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58 ASTER ST4 � U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY Nationat Flood Insurance Program ELEVATION CERTIFICATE IMPORTANT: Follow the instructions on pages 1-9. a�����Z� - ��7U4- , `'C�.% J�'f� ' v �`J) �' --t��� � �� OMB No. 1660-0008 Expiration Date: July 31, 2015 SECTfON A- PROPERTY INFORMATION FoR INSURANCE CoMPANY usE A1. Building Owner's Name PolicyNumber. ' A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P0. Route and Box No. Company NAIG Number: 58 ASTER STREET City CLEARWATER State F� ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) PARCEL 05-29-15-54666-025-0001, BLOCK 25, LOT 5, MANDALAY SUB REPLAT, 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�•9908 Long. 82.8250 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 EIGHT 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) �900 sq ft a) Square footage of attached garage NP` sq ft b) No. of permanent flood openings in the crawlspace or b) Number of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade �$ within 1.0 foot above adjacent grade NA c) Total net area of flood openings in A8.b 3096 sq in c) Total net area of flood openings in A9.b N�P` sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) lNFORMATION 61. NFIP Community Name & Community Number B2. County Name CLEARWATER CITY OF 125096 PINELLAS B4. Map/Panel Number B5. SufFix B6. FIRM Index Date 67. FIRM Panel Effective/ B8. Flood Zone(s) 89. Revised Date 12103C0102 G OS/18/2009 09/03/2003 AE I63. State FL Base Flood Elevation(s) (Zone A0, use base flood depth) 11.0 FT 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: ❑ FlS Profile � FIRM ❑ Community Determined ❑ Other/Source: 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 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 Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: �PS 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 buildin� elevations must be the same as that used for the 6FE. a) Top of bottom floor (including basement, crawlspace, 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) 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 Check the measurement used. 4.4 � feet ❑ meters 5.63 � feet ❑ meters N/A � feet ❑ meters N/A � feet ❑ meters 4-4 � feet ❑ meters 4_0 � feet ❑ meters 4_4 � feet ❑ meters 4_0 � feet ❑ meters SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFlCATION This certification is to be si�ned and sealed bv a land survevor. en�ineer_ or architer.t authnri�Pd nv iaw rn carr�r,� PiP�ar��n ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or F0. Route and Box No. FOR INSURANCE COMPANY USE 58 ASTER STREET PolicyNumber.` City State CLEARWATER ZIP Code Company NAIC Number: 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 - r,.r - — � vate 12�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,and C. For Items E1—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is . � feet ❑ meters b) Top of bottom floor (including basement, crawlspace, or enclosure is � above or ❑ below the HAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9�(see pa❑g s 8-9 of In�structio s), ❑ below the LAG. the next higher floor (elevation C2.b in the diagrams) of the building is N� ,'4 � 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 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 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 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 fioor (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 Title CLEARWATER CITY OF Telephone Date ❑ Check here if attachments. FEMA Form 086-433 (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. 58 ASTER STREET CLEARWATER, FL 33767 PICS TAKEN 12-02-2013 FRONT AND CONTINUE AROUND BUILDING � �a,�: �; a ir� �."'��`u{.� .. . :�., ,� �. � �� � 3 #, �* � �. �F _ � � -.n_ �.�.---- — _-- � �; �- � } , .