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750 ELDORADO AVEU.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY National Flood Insurancc Program ELEVATION CERTIFICATE IMPORTANT: Follow the instructions on pages 1-9. ,./02a/.2 - 417037 OMB No. 1660-0008 Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or PO. Route and Box No. 750 ELDORADO AVENUE City CLEARWATER Policy Number: Company NAIC Number: State FL ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) PARCEL 05-29-15-54666-003-0050, BLOCK 3. LOT 5. MANDALAY SUB, PLAT BOOK 014, PAGE 032. PINELLAS COUNTY, FLORIDA A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) A5. Latitude/Longitude: Lat. 27.9917 Long. 82.8277 A6. Attach at least 2 photographs of the building if the Certificate is being used A7. Building Diagram Number SEVEN A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) b) No. of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b d) Engineered flood openings? ❑ Yes E No N/A N/A N/A RESIDENTIAL Horizontal Datum: ❑ NAD 1927 E NAD 1983 to obtain flood insurance. sq ft sq in A9. For a building with an attached garage: a) Square footage of attached garage sq ft b) Number 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 d) Engineered flood openings? ❑ Yes N/A ® No sq in SECTION B - FLOOD INSURANCE RATE M 61. NFIP Community Name & Community Number CLEARWATER CITY OF 125096 62. County Name 83. State PINELLAS FL 84. Map/Panel Number 12103C0102 65. Suffix G 86. FIRM Index Date 08/18/2009 87. FIRM Panel Effective/ Revised Date 09/03/2003 68. Flood Zone(s) VE 89. Base Flood Elevation(s) (Zone AO, use base flood depth) 13.0 FT B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: D FIS Profile E FIRM 0 Community Determined 0 Other/Source- B11. Indicate elevation datum used for BFE in Item 69: 0 NGVD 1929 IN NAVD 1988 ❑ Other/Source' 812.1s the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes ® No Designation Date- / / 0 CBRS 0 OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ 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 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 C2.8 -h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: CITY OF CLEARWATER 1-02 Vertical Datum- Indicate atum NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 E 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) 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 7.5 17.54 14.0 N/A N/A 6.5 7.5 6.5 Check the measurement used. E feet ❑ meters feet 0 meters E feet ❑ meters ® feet ❑ meters E feet 0 meters 1.4 E feet E feet E feet ❑ meters ❑ meters ❑ meters SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer. or architect authorized by law to certify elevation information. I certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any 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 0 Check here if attachments. licensed land surveyor? E Yes ❑ No Certifier's Name BILL 11. HYATT. JR License Number #4636 Title PRESIDENT Company Name KNOW IT NOW INC Address 1497 MAIN STREET #321 Signature 4,/t City DUNEDIN State FL ZIP Code 34698 Date 1-23-2013 Telephone (727) 415-8305 FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. `r ELEVATION CERTIFICATE, page 2 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 PO. Route and Box No. 750 ELDORADO AVENUE Policy Number: Cty CLEARWATER State FL ZIP Code 33767 Company NMC Number: SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for 11) community official, (2) insurance agent/company, and (3) building owner. Comments Signature Date 01/23/2013 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 El -E5. If the Certificate is intended to support a LOMA or LOMR-F request. complete Sections A. Band 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, crawlspace. or enclosure) is b) Top of bottom floor (including basement, crawlspace. or enclosure) is ® feet ❑ meters ® above or ❑ below the HAG. eet 0 meters g 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 Ni A ® feet 0 meters r. above or 0 below the HAG. E3. Attached garage (top of slab) is ® feet ❑ meters ® above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is feet 0 meters ® above or 0 below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? 0 Yes 0 No ❑ 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, 8, 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 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 items) and sign below. Check the measurement used in Items G8-010. In Puerto Rico only. enter meters. Gl. 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. ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone A0. 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: 0 New Construction 0 Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet 0 meters 0 meters 0 meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet Datum G1.0.Community's design flood elevation: 0 feet Datum Local Official's Name Title Community Name CLEARWATER CITY OF Telephone Signature Date Comments 0 Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS CONTINUATION PAGE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 750 ELDORADO AVENUE CLEARWATER, FLORIDA 33767 ALL PICTURES WERE TAKEN 01-23-2013 FRONT VIEW LEFT SIDE VIEW RIGHT SIDE VIEW U.S. DEPARTMENT OF HOMEIAND SECURITY ELEVATION CERTIFICATE OMB NO. 1660-0008� FEDERAL EMERGENCY MANAGEMENTAGENCY National Flaad Insurancc Pro9r°m IMPORTANT: Follow the instructions on pages 1-9. EXpiration Date: JUIy 31, 2015 SECTION A - PROPERTY INFORMATION A1. Building Owner's Name A2. Building Street Address (including Apt., Unit, Suite, and/or Bidg. No.) or P0. Route and Box No. FOR INSURANCE COMPANY USE Policy Number: NAIC Ciry CLEARWATER State F� ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legai Description, etc.) PARCEL 05-29-15-54666-003-0050, BLOCK 3, LOT 5, MANDALAY SUB, PIAT BOOK 014, PAGE 032, PINELLAS COUNTY, FLORIDA A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIOENTIAL A5. Latitude/Longitude: Lat. 27•9917 Long. 82•8277 Horizontal Datum: ❑ NAD 1927 �x 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-A _ _A8.--Eor-a-building-w+t4�-a-srawlspaoe-or-enelosnre(s}: - -- --- -A9� Fora bafidirtg wfth �rs �ttfi�fied �ara�e: . . a) Square footage of crawlspace or enclosure(s) N�A sq ft a) Square footage of attached garage 575 S� b) No. of permanent flood openings in the crawlspace or 4 enclosure(s) within 1_0 foot above adjacent grade D(!I�( 2 b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade � 3 c�) Total net area of flood open;ngs in A8.b �_ sq in c) Totai net area of flood openings in A9.b �o�rx �nn sq in ) Engineered flood openings. �Yes �i�X /1� 4-2-14 d) Engineered flood openings? [�Yes �� o' 4-2-14 SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Communi�tvEN�a WATER CITY OF' �125096r L 84. Map/Panel Number B5. Suffix 66. FlRM Date 62. County Name PINELLAS FIRM Panel E Revised Date A0, use base flood depth) 12103C0102 G 08/18/2009 09/03/2003 VE 13.0 FT 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in item 69: ❑ FlS Profile � FIRM ❑ Community Determined ❑ Other/Source: B11. indicate elevation daium used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: B12.Is the building Iocated 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* *A new Elevation Certificate wiil be required when construction of the building is complete. � Finished Construction 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: CITY OF CLEARWATER 1-02 Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 � NAVD 1988 Datum used for building elevations must be the same as that used for the BFE, ❑ Other/Source: B3. State FL Flood Zone(s) 89. Base Flood Elevation(s) (Zone a) Top of bottom floor (including basement, crawispace, or enclosure floor) b) Top of the ne� 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 structurai support Check the measurement used. 7.54 � feet ❑ meters ��•� � feet ❑ meters 15.85 �feet ❑ meters �'� � feet ❑ meters NA � feet ❑ meters 6'8 � feet ❑ meters �� feet ❑ meters 6'8 � feet p meters SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFlCATION 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 information on thls Certiflca[e represenfs my best efforis to interpret the data available. I understand that any false statement may be punishable by fine or imprlsonment under 18 U.S. Code, Section 1001. ❑ Check here if comments are provided on back of form. Were latitude and Iongitude in Section A provided by a ❑ Check here if attachments. licensed land surveyor? � Yes ❑ No Certifier's Name BILL H. HYATT. JR PRESIDENT 1497 MAIN STREET #321 Signature FEMA Form 086-033 (7/12) License Number #4636 Company Name KNOW IT NOW INC City State ZIP Code DUNEDIN FL 34698 Date Telephone _ 10-3-2013 (727)415-8305 See reverse side for continuation. z�ysr•. w 4636 ST'ATH O! FLORID\ Rep�aces ali previous editions. ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the correspondi�g information from Section A. Building Street Address (including Apt., Unit. Suite, and/or Bldg. No.) or P.O. Route and Box No. 750 ELDORADO AVENUE City State ZIP Code CLEARWATER FL 33767 FOR INSURANCE COMPANY USE Policy Number: Comparry 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 �R��$� �p�p��X XB«tS7AHi�7�71&P(Ii�3�9C0(4lRR�)9DN498ACTi�t6iXXX49dri2CDG(7AQ71C�R)QH6t�DikRx�fXX)QC OOp(X C.2.e - equipment is air conditioning unit on the roof, no equipment - exist on outside of building at floor level rev 4-2-2014 Signature Date 10/03/2013 _ _-----_ _ _ _---- ___ _. __ _ _ _ _ __ . 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,a�d 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 �owest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enciosure) 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 N� . A � 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 or Owner's Authorized Representative's Name Address Signature Comments City Date State ZIP Code Teiephone ❑ Check here if attachments. SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local officiai 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. Compiete the applicabie 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 community official completed Section E for a building �ocated in Zone A(without a FEMA-issued or community-issued BFE) or Zone A0. G3. ❑ The following information (Items G4-G9) is provided for community floodplain ma�agement purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued u7. i nis permit has been issued for: ❑ New Construction ❑ Substantiai improvement G8. Elevation of as-built lowest floor (including basement) of the building: . ❑ feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: . ❑ feet ❑ meters Datum G10.Community's design flood elevation: . ❑ feet ❑ meters Datum Local Official's Name Community Name Signature Comments FEMA Form 086-0-33 (7/12) Title CIEARWATER CITY OF Telephone Date ❑ Check here if attachments. Replaces all previous editions. ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS CONTINUATION PAGE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. ADDRESS: 750 ELDORADO AVENUE CLEARWATER, FLORIDA 33767 PICS TAKEN 10/2/2013 FRONT VIEW AND CONTINUING AROUND BUILDING � , :;� * �."� � r�� .N�i � � t�� -� �y : � � � _� � ; x� ��,,� �`` � ._ r� � =- � _,_.,:-^, _ �....r�'�'" ..✓'' �. � ;�_;;#.;- ��'. �' t � � � � � . � f �.�� i :��. �, . � -------.�.,. � '.� R��:�� `4 � . :i A- y'P: � � y�I" ._.. °�T • - ��,, ti�� + • �, `' �� ,� �� :�' �}:,�` . !�'s�� r � , ..� � ., . Fi. ' . F:.. <� 4��' , ' �� .� �'..&.... � r , sa£y, 1 . . . �� r'f t � i C , � / �= � '��F� �.' �� a , � M,,�.r �,� .. . �1 < : •• i� . � 'at'+ F ,; �; � ;3 w # .� . ip � ��t� � `'� �, �``� � �,• � � �I �� . .. d. �� ` � M �:�r .. .. L' . .: � ip" ., , r, � t f i� � �� ''M'# � �* rL� . � p�� A e� ,�.,.�.' . id � � � �? a� � ': i� . .p� � �' "` „ '� rw K g . ,. "'x' '�'°3"'°�° .. ' * N -. :-; <.-: - . �..,�, �' ��. , ,��20/2_ �70,37 U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 FEDERAL EMERGENCY MANAGEMENT AGENCY EXplfatiOn Date:JUIy 31, 2015 M1a�;oml Flood tnsurance Program IMPORTANT:Follow the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Buiiding Owner's Name Poiicy Number: A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P0.Route and Box No. Comparry NAIC Number: � 750 ELDORADO AVENUE ��Ty CLEARWATER State F� ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcei Number,Legai Description,etc.) PARCEL OS2&15-546660030050,BLOCK 3,LOT 5,MANDALAY SUB,PLAT BOOK 014,PAGE 032,PINELLAS COUNTY,FLORIDA A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL A5. Latitude/Longitude:Lat.2�99» Long. az.82�� 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. Buiiding Diagram Number SEVEN A8. For a building with a crawlspace or enclosure(s): A9.For a buiiding with an attached garage: a) Square footage of crawispace or enclosure(s) N�A sq ft a) Square footage of attached garage � sq ft b) No.of permanent flood openings in the crawispace or b) Number of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade N�p` within 1.0 foot above adjacent grade NA 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(FlRM) INFORMATION 81. NFlP CommunCtV Nam,�eA&ERoC�m�unOitv N2�r 62.County Name P�NELLAS B3. State FL LEAR F 84. Map/Panel Number 65.Suffix B6.FIRM Index Date 87.FlRM Panel Effective/ 68.Flood Zone(s) B9.Base Flood Eievation(s)(Zone Revised Date A0,use base flood depth) 12103C0102 �`, OS/18/2009 09I03l2003 VE 13.0 FT 610.Indicate the source of the Base Flood Elevation(BFE)data or base fiood depth entered in Item 69: ❑FIS Profile �FlRM ❑Community Determined ❑Other/Source: 611.Indicate elevation datum used for BFE in item 89: ❑NGVD 1929 �NAVD 1988 ❑Other/Source: 612.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. Buiiding elevations are based on: ❑Construction Drawings• ❑Building U�der Construction* �Finished Construction *A new Elevation Certificate wilf be required when consVUCtion of the building is compiete. C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,Vl-V30.V{with BFE),AR,AR/A,AR/AE.AR/A1-A30,AR/AH,AR/AO.Compiete Items C2.a-h below according to the building diagram specified in Item A7.In Puerto Rico only,enter meters. Benchmark Utilized: CITY OF CLEARWATER I-02 Vertical Datum: NAVD 1988 Indicate elevation datum used for the efevations in items a)through h)below. ❑NGVD 1929 �NAVD 1988 ❑Oiher/Source: Datum used for buiiding elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor(including basement,crawispace,or enclosure floor) �5 �feet ❑meters b) Top of the next higher floor »� �feet ❑meters c) Bottom of the lowest horizontal structural member jV Zones only) 14� �feet ❑meters d) Attached garage(top of slab) N�'4 �feet ❑meters e) Lowest elevation of machinery or equipment servicing the building N�A �feet ❑meters (Describe type of equipment and location in Comments) � Lowest adjacent(finished)grade next to building(LAG) 6 5 �feet ❑meters g) Highest adjacent(finished)grade next to building(HAG) �5 �feet ❑meters h) Lowest adjacent grade at towest elevation of deck or stairs,including 6 5 �feet ❑meters structural support SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFlGATION This certiflcation is to be signed and sealed by a iand surveyor,engineer,or architect authorized by law to certiry elevation information.1 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 � ❑Check here if attachments. licensed land surveyor? �Yes ❑No 41 ' Certifier's Name License Number �� BILL H.HYATT.JR #4636 '�'� Title Company Name � PRESIDENT KNOW IT NOW INC Address Ciry State ZIP Code 7497 MAIN STREET#321 DUNEDIN FL 34698 Signature Date Telephone ` L 3 ' �-3 1-23-2013 �727)415-8305 FEMA Form 086-0-33(7/12) See reverse side for continuation. Replaces all previous editions. r �� ELEVATION CERTIFlCATE, page 2 ,'� IMPORTANT:In these spaces,copy the corresponding intormatfon from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bidg. No.)or P0.Route and Box No. Policy Number: 750 ELDORADO AVENUE City StBte ZIP COde Comparry NAIC Number: CLEARWATER FL 33767 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 Signature Date 01/23I2013 SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete(tems El-E5.If the Certificate is intended to support a IOMA 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 beiow the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including baseme�t,crawlspace,or enclosure)is . �feet ❑meters �above or ❑below the HAG. b}Top of bottom floor(including basement,crawlspace.or enclosure)is . �feet ❑meters �above or ❑below the LAG. E2.For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions), the next higher floor(elevation C2.b in the diagrams)of the building is N� . A �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 iocai official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFlCATION 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 rrry knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments. SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the communitys floodplain management ordinance can complete Sections A,B,C(or Ej,and G of thfs 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 official compieted Section E for a building located in Zone A(without a FEMA-issued or community-issued BfE)or Zone AO. G3. ❑ The following information(Items G4-G9)is provided for community floodpiain management purposes. G4. Permit Number G5.Date Permit Issued G6.Date Certificate Of Compliance/Occupancy issued G7. This permit has been issued for: ❑New Construction ❑Substantiai Improvement G8. Etevation of as-buiK lowest floor(inctuding basement)of the building: ❑feet ❑meters Datum G9. BFE or(in Zone AO)depth of flooding at the building site: . ❑feet ❑meters Datum G10.Community's design flood e�evation: . ❑feet ❑meters Datum Local Official's Name Titie Community Name CLEARWATER CITY OF Telephone Signature Date Comments ❑Check here ff attachments. FEMA Form 086-033(7;12) Replaces ali previous editions. ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS CONTINUATION PAGE Building Street Address(induding Apt., Unit, Suite,and/or Bidg. No.)or P.O. Route and Box No. 750 ELDORADO AYENUE CLEARWATER, FLORIDA 33767 ALL PICTURES WERE TAKEN 01-23-2013 -�. ,� t G � ..,."�,°"^°' .�', _..'-.` '��- . �� .�� -. - �;.,��: �� . y� � ` FRONT VIEW LEFT SIDE VIEW �� -:. ��:�� `r�,r" � � �.; . �� :�r '.� �, :�.,� �.� , ��4 4�� r �k�. 5�. 1"��. � i . '�:��' ..*. �. . :.a:yC1'Y; � .�.�� .. .:'. . 4` - 1 +i"a � � .. P'�'� �.�;A �t, ` �; �� .�. I �.� *� ,�.=�;� � �.S f" .:".�,,,;;„,. � 3 � �' � � �"'� r✓�F'�.�f;. � 4 a�� W ° � � RIGHT SIDE VIEW ,:.,.... � , �u - I < �� ' , V ZONE DESIGN CERTIFICATE Name�'� �(��_ s�� _ Policy Number (Insurance Co. Use) Building Add�:ess or Other Description �]� �1 _D„�Q�p G;(,��-� cy�. �L Permit Na�P%12-0'�03'�l City el�tr�W Q State�Zip Code I 3'j SECTION I: Flood`Insurance Rate Map (FIRM) Information Community No. I Z I O� Panel No. Oje 2 Su�x � FIRM Date � 3�3 FIRM Zone(s) Y E SECTION 11: Elevation Information Used fo� Design �NOTE: This section documents elevations used in the design - it does not subsiitufe for an Elevafion Cert�cate.J 1. Elevation of the Bottom of Lowest Horizontal Structural Member ................................�feet (NAVD88) 2. Base Flood Elevation (BFE) .......... ........................................... .................. 1�feet (NAVD88) • ....... 3. Elevation of Lowest Adjacent Grade ................... ................................................5.�1 feet (NAVD88) 4. Approximate Depth of Anticipated ScouNErosion used for Foundation Design ............. .�feet (NAVD88) 5. Embedment Depth of Pilings or Foundation Below Lowest Adjacent Grade ...............��Lfeet (NAVD88) SECTION III: V Zone Design Certification Statement (NOTE. This secfion must be cert�ed by a regisfe�d engineer or a�hitect j I certif�r that: (1) I have developed or reviewed the structural design, plans, and specfications for construction and (2) that the design and methods of c�nstruction to be used are in accordance with accepted standards of practice for meeting the following provisions: • The bottom of the lowest horizontal structural member of the lowest floor (excluding piles and columns) is elevated to or above the BFE; and • The pile and column foundation and structure attached thereto is anchored to resist flotation, collapse, and lateral movement due to the effects of the wind and water loads acting simultaneously on all building components. Water loading values used are those associated with the base flood. Wnd loading values used are those required by the applicable State or local building code. The potential for scour and erosion at the foundation has been anticipated for conditions associated with the base flood, including wave action. SECTION IV: Breakaway Wall Design Certification Statement [NOTE. This section must also be certified by a registered engineer or architect when breakaway walls ezceed a design safe loading resistance of 20 pounds per square foot.J I certify that (1) I have developed or reviewed the structural design, plans, and specifications fo� construction and (2) that the design and methods of construction to be used for the breakaway walls are in accorctance with accepted standards of practice for meeting the following provisions: • Breakaway wall collapse shall result from a water load less than that which would occur during the base flood; and • The elevated portion of the building and supporting foundation system shall not be subject to collapse, displacement, or other sVuctural damage due to the effects of wind and water loads acting simultaneously on all building components (wind and water loading values to be used are defined in Section III). SECTION V: Certification and Seal This certification is to be signed and sealed by a registered professional engineer or architect authorized by law to certify � structural designs. l ceiti(y the V Zone Design Certification Statement in Section ll! and the Breakaway Wall Design Ce�tif`�catio Staf� nt in Section N(if a plicable). ��.�,�k�,y�•�� -- � /� oF� �o►�� "�.�°� �'-clr`�'l�170� �`�� -� . r r 0 u �- ` -` :: �' :. . . ., ,,.....,, � C rtifier's Name License Number �..P �r� l�� ;� �" ��'% '". `� O ��[�.1 �t.v .,ri �L� v fkPC� � -�nr , -P1a:C� ��a�' ' � ti. i r I itle CompanyN me '.'"' :1�,;��f$, �,�. ". `'' /�i �8'�h3 uS ��1 �l �� paa G��al-a�r fz- a��l r� x�� .� ... Addres Ci�i State ��aD Zlp � T' ,� ,O z. l� ': � �• t ;, . " � Signatu Date Telephone ;;»� i'� ,� .�� ,yn��` •,,��'1l �, �� °� Q�f f,� r .r:'- - �j� � � � �?a�� c. . V �`.�� - ' r. _.. �