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704 ELDORADO AVEY � US. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY Nati�ai Flood Iqcut�ce Pragram ELEVATION CERTIFICATE OMB No. 1660-0008 IMPORTANT: Follow the instructions on pages 1-9. ExpirBtion Date: July 31, 2015 � SECTION A - PROPERTY INFORMATION A1. Building Owner�s ►vame Lawrence A. Seigel and Arlene W. Seigei No.) or PO. Route and Box �'�' Clearwater Beach state F� ziP code ��� � 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Descriptio�, etc.) pARCEL id# 05-29-1 r54666-002-0010 A4. Bmlding Use (e.g., Residentiai, Non-Residential, AddiUOn, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. �7 5.Q �� 3N Long. �2 d9 39.4W 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 f+ , A8. For a building with a crawispace or enclosure(s): A9. For a building with a� attached garage: a) Square footage of crawlspace or enclosure(s) � 760 sq ft a) Square footage of attaChed garage �/a S ft b) Number of Q permanerrt flood openings in the crewispace b) Number pf permanent flood openings in the attached garage or enclosure(s) wiihin 1.0 foot above adjacent grade 4 within 1.0 foot above adjacerrt grade n/a c) Totat net area of flood openings in A8.b � 895 sq in c) Total net area of flood openings in A9.b ►+�a s in d) Engineered flood openingsl ❑ Yes � No 4 d) Engineered flood openings? ❑ Yes ❑ No SECTION B- FLOOD INSURANCE RATE MAP (FlRM) INFORMATION 61. NFlP Communfty Name & Community Number 62. County Name 83. 5tate CITY OF CLEARWATER 125096 PINELLAS FL 84. Map/Panel Number 85. Suffix B6. FlRM Index Date 87. FtRM Panel Effective/ 88. Flood Zone(s) 89. Base Flood Elevation(s) (Zone Revised Date AO, use base flood depth) 12103C0102 G 06/18/2009 09/03/2003 VE �3 B10.Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: ❑ FIS Profile � FIRM ❑ Community Determined ❑ pther/Source: B11.Indicate elevation daYum used for BFE in )tem B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: 612. IS the building Ipcated in a Coastai 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 Under Construction* ❑ Finished Constructlon *A new Elevation Certificate wiil be required when construction of the building is comptete. C2. Elevations - Zones Ai-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 ftem A7. in Puerto Ricq only, enter meters. Benchmark Utilized: NE SOMERSET Vertical Datum: NAVD'88 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 � NAVD 198$ ❑ Other/Source: Datum �sed for building elevations must be the same as that used for the BFE. a) Top of bottom floor (including basement, crawispace, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones onty) d) Attached garage (iop of slab) e) Lowest elevation of machinery or equipment servicing the buitding {Describe type of equipment and location in Comments) � Lowest ad�acent (finished) grade ne�R to buiiding (LAG) g) Highest adjacerrt (finished) grade next to building (HAG) h) Lowest adjaceM grede at lowest elevatian of deck or stairs, including structural support 6,7 7 15 14 7 N/A N/A _� . 0 _� . �2_- 7 .1�- Check the measurement used. � feet ❑ meters � feet ❑ meters ¢� feet ❑ meters ❑ feet p meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters SECTION D- SURYEYOR, ENGINEER, OR ARCHITECT CERTIFlCATION This certification is to be signed and sealed by a land surveya, engineer, or architect authorized by law to certify elevation iriformation. I cerUfy that the informafion on this Certlficate r2presents my best etforts to interpret ihe data avallable. f understand that any false Statement may be punishable by fine or Imprisonmeni under 18 U.S. Cotle, SeCt7on 1001. � CheCk here 'rf comments are provided on back of form. Were latitude and longitude in Section A provided by a �f r; � fvs `+ ❑ Check here if attachments. licensed land surveyor? � Yes ❑ No ; ��'� Certifier's Name license Number � '� FRANK A. JULIAN une �`,'� �'ry ('� ����� ' � ' e� � � : �,� ���A 5 ,�i#� . i ' . ���� �� 9...�x , ',� � . .y=. t�R�FE5510NAL SURVEYOFt & MAPPER Address 6438 POLK ST signature FEMR Form 086-a33 iRev ed 7/12) State PORT RICHE FL See reverse side for cor�tinuation. r e: ,N ,w nE q ms. �- � ELEVATION CERTIFlCATE, page 2 IMPORTANT: In these spaces, copy tlre corresponding idformation fiom Section A. City Street Address (inciuding Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. State ZIP Code FL 33767 SECTION D— SURVEYOR, EN(i1NEER, OR ARCHITECT CERTIFlCATION (CONTINUED) Copy both sides of this Elevation Certificate far (1) community official, (2) insurance ageM/comparry, and (3) building owner. Comments RE: C2a & b) THERE IS A 0.45' STEP UP IN THE BOTTOM FOUNDATION SLAB, THE LIVING FLOOR ELEV= 16.9 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 G. For Items Ei-E4, use natural grade, ff available. Check the measurement used. In Puerto Rico onty, enter meters. E1. Provide etevation irrformation 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, crawispace, or enclosure) is . ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 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 machi�ery 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 Iocal official must certify this information in Section G. SECTION F— PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFlCATION The pro�rty owner or ovmer'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 Ciry Date State ZIP Code Tefephone ❑ Check here if attachme�s. SECTION (i - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the communitys floodpiain management ordinance can complete Sections A, B, C(or E), and G of this Elevation Certificate. Complete 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 documerrtatfon that has been signed and sealed by a licensed surveyor, engineer, or arChitecL 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-G10) is provided for community floodplain management purposes. G4 ermi ber �� 1 G5. Date Permit Issued G6. Date Certiflcate Of Compliance/Occupancy issued -.. 4` G7. This permit has been issued for: ❑ New Construc[ion ❑ Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the buiiding: . ❑ feet ❑ meters Datum G9. BFE or (in Zone AO) depih of flooding at Yhe building site: . ❑ feet ❑ meters Datum G10. Communiry's design flood elevation: . ❑ feet ❑ meters Datum local Official's Name Community Name Signature Comments TiUe Telephone Date ❑ Check here if attachments. FEMA Form 086-0-33 (Revised 7/12) Replaces ali previous editions. � D U.S. DEPARTMEN PEDERAL EMERGE NaUwaial Flood Ias Program Q�'� ���1/ATION CERTIFICATE MPOR f ItNT: Foilow the instructions on pages 1-9. A - PROPERTY INFORMATION A1. Buiiding Owner�s Name Lawrence A. Seigel & Arlene W. Seigel A2. Buildin� Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. � w ru_---�- -- �OMB No. 1660-0008 � I Expiration Date: July 31, 2015 `'"'" Clearwater Beach S�te fl Z�P CO`ie 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Numbe , Legal Description, etc.) tax id- 05-29-15-54666-002-0013 A4. Buiiding Use (e.g., Residentia�, Non-Residentiai, Addition, Accessory, etc.) -�esideMial A5. Latitude/Longitude: l.at. 27 5G �� 3�, Long. 82 49 39.4 W Horizontal Datum: ❑ NAD 1927 �x NAD 1983 A6. Attach at �east 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number R A8. For a building with a crawlspace or enciosure(s): � A9. For a buiiding with an attached garage: a) Square footage of crawlspace or enclosure{s) � 62 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 within 1.0 foot above adjacent grade � c) Total net area of flood openings in A8.b � sq in c) Total net area of flood openings in A9.b � d) Engineered flood openings? ❑ Yes � No sq in d) Engineered flood openings? ❑ Yes � No SECTION B- FLOOD INSURANCE RATE MAP (FlRM) INFORMATION B1. NFlP Community Name & Commu�ity Number 62. County Name 63. State CITY OF CLEARWATER 125096 PINELLAS FLORIDA 64. Map/Panel Number 85. Sufflx 66. FlRM Index Date B7. FlRM Panel Effective/ 68. Flood Zone(s) B9. Base Flood Elevation(s) (Zone Revised Date AO, use base flood depth) 12103C-0102 G 06/18/2009 09/03/2003 VE 13 810. indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69: ❑ FlS Profile � FlRM ❑ Community Determined ❑ Other/Source: 611. indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: 812. Is the building located in a Coastai Barrier Resources System (CBRS) area or Othervvise Protected Area (OPA)? ❑ Yes � No Designation Date: / / ❑ CBRS ❑ OPA SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: Q Construction Drawings* � Buiiding 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 G2.a-h below according to the building diagram specified in item A7. In Puerto Rico only, errter meters. Benchmark Utiiized: L-NET GPS NETWORK-KAS Vertical Datum: NAVD88 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGYD 1929 � NAVD 1988 ❑ Other/Saurce: 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) �. 06 � feet ❑ meters b) Top of the next higher floor 15 33 . � feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) 15 , 20 � feet ❑ meters d) Attached garage (top of siab) N/A . ❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the buiiding N�A . ❑ feet ❑ meters (Describe type of equipment and location in Comments) � Lowest adjacent (finished) grade next to building (LAG) _� . 2 � feet ❑ meters g) Highest adjace�t (finished) grade ne�R to building (HAG) 6. 7 � feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including ��L .,�_, � feet ❑ meters structural support SECTION D- SURVEYOR, EN(i1NEER, 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. 1 certify that the Information on this Certiflcate represents my best efforts to interpret the data available. 1 understand that any false siatement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1�1. ❑ 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 ❑ Yes � No .�- ;� Certifier's Name FRANK A. JULIAN Tttle PROFESSIONAL SURVEYOR Address 6438 POLK ST Signa FEMA rm 086-43 evised 7/12) 5495e Number Compa�y Name ��LY State ZIP Cod NEW PORT RICHE FL 34653 Date Telephone 07i29/2014 727 845-0389 See reverse side for continuation. °,���� t/�� . �u � � �� . ,��, � i�! v �1y' ��1 ��, �.A` � - � / ta . ` s ���i �l y� ti-�. `, _ = Rephaces all;dr�vibtiseditiQr�S. +acas'+`` � � � Building Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. Building SVeet Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 704 ELDORADO AVE City CIEARWATER BEACH State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Pdicy Number: Company NAIC Number: If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs taelow 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 Yiew." 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. ,: �.� ""� �' . � ' �' �„" 111 w _� � ,���...� a.�....�a, wa: , �: � ��_�������� . ..�. z����� � �� �� FRONT VIEW 7/28/2014 ' "" i��, x�,�', 1 � � � � � + , �° ,. � �._. a'""�"�R:, _ , �,,�.. � �,.� � _ , 5�;� � ����.. . . - � - - � t � � � � - �_— , _ . Y. . � �. �x � � �. ,�.:;� � �:� __�4w _ -_ ��. �.�:.�r�"'''`•a�w"� , LEFT SIDE VIEW 7/28/2014 �I � �# 4 �. . .. �,.: A:� � �` . i ,; — � `\ REAR VIEW 7/28/2014 �,�,"�,,.�.-*�`�'� �<< � ��_ �; �:: � � i 'b RIGHT SIDE VIEW 7/28/2014 FEMA Form 086-0-33 (7/12) Replaces all previous editions.