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1070 ELDORADO AVE. U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY National Flood Insurance Program A1 ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION A2. Building Street Address (including Apt., Unit, Suite, a�d/or Bidg. No.) or P.O. Route and Box No. 1070 ELDORADO AVENUE City CLEARWATER BEACH, State FL ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Ta�c Parcel Number, Legal Description, etc.) LOT 6, BLOCK 70, MANDALAY SUBDIVISION OMB No. 1660-0008 Expiration Date: July 31, 2015 FOR {NSURANCE COMPANY USE Policy Number. A4. Building Use (e.g., Residential, Non-Residential, Addition, Acxessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 28 dea. 00' 17.4" Long. 82 dea. 49' 36.0" Horizontal Datum: ❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building if the Cert�cate is being used to obtain flood insurance. A7. Building Diagram Number 8 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) � sq ft a) Square footage of attached garage 484 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 2 within 1.0 foot above adjacent grade 1 c) Total net area of flood openings in AB.b 288 sq in c) Total net area of flood openings in A9.b 2� sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP Community Name & Community Number B2. County Name B3. State CLEARWATER! 125096 PINELLAS FLORIDA B4. Map/Panel Number 65. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12103 C 0064 G 08-18-09 Effedive/Revised Date Zone(s) AO, use base flood depth) 9-03-03 VE 13' 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/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ OthedSource: B12. 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: ❑ Construdion Drawings* ❑ Building Under Construction` � Finished Construction 'A new Elevation Certificate wiN 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 ltems C2.a-h befow according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: CITY OF CLEARWATER J-02 Vertical Datum: 4.43 ' 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 (inGuding 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) fl Lowest adjacent (finished) grade ne� 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 6.4 13.2 +/- 4.2 6.5 3.7 5.9 N/A. Chedc the measuremerrt 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 suroeyor, engineer, or architect authorized by law to certiy elevation information. 1 certify that the info►mation on this Certificate repr�sents my best efl`orts to interpret the data available. r �� ��. ! understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 9001. ���' ,���'.:. „� �? *�"� .� � Check here if comments are provided on badc of form. Were latitude and longitude in Sedion A provided by a�� ,-"'i�,� !'•. "c�'s ° � Check here if attachments. licensed land surveyoi'? � Yes ❑ No •��J +� "' ��`�'«��p�'•, �- Certifier's Name LARRY L. EVANS License Number FL. LS #2937 ;~` �� ��v� �� , ::.; Title LAND SURVEYOR Company Name EVANS LAND SURVEYING, Inc. `'' �'y p5¢! ' i',� rt 'ii+I��A�I. hPi� i� Address 1460 BEL^TRE�$.�EET City DUNEDIN, State FL ZIP Code 34698 ��,6�}�;��,'� ;� ;' � 1� / yM � . -�' � '��a � � �9p � � ��� Signature FEMA Form 086-0- (7/12) Date 09-30-2014 Telephone (727) 734-3821 See reverse side for continuation. '�4fia.Y.%� eplaces �all previous editions. ELEVATION CERTIFICATE, pas�e 2 IMPORTANT: In these spaces, copy the corresponding information from 3ection A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1070 ELDORADO AVENUE City CLEARWATER BEACH, State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Numbec SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation CeR�cate for (1) community official, (2) insurance agent/company, and (3) buitding owner. Comments A8. & A9.): SQUARE FOOTAGE FIGURES WERE TAKEN FROM PROPERTY APPRAISERS WEBSITE. C2.c): ENTIRE FOUNDATION IS ENCLOSED. C2.e:) ARE EXTERIOR A/C COMPRESSORS ON GROUND LEVEL PADS. Signature SECTION E-- BUtLDING ELEVATION INFORMATION Date 9-30-2014 RVEY NOT REQUIREDI FOR ZONE AO AND Z�NE A 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 E7-E4, use natural grade, if available. Check the measurement used. �n Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the e�evation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (inGuding basement, 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 ❑ 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 infortnation 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 coRect to the best of my knowledge. Property OwnePs 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) The local offiaal 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 It�ns GS-G10. In Puerto Rico onty, 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 AO. G3. ❑ The following inforrnation (Items G4-G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Cert�cate Of Compliance/Ocxupancy 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. Community's design flood elevation: ❑ feet ❑ meters Local Official's Name Community Name Signature Comments Title Telephone Date Datum Datum Datum Check here ff attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 guiiding 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. 1070 ELDORADO AVENUE City CLEARWATER BEACH, State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Policy Number: 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 Vievd'; 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. FRONT VIEW 09-30- .��'' s % i i- �«�; ; _ . 2014�. :� � ��� . , �`� :'`".� l y� � ,•, ..t �"`yr • _ �`; . .5, 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., Und, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1070 ELDORADO AVENUE City CLEARWATER BEACH, 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 Vievd' 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. 1 REAR VIEW 09-30- ifi � ( � FEMA Form 086-0-33 (7/12) Replaces all previous editions.