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619 GULFVIEW BLVD SPAIITMq/iT OF HELAND SECURITY FEDER�ALEMERGENCY MAN GEMENT AGENCY Vational Flood Insurance Program ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION Al. Building Owner's Name Shephard Family Trust A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 619 S GulMew Boulevard City Clearwater State FL ZIP Code 33767 OMB No. 1660-0008 Expiration Date: July 31, 2015 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lots 1 thru 5, Block 'C, Bayside Subdivision #5 Plat Book 38, Pages 38, A4. A5. A6. A7. A8. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Non -Residential Latitude/Longitude: Lat. 27°5501.59-N Long. 82'49'36.87'W Horizontal Datum: 0 NAD 1927 ® NAD 1983 Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. Building Diagram Number For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 7326 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 0= c) Total net area of flood openings in A8.b Q sq in d) Engineered flood openings? 0 Yes ® No A9. For a building with an attached garage: a) Square footage of attached garage 7133 sq ft b) Number 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 sq in d) Engineered flood openings? 0 Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number Clearwater, City of / 125096 B2. County Name Pinellas B3. State Florida B4. Map/Panel Number 12103C0104 B5. Suffix G B6. FIRM Index Date August 18, 2009 B7. FIRM Panel Effective/Revised Date September 3, 2003 B8. Flood Zone(s) AE, VE B9. Base Flood Elevation(s) (Zone AO, use base flood depth) 12, 13 310. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM 0 Community Determined 0 Other/Source: 311. Indicate elevation datum used for BFE in Item B9: 0 NGVD 1929 ® NAVD 1988 0 Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date: ❑ CBRS 0 OPA 0 Yes ® No SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) 01. Building elevations are based on: 0 Construction Drawings' 0 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/A0. Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: F-02 City of Clearwater Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. 0 NGVD 1929 Datum used for building elevations must be the same as that used for the BFE. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servldng the building (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 0 NAVD 1988 0 Other/Source: Check the measurement used. ¢.51 ® feet 0 meters 22.42 ® feet 0 meters 21.47 ® feet 0 meters §.1.1 ® feet 0 meters 1.49 ® feet 0 meters ¢.4 ¢.¢ ® feet IS feet ® feet ❑ meters ❑ meters 0 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. / 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. ® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a CO Check here if attachments. licensed land surveyor? ® Yes 0 No Certifiers Name David William McDaniel License Number LS 5840 Title Project Manager Company Name Deuel & Associates Address 565 S Hercules Avenue City Clkeawwater State FL ZIP Code 33764 Signature -.5 Date 02/12/2014 Telephone 727 822-4151 rrIInn., n nn /ll4n\ 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. 619 S Gulfview Boulevard City Clearwater State FL ZIP Code 33767 SECTION D - SURVEYOR, ENGINEER, ORARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments A9a the garage is open on the north side. C2e elevator shaft bottom. C2h adjacent grade to stairs. Architect ground floor plan attached. "Floodproofing Certificate for non-residential structures attached. Signature Date 02/12/2014 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. 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, 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 ages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is . ❑ feet 0 meters 0 above or [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 0 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 ❑ Unknown. The local offldal 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 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 administerthe community's floodplain management ordinance can complete Sections A. 6, C (or E), and G )f this Elevation Certificate. Complete the applicable items) and sign below. Check the measurement used in Items G8-010. In Puerto Rico only, enter meters. 31. ❑ 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.) 32. 0 A community offldal completed Section E for a building located In Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. 33. 0 The following information (Items 04-G10) Is provided for community fioodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: 0 New Construction 0 Substantial Improvement 38. Elevation of as -built lowest floor (including basement) of the building: 0 feet 0 meters Datum 69. BFE or (in Zone AO) depth of flooding at the building site: 0 0 meters Datum 310. Community's design flood elevation: 0 feet 0 meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here if attachments. ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. aligkafiy. Building Street Address (including Apt., Unit, Suite and/or Bldg. No.) or P.O.Route and Box No, 619 S Gultview Boulevard City Clearwater State FL ZIP Code 33767 If using the Elevation Certificate 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 Viewand "Left Side View." When applicable, photographs 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. FRONT EAST SIDE FRONT FROM WEST FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 Building Photographs Continuation Page 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. 619 S Gulfview Boulevard City Clearwater State FL ZIP Code 3 767 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." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. REAR EAST SIDE REAR FROM EAST FEMA Form 086-0-33 (7/12) Replaces all previous editions. ATTACHMENT TO ELEVATION CERTIFICATE 619 S Gulfview Boulevard, Clearwater, Florida 33767 Architect Ground Floor Plan --- ---. 1 S 4-. .. - Illrwa = s , , CD 11 jII l ° BU, ll ° .,," j(Di 0 ell r1:r (5—' ' i►_In � i fformaillaiiIT. :.. o f r t,. *it; Q' 11 Id -- 0 �� :' nr:��N`\��• a ^ 0 I, I It o ° f 4D 0 1' ,nom Ti `✓ d i, ' �_Z`�`S ... q I Cif U. - _i�� / ... o o r " l' / .ii 0 NI 1111 lilt ''1 ;°° II i °I 1 1111 I; I 11i..III 1�III1IflrIijr9Ifl i t3eeeeeseeaeeeeeeeeeeeeeaee i I 11111 VIII 1 11 1 9HEPHARD8 wi$RESORT L BEACH 3 !� g ��f��„„fr TOWER !;111•'a.EARWA7fA � HI i1' 1� }1r••1 JRS.PLANM7'+C f y 3 g lll1)lll1g� til I! li AYGN7ISCTCRf•W'[�JO U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY NeWoei Flood locus= hop= FLOODPROOFING CERTIFICATE FOR NON-RESIDENTIAL STRUCTURES OMB No. 1660-0008 Expiration Date: July 31, 2015 The floodprooflng of non-residential buildings may be permitted as en alternative to elevating to or above the Base Flood Elevation: however. a floodproofing design certification Is required. This form Is to be used for that certification. Floodproofing of a residential building does not alter a community's floodplain management elevation requirements or affect the Insurance rating unless the community has been Issued an exception by FEMA to allow floodproofed residential basements. The permitting of a floodproofed residential basement requires a separate certification specifying that the design complies with the local floodplain management ordinance. BUILDING OWNER'S NAME STREET ADDRESS (kn *ucng APL. Unl, Sub, and/or Bldg. Number) OR P.O. ROt1WE ANo am NUMBER 619 S. Guifview Boulevard OTHER DESCRIPTION pat and Block Numbers, eta.) Lots 1 thru 5, Block "C", Bayside Subdivision #5 Plat Book 38, Pages 38 cnY Clearwater STATE Florida nP X33767 SECTION 1- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the foliib1ng from the proper FIRM; COk000017 NUMBFa 125096 _August PANLU NUMBER 12103C0104 SUM G DATE Of FIRM MOD 18, 2009 MI 2011E AE, VE BASE FOOD E.EVA710a De A0 oma. we D10W 12, 13 elevation datum used for Baso Flood Elevation shown above: 0 NGVD 1929 C9 NAVD 1988 0 Other/Source: SECTION 11- FLOODPROOFINO INFORMATION (By a Registered Professional Engineer or Architect) Elevations we based an: 0 Consbu ion DravAngs 0 Building Under Construe OOn ® Finished Construction Floodprooling Design Elevation information: Building is floodproofed to an elevadon of . Q- het (In Puerto Rico only: - meters). 0 NGVD 1929 3 NAVD 1988 0 Other/Source: (Devotion datum used must be the same as that used for the Base Flood Elevation.) Height of Iloodproosng on the bugling above the lowest adjacent grade is 4.8 feet (In Puerto Rico only meters). For Unnumbered A Zones Only: Highest adjacent (finished) grade next to the bulkUng (HAG) _ feet (In Puerto Rico only , meters) 0 NGVD 1929 0 NAVD 1988 0 Oiher/Sourcer (NOTE: For Insurance rating purposes, the building's floodproofed design elevation must be et least 1 foot above the Base Flood Elevation to receive rating credit. If the building Is f oodproofed only to the Base Flood Elevation, then the building's insurance rating will result In a higher premium.) SECTION 111 - CERTIFICATION (By a Registered Professional Engineer or Architect) Non -Residential Floodproofed Construction Certification: I certify that, based upon development and/or review of structural design, specifications, end plans for conatfuctlon, the design and methods of construction are In accordance with accepted standards olpractce ler meeting the following pfONsions: The structure, together with attendant utilities and sanitary facilities, is watertight to the Iloodprooled design elevation indicated above, with walls that are substantially impermeable to the passage of water. AR structural components are capable of resisting hydrostatic and hydrodynamic flood forces, including the effects of buoyancy, and anticipated debris impact forces. I 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. CERT$AER'S NAME CHOU-WUN YONG LICENSE NUMBER (or A}ax Sean 61016 STRUCTURAL ENGINEER Mtn ENGINEERING GROUP, LLC ADDRESS 3998 EAST SR64 SIGNATURE CITY STATE WI CODE BRADENTON FL 34208 Dal 2014/02/02 (813)252-1033 Copies should be made of this Certificate for: 1) community official, 2) Insurance agent/compsny, and 3) building owner. 1104 Form 088.0-34 (7/12) REPLACES ALL PREVIOUS EDITIONS 1-056 U:S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY National Flood Insurance Program Important: Read the instructions on pages 1-9. ELEVATION CERTIFICATE SECTION A - PROPERTY INFORMATION OMB No. 1660-0008 Expiration Date: July 31, 2015 FOR INSURANCE COMPANY USE Al. Building Owner's Name Shephard Family Trust Policy Nuinber. A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 619 S Gulfview Boulevard Company NAIC Number: City Clearwater State FL ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lots 1 thru 5, Block "C", Bayside Subdivision #5 Plat Book 38, Pages 38, A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) A5. Latitude/Longitude: Lat. 27'58'01.59"N Long. 82°49'36.87'W A6. Attach at least 2 photographs of the building if the Certificate is being used A7. Building Diagram Number 6 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) NN/A' sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A* c) Total net area of flood openings in A8.b NN/A` sq in d) Engineered flood openings? 0 Yes ® No Non -Residential Horizontal Datum: 0 NAD 1927 ® NAD 1983 to obtain flood insurance. A9. For a building with an attached garage: a) Square footage of attached garage NN/A• sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade NN/A' c) Total net area of flood openings in A9.b NN/A' sq in d) Engineered flood openings? 0 Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP Community Name & Community Number Clearwater, City of / 125096 B2. County Name Pinellas B3. State Florida B4. Map/Panel Number 65. Suffix 86. FIRM Index Date 67. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12103C0104 G August 18, 2009 Effective/Revised Date Zone(s) AO, use base flood depth) September 3, 2003 AE, VE 12, 13 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69. 0 FIS Profile ® FIRM 0 Community Determined 0 Other/Source: 611. Indicate elevation datum used for BFE in Item 69: 0 NGVD 1929 ® NAVD 1988 0 Other/Source: 1312. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date: 0 CBRS 0 OPA ❑ Yes ® No 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, 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: F-02 City of Clearwater Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. 0 NGVD 1929 0 NAVD 1988 0 Other/Source: Datum used for building elevations must be the same as that used for the BFE. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 22.42 21.47 N/A." la 4.1 N/A.** Check the measurement used. 0 feet 0 feet ® feet 0 feet ® feet 0 feet ® feet ® feet ❑ meters ❑ meters ❑ meters 0 meters ❑ meters 0 meters ❑ meters ❑ meters SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION „r < 1 i 1 rA f T-- This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation ��! �;•r�7= information. / certify that the information on this Certificate represents my best efforts to interpret the data available. . • • l understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ,-' ;�'a 12l'..5 0 Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a -" ❑ Check here if attachments. licensed land surveyor? 0 Yes 0 No44 Certifiers Name David William McDaniel License Number LS 5840 4.44 Title Company Name Deuel & Associates Address 565 S Hercules Avenue City Clkearwater State FL ZIP Code 33764 • T O 9 Signature_�- ,,.--. Date 07/30/2013 Telephone 727 822-4151 f W rte J . +,S j'rr#1414141( . r FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. VVI_ V f111V I• vV.,\111 1,60/11 I_, f/OaQ '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. 619 S Gulfview Boulevard FOR INSURANCE COMPANY USE Policy Number: 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 * A8&A9 - wall lines are not complete on the 1$' level. insufficient data to calculate this section. '• C2a top of lobby floor. "C2d garage floor not poured. **C2h area incomplete. C2e elevator shaft bottom. Signature • Date 07/30/2013 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. Et . 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 ❑ 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 ❑ 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 0 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, B, 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 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, 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 G10. In Puerto Rico only, enter meters. 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 04-G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued 07. This permit has been issued for: 0 New Construction 0 Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: G9. BFE or (in Zone AO) depth of flooding at the building site: G10. Community's design flood elevation: ❑ feet 0 feet ❑ feet ❑ meters 0 meters ❑ meters Datum Datum Datum Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 619 S Gulf -view Boulevard Policy Number: City Clearwater State FL ZIP Code 33767 Company NAIC Number If using the Elevation Certificate 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, photographs 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. FRONT EAST SIDE FRONT WEST SIDE FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 Building Photographs Continuation Page IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 619 S Guitview Boulevard Policy Number: City Clearwater State FL ZIP Code 33767 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 View.' When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. REAR EAST SIDE FEMA Form 086-0-33 (7/12) Replaces all previous editions. FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FL000 INSURANCE PROGRAM FLOODPROOFiNG CERTIFICATE FOR NON-RESIDENTIAL STRUCTURES 0.14.8. No 3067.0077 Expires Miy 31,, 1903 •(he floodproofing of non-residential buildings may be permitted as an alternative to elevating to or above the Base Flood Elevation: however, a fIoodproofing design certification is required. This form Is to be used for that certification. Floodprooling of a residential building does not alter a community's floodplain management elevation requirements or effect the Insurance rating unless the community has been issued an exception by FEMA to allow floodproofed residential basements. The permitting of a lloodprooled residential basement requires a separate certification specifying that the design Complies with the local floodplain management • ordinance. FOR INSURANCE COMPANY USE BUILDING OWNER'S NAME HPH&D TU�e W 1 u./kM M M. G� STnEET ADDRESS (Including Apt. Unit. Suit. and/or Bldg. Number) OR P.O1ROUTE'AND BOX NUMBER Coto 5• viaw Cat -Jr'. POLICY NUMBER COMPANY NAIC NUMBER ETHER DESCRIPTION )L 1 pled /)6144 1��r, ()1 t CITY T Lr— .w L STATE ZIP CODE SECTION I FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM: COMMUNITY NUMBER a it 9 (0 PANEL NUMBER 00 (4- SUFFIX a �JDATE1OF FIRM INDEX `/aJU ley/9 Z FIRM/�ZONE r"� BASE FLOOD ELEVATION i lin Aozons.. use depth) SECTION II FLOODPROOFiNG INFORMATION (By a Registered Professional Engineer or Architect) Floodproofing Design Elevation information: Building is floodproofed to an elevation of 1 1 1 11 (21.1j feet NGVD. (Elevation datum used must be the same as that on the FiRM.) Height of floodproofing on the building above the lowest adjacent grade is L .t1 feet. (NOTE. for insurance rating purposes, the building's floodproofed design elevation must be at least one foot above the Base Flood Elevation to receive rating credit. 11 the building is floodproofed only to the Base Flood Elevation, then the building's insurance rating will result In a higher premium.) SECTION 111 CERTIFICATION (By a Registered Professional Engineer or Architect) Non -Residential Fioodproofed Construction Certification: I certify that based upon development and/or review of structural design, specifications, and plans for construction that the design and methods of construction are in accordance with accepted standards of practice for meeting the following provisions: The structure, together with attendant utilities and sanitary facilities, is watertight to the floodproofed design elevation indicated above, with walls that are substantially impermeable to the passage of water. AH structural components are capable of resisting hydrostatic and hydrodynamic flood forces, including the effects of buoyancy, and anticipated debris impact forces. I certify that the information on this certificate represents my best efforts to interpret the data available. f understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. :ERTIFIER'S NAME r TITLE --a)Lcs° LICENSE NUMBER (or Affix Seal) tzra 5' 4-41 COMPANYnNAME t:.i1►�'••"rro a I ADDRESS 4 `�'�1 E-,.� �'a�I •�_� n G ., • STEL{ ZIP_ • 91GNATURE prisiinficeM-1 CITY DATE p�� FKiNEG. � - PCZ) Copies should be tit •Bot, Is etllll! •r• : 1 community officio M surance egenVcompany, and 3) building owner. FEMA form 91.65, MAY 90 tvi`el� Z11(iF� f�p4 ��titt:tDb L • WHICH IS OBSOLETE SECTION E CERTIFICATION 'errf cation ,s to oe s onec Dv' a lane surveyor. eno;neer. or arcnitec: wno !s autnonzec Dv state or locai law to certliv elevation ' n'orrnanon wnen the elevation ,ntormanon fdr Zones A' -A30. AE. Al-. .A wltn BFE;.V V3C.VE..anc V own. 3FF_�_ recurred. Community officials wno are authorized by local law or ore:nance to provide fIoocotain management intdrmat:on. may 'also Sion the certification In tne case of Zones AC ono A :without a FEMA or community issued BFE,. a Duilalno officio:. a property owner. or an owner s representative may also sign the certification. Reference level diagrams 6. 7 and 8 - Disnnguisning Features -If tne certifier is unable to certify to DreaKaway-non-DreaKaway wall. enctosure size. location of servicing eoulomen:. area use. wail openings, or unfrnrsneo area Featureis:.•then fist the Features not included in the certification unoer Comments oelow. The (Nearam number. Section C. Item 1. mus! still be entered. I certify that tne information In Sections B and C on this certificate represents my oest errorts to interpret the data available. I understand that any false statement may oe ounlsnaole ov rine or tmerlsonment unoer 76 (..).S L'oae. Section 1007. CERT rFIER'S NAM= TITLE _ =ENSE tNUMBETA o• At. Sea; 1 w� A¢.C=.g 41 MPAN NAME SIGNATURE ow 'S. 1-4 Joe. STATE ZIP *ID t �>J FL 3375Co 13/pa4 RHONE 727. 444. 2021 Copies should b'made of this Certificate for: 1) community official. 2) insurance agent -company. and 3) building owner. COMMENTS: ON WTI SLAP BASEMENT :oNEs =ONES IAF•F=FHCEL., l•� A. ss^T A_• ,;4CFN' a4r I,c:E.ENCE ON PILES. PIeRs OR COLUMNS Z]NES —� ^�q `145: =t00C. AL.4CEl'T The elacrams above Illustrate the points at when me elevations snould be measureo in A Zones and V Zones. Elevations for all A Zones Snoutd be measured at the too JT the reference leve! floor Elevations for ail V Zones snould De measured at the oottom of •`ie :owest nonzorta: structural member. U.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 For Insurance Company Use: Al. Building Owner's Name SHEPARDS BEACH RESORT Policy Number A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 619 S. GULFVIEW BOULEVARD (EASTERNMOST MASONRY FRAME CABANA) Company NAIC Number City CLEARWATER BEACH State FL ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 1-5 BLOCK C, BAYSIDE SUB *5, PLAT BOOK 38 PAGES 38 & 39, PINELLAS COUNTY, FLORIDA. A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) A5. Latitude/Longitude: Lat. N27°58'00.2" Long. W82.49'36.7 - A6. Attach at least 2 photographs of the building if the Certificate is being used A7. Building Diagram Number 1 A8. For a building with a crawlspace or endosure(s): a) Square footage of crawlspace or endosure(s) b) No. of permanent flood openings in the crawlspace or endosure(s) within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b d) Engineered flood openings? 0 Yes IN No NJ9 N@ N/A sq ft sq in NON-RESIDENTIAL Horizontal Datum: 0 NAD 1927 ® NAD 1983 to obtain flood insurance. A9. For a building with an attached garage: a) Square footage of attached garage sq ft b) No. of permanent flood openings in the attached garage within 1.0 foot above adjacent grade Le c) Total net area of flood openings in A9.b ) sq in d) Engineered flood openings? 0 Yes ® No SECTION 8 - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number CITY OF CLEARWATER 125096 B2. County Name PINELLAS 63. State FL 84. Map/Panel Number B5. Suffix B6. FIRM Index 87. FIRM Panel 88. Flood B9. Base Flood Elevation(s) (Zone 12103C0104 G Date Effective/Revised Date Zone(s) AO, use base flood depth) 5/17/05 9/3/03 VE 13' & 14' B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 09. 0 FIS Profile ® FIRM 0 Community Determined 0 Other (Describe) B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 0 Other (Describe) 812. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes Designation Date W.6 0 CBRS 0 OPA ® No 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 Al -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 SEE COMMENTS Vertical Datum NAVD 1988 Conversion/Comments NONE a) b) c) d) e) f) 9) h) Top of bottom floor (Including basement, crawlspace, or enclosure floor) Q.,'}j. Top of the next higher floor Bottom of the lowest horizontal structural member (V Zones only) Attached garage (top of slab) Lowest elevation of machinery or equipment servicing 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 Check the measurement used. ® feet ❑ feet ® feet ❑ feet ® feet ® feet ® feet ® feet ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) 0 meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ 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.1 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 licensed land surveyor? ® Yes 0 No Certifiers Name JEFFERY A. COPELAND License Number 5279 Title REGISTERED LAND SURVEYOR Company Name SUNCOAST LAND SURVEYING, INC. Address 111 FOREST LAKES $LCity OLDSMAR State FL ZIP Code 34677. it Sikdaature Date 2/18/11 Telephone 813-854-1342 FEMA Form -31, Mar 09 See reverse side for continuation. %) °a .r Repla. y$rpr&ttiidus 'editions IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: • Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 619 S. GULFVIEW BLVD. (WESTERNMOST MASONRY and FRAME CABANA) Policy Number 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 A5. DETERMINED USING HAND-HELD GPS DEVICE. C2. UTILIZED CITY OF CLEARWATER BENCHMARK F-02 ELEVATION = 4.0574' (NAVD 1988) C2e. BOTTOM OF LIGHT BOX Signature Date 2/18/11 0 Chedc 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. El. 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, aawlspace, or enclosure) is 0 feet ❑ meters ❑ above or 0 below the HAG. b) Top of bottom floor (induding basement, aawlspace, 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 (seepages 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 j] 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 0 above or 0 below the I-IAG. 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 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 0 Check her if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's 800dplaln 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. 01. ❑ 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. 0 The following information (Items G4 -G9) is provided for community floodplain management purposes. G4. Permlt Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for. 0 New Construction 0 Substantial Improvement G8. Elevation of as -built lowest floor (induding basement) of the building: 0 feet 0 meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: 0 feet 0 meters (PR) Datum 010. Community's design flood elevation 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. For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 619 S. GULFVIEW BLVD. (EASTERNMOST MASONRY and FRAME CABANA) Policy Number City CLEARWATER State FL ZIP Code 33767 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. SOUTH SIDE 2/18/11 1;4; 44.4_ 4.4 044%. WEST SIDE 2/18/11 11111, ,44t.ra, Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. G19 S. GULFVIEW BLVD (VVESTERNMOST MASONRY and FRAME CABANA) Policy Number City CLEARWATER State FL ZIP Code 33767 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. SOUTH SIDE 2/18/11 EAST SIDE 2/18/ • .. ,." ••• • Iw ' •ift, - • il . . ,,,,,... i - - U.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 Al. Building Owners Name SHEPARDS BEACH RESORT For Insurance Company Use: Policy Number A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 619 S. GULFVIEW BOULEVARD (WESTERNMOST MASONRY FRAME CABANA) Company NAIC Number City CLEARWATER BEACH State FL ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 1-5 BLOCK C, BAYSIDE SUB #5, PLAT BOOK 38 PAGES 38 8 39, PINELLAS COUNTY, FLORIDA. A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory A5. Latitude/Longitude: Lat. N27'58'00.5" Long. W82'49'37.3 - A6. Attach at least 2 photographs of the building if the Certificate is being A7. Building Diagram Number 1 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or endosure(s)f! 0/ sq ft b) No. of permanent flood openings in the crawlspace or endosure(s) within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b jyt6 sq in d) Engineered flood openings? 0 Yes ® No etc.) NON-RESIDENTIAL Horizontal Datum: 0 NAD 1927 El used to obtain flood insurance. NAD 1983 A9. For a building with an attached garage: a) Square footage of attached garage jy(e sq It b) No. of permanent flood openings in the attached garage within 1.0 foot above adjacent grade Na c) Total net area of flood openings in A9.b jy 6 sq in d) Engineered flood openings? 0 Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number CITY OF CLEARWATER 125096 82. County Name PINELLAS B3. State FL B4. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 1210300104 G Date Effective/Revised Date Zone(s) AO, use base flood depth) 5/17/05 9/3/03 VE 13' & 14' 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 89. 0 FIS Profile ® FIRM 0 Community Determined 0 Other (Describe) BI 1. Indicate elevation datum used for BFE in Item 89: 0 NGVD 1929 ® NAVD 1988 ❑ Other (Describe) 812. Is the building located In a Coastal Banter Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes Designation Date wig ❑ CBRS 0 OPA ® No 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, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/A0. Complete Items C2.a-h below according to the building diagram specified In Item A7. Use the same datum as the BFE. Benchmark Utilized SEE COMMENTS Vertical Datum NAVD 1984 Conversion/Comments NONE a) b) c) d) e) f) 9) h) Top of bottom floor (including basement, crawlspace, or enclosure floor) _4.41, Top of the next higher floor Bottom of the lowest horizontal structural member (V Zones only) Attached garage (top of slab) Lowest elevation of machinery or equipment servicing 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 Check the measurement used. ® feet 0 meters (Puerto Rico only) ❑ feet 0 meters (Puerto Rico only) ® feet 0 meters (Puerto Rico only) ❑ feet 0 meters (Puerto Rico only) IR feet 0 meters (Puerto Rico only) ® feet ❑ meters (Puerto Rico only) ® feel 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./ understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.0 Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? ® Yes 0 No Certifiers Name JEFFERY A. COPELAND License Number 5279 Title REGISTERED LAND SURVEYOR Company Name SUNCOAST LAND SURVEYING, INC. Address 111 FOREST LAKES BLVD. City OLDSMAR Signatu State FL •rad•5-243\ ZIP Code 34877 G) : IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 619 S. GULFVIEW BLVD. (EASTERNMOST MASONRY and FRAME CABANA) Policy Number 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 agenVcompany, and (3) building owner. Comments A5. DETERMINED USING HAND-HELD GPS DEVICE. C2. UTILIZED CITY OF CLEARWATER BENCHMARK F-02 ELEVATION = 4.0574' (NAVD 1988) C2e. BOTTOM OF LIGHT BOX. 4i(L- 0 Check here If attachments SECTION 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 El -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. El. 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 ❑ 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 ages 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 (� 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 0 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. Signature Date 2/18/11 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 City State ZIP Code Signature Date Telephone Comments Chedk 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. 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 -G9) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G8. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for. ❑ New Construction 0 Substantial Improvement G8. Elevation of as -built lowest floor (induding basement) of the building: 0 feet 0 meters (PR) Datum 09. BFE or (in Zone AO) depth of flooding at the building site: 0 feet 0 meters (PR) Datum 010. Community's design flood elevation 0 feet 0 meters (PR) Datum Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions • • • FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM FLOODPROOFING CERTIFICATE FOR NON-RESIDENTIAL STRUCTURES �.GF:) cicict- Iz2z1 O.M.B. NO. 3067-0077 Expires July 31, 1999 ADAMS MAC2� 430 5. &AlcvleLLJ The floodproofing of non-residential buildings may be permitted as an alternative to elevating to or above the Base Flood Elevation; however, a floodproofing design certification is required. This form is to be used for that certification. Floodproof(ng of a residential building does not alter a community's f!oodpla/n management elevation requirements or effect the insurance rating unless the community has been issued an exception by FEMA to allow floodproofed residential basements. The permitting of a floodproofed residential basement requires a separate certification specifying that the design complies with the local floodplain management ordinance. FOR INSURANCE COMPANY USE BUILDING OWNER'S NAME HBE - Florida Corporation STREET ADDRESS (Including Am, Unit. Suite andror Bldg. Number) OR P.O. ROUTE AND BOX NUMBER 11330 Olive Boulevard OTHER DESCRIPTION (Lot and Block Numbers. etc.) POLICY NUMBER COMPANY NAIC NUMBER CITY St. Louis STATE MO ZIP CODE 63141 SECTION I FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM: COMMUNITY NUMBER 1 2S p(3G) PANEL NUMBER 0007 SUFFIX D DATE OF EIRM IN5-9 IZ.X 1991 Firm Map FIRMIRZONE r -(G BASE FL000 ELEVATION 12OAOZones, usedeWh) SECTION 11 FLOODPROOFING INFORMATION (By a Registered Professional Engineer or Architect) Floodproofing Design Elevation Information: Building is floodproofed to an elevation of 1 1 11 12 LEL] feet NGVD. (Elevation datum used must be the same as that on the FIRM.) Height of floodproofing on the building above the lowest adjacent grade is I 151.L5_ feet. (NOTE: for insurance rating purposes, the building's floodproofed design elevation must be at least one foot above the Base Flood Elevation to receive rating credit. If the building is floodproofed only to the Base Flood Elevation, then the building's insurance rating will result in a higher premium.) SECTION 111 CERTIFICATION (By a Registered Professional Engineer or Architect) Non-Residentlal Floodprooted Construction Certification: I certify that based upon development and/or review of structural design, specifications, and plans for construction that the design and methods of construction are in accordance with accepted standards of practice for meeting the following provisions: The structure, together with attendant utilities and sanitary facilities, is watertight to the floodproofed design elevation indicated above, with walls that are substantially impermeable to the passage of water. AH structural components are capable of resisting hydrostatic and hydrodynamic flood forces, including the effects of buoyancy, and anticipated debris impact forces. I 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. CERTIFIER'S NAME LICENSE NUMBER (or Affix Seal) Anwar Yusuf, P.E. 0047348 TITLE Structural Department Manager ADDRESS 11330 Olive Bou and SIGNATURE Copies shoul. • made of COMPANY NAME HBE Corporation •r!i, CITY STATE ^1✓tIT/�.;'• St. Louis MO �? •. (9 •. "114 1i`yP 4 >: DATE PHONE February 21, 2000 314/567-9000 I. t ab ? 1j- omalunIty official, 2) Insurance egenVcompany, and 3) building owner. BP 63141 FEMA form 81-65, FEB. 97 00005612/97) U.S. DF�PA�TM�NT OF HOMELAND SECURITY ELEVATION CERTIFICATE rEDERAI ME GENCY MANAGEMENT AGENCY NationalFloodlnsuranceProgram �ry►p01'�a/it: Read the inst�uctions on pages 1-9. SECTION A- PROPf RTY INFORMATION A1. Building Owner's Name Shephard Family Trust A2. Building Street Address (inGuding Apt., Unit, Suite, and/or Bldg: No.) or P.O. Route and Box No. 619 S Gulfiriew Boulevard City Clearwater State FL ZIP Code 33767 A3. Property Description (Lot and Blodc Numbers, Tax Parcel Number, Legal Descxiption, Lots 1 thru 5, Blodc "C", Bayside Subdivision #5 Plat Book 38, Pages 38, OMB No. 1660-0008 Expiration Date: July 31, 2015 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) Non-Residentlal A5. LatitudelLongitude: Lat. 27°58'01.59"N Long. 82°49'36.87"W Horizontal Datum: ❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building ff the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 6 A8. For a building with a orawlspace or enGosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 7326 sq ft a) Square footage of attached garage 7133 sq ft b) Number of permanent flood openings in the crawlspace b) Number of pennanent flood openings in the attached garage or 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 � No d) Engineered flood openings? ❑ Yes � No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bi. NFIP Community Name & Community Number I 62. County Name Clearvvater, City of / 125096 PineNas B3. State Fbrida B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12103C0104 G August 18, 2009 Effedive/Revised Date Zone(s AO, use base flood depth) September 3, 2003 AE, � 12, 13 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in item B9. ❑ FIS Profile � FIRM ❑ Community Detertnined ❑ OthedSource: 811. Indicate elevation datum used for BFE in item 69: ❑ NGVD 1929 � NAVD 1988 ❑ OthedSource: 812. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes � No Designation Date: ❑ CBRS ❑ OPA SECTION C- BUILDING ELEVATION INFORMATION (SURVEY RE(1UIRED) C1. Buiiding 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, ARIAO. Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmaric Utilized: F-02 CiN of Clearvvater Vertical Datum: NAVD 1988 Indicate elevafion 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. a) Top of bottom floor (induding basement, crawispace, or enGosure floor) b} Top of the next higher floor c) Bottom of the iowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) fl Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including sVuctural support 6.51 22.43 21.47 6.13 1.49 6.3 6.4 6.5 Check the measurement used. � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters _ _ � 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 �' 3-�-r information. I certify that the information on this Certificate represents my best efforts to interpret the data available. v`� �'- . I understand that any false statement may be punishable by �ne w imprisonment under 18 U.S. Code, Section 1001. _� `.�� y` � � Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a, �• �' -"�� ^� '� ." � Check here if attachments. licensed land surveyor? � Yes ❑ No ' ' / i � � Certifiers Name David William McDaniel License Number LS 5840 R � Title Project Manager Company Name Deuel 8 Associates . ��(y �. Address 565 S Hercules Avenue City Clkearwater State FL ZIP Code 33764 � p��' Signature •.,�-� Date 02N2/201 Telephone 727822-4151 � � rr��n r_� nnn n nn i�ien� [�__ ��..�� :J� L__ ___af_..�a!__ I'1__Y___� ��11 ��_.d_'._ _J[�!_-_ J ' �r.��r�� v�� v�� u� �vr�� royc � IMPORTANT: {n these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Onit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 619 S Gulfview Boulevard Ciy Clearvvater State FL ZIP Code 33767 SEGTION D- SURYEYOR, ENGINEER, OR�ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUc�ompany, and (3) building owner. Comments A9a the garage is open on the north side. C2e elevator shaft bottom. C2h adjacent grade to stairs. Architect ground floor plan attached. "Floodpr�fing Certificate tor non-residential structures attached. Signature . �-� Date 02/12/2014 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. Chedc 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 endosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (inGuding basement, crawlspace, or endosure) 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 (elevatlon 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 communiry's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certity 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 knowtedge. Property Owner's or Owner's Authorized Representative's Name Address Signature Comments City Date State Telephone ZIP Code Check here if attachments. SECTION G - COMMUNITY INFORMATION (OPTIONAL) rhe local offic�al who is authonzed by law or ordinance to administerthe community's floodplain management ordinance can complete Sectiorts A, B, C(or E), and G �f this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8-G10. In Puerto Rico only, enter meters. 31. ❑ 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 informatlon. (Indicate the source and date of the elevation data in the Comments area below.) 32. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or communiry-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 Cornpliance/Occupancy Issued G7. This pertnit has been issued for: ❑ New ConsUuction ❑ Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: ❑ feet ❑ meters G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters G10. Community's design flood elevation: ❑ feet ❑ meters Local Official's Name Community Name Signature Comments ,-�..,, .---- . ...... .. .... ."..,. Title Telephone Date Datum Datum Datum Check here if attachments. n__�........ _u ___..._.... _.�x:,...... EL�VATION CERTIFICATE, page 3 guilding Photographs See Instructions for Item A6. 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. 619 S Gulfview Boulevard City Clearvvater State FL ZIP Code 33767 If using the Elevation Certificate 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 Vievd' and "Rear Viev�'; and, if required, "Right Side View" and "Left Side View." When applicable, photographs 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. FRONT EAST SIDE FRONT FROM WEST FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 guilding Photographs Continuation Page + 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. 619 S Gulfview Boulevard City Clearvvater 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 VievW' and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. REAR EAST SIDE REAR FROM EAST FEMA Form 086-0-33 (7/12) Replaces all previous editions. • • . • :. . . .. . . . .. �!`to�■ r'�_�s1111�c?� �i ��D ° t�D <� o ��i�� , �..�. aD a>a� ��/� aD �� '� �� o.�� _ _ � , • � �a q►� � :� �' ^ s� ;,,� � �� ;� '" „ .�� ID ___ � , � _ �� _ ,, ,. = a D " ; • !, �. ,-' ,�: . . .F,. ;, � -� � �� Qd, o „ �� 1 " ��'.. " `� � 'J' J }„ ; 0 ��II� .. .,.. .... o ,�.� o -- �.0 ■ �Q�i . � �� " �►%: �� \\�\\\tl�� .:` � ( :��: t� :�7.r i �I � I►_ �'�.�i- - - i� `�� ;:►'• ti'.;: ;�:aQ� a �?° , ^ �� , ,� ,� ' �� i ; - �,^-JJ � - ; ;�ia p o , , �-��, _� O ' � �:., � � � � __- — � 0 � 0 -'� � � ' � ' � �IY� � o � �, � ° �� -�� CD '= o 0 : . . : . 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'. t .'�. : � �� - : = t�' ' _ ° ` _ U.S. DEPARTMENT OF HOMELAND SECURITY �OODPROOFING CERTIFlGATE rOM6 No: 1660-0008 � FEDERl1l EMERGEI�ICI' NUIWAGEMEW7 AGENCY N�.t t�a r�.�� P„� FOR NON-RESIDENTIAL STRUCTURES � ExplraUon Date: Juty 31, 2015 The floodprooflng of non-resideMial buildings may be permitted as an alternative to elevating to or above the Base Flood Elevation; however, a floodprooflng design certification is required. This form ts to be used for that certiflcaUon. Floodproofing of a residentlal building dces not etter a community's floodplafn management eievation requirerr�ents w affect the insurance rating uNess the community has been issued an exception by FEAAA to allow floodproofed residenUal basemeMS. The permttUng of a floodproofed residentlal basement requires a separate certification specifying that the design complies with the local floodplain management ordinance. BUIIDING OWNER'S NAME SIREET ADDRESS pntludin( Apt. UnR. Sulb. arW/a Bldg. Number) OR P.Q ROU�E M� 80X NlNdBER 619 S. Gulfv+ew Boulevard OIFIER DESCRiv710N (Lot and B�ock Numbws, ea.) Lots i thru 5, Block "C", Bayside Subdivision #5 Plat Book 38, Pages 38 cm Ciearwater �A�Ftorida nPC�33767 SECTION 1— FLOOD INSURANCE RATE MAP (FlRM) INFORMATION P►oWde ths following f►om the prope► FlRM: � COAMWl11YNUMBEA PANELNUMBER � SUFFI% DII7EOFfliU1NIDOI FII�IZONE 8115EF100DElEVA710N 125096 12103C0104 G August 18, 2009 AE, VE �� 12 13 � �n�cace elevaUon aan�m used tor ease Fboa oevsnon slahm snove: ❑ rww� is2s � ronw lsea � oaier/saxce: SECTION 11— FLOODPROOFlNG INFORMATION (Bp a Reglstered Professional Engineer or Architect) Devanons are nased on: O conswaion urawi� ❑ 6uN�ng under consauctlon f� FlnBned car�ructlon Floodproofln� Design Elevation Information: 9uiWfnB is tbo�mofed to an Nevatlon of �. � feet (In Puerto Rico aYy: _._ meter�. ❑ N�W 1929 (Elevatbn datum used must be the same as that used iw U�e Base Flood Elevatlon.) Height of lbodprooNng on the building above the lowest adjacerrt g►ade is 4.8 test {in Puerto Rko onry: - For Unnumbered A 2ones Onry: Fifghest adjaixM (finished) gnade �ext to the building (HAG) . feet (le Puerto Riw ony: ❑ NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: � NAVD 1988 ❑ OU�erySou►c� meters� mCte�s) (NOTE: Por insurence rating purposes, the �ildk�g's floodproofed design elevetfon must be at least 1 toot above the Base Flood Devatlon to raceive rating credit. H the bupding b floodproofed only to the Bese Fiood Elevatlon, then tAe buiWing's insuronce ratlng wip resuR in e Aigher prerMum.) SECTION 111— CERTIFlCATION (By a Reglstered Probaslonal Engineer or Archftect) Non-Resldentlal Floodproofed Construetion CertHleaUon: 1 cerUfy that, based upon devefopment and/arevlew oJswcWral deslgn, speciRcaGons, and plans Aor cortsVUCUon, Me deslgn and methods o/constnrctlon are In accordance wtth accepted standards o►pracUce ia meetlng the foUOwing provhlonx Tha structure, together with attendant utilitfes and sanftary tacilitles, is watertight to the 1loodproohd design elevaUoa Indicated above, with walls that are substaMialiy Impermeabk w the passage of watec All structurel components are capable of resisting hydrostetic and hydrodynarNe flood toroea, fncWding the effects of buoyancy, and aMfcipeted debrisimpactiorces. I certlry that the informaUon on tlds certMCate represents my best effoKS to Jnterpret tAe data avallable. l understand that arry talse statement may be pudshabk by ftne a imprlsonment under 18 U.S. Code, Section IOOL CERTIFlER'S NAME � 110EN5E NUMBER (or AMx Seal) � CHOU-WUN YONG 61016 STRUCTURAL ENGINEER G��P� ENGINEERtNG GROUP, LLC aoors�ss cro srni� nvcooe . 3998 EAST SR64 BRADENTON FL 34208 S�CaNATURE DATE PHONE � �'" ��. � 2014/02/02 (813)252-1033 Copies should be made of this Certlflcate tor: 1) communfty offlclel, 2) Insuronce agent/company, and 3) bullding owner. FEMA Pam 088-0-34 p/12) REPLACES ALL PREVIOUS EDITIONS F056 U.S.DEPARTMENTOFHOMELANDSECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION A1. Building OwnePs Name Shephard Family Trust A2. Buiiding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 619 S GulNiew Boulevard City Clearwater State FL ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcei Number, Legal Description, etc.) Lots 1 thru 5, Block "C", Bayside Subdivision #5 Ptat Book 38, Pages 38, OMB No. 1660-0008 Expiration Date: July 31, 2015 CBMF�i#NY IJSE Y ' A4. Building Use (e.g., Residential, Non-Residential, Add'Rion, Accessory, etc.) Non-Residential A5. Latitude/Longitude: Lat. 27°58'01.59"N Long. 82°49'36.87'1N 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 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) N/A* sq ft a) Square footage of attached garage N/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 N/A* 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 � No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number 62. Counry Name B3. State Clearwater, City of / 125096 Pinellas Florida 64. Map/Panel Number 65. Suffix B6. FIRM Index Date 67. FIRM Panel 68. Flood B9. Base Flood Elevation(s) (Zone 12103C0104 G August 18, 2009 Effective/Revised Date Zone(s) AO, use base flood depth) September 3, 2003 AE, VE 12, 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 ❑ OtheNSource: 611. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: 612. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date: ❑ CBRS ❑ OPA ❑ Yes � No 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: F-02 Citv of Clearwater Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations i� items a) through h) below. ❑ NGVD 1929 � NAVD 1988 ❑ OthedSource: 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) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) � Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of dedc or stairs, including structural support 6.51** 22.43 21.47 N/A.�" 1.49 4.8 6.1 N/A.** � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION ,,,a �; �. E� �n r,, This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation �`.�'+�-9s, �,, .,`. inforrnation. 1 certify that the information on this Certificate represents my best efl`orts 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. �- -;� ' , '' � 'r � Check here if comments are provided on back of form. Were latitude and longitude in Sedion A provided by a� R ,` � c �'�� , � ❑ Check here if attachments. licensed land surveyor? � Yes ❑ No �� ;; �`� � r�` $' � i"' . , Certifier's Name David William McDaniel License Number LS 5840 �» ;' £' ' � : � e'�.` +�r % Q, Title Company Name Deuel & Associates o, `9 ;'• ��. . �,� � ,��,,..� ;: r� �� a � Address 565 S Hercules Avenue City Clkearvvater State FL ZIP Code 33764 %,�`� o�..'��, .'4 �os�. Signature ,,.•�Date 07/30/2013 Telephone 727 822-4151 �`'�r,Y `��w �C�`i =� A�� Fla,._.._.r�� FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. ��rr��v�• v��n �vr��, NiiM�i i 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. 619 S Gulfview Boulevard Ciry Clearvvater State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number. 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 * A8&A9 - wall lines are not complete on the 1�` level. insufficient data to calculate this section. *"' C2a top of lobby floor. **C2d garage floor not poured. ""'C2h area incomplete. C2e elevator shaft bottom. Signature � �—�.� Date 07/30/2013 � 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 inforrnation 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 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 Instruetions), 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, B, and E are correct to the best of my knowledge. Property Owners or Owner's Authorized Representative's Name Address Signature Comments Ciry Date State Telephone ZIP Code Check here ff 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. Chedc the measurement used in Items G8--G10. In Puerto Rico only, enter meters. 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 communiry 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 G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters G10. Communiry's design flood elevation: ❑ feet ❑ meters Local Official's Name Community Name Signature Comments Title Telephone Date Datum Datum Datum Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 guilding Photographs See Instructions for Item A6. 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. 619 S Gulfview Boulevard City Clearwater State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number. If using the Elevation Certificate 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 VievW' and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs 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. �-,., r��;� FRONT EAST SIDE ,, ___._ �� _ �� , ,��.,�_�� - ��.,. _ �. .. _ - �.. FRONT WEST SIDE .a .. ,.... . ; � �...., - ,�,� .. , - .. ;> �,..> ��Y ..�.,...i':� .i .i��r� ri' �.. y�w� .,.,�W,.� FEMA Form 086-0-33 (7/12) Replaces all previous editions. . ELEVATION CERTIFICATE, page 4 guilding Photographs Continuation Page IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 619 S Gulfview Boulevard City Clearwater State FL ZIP Code 33767 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 VievW' and "Rear View"; and, if required, "Right Side VievW' and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. + ` � �, . � � ?�. :• REAR EAST SIDE .►i �: _ �� ,. � �� , �`. � �. � ��:�� REAR WEST SIDE � � � �j�t�� i �r �� r' �� -, �� I '" � r �-' � sS �� b -, �~- � �..� �` � � �.,.,,,,.�s , : � ,_ � _ �s�.:.� FEMA Form 086-0-33 (7/12) Replaces all previous editions. 3'/ / � �� J ^�/ r� �� ., � � ��., � � �� ..� ,�:Z ,� -� �. �.�� '� � ( . � � , ; �� FEDERAL EMERGENCY MANAGEMENT AGENCY o.l�+.e.n►o3o6�-op» � NATlONAL FLOOD INSURANCE PROGRAM FXw�esn.+:y3r, 1g93 . FLOODPROOFING CERTIFICATE FOR NON-RESIDENTIAL STRUCTUAES •(he Iloodproolrng ol non-residential buildrngs may be permitted as an allernadye to elevating to or above the 8ase Flood E/evation; l�owever, a lloodprooling desi9n certllicadon is required. This/orm!s to be uaed lor that certilication. Floodprooling o!a residentral budding does not alter a community'a lloodplain manapemenf elevatlon requlrementa or eNect the lnsurence rating unless the con,mun�ry has been issued an exception by FE�41A to allow lloodproofed residential basements. The permitirng of a Roodpr00%d �esident�al basement requires a separate ceRilication specilying that the design complies with the local ifoodplain management ordinance. FOR INSURANCE COMPANY USE BUIIDING OWNER'S NAME ; POLICY NUMBER W ��-1.��+1 • ��►�✓ 1 t��.�( G� STf7EET AODfiESS(InGudinQ Apt• Unit.3uits end�w B�dO.Numb�r)OR P.O.flOUTE AND BOX NUMBER COMPANY NAiC NUMBER Co I� S• v V IEv.� l3�-vn. OTHER DESrRIPTION(Lot and Blodc Numbsre.etc.) y. � , ----- �'� I Tt'1�� ? P�U� �C..�� j�(� SV(�t � �— " STATE ZIP COOE CITY ^ G�r'..-�z.w,�;� ��. 337�� SECTION 1 FLOOD INSURANCE RATE MAP(FIRM)I�IFORMATION Provide the foilowmg from the proper FIRM: CCIAMUNITV NUMBER PANEL NUMBER SUfFIX DATE OF FIRM INDEX FIRM ZONE BASE FLOOD ELEVATIUN 2 JU l�y 'Z �� (in AO Zones,uee depth) IZ��c�9 � rao l �- � � `� �2 .0 SECTION II FLOODPROOFING INFORMATION (By a Reglatered Professlonal Engfnee�or Architect) Flood�rooflnq Desiqn Elevstlon Informatlon: Building is floodproofed to an elevatlon of I I I 11 (�i.0 feet NGVD. (Elevation datum used must be the same as that • on the FiRM.) Hefghi of floodprootinp on the building above the lowest ad�acent grade is ��`a.U feet. (NOTE:(or insurance rating purposes, the building's lloodproo/ed design elevation must be at least one foot above the 8ase Ffood Elevatron to receive rafing credit. 1l the building is tloodproofed only to the Base F/ood E/evation, then the buitding's insurance rating wi11 result!n a higher premium.) SECTION III CERTIFICATION (By e Aeylstered Professionel Engineer or Archltect) Non-Fiesidential Floodproofed Canstructfon Certiflcatlan: I certily that based upon development and/or review ol structural design, specilications, and plar.s/or construction that the des�gn ar,d methods ol construction ars in accordance with,accepled standards o1 practice 1or meeting!he lollowing provisions: The structure, together with attendant utilities and sanitary facilities, is watertight to the iloodproofed design elevation indicated above, with walls that are substantially impermeable to the passage of water. All structural components are capable oi resisting hydrostatic and hydrodynamic flood forces, inciuding the effects of buoyancy, and anticipated debris impact forces. I certrly that the information on thrs certilicate represents my best eHoris to interpret the data available. I understand that any/alse statement may be punishable by fine or imprisonmrint under 18 U.S. Code, Section 1001. �ERTIFIER'S NAME LICENSE NUMBER(a AMix Seel) __ hi��nl �•�`," �w�.r°.. _ �.►2�5 q.q.� --- TiTI.E � COMPANY NI1ME --- �'�� ,� l��(,FQ � �t i�G_ nDDRESS �,e �"��' " � ' CITV STATE Z�p �42i.�w` v °s. _ . � � �� .�� G� � �L� 33 �. --- , . � �IG��ATURE "`'.' �� •" ,' '- � , � .,, DATE FK�NE � � � CoQlee should be Rt M o��"�6rt11 T: 1)commuMty officl , i surence eqenUcompany, end 3)building owner. .-.,..,t. �m..Mrt�w ,w�!7.�9 Y�V�� '��{�`"..� +.{ .p� .Y 0I � V `{ f�M.�4°!i� ,'�, ��,��S a`,r'q FEMA form 81-65,MAV 90 °' ��W'AI M�# ,WNICN IS 08SOLETE . � ��`r �rbtas i '' ,.. n, . ..._;�,.. a,.�.;�:d.��,..��... . .. _ . ... _ � SECT(ON E CERTIFI��ATiON �n�s .e^r�cat�on �s ro oe sipnec ov a ianc surveve�. eno;neer. c�arcn,te:,�:wno �s au:nor�ec �v s,ate er �oca: iaw ;o c�rt�i�� eieva*,ior � �r,ror^;aUCn wnen the elevaUOn ;ntormauon rc�Zone= a'-A3C Ac. A�. A �wrtr B!=c, V�-'��3� V-.,�nc ✓ r�vit^ B�-_ �s reawred � �ommunitv affiaais wno ars aumouzec by iocai iaw o�ore�^ance to arovioe flooCplain �naraoemer,? mterm2i�or �na,-�iSC s+en rne C2rtriiCallOn In the case o!Zones AC ana ti �wittlOUi 2 `�Mr" 0'communrt;� issueo Br=,. a owloing etf�ca;. a prooertv owner. Cr an owner s representative mav also sion the cerbticatior. � Reference levei diagrams 6. � and 8 - Disnnowsning �eatures-�f tne cenifier is unabie to cerUt��to oreaKaway-non-breaKaway wa�!. enaosure size. location ot serv�cma eawqmen;. area use. waii openmCS. o!unfm;snea area Featureis;. mer i�st tne Featurets� not �ncluded m tne certification under Comments oeiow. The oiaaram numbe: Sect�on C. Item �. mus: still be entered. 1 cer�tv that the rnier.m.aUOn in Sectrons 8 and C on !.h,s ceRnc�are reDresenrs mv dest e;rorrs rc�nterpret the data available. 1 understand that any taise sratement may de pun�snanre oy nne or;morrsonme��7 under ?B U.S. Coae. Sectron 1COi. C�RT-IER'S NAME � _.�chSc�vUMBE=+ e•Ar�. Sea� 1 �2��L ----- - ___��--L TITL� �onnFan�n�Ars_ ��'T-.-• 3 --- Ow __��5. -- -�__�-�i�C - ADDAESS ,, % �!""'� STAT_ ZIP ��2 ' r :'� . - =--- � _Gc-��J - - __---__�t- 3375G, _ SIGNATURc � i� / � �HONE ` 2�. . 202( Copies should,b made of this Gertificate for. 11 community offic}al. 2) insurance agent company. and 3) building owner. COMMENTS: — -------- -------- -_— — - --__----- -___ ---- • ON 'NITN CN PILES. � SIAE dASEMENT PIERS OR COIUMNS � .. ZOivES ZONES � =. .__ _�r,�i ��NES �++ .;.,.� ;^'` �� - �:. ._ � IRFc� E^Ek�c. �K. � ��—� .A.` 'y�. '.., � FFFRCN:: �� I[. � !� � ��ne _.. �_ .�_-`� . � �^^�t� r �.--r�.�,.........n�,.,..�.ti...`.y.. i Y - ...-�—`-----" _____1. ��T�— � ' 7AJ: ..A :+r� 'ACEN' � � I�"- =aFN`- �� - p�,� . �" .GT�.ON -_E�•- �'� � .., � - 'nA.�f � cy` i F,- , .. /,- . _ ;I��', � —�,i�h 1,---�-�,�,�,�'��;, . � •� ��'��(j! � �y .��.;c,:,Er:r ,, h�i :iR0.�= , The a�ac�ams aoove u�us;race tne pomts at wn�c;�tne eievations srowd be meascreo �n A �ones and `' Zcnes. , � =ievauons for all A Zones snou�d be measured ac me coo c?me rerererce ievei floor • � �levauons for all V Zones snowd be measurec at the oottor^ ��~e owest r,onzorTai structurai memtier I ! I _ _. �U.S.DEPARTMENT OF NOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency ManagementAgency F�cpires Mai'Ch 31,2012 IVational Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION For insurance Company Use: A1. Building Owners Name SHEPARDS BEACH RESORT Policy Number A2. Building Street Address(induding Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIG Number 619 S.GULFVIEW BOULEVARD(EASTERNMOST MASONRY FRAME CABANA) City CLEARWATER BEACH State FL 21P Code 33767 A3. Property Desaiption(lot and Blodc Numbers,Tax Paroel Number,Legal Desaip6on,etc.) LOT 1-5 BLOCK C,BAYSIDE SUB�5,PLAT BOOK 38 PAGES 38&39,PINELLAS COUNTY,FLORIDA. A4. Buiiding Use(e.g.,Residential,Nan-Resider�tial,Addition,Accessory,etc.)NON-RESIDENTIAL A5. Latitude/Longitude:Lat.N27°58'00.2" Long.V1l82°49'36.7" Horizontat Daium: ❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building'rf the Certficate is being used to obtain flood insurance. A7. Building Diagram Number 1 A8. For a building with a cxawlspace or endosure(s): A9. For a building with an attached garage: a) Square footage of crawispace or endosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft b) No.of pertnanent flood openings in the aawlspace or b) No.of permanent flood openings in the attached garage endosure(s)within 1.0 foot above adjacent grade WQ witliin 1.0 foot above adjacent grade � c) Total net area of flood openings in AB.b WA sq in c) Total net area of flood openings in A9.b N�A sq in d) Engineered flood openings? ❑ Yes � No dy Engineered flood openings? ❑ Yes � No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name 8 Community Number B2.County Name 63.State CITY OF CLEARWATER 125096 PINELLAS FL 64.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel 68.Flood B9.Base Flood Elevation(s)(Zone 12103C0104 G Date Effective/Revised Date Zone(s) AO,use base flood depth) 5/17/05 9/3/03 VE 13'&14' B10. Indiqte the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69. ❑ FIS Profile � FIRM ❑ Community Determined ❑ Other(Describe) B11. Indicate eievation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other(Describe) B12. Is the building located in a Coastal Banier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes � No Designation Date N/A ❑ CBRS ❑ OPA SECTION C-BUILQING ELEVATION INFORMATION(SURVEY REQUIRED� C1. Building elevations are based on: ❑ Construction Drawings' � Buitding Under Construction' ❑ Finished Construdion •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,ARlAH,AR/AO. Compiete Items C2.a-h below accorcling to the building diagram speafied in Item A7. Use the same datum as the BFE. Benchmaric Utilized SEE COMMENTS Vertical Datum NAVD 1988 ConversionlComments N NE Check the measurement used. a) Top of bottom floor(induding basement,crawlspace,or endosure floor)�.,�1 �feet ❑meters(Puerto Rico only) b) Top of the next higher floor WA. ❑feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal strvdural member(V Zones only) 15.3Q, �feet ❑meters(Puerto Rico only) d) Attached garage(top of slab} I�/q. ❑feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 1�.44 �feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) � Lowest adjacent(finished)grade ne7ct to building(LAG) ¢.1 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished}grade neM to building(HAG) ¢.6 �feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest etevation of dedc or stairs,induding f.1 �feet ❑meters(Puerto Rico only) Sfivdural support SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land sunreyor,engineer,or architect authorized by law to certify elevation information. 1 certi(y that the information on this Certificate represents my best etiorts to interpret the data evailable.l °• understend that any false statement may be punishable by fine or imprisonment under 18 U S.Code,Section 1001.� • ,, Chedc here if comments are provided on back of form. Were latitude and longitude in Section A provided by a � � h�' ". licensed land surveyor? � Yes ❑ No .�t.� �� •a �'�e -:� Certifier's Name JEFFERY A.COPELAND License Number 5279 • , e�� 'i��'>s�!7 �: �`i: �t-S S'�.��$ : Title REGISTERED LAND SURVEYOR Company Name SUNCOAST LAND SURVEYING,INC. ,3 ,.-; �,� Address 111 FOREST LAKE LV . City OLDSMAR State FL ZIP Code 34677 ' ��"�i��l' 4�� ` Lf, - � � Si ature Date 2/18l11 Telephone 813-854-1342 �. ^< �e h : �� • °, �,,?��,. � e° �. - - a,�f .`s��.�..e�' �., FEMA Form -31,Mar 09 See reverse side for conUnuation. . I�epl �Fpr�afidus editions � 's'��'.,......aea' � � ' IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use: • Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. PoRcy Number 619 S.GULFVIEW BLVD.(WESTERNMOST MASONRY and FRAME CABANA) �City CLEARWATER State FL ZIP Code 33767 Company NAIC Numt�r SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUEDj Copy both sides of this Elevation Certificate for(1)community otfiaal,(2)insurance agenUcompany,and(3}building owner. Comments A5.DETERMINED USING HAND-HELD GPS DEVICE. C2.UTILIZED CITY OF CLEARWATER BENCHMARK F-02 ELEVATION=4.0574'(NAVD 1988) C2e.BOITOM OF�IGHT BOX Signature Date 2/18N 1 Chedc here N attachmenis SECTION E-BUiLDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR 20NE 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,'rf available. Chedc the measurement used. In Puerto Rico only,enter meters. E1. Provide elevation iMormation for the following and chedc the appropriate boxes to show whether the elevation is above or below ihe highest adjacent grede(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(induding basement,crawispace,or enGosure)is ❑feet ❑meters ❑above or�below fhe HAG. b)Top of bottom floor(induding 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&9 of lnsUuctions),the next higher Aoor (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 platfortn of machinery and/or equipment serviang 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 wmmunityfs floodplain management ordinance? ❑Yes ❑ No ❑ Unknown. The locat offiaal must certify this inlormation in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property aaner or owner's authorized representative who completes 5ections A,B,and E for Zone A(without a FEMA-issued or community-issued BFEj 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 RepresentaUve's Name Address City State ZIP Code Signature Date Te{ephone Comments ❑Credc here'rf attachments , SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local oftidal who is authorized by law or ordinance to administer the community's tloodplain management ordinance can complete Sedions A,B,C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Chedc the measurement used in Items G8 and G9. G1.❑ The infom►ation in Sedion C was taken from otl�er documentation that has been signed and sealed by a licensed sutveyor,engineer,or architect who is authorized by law to certify eleva6on information. (Ind'rcate the souroe and date of the elevation data in the Comments area below.) G2.❑ A community offiaal completed Section E for a buiiding located in Zone A(wifhout 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 CerGficate Of CompiiancetOccupancy issued G7. This pertnit has been issued for. ❑New Construdion ❑SubstaMial Improvement G8. Elevation of as-buift lowest floor(induding basement}of the buiiding: ❑teet ❑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 Offiaal's Name Title Community Name Telephone Signature Date Comments ❑Chedc here if attachments FEMA Form 81-31,Mar 09 Replaces all previous editions . . . � Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Poiicy rvumber 619 S.GULFVIEW BLVD.(EASTERNMOST MASONRY and FRAME CABANA) CI�/ CLEARWATER State FL ZIP COd@ 33767 Company NAIC Number 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 Viev�'and"Rear Yev✓'; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. SOUTH SIDE 2/18/11 n�,,,�„�.., ,• ,�. ,�,, �� „`��"`�-�9., '�� g �M i . • �;. � w r �€ ; - � �= � :,it #-' . . .�u> � �. 1�,��`Y`��, . � � 4 • � ,. �� y�xx - „ � . . . � �. �, .._ . 9 ,� �, ;� � �r ti- h � ... __' ++�i � � � � � ��! 7?. i ` �F1 �, �3�y� ? :�� l. �r /•.�� .,'� � . '� �;�; _ .�:'�`��.I�� , �,�, ; - ... ,,. � .�� ; .��.-.-... � � �� ,� �c• � � � - � `d � ,; �.. � : �►-f :�,�;. "a v..-.��. WEST SIDE 2/18/11 � !�t� ::� r ��k ��. � # l:.sy�-w;+K��kwr ,. � �"�" ,-, ., ��;;«.�,....„ ��' � �• �,x � �.��tu .,. � � �"t; � �r . , . rd �'�' '� f. �° � � � ` P� ; � ;t� � F� , �_ ,..�� '.��o��d . �� b . �"��' , .� ' �. -�p� � �P �+«s�A:J.. �� '�Y �� ^ .� , _ � „ .....��« , ; ` , � . ' � �,,, ...�. � w,�.�, . . �. �`� � � `� ' .s,� r `;;�� _-,, , :.. _ ��,,, e � -.__ � �-��. „.� � '* � -. � � � �: `�� . �:�� , . � Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(induding Apt., Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Poiicy Number 619 5.GULFVIEW BLVD.(WESTERNMOST MASONRY and FRAME CABANA) I , CItY CLEARWATER State FL ZIP COd@ 33767 Company NAIC Number � 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 vev✓'and"Rear�ew"; and, if required, "Right Side View� and �Left Side Vew." If submitting more photographs than will fit on this page, use the Continuation Page, following. SOUTH SIDE 2/18/11 ��t��t„�y � _ �• � �"`"�^� +�fem _ , . � .l!"R° �, � f ' � � ,� ;.��""�"""'-" __ ._, � '" �S .,:� !� s �_ �< �-�-�� , s��_,. � �jXi � ` � � , � � � . .._... ... : ;' �� )"�.�J , F ......d u,. . F �� ...�.� r ,�5 t . ��x� . �,�' .... '�'w'�..._ � � ��'��re . .. .�� a � <. , "' ...�_ .�-_ •�: . —._. _� r.... -:.��.�. ,. . . L, _.,_.._ � _.t � � --� �' � �. �.. ��""""`� .� � ; � . �r. ,. ::^-_ �-- : .�, -°� �� - :� _ EAST SIDE 2/18/11 i ��r � , a: � t �d _ ... �{a�= C ` �� w � 4 . _ .. � � 3� I .� � - � , �.: � ,� - =�- .�� itv� �' -'�i-a',+c � . `f � , ' " �x��'� � � � � , � ��"`#.�---�� , . �. � � �`_ _ i��;�! 2 '� '�..�''� �., - -r ..w s� � ' �. yp - .. ..' .� ,;.. > ,� .�.�... - 'r ` �7.s. .. . ..., .,� �� t-"k. ^,;:. ��. :_._.. � �. ,:"'�"-,N . � . _ Q*'�� U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Fed�ral Emergency Management Agency Expires March 31,2012 Nat�onal Flood insurance Program Important: Read the instn�ctions on pages 1-9. SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1. Building Owner's Name SHEPARDS BEACH RESORT Policy Number AZ. Building Street Address(inGuding Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number 619 S.GULFVIEW BOULEVARD(WESTERNMOST MASONRY FRAME CABANA) City CLEARWATER BEACH State FL ZIP Code 33767 A3. Property Desaiption(lot and Blodc Numbers,Tax Parcel Number,Legal DescripUon,etc.) LOT 1-5 BLOCK C,BAYSIDE SUB#5,PLAT BOOK 38 PAGES 38&39,PINELLAS COUNTY,FLORIDA. A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)NON-RESIDENTIAL A5. Latitude/Longitude:Lat.N27°58'00.5" Long.W82°49'37.3" 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 1 A8. For a building with a crawlspace or endosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or endosure(s) 1/ sq ft a) Square footage of attached garage � sq ft b) No.of permanent flood openings in the a�awlspace or b) No.of pertnanent flood openings in the attached garage endosure(s)within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grede 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 WA sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B-FIOOD INSURANCE RATE MAP(FIRM)INFORMATION 61.NFIP Community Name 8 Community Number B2.County Name B3.State GTY OF CLEARWATER 125096 PINELLAS Fl 64.Map/Panei Number 65.Suffix B6.FIRM Index 67.FIRM Panel B8.Fiood 69.Base Flood Elevation(s)(Zone 12103C0104 G Date Effective/Revised Date Zone(s) AO,use base flood depth} 5/17/05 9/3/03 VE 13'&14' 610. Indicate the souroe of the Base Flood Elevation(BFE)data or base flood depth errtered 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) 612. Is the bufiding located in a Coastal Bartier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes � No Designation Date N/A ❑ CBRS ❑ OPA SECTION C-BUILDIN(i ELEVATION INFORMATION(SURVEY REQUIRED) Ci. Building elevations are based on: ❑ Construction Drawings• � Building Under Construction• ❑ Finished Construction 'A new Elevation Certificate wiil be required when consUuction of the building is complete. C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(wifh BFE),AR,AR/A,AR/AE,AR/A7-A30,AR/AH,AR/AO. Complete Items C2.a-h beiow according to the building diagram speafied in Item A7. Use the same datum as the BFE. Benchmark Utilized SEE COMMENTS Vertical Datum NAVD 1988 ConversioNComments NONE Chedc the measurement used. a) Top of bottom floor(induding basement,crawlspace,or endosure floor)�.47 �feet ❑meters(PueRo Rico only) b) Top of the next higher floor WA. ❑feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal stnictural member(V Zones only) y�.2� �feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) j�q/ . ❑feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment serviang the building 1�.¢¢ �feet ❑meters(Puerto Rico only) (Desaibe type of equipment and location in Comments) � Lowest adjacent(finished)grade next to building(LAG) 6.� �feet ❑meters(Puerto Rico onty) g) Highest adjacent(finished)grade next to buiiding(HAG) ¢.7 �feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of dedc or stairs,induding C.� �feet ❑meters(Pue►to 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 certi(y that the information on this CeRificate rep�sents my best elfnrts to interpret the deta availableJ ,, understend that any felse statement may be punishable by fine or imprisonment under f 8 U.S.Code,Section 1001.� `� " ' " Chedc here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? � Yes ❑ No � A • Certifiers Name JEFFERY A.COPELAND License Number 5279 , ,,��P`��C��•.��-'•��'• TiUe REGISTERED LAND SURVEYOR Company Name SUNCOAST LAND SURVEYING,INC. r��•=p�-;S �� '.�.. �.� - � . Address 111 FOREST LAKES BLVD. City OLDSMAR Stete FL ZIP Code 346�7 �3 : ` �� '�:, � -- �'i p��`�� 11 Signatu Date 2118/11 Telephone 873-854-1342 ' + .�`� =�" ` _ �• � C/��• e eoe � � . +o �i FEMA Form - 1,Mar 09 See reverse side for continuation. pJ6q��s� p� editions �:�0 J `,:a,. ?t:.. ,a2 . � IMPORtANT: in these spaces,copy the corresponding information from Section A. For Insuranoe Company Use: Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number 879 S.GULFVIEW BLVD.(EASTERNMOST MASONRY and FRAME CABANA) City CLEARWATER State FL ZIP Code 33767 Company NAIC Number SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certiticate for(1)community otficial,(2)insurance agenUcompany,and(3)building owner. Comments A5.DETERMINED USING HAND-HELD GPS DEVICE. C2.UTILIZED CITY OF CLEARWATER BENCHMARK F-02 ELEVATION=4.0574'(NAVD 1988) C2e.BOTTOM OF LIGHT BOX. Signature Date 2l18/11 Chedc he�+e'rf attachments SECTION BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR 20NE AO AND 20NE A(1MTHOUT 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. Chedc the measurement used. In Puerto Riw only,eMer meters. E1. Provide elevation ir►formation for Uie following and chedc the appropriate boxes to show whether the elevatiw�is above or below the highest adjacent grede(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawispace,or enclosure)is ❑feet ❑meters ❑above or�below the HAG. b)Top of bottom floor(including basement,crawlspace,o�enclosure)is 0 feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-9 with pertnanent flood openings provided in Section A Items 8 and/a�9(see pages 8-9 of Instructions),the neut 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 platfortn of machinery and/or equipment servidng the building is ❑feet ❑meters ❑above or�below the HAG. E5. Zone AO only: if no flood depth number is avaitable,is the top of the bottom floar elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑ Unknown. The tocal official must certify this information in Section G. � SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATNE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or cornmunity-issued BFE) or Zone AO must sign here. The statements in Sections A,B,and E are correcl to the best of my knowledge. Property Owners or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments �� • ____ ❑Chedc hene'rf attachments SECTfON G-COMMUNITY INFORMATION(OPTIONAL) The local offiaal who is authorized by law or ordinance to administer the community's floodpiain management ordinance can complete Sections A,B,C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Chedc the measurement used in Items G8 and G9. G1.❑ The infortnation in Sedion C was taken from oUier documentation that has been signed and sealed by a Gc�nsed surveyor,engineer,or architect who is authorized by law to certify elevation infortnadon. (indicate ihe source and date of the eievation data in the Comments area below.) G2.❑ A community offiaal completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.❑ The following infortnation(Items G4-G9y is provided for community floodplain managemerrt purposes. G4.Pertnit Number G5. Date Pem►it Issued G6. Date Certifiqte Of CompliancelOccupancy Issued G7. This permit has been issued for. ❑New Construction ❑Substantial Improvement G8. Elevation of as-buift lowest floor(induding basement)of the buiiding: ❑Teet ❑meters(PR)Datum G9. BFE or(in Zone AO)depth of flooding at the buikling site: ❑teet ❑meters(PR)Datum G10.Community's design flood elevation ❑feet �meters(PR)Datum Local Offiaal's Name Title Community Name Telephone Signature Date Comments ❑Chedc het�e if attachments FEMA FoRn 81-31,Mar 09 Replaces all previous editions _ _ _ _ _ _ _ . �jG� �G�Gj�_ I �L ZL� . ' � � o.M.e.r�o.3os�-oon ' FEOERAL EMERGENCY MANAGEMENT ACaENCY Expiros luly 31,1999 NATIONAL FLOOD INSURANCE PROGRAM �D/�M S Mf�� • FLOODPROOFING CERTIFICATE �� . ��1e� FOR NON-RESIDENTIAL STRUCTURES The floodproo/ing of non-residential buildings may be permitted as an alternative to elevating to or above the Base Flood Elevation; however,a lloodproo/ing design certilication is required. This form is to be used for that certification. Fioodproohng of a residential building does not alter a community's floodplain management elevation requirements or eNect the insurance rating unless the community has been issued an exception by FEMA to albw lloodproofed residential basements. The peimitting of a floodproofed residential basement requires a separate certi�icallon speCilying that the design complies with the local floodplain management ordinance. FOR INSURANCE COMPANY USE BUILDING OWNER'S NAME POI.ICY NUMBER HBE - Florida Corporation STREET ADORESS(Including Apt.,Unit.Suite and�a Bidp.Number)OR P.O.ROUTE AND BOX NUMBER COMPANY NAIC NUMBER 11330 Olive Boulevard OTHER DESCRIPTION(Lot and Blodc Numbers,etc.) CITY STATE 21P CODE St. Louis MO 63141 SECTION 1 FLOOD INSURANCE RATE MAP(FIRM)INFORMATION Provide the following from the proper FIRM: COMMUNI7v NUMBER PANEL NUMBER SUFFIx DATE OF IRM IN X FIRM ZONE BASE FIOOD ELEVATION '��_C+�� hC (i�AO 2onea,use deplh) `�5�� 0007 D 1991 Fi rm Map /-{�. 12.0 SECTION il FLOODPROOFlNG INFORMATION (By a Regtatered Proleasional Enpineer or Architect) Floodproofing Design Elevation Information: . � • Building is floodproofed to an elevation of i ' I I� IZ I.LI feet NGVD. (Elevation datum used must be the same as that on the FIRM.) Height of floodproofing on the building above the lowest adjacent grade is W.L feet. (NOTE:1or insurance rating purposes, fhe building's floodproofed design elevation must be at least one fooi above the Base Flood Elevation to receive rating credit. If the building is floodproofed only to the Base Flood Elevation,then the building's insurance rating will result in a higher premlum.) SECTION 111 CERTIFICATION (By a Registered Professional Engineer or Architect) Non-Residential Floodprooted Construction Cenificatfon: I certify that based upon development and/oi review ol shuctural design,specificatlons,and plans for consiruciion that the design and methods ol construclion are in accordance with accepted standards of practice for meefing the/ollowing provisions: The structure,together with attendant utilities and sanitary facilities,is watertight to the floodproofed design elevation indicated above,with walls that are substantially impermeable to the passage of water. All st►uctural components are capable of resisting hydrostatic and hydrodynamic flood forces,including the effects of buoyancy,and anticipated debris impact forces. I certify thal the in/ormation on ihis certificate represents my best eHorts to interpref the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER(or Affix Seal) Anwar Yusuf, P.E. 0047348 TITLE COMPANY NAME , Structural Department Manager + „�� '•,, �°: HBE Corporation ADDRESS +,�#�,-�,',`•`u ,j,� •;, • CITY STATE � .i,4 +W � �f • 11330 O1ive Bou ard � ^':'C�'(��'•�� '�� St. Louis MO 63141 SK'�NATURE `� ' :;y: ,v}��: °.y . DATE PFIOlE • ��'r��'�'��"'�:- February 21, 2000 314/567-9000 s'r.� Coples shoul made of s � rM.�g o�r"�1,�+communlry ofticlal�2)Insurance s�enVcompany,and�bulldlnp oM►ner. f • ` Y. , .. FEMA Fortn 81-65, FEB.97 `«;"+ •�•' ��pfACES ALL PREVIOUS EDfTIONS OOO�C�6(2�97) ` ''� f�°^. � i3.S.DEPARTMENTOFHOMELANDSECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY OMB NO. 1660-0008 National F1oodlnsuranceProgram Important: Read the instructions on pages 1-9. Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION � A1. Building Owner's Name Shephard Family Trust A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. �,� � Y � 619 S Gulfview Boulevard �� ;` ��„; " -� �. , ,,, ,. City Clearwater State FL ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lots 1 thru 5, Block "C", Bayside Subdivision #5 Plat Book 38, Pages 38, A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) Non-Residential A5. Latitude/Longitude: Lat. 27°58'01.59"N Long. 82°49'36.87"W 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 6 A8. For a building with a crawlspace or enciosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 7326 sq ft a) Square footage of attached garage 7133 sq ft b) Number of pertnanent 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 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 B1. NFIP Community Name & Community Number B2. County Name B3. State Clearwater, City of / 125096 Pinellas Florida B4. Map/Panel Number B5. Suffix 66. FIRM Index Date B7. FIRM Panel 68. Flood 69. Base Flood Elevation(s) (Zone 12103C0104 G August 18, 2009 Effective/Revised Date Zone(s) AO, use base flood depth) September 3, 2003 AE, VE 12, 13 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile � FIRM ❑ Community Determined ❑ OthedSource: _ B11. indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: 612. Is the building located in a Coastal Barrier Resources System (CBRS) area or Othenvise Protected Area (OPA)? ❑ Yes � No Designation Date: ❑ 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: F-02 Citv of Clearvvater 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. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) � Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 6.51 22.43 21.47 6.13 1.49 6.3 6.4 6.5 Check the measurement used. � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � 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. l certify that the information on this Certificate represents my best efforts to interpret the data available. �y'�''; �"y,,;w.y�w�� < �`'�, �b� .,,...„ ` ' 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ,� �. �o °• :,,,�' � � Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a�° ��.!,� r��'< ."p• � �, �� ' � r � Check here if attachments. ticensed land surveyor? � Yes ❑ No � � �� •, �w � Certifier's Name David William McDaniel License Number LS 5840 � ; .. ��, Title Project Manager Company Name Deuel 8 Associates : � a,'� � .: ; .:i�,�;'.. Address 565 S Hercules Avenue City Clkearvvater State FL ZIP Code 33764 ''�, `� :� "•�* � a�"� ; s°`� � . ►, .. Signature D te 02/12/2014 Telephone 727822-4151 � p�t?�%,�'� •..<•-° �4•j"`,��` .,a' � l�'Sls�.a� r�8,5�1 EMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. �� ur� � �vn v�� n �vr� � �� Nwyc i 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. 619 S Gulfview Boulevard City Clearwater State FL ZIP Code 33767 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 A9a the garage is open on the north side. C2e elevator shaft bottom. C2h adjacent grade to stairs. Architect ground floor plan attached. **Floodproofing Certificate for non-residential structures attached. Signature . � Date 02/12/2014 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 enGosure) 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, 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. 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--G10. In Puerto Rico only, enter meters. 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 communiry o�cial 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: G9. BFE or (in Zone AO) depth of flooding at the building site: G10. Community's design flood elevation: Local Official's Name Community Name Signature Comments ❑ feet ❑ meters Datum ❑ feet ❑ meters Datum ❑ feet ❑ meters Datum Title Telephone Date Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 guilding Photographs See Instructions for Item A6. 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. 619 S Gulfview Boulevard City Clearwater State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Policy Number: Company NAIG Number: If using the Elevation Certificate 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, photographs 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. FRONT EAST SIDE � � � � } � �� 5� � � � � �� : � � �� : � �, �� E � � � E� � , � � �t ��, �� €, , � �„ E ��.� � � � � � � gr � �x,� � ,�� _.� �°' �� u �� , � � � � �..��k � �' �� 4�� . .� ��. �� r � P _ �. � � �i � �, � � ... .. . ,. �g .. � �` R. + m j � . �,:.. . � � . ��. � �...:.. .. . .. � � ...... . .. . .. %h_ �'��PL `� _ . .. .. . . ':%3s „7 / d� ,:, :. � . . .. FRONT FROM WEST FEMA Form 086-0-33 (7/12) Replaces all previous editions. • ELEVATION CERTIFICATE, page 4 guilding Photographs Continuation Page IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 619 S Gulfview Boulevard City Clearwater State FL ZIP Code 33767 Company NAIC Numbec 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." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. + REAR EAST SIDE �_ ��i �E(i�.,,.y ;. 3 a� �' � �� '�.. �ebi,�il� �.e6�i��l �3�.�,,a� � � ��. ,� ��t,��i (1111=� � � � REAR FROM EAST �° , �,�; � „�' ,�� ,,, ��i�¢�i�� FEMA Form 086-0-33 (7/12) Replaces all previous editions. • • . • :. � . .. . � . � .. �li�_�`�� II�L � � ap ° aD'� °�!��■�� ,., -- _ r — - , a� � � .�..�� dp �aD � � a� , o�� .-. ---- - . . -------- - -- . � - • �� }}}r q�; � �r �i _ __... �- � �� y � i��l �L:. ��. i i� -' __ �� - _ ti �__- '�=��1►— ._'��s_,� Fi _ - - -- � EI� ,. ., c� n Q� �i►l► �� .� u(� /. �—� ri �il, . ___—....._ .. � . � O , � O , I � 1 -��_� � �� i a�• 0 �� ( t� = C r� C .„ 0 __ _ , - . o...� s ....... ............. . ,;II =■ �Q� i ��'� � � �� = c t' , ►►%: t� \\\�\\\�� ,� . : . � I = _ _— - - F, _� `— �—, . -_�7:�id il► �°.1 `_ �� ,,``'�-- 0.;= !,i7foQ� o ° I 1�'0 p i i p �` ' � �. �;I�° aD o o ,,l ° o 0 0 0 ;%� ��' ;,I`,o: _ o � - :� �� i =�� o 0 E� � o_ �� aD i: � <�n . a III� yl/ -' i ,;,. • �� : �� 4�� r�� '- �� 6r • --�-■ 0 h „ 0 0 ` � �� ` � �` :��i p �� + 0 ap ��`' '°�¢ii Ry� o aD ° aDo I� ; �°e� , o 0 e I��. - - ! ] o :3'�� . ��.tZl1`t�`s``� ' O II � O t��py� �O i" � p � , � °�I -°„ �� p 0 .i 00 �'� �� p. , p ° �� O��-... �% ; =r-.•-t� �-°- ° � �� _ . ,. .n�: { - -" f/ � �1. u v u O -�11 `` � �� \� d : r-+ 'cs�ll��l«' 0 ,, !i \:`�`�\ � _ - � �_.� �e. -€ � � . .� , �.. �� ; 0:..,,......r `u .... ...F+,-�I ..,..... ........................ ' " : �� !hMN��' "�i� ° „ '_ " a \ . . �----..___ _ �� t ��I�, n � �/` ° �: �� _ _ _ l� ,�a�°1�l� . �+ . ........�� J � o __ , „ ► .' aD dp ''� � „ ., ap ., �o �, � - �� dp � c o 00 0 0 -, �ccccc�:oceoeec.00OCCCC:c: : a � �- _.. - -. : . 1, �. � �, . - � t � i� f. ' U.S.DEPARTMENTOFHOMELANDSECURITY Fl,OODPROOFING CERTIFICATE OMBN0:1660-0008 FEDERAL EMERGENCY MANAGEMENT AGENCY FOR NON-RESIDENTIAL STRUCTURES Expiration Date: July 31, 2015 Natloml Fbod Iasu�mue Pmgmm The floodproofing of non-resideMial buildings may be permitted as an alternative to elevating to or above the Base Fiood Elevation; however, a floodprooftng design certification is required. This form is to be used for that certification. Floodproofing of a residentiai building dces not alter a community's floodplain management elevation requirements or affect the insurance rating uniess the community has been issued an exceptfon by FEMA to allow floodproofed residential basements. The permitUng of a floodproofed residential basement requfres a separate certiflcation specifying that the design complies with the local floodplain management ordinance. BUILDINCa OWNER'S NAME STREET ADDRESS (Including Apt., UnR, Suite, and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER 619 S. Gulfview Boulevard OTHER DESCRIPTION (Lot and Blxk Num6ers, etc.) Lots 1 thru 5, Block "C", Bayside Subdivision #5 Plat Book 38, Pages 38 cm �isarwater �a�Flarida zirco�3767 SECTION 1- FLOOD INSURANCE RATE MAP (FlRM) INFORMATION Provide the following from the proper FIRM: COMMUNRYNUMBER PANELNUMBER SUFFl% DATEOFFlRMINDpf FIRM20NE BASEfL00D0.EV0.T10N (In AO Zonea Uw Depih) 125096 12103C0104 G August 18, 2009 AE, VE 12, 13 Indicate elevetion datum used far Base Flood Elevation shown above: ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: SECTION 11— FLOODPROOFING INFORMATION (By a Registered Professional Engineer or Architect) Qevations are based on: ❑ ConstrucGOn Drawings ❑ Building Under Construction li� Flnished Cor�sWCtion Floodprooflng Design Elevation Information: Building is floodproofed to an elevation of � i. � feet (In Puerto Rico only: _.— meters). ❑ NGVD 1929 (ElevaUon datum used must be the same as that used for the Base Flood Elevatlon.) Height of floodprooflng on the buildfng above the lowest adjacerrt grade is 4-$ feet (In Puerto Rico only: _ For Unnumbered A Zones Only: Highest adjacent (finished) grade next to the building (HAG) . feet (In Puerto Rico only: ❑ NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: � NAVD 1988 ❑ Other/Source: mQters) meters). (NOTE: For insaronce rating purposes, the building's floodproofed design elevation must be at least 1 foot above the Base Flood ElevaUon to receive rating credit. If the buiiding is floodproofed only tu the Base Fiood Elevation, then the building's insurance rating will resuft in a higher premium.) SECTION 111- CERTIFICATION (By a Registered Professtonal En�neer or Architect) Non-Residentlal floodproofed Construetion Certiflcatlon: 1 certify that based upon devefopment and/orrevlew of sVUCt�ral deslgn, speciflcatfons, and plans for corrsbuctlon, the deslgn and methods ofconstrucUon are In accordance with accepted standards o/practice for meeGng the following proNsfons: The structure, together with attendant uUlfUes and sanitary facilities, is watertight to the floodproofed design elevation Indicated above, with walls that are substanTially impermeable to the passage of water. All structural components are capable of resisting hydrostatic and hydrodynamic flood forces, including the effects of buoyency, and anticipated debrisimpactforces. I cerUfy that the informatlan on this certiflcate represents my best efforts to interpret the data avaflable. l understand that any false statement may be punishable by fine or imprisonment under IS U.S. Code, Section 1001. CERTIFIER'S NAME CHOU-WUN YONG STRUCTURAL ENGINEER ADDRESS 3998 EAST SR64 . �.— SI�NATURE ` A - �,.f . �: :a l �.� , ... LICENSE NUMBER (or Affiz Seap 61016 G��°0��'� ENGINEERING GROUP, LLC CITY STATE ZIP CODE BRADENTON FL 34208 2014/02/02 (813)252-1033 Copies should be made of thfs Certiflcate for: 1) community officlal, 2) insurence agent/company, and 3) bullding owner. FEMA Form 086-0-34(7/12) REPLACES ALL PREVIOUS EDITIONS F-056 U.S. DEPARTMENT OF HOMELAND SECURITY FLOODPROOFING CERTIFICATE OMB NO. 1660-0008 FEDERAL EMERGENCY MANAGEMENT AGENCY National Flood lnsurance Program FOR NON-RESIDENTIAL STRUCTURES Expiration Date: July 31, 2015 The floodproofing of non-residential buildings may be permitted as an alternative to elevating to or above the Base Flood Elevation; however, a fioodproofing design certification is required. This form is to be used for that certification. Floodproofing of a residential building does not alter a community's floodplain management elevation requirements or affect the insurance rating unless the community has been issued an exception by FEMA to allow floodproofed residential basements. The permitting of a floodproofed residential basement requires a separate certification specifying that the design complies with the local floodplain management ordinance. Bl11LDING OWNER'S NAME STREET ADDRESS (Including Apt., Unit, Suite, antl/or Bldg. Number) OR P.O. POUTE AND BOX NUMOER 619 S. Gulfview Boulevard FOR INSURANCE COMPANY USE POLICY NUMBER OTHER DESCRIPTION (Lot and Block Numbers, etc.) CDMPANY NAIC NUM6EA Lots 1 thru 5, Block "C", Bayside Subdivision #5 Plat Book 38, Pages 38 CITY STATE ZIP CODE Clearwater Florida 33767 SECTION 1- FLOOD INSURANCE RATE MkP (FIRM) INFORMATION Provide the following from the proper FIRM: COMMUNITYNUMEER PpNELNUM�ER 125096 � 12103C0104 SUfFIX DATE OF FIRM INDEX FIpM ZONE BASE FLOOD EIEVATION �In AO Zones, Use Depth) G August 18, 2009 AE, VE 12, 13 Indicate elevation datum used for Base Flood Elevation shown above: ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: SECTION 11 - FLOODPROOFING INFORMATION (By a Registered Professional Engineer or Architect) Elevations are based on: ❑ Construction Drawings � Building Under Construction ❑ Finished Construction Floodproofing Design Elevation Informatfon: Building is floodproofed to an elevation ot 1 3, � teet (In Puerto Rico only: _._ meters). ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: (Elevation datum used must be the same as that used for the Base Fiood Elevation.) Height of tloodproofing on the builtling above the lowest adjacent grade is 4�$ feet (In Puerto Rico only: meters). For Unnumbered A Zones Only: � Highest adjacent (tinished) grade next to the building (HAG) , feet (In Puerto Rico only: , meters) � ❑ NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: (NOTE: For insurance rating purposes, the building's fioodproofed design elevation must be at least 1 foot above the Base flood Elevation to receive rating credit. If the buirding is floodproofed only to the Base Flood Elevation, then the building's insurance rating wili result in a higher premium.) . • SECTION III - CERTIFICATION (By a Registered Professional Engineer or Architect) Non-Residential Floodproofed Construction Certificatfon: 1 certi(y that, based upon development and/or review ofs[ructura! design, specifications, and plans for construction, the design and methods o/consfruction are in accordance with accepted standards ol practice for meeting the following provisions: The structure, together with attendant utilities and sanitary facilities, is watertight to the floodproofed design elevation indicated above, with walls that are substantially impermeable to the passage of water. All structural components are capable of resisting hydrostatic and hydrodynamic flood forces, inclutling the effects ot buoyancy, antl anticipated debris impact forces. 1 cer[i(y that the information on this certificate represents my best efforts to interpret the data availabie. 1 understand that any Ialse statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME CHOU-WUN YONG TITLE STRUCTURAL ENGINEER 3998 EAST SR64 SIGNATURE LICENSE NUMBER (or Aftix Seal) 61016 COMPANY NAME � GENESIS ENGINEERING GROUP, LLC BRADENTON �LE z�3P�2�g DATE 12, Copies should be made of this Certificate for: 1) community FEMA Form 086-0-34 (7/12) PHONE lfl ��-. ial, 2) Insurance agent/company, and 3) building owner. REPIACES ALL PREVIOUS EDITIONS F-056 619 S GULFVIEW BLVD BCP2013-02542D PLAN AMENDMENT SHEPHARDS BEACH RESORT Zoning: Tourist Atlas #: 285A ,. ?/�T� v m � w ' �a�, � . o � �;_ w �G �, � �_