1525 ROSEMERE RD """�w �������� OMB No. 1660-0008
U.S.DEPARTMENT OF ME ND SECURITY ELEVATION CERTIFICATE
Federal Emergency Management Agency Expires FebruaN 28. 2009
National Flood Insurance Program Important: Read the instructions on pages 1-8.
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
A1. Building Owner's Name Policy Number
DAYS REAL ESTATE CORPORATION
. Building Street Address(including Apt.,Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Company NAIC Number
1525 ROSEMERE ROAD
City State ZIP Code
CLEARWATER FLORIDA
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)
LOT 102-GLENWOOD RESTRICTIONS PLAT BOOK 8 PAGE 14, PINELLAS COUNTY,FLORIDA
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL
A5. Latitude/Longitude:Lat.N27°58'721" Long.W82°46'26" 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_ONE_
A8. For a building with a crawl space or enclosure(s);provide: A9. For a building with an attached garage,provide: ' •
a) Square footage of crawl space or enclosure(s) N/A_ sq ft a) Square footage of attached garage 400+- Sq ft
' ' b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage
enclosure(s)walis within 1.0 foot above adjacent grade walls within 1.0 foot above adjacent grade N/A
• c) Total net area of Flood openings in A8.b sq in c) Total net area of flood openings in A9.b N/A sq in
SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION
61. NFIP Community Name&Community Number B2.County Name 63.State
(PINELLAS 12103C)CLEARWATER 125096 PINELLAS COUNTY FLORIDA
64.Map/Panel Number 65.Suffix 66. FIRM Index B7.FIRM Panel 68.Flood 69.Base Flood Elevation(s)(Zone
12103C 107 Date Effective/Revised Date Zone(s) AO,use base flood depth)
� H 9-3-03 5-17-05 A 46.32 FEET
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69.
❑FIS Profile ❑FIRM �Community Determined ❑Other(Describe)
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 �NAVD 1988 ❑Other(Describe)
�2. 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 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/A0. Complete it ��&�a g
below according to the building diagram specified in Item A7. �ptn�
Benchmark Utilized CITY OF CLEARWATER BM J-07 1988 ELEV 21.40 FEET Vertical Datum NAVD 1988 ��� C p����P'(�� .
. • a) Top of bottom floor(including basement,crawl space,or enclosure floor 47.55 feet �QP� G�-�� \QN�
b) Top of the next higher floor NA feet�E+Q11Q�G�"(��N Q�G� ,�
• c) Bottom of the lowest horizontal structural member(V Zones only) NA feet ��pG• �
d) Attached garage(top of slab) 47.05 feet �� �
e) Lowest elevation of machinery or equipment servicing the building NA feet �P�� /i�
(Describe type of equipment in Comments)(OUTSIDE AC UNIT) ,�
� Lowest adjacent(finished)grade(LAG) 44.05 feet
g) Highest adjacent(finished)grade(HAG) 46.5 feet
SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION -; �" : ;�, w .
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation ' ! • �
information. 1 certify that the inforrnation on this Certificate represents my best efforts to interpret the data availab/e. �'� , ' �r''
I understand that any fa/se statement may be punishable by fine or impnsonment under 18 U.S. Code, Section 1001. B I LI;'eT�'�'A�o'Y', - ;� -;
❑ Check here if comments are provided on back of form. :�� ��, �R���" �, wf'� �, ?
Certifier's Name License Number � *
BILL HYATT FLORIDA LICENSE#4636 • ��1 @-O� �" 1K' ° , � +�
Title Company Name -' • "� ::� � -
PRESIDENT KNOW IT NOW INC. "' �t .
'. ..�i'. er . .
Address City State ZIP Code � � �'� '
MAIL=1497 MAIN STREET#321 DUNEDIN FLORIDA 34698 . �:�" ;
�nature ;y '.,„�.t,,i`"
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DATE: 04 18 08 TELEPHONE: 727-415 8305
� � FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use:
Building.StreetAddress(including Apt., Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Policy Number
1525 ROSEMERE ROAD
City � State ZIP Code Company NAIC Number
, CLEARWATER FLORIDA
,,,��• ;,,,,,SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION (CONTINUED)
py boYh�sid�o�'t1ii��I�L��'ofY�ertificate for(1)community o�cial, (2)�nsurance agent/company,and(3)building owner.
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Comm� g '.��{k')t ' 1�,, . ,
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Sign�tyrg;�u 4 ; "''�, , " " Date 4-18-08
^. :�, , "�` '•' Check here if attachments
SECTIAN��-��I_. T�*, LEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
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For Zones AO and A�withqyA�FE),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'E�=�4,°use natural grade,if avaitable. 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,crawl space,or enclosure)is ❑feet ❑ meters ❑ above or ❑ below the HAG.
b)Top of bottom floor(including basement,crawl space,or enciosure)is _�feet ❑meters ❑above or ❑ below the LAG.
E2. For Building Diagrams 6-8 with permanent flood openings provided in Secti¢n�A Items 8 and/or 9(see a e 8 of Instructions),the next higher floor
(elevation C2.b in the diagrams)of the buiiding is _❑ feet u meters ❑above or �below the HAG.
E3. Attached garage(top of slab)is �feet Q meters � above or � below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is _�feet �meters �above or �below the HAG. , �
E5. Zone 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 officiai 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 correcf to the best of my know/edge. • .
=perty Owner's or Owner's Authorized Representative's Name
ress City State ZIP Code
Signature Date Telephone
Comments
❑Check here if attachments
SECTION G -COMMUNITY INFORMATION (OPTIONAL)
The local o�cial who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),
and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8.and G9.
G1. � The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architECt who
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.j �
G2. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO.
G3. ❑ The following information(Items G4.-G9.)is provided for community floodplain management purposes.
G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued
G7.This permit has been issued for: � New Construction ❑Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters(PR) Datum
G9.BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR) Datum
Local Official's Name � Title �
Community Name Telephone
' Signature Date
ments
❑Check here if attachments
FEMA Form 81-31, February 2006 Replaces all previous editions
9
� ,� Building Photographs
See Instructions for Item A6.
For Insurance Company Use:
uilding Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number
1525 ROSEMERE ROAD
City State ZI P Code Company NAIC Number
CLEARWATER FLORIDA �
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.
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