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779 ISLAND WAY. "•s• °�"�"T� ��o ��u� ELEVATION CERTIFICATE FEDERAI EMERliENCY MANA6ENIENT AGENCY OMB No. 1660-0008 NationalFloodlnsuranceProgroRr Important: Read the instructions on pages 1-�. �P��tion Date: July 31, 2015 22994� SECTION A- PROPERTY INFORMATION FOR II+ISURANGE CO�+IpAt�1� t3� A7. Bui�ding Owner's Name TIMOTHY WESLEY AND MELINDA WESLEY p�Cy ��; A2. Buiiding Street Address (inGuding Apt., Unit, Suite, andlor Bidg. No.) or P.O. Route and Box No. 7791SLAND WAY Comperf�r N1AtG �; City CLEARWATER State FL ZIP Cade 33767 �• �P�Y �escription (Lot and Block Numbers, Tax Parcel Numbe�, Legai Descrip6on, etc.) A4. Buiiding Use (e.g., Residential, Non-Residential, Additlon, Accessory, etc.) RESiDENTiAL A5. Latitude/Longitude: Lat. �7°59'33.93"N Long. 82°49'12.87"VU A6. Attach at least 2 photc�graphs of Uie buiiding ff the Certificate is being used to obtain flood insurance �tal Datum: ❑ NAD 1927 � NAD 1983 A7. Building Diagram Number 1A A8. For a buitding with a cxawlspace or endosure(s): a) Square footage of cra�Mspace or endosure(s) � S ft A9. For a building with an attad�ed garage: b} Number of pertnar�nt flood Q a) Square footage of attad�d garage gQQ Sy g °��� �� �e ���ce b) Number of pemianent flood openings in q� attad�ed garage or enclosure(s) within 1.0 foot above adjacent grade g within 1.0 foot above adjacent grade Q c) Total net area of flood openings in AS.b 0 sq in c) Total net area of flood openings in A9.b Q �� d) Engineered flood openingsp ❑ Yes � No � Engineered flood o ru s� � Pe �9 • ❑ Yes � No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMqTiON 61. NFIP Community Name 8 Community Number 62. County Name 125096 PINELLAS B4. MapiPanei Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel 12013C0102 G 9l3/2003 EffectivelRevised Date 9/3/2003 B3. State Florida 68. Flood B9. Base Fbod Elevation(s) (Zone Zone(s) AO. uge base flood depth) AE(NAVpgg) 11/72 Bf 0. Indicate the source of the Base Flood Elevation (BF� data or base flood depth entered 'm Item 69. ❑ FIS Profite � FIRM ❑ Community Detennined � p�ry��: 811. indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Bartier Resources System (CBRS) area or Othe� protected qr,�a (OPA)? � y� Designation Date: ❑ CBRS ❑ OPA � No SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIREDj C1. Building elevations are based on: ❑ Construcction Drawings* ❑ Building Under Construction' �A new Elevatlon Certificate wi�� be reyuired when construction of the buiitii� is compiete. � Finished Constniction C2. Etevations -Zones A1-�A30. AE. qh�. A(with BF�. VE. V1 V3Q, V(with BF�. AR, AR/A, AWAE, qR/A1�q3p, qR/qH. AR/A0. Complete Items C2.a-h beiow according to the building diagram specified in ttem A7. In Puerto Rico oMy, enter meters. Benchmark Utilized: i-0,3.� Yertical Datum: NAVD 1988 indicate elevation datum used for Mie elevations in items a) through h) below. ❑ NGVD 1929 � NqVD 1988 O OthedSource: Datum used for bu'iding elevaHons must be ihe same as that used for the BFE. - Chedc U�e measuremern used. a) Top of bottom floor (induding basement, cxawlspace, or endosure floo�) �,_ b) ToP of Uie next higher floor � feet ❑ meters c) Bottom of the lowest horizontal sWCtural member 2on� on N/A'- � feet ❑ meters � ty) WA. � feet ❑ meters d) Attached garage (top of slab) - e) Lowest elevation of machine or �'- ��t ❑ mete� (Describe type of equi ry ���p�nt servicing the building 7_7._ ��t pmeM and iocation in Comments) ❑ meters � Lowest adjacern (finished) grade next to building (LAG) �_ g) Highest adjacent (finished) grade neut to building (HqG) ��t ❑ meters h) Lowest adjacent grade at low�est elevation of dedc or stairs, induding structural support N A �� ��t� � teet ❑ meters SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFiCAT10N This certification is to be s�qned and sealed by a land surveyor, engineer, or architect authorized by law to oertitv eievafi�� information_ ! ce,tifv nuar rtie ;..�,,.,,.s.:,... ,,., ...:_ ,._�__._ - - - ---- . _. _,,..,...,.ou..� �. rceplaces ail previous editions_ CERTIFICATE, page 2 (Z28941) IMPORTANT: In these spaces, copy the corr�pondin iM'ormation from Section A. Building Street Address (inciuding qpt�. Unit, Suite, and/or Bldg. No.) or P.O. Route a� Box No. T791SLAND WAY City CIEARWATER State FL ZIP Code 33767 FOR tNSURANCE CQMF PoliCy Numbet: ' Company NAIG Number: SECTION D- SURVEYOR, ENGINEER, OR ARCHtTECT CERTIFICATION (CONTINUED) Copy both sides of this Elevatio� Certificate for (1) community official, (2) insurance agenUcompany, and (3) building ovvne�. Comments GARAGE SQUARE FOOTAGE IS ROUNDED TO THE NEAREST 100 SQUARE FEET. ACCESS UNAVAILABLE. ELEVATIONS IN SECTION C2-E ARE ELEVATIONS OF A/C SLAB. Signature �--`� Date 5/20/2015 c�.-�! SECTION E- BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR 20NE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(witl�out BFEj, 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 naturai grade, if available. Chedc the measurement used. in Puerto Rico ony, 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 adjac�rn grade (LAG). a) Top of bottom floor (induding basement, aawlspace, or endosure) is __ ❑ feet ❑ meters � above or � below the HAG. b) Top of bottom floor (induding basement, crawlspace, or endosurej is __ ❑�t ���� � above or ❑ below the I.AG. E2. For Building Diagrams 6-9 with permaneM flood operrings provided in Section A ttems 8 and/or 9(see pages �9 of Instructions), the next higher floor (elevatio� C2.b in the diagrams) of the building is =_ � feet ❑ rr�eters ❑ above or ❑ beiow the HAG. E3. Attached garage (top of slab) is __ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of piatform of machinery andlor 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 U�e community's floodpiain management ordinance? ❑ Yes ❑ No ❑ Unknown. The locai offiaal must certify this information in Section G. SECTION F- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The properly owner or owner's authorized representative who completes Sections A, B, and E for Zone A(writhout a FEMA-issued or community-issued BFE) or Zor� AO must sign he►e. The statemer�ts in Sections A, B, and E are correcf to the best of my knowledge. Property Owner's or Owner's Authoriz� Representative's Name Address Signature Comments City Date State ZIP Code Telephone Chedc here if atta ntc. SECTION G - COMMUNITY INFORMATION (OPTIONAL) The I�al offiaal who is authorized by law or ordinance to administer the communit�s floodplafn managerr�nt orclinance can complete Sections A, B, C(or E), and G of th� Elevation Certificate. Complete ihe applicable item(s) and sign bebw. Chedc ttie measurement used in Items G8-G10. In Puerto Rico only, errter meters. G1. ❑ The information in Seaion C was taken from other documeMation fhat has been signed arx! sealed by a licensed surveyor, engineer, or architect who is authorized by law to cerqiy elevation infortnation. (Indicate tl�e source and date of the elevation data in the Comments area beiow.) G2. ❑ A communily official completed Section E ior a building located in Zone A(without a FEMA-issued or community-issued BFE) or Zone AO. G3. ❑ The foilowing irrfwmation (Items G4-G1p) is provided Tor community floodplain management purposes. G4. Permit Number G5. Date Pertnit Issued G6. Oate Certificate Of Compiiance/Occupancy �ssued G7. This permit has been issued for: ❑ New Cons6vcfion ❑ Substantiai Improvement G8. Elevation of as-buift lowest floor (induding basement) of the building: __ ❑ feet ❑ meters Datum G9. BFE or (in 2one AO) depth of flooding at the building site: __ ❑ Teet ❑ meters Datum G10. Community's �sign flood elevation: __ ❑ feet ❑ meters Datum Local Offiaal's Name Community Name Signature Comments Title Teiephone Date ■ rz.. �_,- i .u.��n,-u� FEMA Form 086-0-33 (7/12) Replaces all previous editions. � ELEVATION CERTIFICATE, pags 3 guilding Photographs See Instructions for item A6. (229941) IMPORTANT: In these spaces, copy the corr�ponding ir�fortnation from Section A. Building Street Address �nduding Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. 779 ISLAND WAY City CLEARWATER State FL ZIP Code 33767 FOR INSURANCE COMPANY USE Poticy Number: Company NA1C Number. if using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 buiiding photographs below according to the instructions for item A6. Identify all photographs with date takerr, "Front VieW and "Rear �e�M; and, if required, °Right Side VieW' and °Left Side Vew." When applicable, photographs must show the foundation with represeMative exampies of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will frt on this page, use the Continuation Page. FRONT VIEW REAR VIEW FEMA Fo►m 086-0-33 (7h2) Replaces ali previous editions.