ NAD 1927 � NAD 1983 A6. Attach at least 2 pho4ographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 6 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) 8752 sq ft a) Square footage of attached garage Pl/A sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade 44 within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in AS.b 8800 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 � No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP Community Name & Community Number B2. County Name CITY OF CLEARWATER 125096 PINELLAS 64. Map/Panel Number 65. Su�x B6. FIRM Index Date 67. FIRM Panel Effective/Revised Date 12103C-0064 G 8-18-09 9-3-03 68. Flood Zone(s) AE 63. State FLORIDA B9 Base Flood Elevation(s) (Zone AO, use base flood depth) 13' 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69. ❑ FIS Profile � FIRM ❑ Community Deterrnined ❑ OtheNSource: 611. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 ❑ OtheNSource: 612. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise 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. In Puerto Rico only, enter meters. Benchmark Utilized: CLEARWATER B.M. "J-02" Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 � IJAVD 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) 6.14 � feet ❑ meters b) Top of the next higher floor 16.87 � feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A � feet ❑ meters d) Attached garage (top of slab) N/A � feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 13.79 � feet ❑ meters (Describe type of equipment and location in Comments) � Lowest adjacent (finished) grade next to building (LAG) 5_5 � feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 6_1 � 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 fa/se statement may be punishable by frne or imprisonment under 18 U. S. Code, Section > 001. "� U��A� -, c:� U Ed � Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a �,�.�� a ;•-., �� Check here if attachments. licensed land surveyor? � Yes ❑ No ��,'C � �� ': !� - Certifier's Name GEORGE A. SHIMP III Job Number 070260U License Number 6137 Title VICE PRESIDENT Company Name GEORGE A. SHIMP II & ASSOCIATES, INC. Address 3301 DeSOTO BLVD., SUITE D City PALM HARBOR State FL ZIP Code 34683 Si n ture �� n-" � FEMA Form 086-0-33 (7/12) Date 12-3-2014 Telephone 727-784-5496 See reverse side for continuation. , � � -rt `t ifc.fi':37 ' - ;a : '�� - ~n - : _ ��p�/,�,��ti �,��.� ": �lC`fii SF� • �r ' ��s,1 �3�i Q��+ .� u �'° ,..., Replaces all previous editions. IMPORTANT: In these spaces, copy the corresponding inforrrsation from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1160 MANDALAY POINT ROAD Ciry CLEARWATER State FL ZIP Code 33767 SECTION D— SURVEYOF2, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner. Comments SEE PAGE 5 FOR SURVEYOR'S COMMENTS (THIS DOCUMENT IS NOT VALID WITHOUT ALL 5 PAGES) Signature Date 12-3-2014 0 C l�umber. SECTION E— BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(VUITHOUT 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 nex4 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, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address Signature Comments City Date State ZIP Code Telephone ❑ Check here if attachments. �ECTION 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 4he measurement used in Items G8—G10. In Puerto Rico only, enter meters. G1. ❑ The information in Sec4ion 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: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Communitys design flood elevation: ❑ feet ❑ me4ers Datum Local Official's IVame Community Name Signatur� Comments FEMA Form 086-0-33 (7/12) Title Telephone Date _❑ Check here if attachments. Replaces all previous editions. ELEi/e4TIOIV CERTIFICATE, page 3 guilding Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding Bnforrnation froni Section �!. FOR INSURANGE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. fVo.) or P.O. Route and Box fVo. Rolicy Number: 1160 MANDALAY POINT ROAD City CLEARWATER State FL ZIP Code 33767 Company NAIC Number: If using the Elevation Certifica4e 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, pho4ographs 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. �� , ;: � FEMA Form 086-0-33 (7/12) � - �� ' � �� :I � �, I �' �. � r - ,� - = � �.,�!� � � .� �' FIZONT VIEUV PicYure taken on: 12-3-2014 � � — � .� �. : � tr u ' ." . r. _ _ _ „�,- _ �,_. � � L`.�:+:� ��, � �:��°�.�,� . _ Replaces all previous editions. ��EV�gao� c��ri��c��, ��g� � �uilding Photographs Continuation Page IMPORTANT: In these spaces, copy the corresponding information from Sectlon A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box fVo. 1160 MANDALAY POINT ROAD City CLEARWATER State FL ZIP Code 33767 � FOR INSURANCE COMPANY USE Policy Plumber: 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 Vievv." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. �� i i;� , �' � � � ^ !� - .n � ;e: ;. �� ` � �`� � �y, � ;.'r k r / �.. 4N r '�1, # ,6 � }� • .. � . . � 'b � r-�y+ . '_ ^i.� G JK :£..�..-.. r k <;�. � .� .�� t= �� r � ��' � J� t `�� ' i� '� f�^- . r�.. i.x.< .;e �.. k t �y:. }„.;; i' �E�� I�� Picture taken on: 12-3-2014 � � � t 4?I FEMA Form 086-0-33 (7/12) Replaces all previous edi4ions. �� 8��, ��e s Surveyor's Notes Continuation Page EMPORTANT: In these spaces, copy the corresponding information from Section �e. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1160 MAfVDALAY POINT ROAD City CLEARWATER State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number: SECTION D– SURVEYOR'S CEl�TIFICATiON (CONTINUED FROM PAGE 2) A1. ) THIS ELEVATIOfV CERTIFICATE WAS PREPARED EXCLUSIVELY FOR THE USE AiVD BEIVEFIT OF JAMES P. (�ILLS III & JOl'CE P. C�ILLS FOR THE SPECIFIC PURPOSE OF OBTAINING FLOOD INSURANCE AND/OR VERIFYING FLOOD ZOIVE COMPLIAIVCE WITH THE LOCAL GOVERNING AUTHORITY. THIS DOCUMENT SHALL NOT BE VALID AND BINDING AGAINST THE SIGNING SURVEYOR WITHOUT THE ORIGINAL RAISED SEAL AND SIGNATURE OF THE FLORIDA LICENSED SURVEYOR AfVD f1�APPER. USE OF THIS DOCUMENT BY ANY OTHER PARTY OR FOR ANY OTHER PURPOSES IS STRICTLY PROHIBITED AND SHALL REfVDER THIS DOCUMENT INVALID FOR THOSE PURPOSES. UNAUTHORIZED COPIES ARE STRICTLY PROHIBITED AfVD SHALL NOT BE VALID. REQUESTS FOR ANY ADDITIONAL OFFICIAL SIGNED AND SEALED COPIES MUST BE DIRECTED TO GEORGE A. SHIMP II & ASSOCIATES, INC. A4.) THE BUILDING USE VVAS DETERMINED BY PHYSICAL OBSERVATIOIVS MADE ON THE DATE OF SURVEY. A5.) THE LATITUDE AND LOfVGITUDE COORDIfVATES WERE OBTAIfVED USING A HAND HELD G.P.S. UNIT WHICH nflEETS OR EXCEEDS FEMA'S REQUIRED ACCURACY OF 66 FEET. A7.) THE BUILDING DIAGRAM NUIVIBER WAS DETERMINED BY PHYSICAL OBSERVATIONS MADE ON THE DATE OF SURVEY. CERTAIN STRUCTURAL FEATURES NOT \11SIBLE TO THE SURVEYOR (PILIfVGS, GRADE BEHMS, ETC.) CAN AFFECT THIS DETERMINATIOV. A8.) FOR THE PURPOSE OF THIS DOCUMENT, A BUILDING ENCLOSURE IS DEFINED AS THAT PORTION OF AN ELEVATED BUILDIfVG, BELOW THE LOWEST ELEVATED FLOOR, THAT IS EITHER PARTIALLY OR FULLY SHUT I(V BY RIGID WALLS. A GARAGE BELOW OR ATTACHED TO AN ELEVATED BUILDIfVG IS CONSIDERED AN ENCLOSURE. SUCH AREAS SHALL NOT COfVTAIN MORE THAN 20 LIfVEAR FEET OF FINISHED INTERIOR WALLS (PANELING, ETC.) OR IT WILL BE COfVSIDERED A FIIVISHED (HABITABLE) �4REA. IF APPLICABLE, THE STRUCTURE CONTAINS: ❑ CRAWLSPACE � ENCLOSURE ❑ N/A IF APPLICABLE, THE CRAVI/LSPACE CONTAINS N/A SMART �fENT(S) CERTIFIED TO COVER �1/,4 SQ. FT. PER VE�1T. IF APPLICABLE, THE BOTTOM FLOOR ENCLOSURE CONT,41fVS 8" X 16" SfViART VENT(S) CERTIFIED TO COVER 200 SQ. FT. PER VERIT. — IF APPLICABLE, DOES THE BOTTOM FLOOR ENCLOSURE APPEAR TO COIVT,41N BREP,K-F�WAY WALLS? ❑ YES � I�O ❑ I�/A A9.) IF APPLICABLE, THE ATTACHED GARAGE CONTAIfVS N/A SMART VENT(S) CERTIFIED TO COVER N/A SQ. FT. PER VEIVT. A8. & A9.) FOR THE PURPOSE OF THIS DOCUMENT, A FLOOD OPENING IS DEFINED AS ,4 PERMANENT OPENIIVG IIV AIU EXTERIOR WALL THAT IS NO HIGHER THAN 1.0 FOOT ABOVE THE HIGHER OF THE EXTERIOR OR IfVTERIOR GRADE OR FLOOR IMMEDIATELY BELOW THE OPENING. B8.) UNLESS OTHERWISE NOTED IN SECTION B, ITEM 10, THE FLOOD ZONE WAS DETERMIIVED BASED OfV THE FLOOD INSURANCE RATE MAP. IN CERTAIfV CASES WHERE AN ACCURATE DETERMINATION COULD fVOT BE MADE FROM THE M,4P, THE COUNTY'S G.I.S. OVERLAY MAY HAVE BEEfV UTILIZED TO DETERMINE THE FLOOD ZONE. fV0 SEARCH OF THE PUBLIC RECORDS WAS PERFORMED FOR LOMA'S, LOMR'S, ETC. WHICH MAY AFFECT THE SITE. A8.a) THE BOTTOM FLOOR ENCLOSURE AREA IS BASED ON CONSTRUCTION PLANS C2.e) GENERATOR OiV ELEVATED COf�CRETE DECK; ELEVATIORI OF BOTTOM OF ELEVATOR SHAFT = 4.54' R U.S.DEPARTMENT 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 INFORMATION For Insurance Comparry Use: A1. Building Owner's Name JAMES AND JOYCE GILLS Policy Number ,�,� A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Company NAIC Number : � 1160 MANDALAY POINT ROAD I"� City CLEARWATER State FL ZIP Code 33767 Z A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) � LOTS 14, 14A, 15, 15A, 16, 16A, 17& 17A, FIRST ADDITION TO MANDALAY POINT SUBDIVISION (PARCEL ID#32-28-15-54702-000-0160) (L A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.)RESIDENTIAL � A5. Latitude/Longitude: Lat.N 28°00'21.1" Long.W 82°49'37.9" Horizontal Datum: ❑ NAD 1927 � NAD 1983 Q� 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 crawlspace or enclosure(s): A9. For a building with an attached garage: Q O a) Square footage of crawlspace or enclosure(s) 9495 sq ft a) Square footage of attached garage N/A sq ft z O 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 7 within 1.0 foot above adjacent grade N/A Q p� c) Total net area of flood openings in AB.b 4361.8 sq in c) Total net area of flood openings in A9.b N!A sq in � O d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No `O SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION (�p a 61. NFIP Community Name&Community Number 62.County Name 63.State � U CITY OF CLEARWATER 125096 PINELLAS FL � m I 64.Map/Panel Number B5.Suffix B6.FIRM Index 67. FIRM Panel 68. Flood B9. Base Flood Elevation(s)(Zone � Date Effective/Revised Date Zone(s) AO, use base flood depth) 12103C-0064 G 8-18-09 9-3-03 AE 13' ` 610. Indicate the source of the Base Flood 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) B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise 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 J-02 Vertical Datum NAVD 88 � �- Conversion/Comments N/A � nrn Check the measurement used. �� G a) Top of bottom Floor(including basement,crawlspace,or enclosure floor)N/A �feet ❑meters(Puerto Rico only) � � b) Top of the next higher floor 16.70 �feet ❑meters(Puerto Rico only) �� c) Bottom of the lowest horizontal structural member(V Zones only) 14.66 �feet ❑meters(Puerto Rico only) t � w � d) Attached garage(top of slab) N/A �feet ❑meters(Puerto Rico only) �� << e) Lowest elevation of machinery or equipment servicing the building N/A �feet ❑meters(Puerto Rico only) �� O � (Describe type of equipment and location in Comments) �` � o � Lowest adjacent(finished)grade next to building(LAG) 2.72 �feet ❑meters(Puerto Rico only) ;�� L g) Highest adjacent(finished)grade next to building(HAG) 6.11 �feet ❑meters(Puerto Rico only) �� c�►- _ C:� h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A �feet ❑meters(Puerto Rico only) -� �._--= � �- structural support �,___w_:______�_, 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 t�e data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. _ ;;;+;,. � Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a .��r� , r`•f licensed land surveyor? � Yes ❑ No �d,� ' "° ' _rs �" Certifier's Name GEORGE A.SHIMP III Job Number 070260P License Number 6137 `�? � "�`!%� Title VICE PRESIDENT Company Name GEORGE A.SHIMP II&ASSOCIATES, INC. '`"y` ,r�'� ,� ��%��-� Address 3301 DESOTO BLVD., SUITE D City PALM HARBOR State FL ZIP Code 34683 #6137 DFi'FE. ' � � �� , Si r,� � � Date 3-22-10 Telephone 727-784-5496 ` r��4� FEMA Form 81-31 Mar 09 See reverse side for continuation. Reolaces all orevious editions r IMPORTANT: In these spaces,copy the corresponding information from Section A. For lnsurance Company Use: Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. PoliCy Number 1160 MANDALAY POINT ROAD City CLEARWATER State FL ZIP Code 33767 Company NAIC Number SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Eievation Certificate for(1)community o�cial,(2)insurance agenUcompany,and(3)building owner. Comments C2.a)BOTTOM FLOOR HAS NOT BEEN CONSTRUCTED Signature G RGE A.SHIMP III Date 3-22-10 � Check here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR 20NE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to suppo�t 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 infortnation for the foliowing 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 Q 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 openings provided in Section A Items 8 andlor 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 Q 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 know/edge. s ,jy 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 iocal o.fficial 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.) G,2. ❑ 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 Official's Name Title Community Name Telephone Signature Date Comments ❑Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions . . ' . ��- • �.`� - � �' - ;�;<�- �C� - �'�D - C7 lC�t� , � U.S:h'�EPARTN�ENTOFHOMELANDSECURITYS ELEVATION CERTIFICATE OMBNo. 1660-0008 Federal Emergency ManagementAgency Expires March 31,2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION For Insurance Company Use: u A1. Building Owner's Name JAMES AND JOYCE GILLS Policy Number �/ A2. Building Street Address(including Apt.,Unit, Sude,and/or Bidg. No.)or P.O. Route and Box No. Company NAIC Number . ' �-- 1160 MANDALAY POINT ROAD Z City CLEARWATER State FL ZIP Code 33767 O A3. Property Description (Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) a LOTS 14, 14A, 15, 15A, 16, 16A, 17&17A,FIRST ADDITION TO MANDALAY POINT SUBDIVISION (PARCEL ID#32-28-15-54702-000-0160) � A4. Building Use(e.g., Residential,Non-Residential,Addition,Accessory,etc.)RESIDENTIAL Q � A5. Latitude/Longitude: Lat.N 28°00'21.1" Long.W 82°49'37.9" Horizontal Datum: ❑ NAD 1927 � NAD 1983 J � A6. Attach at least 2 photographs of the building if the Cert�cate is being used to obtain flood insurance. � A7. Building Diagram Number 6 Q O A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: � ti a) Square footage of crawlspace or enclosure(s) 9495 sq ft a) Square footage of attached garage N/A sq ft � 0 b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage Q Q� enclosure(s)within 1.0 foot above adjacent grade 7 within 1.0 foot above adjacent grade N/A C O c) Total net area of flood openings in AB.b 4361.8 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 � No Q N a. SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION � U 61. NFIP Community Name 8 Community Number 62.County Name 63.State � m CITY OF CLEARWATER 125096 PINELLAS FL I 64. Map/Panel Number 65.Suffix B6. FIRM Index 67.FIRM Panel 68. Flood 69. Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) A0,use base flood depth) 12103C-0064 G 8-18-09 9-3-03 AE 13' B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in item 69. ❑ FIS Profile � FIRM ❑ Communiry Determined ❑ 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(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes � No Designation Oate 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 CeRificate will be required when construdion 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/AiE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2. - -- ---- below according to the building diagram specified in Item A7. Use the same datum as the BFE. Q �� Benchmark Utilized J-02 Vertical Datum NAVD 88 m r'-"�jA�'�-�J CV,__-��.� Conversion/Comments N!A n�.,T. r� Check the measurement used. �Q ��' a) Top of bottom floor(including basement,crawlspace, or enclosure floor)N/A �feet ❑meters(Puerto Rico only) 0 m � � b) Top of the next higher floor 16.70 �feet ❑meters(PueRo Rico only) ('� w � c) Bottom of the lowest horizontal structural member(V Zones only) 14.66 �feet ❑meters(Puerto Rico only) m� � � d) Attached garage(top of slab) N/A �feet ❑meters(Puerto Rico only) y� �� N e) Lowest elevation of machinery or equipment servicing the building N/A �feet ❑meters(Puerto Rico only) �� s �= (Describe type of equipment and location in Comments) p � � � Lowest adjacent(finished)grade next to building(LAG) 2.72 �feet ❑meters(Puerto Rico only) Tri�rr � g) Highest adjacent(finished)grade next to building(HAG) 6.11 �feet ❑meters(Puerto Rico only) �'� �� h) Lowest adjacent grade at lowest elevation of deck or stairs,including N/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 information. I certify that the information on this Certificate represents my best efl`orts to interpret the data availab/e. ° 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. 's�f+ , � Check here if comments are provided on back of fortn. Were latitude and longitude in Section A provided by a "` , ` licensed land surveyor? � �'es ❑ No "' �.��i�>C �� M :. ��, <;;�, �; Certifier's Name GEORGE A. SHIMP III Job Number 070260P License Number 6137 . ,v�y f" } ` ��:�� Title VICE PRESIDENT Company Name GEORGE A. SHIMP II 8�ASSOCIATES, INC. 'pf°,��` F .- ::- �,4t"��»� Address 3301 DESOTO BLVD.,SUITE D City PALM HARBOR State F� ZIP Code 34683 � � #6137:<',�E%T�::.:..� .; jt� Si Ir,J��/'� � Date 3-22-10 Telephone 727-784-5496 `' �' FFMA Form 81-31 Mar 09 See reverse side for continuation. Reolaces al1�revious editions � ' . . ..., y ., -. � ' � _ , � , ,� i�' �o � •. � . ' . e � � � IMPORTANT: in these spaces,copy the cor�esponding information from Section A. For insurance Compaiy Use: ,� Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Potic}R Number � 1160 MANDALAY POINT ROAD City CLEARWATER State FL ZIP Code 33767 Company 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 C2.a)BOTTOM FLOOR HAS NOT BEEN CONSTRUCTED Signature G RGE A.SHIMP III Date 3-22-10 � Check here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED) FOR ZONE AO AND 20NE 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 infortnation 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 know/edge. 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 Eleyation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8 and G9. . 3G1.Q The infortnation 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 floodpiain 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 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 ' 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 1160 MANDALAY POINT ROAD Clty CLEARWATER State FL ZIP COd2 33767 ComparryNAlCNwnber 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. 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