1001 ELDORADO AVEU.�. DEPARIYENT OF HOMELAND S£CiJRRY
FE�At. EMIERGENCY MANAOEMIENT AGENCY
Natin�l ��od Ixsrumece Progmm
ELEVATIC3N CERTIFlCATE
hrtportan� Read the enstructions on pages 4-8.
SECTtON A — PROPERTY fNFOR�AATION
At. Building Orvrler's Name Fat.LiS�"� :3. WiNEii i'%;_-; _�' ��a
A2. Bu�lding Stree:t Address (inc��'i9 Apt� t1r�. Sulbe, artdlor �dg. No.) ar P.O. Ro+�Ee and Box No.
�cx�� ��c��,��o �,v�
c,�ty c�.�,�rw�,�-��? s�e r-� zt�coae ss�s�
A3. PropestY Desa�tlon (t-at a�d Block Numbe►s, Tax Paroel I�lurtiber, 1e9a1 Ueec�ion. etc.)
PARCFL !D - 05-i�15-54f�i6-068-OQ'I O NOr1' �OR , NOT FOR OESIGN
OM8 No. 1680-0W8
E�ivatiort Date: July 31, 2015
FOR. RrStJFtMiCE COMPANY E/SE -
A4. �uil�g ilae {e.g,. Resider�ai. Non-ReaiderHiai, AddlEion� Aoc�►Y. e'tc.1 R�Bi 3�1�9.4
A5. [atB�idM.on9ihxla: L�. �$°�g�;� Lqq. -62'48'95.4' fbrFoot� Datum: ❑ NAO 1927 X NAD 19�i
A6. A�fi at (e�st 2 phato�fis oflhe btdidinp �ttte Ce�e is be�g used tn obtaM fbod �noe.
A7. 8�g EMaptarrt Ntanber A 1
P►S. For a b�Wd�g vr#h a cxew�pace a sr�re(s�: /t9. �'a a b�np wi�e an �ed parape:
a? squauae footaga �f crarNap�ae or ertdosw+e(a) � sq ft $) S� �oo�ka4b of a�actied �ape �152 �9 ft
b) Number af penr�t flood openkgs h Ute cxa�wispaoe b) � d pemlenent f0od openhgs itl the af�dted �arspe
a�s��, �.o�oac�+�e�l�o� t� ,�,m t.a�r�e �a�o�ra� �
c) Tat� net atea ot flood opeMngs in A8.b � sq in ca Ta� net aras of Aood ope�gs M A9.b N�,q aq in
d? En�ee�ed flood apen�? ❑ Yes X No d} En�eerod AOOd o�r�t? ❑ Y� X No
SECTION 8— FLOOD tNSURANCE RATE MAP (FIRMy 1l�t�MATi�i
���� r Ir!
Bf. t�iP Cart�uni�r Natt;e � Camnwn�r Ntar�ber � 62 Cout�iy Name � B3. Sfsie
ClTY OF CLEARWA7ER-125Q9G PiN�LLAS FLORtDA
610. �ielhe soa�ce t�F�e Bs�e Fbod �On tBFEj �ala Or bese flood depth erMe�ed in flem @8.
C7 FIS Pro�le X F�Y{ � Corrtnu�y Oe�rtr�ed � OtlierlSouroa
Bts. �dicala etev�on aahsn e+s� tor eFE in 16em �: p t�i3w 1928 x w�w �888 p aharlsuuroe:
B12 Is the bro:dt�g IocaMed ln a Cosstat Bartler �teaduoss Syatam (CBRSj area ar O�s PrdRlcbd Rrsa (OPA}? ❑ Yes X No
D�on i?abx ❑ CBRS 0 OF''A
�� �/ ����I � I 1 �� " �� ��1
- ev� �vwnt� t�►no�t (sv�tv�r �ats�
c1. Bui�p aevauons are ba8ea on: p cwaauc�ion �ra�• ❑ Bu�ding !lndsr r.araCrudfon- x fh�shea r•on�cflon
•,A n�► Eta�+�aEion Cer�ls rr�l be requ�ted wf�etf co�pn af the buil�np It contpkte. �
C2. EJe+reliora —Zones A1-,I►30. AE. AN, A i� �?. �, ��0. V(wi�f BFEI. AR. AiilA. �1R/AE. I1iiM�1f�11.'!0� ARl/W. JVifAld. CotnpieAe 1lersts C2.a-h�
belo� n000rd�0 to the b�g � apsc�Md tn lbrrt Ai. fn Pusrbo li�o dfgt. en0er rt�sber�.
Be�wAc Eltl�e�k AURAI. NO� 1973 Verticsl Dahx�x NAVD 1988 �
1ndiC�e etevaf3ae dab�n used i�orr the ele�wations in lEe�ns aj dtmu� h) below. ❑ NC,VD �929 X NAVD 1988 C] OthedSouroe: Q
Da�en t�d !or bui�tg ebrstlons mt�t be �a sa�r�e as th�t t�aed fnr ihe BFE.
aj Top of bot�txn Aoor ii�diiW baeement, aa�oe. +x e�do�ur+s ftoorl
b} Tap d 1he r� hipharlba
Cj BOt60ft1 OI° IfIC bN1Nt h01�!'1� �IiN�I tt'lefl� N 7JOfla6 Ofi�i�
d} Al�ed q�a�e (�pp pf stab)
ej l.owest elev�on � madw�ery a equiprhent ae��icir�9 ��D
(Dea�xibe tYPe of eq�pmeN �d locati0n i� Carrar�nks)
�1 � �cr� g�ae �a�� cu��
9) ��(1k►khsd) grade r�eoQ b build�D (tU1�)
h) Lowest �t 9�ade at bwest eieva�ot� ot dadc ot s�s, induidi�i �nec�,rat suPP�
�•a rt�
7.o flgt
14.�
.��$
$•�
a.�
f��i
+Lll.A
.? _
X lbet Q ma�ers
X[] ieet Q lneters
X teet ❑ me�ers
X teat [,3 tnstecs
X feeR ❑ mets�s
x �eec ❑ �
X feet � mebers
X feet � meUets
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J
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SECTION D— SURVE1fQR� ENa11MiEER, OR ARCHITECT CER'TiFlCATiON
. �.._._ �..._._
TtNs oe�tlfic�as is � be siyned and seafed by a land saaveyor. �ee� or ardMlec2 aud�orFaed by la�v to catify elevada�
#n�annatlort.l t�er6�y � the brN�attta�far on thJs Cer9�Ca6e repreae�tts my be�t aAbrts b 1r�Ar�t �e de0e� ava6'a8�s.
1�d ttret �rrty fatse st�ement may be � by frne or bnpisernrtent un�der t8 U.� Co(�le, Sec�ort 1Q01.
Y
� Chedc hero iF corrwna+rts are pcovided on badc d f�m. Were te�ude and iorpitude in SecNon A pravi�fed by a
❑ cneck ne�e if a�netks. Iicens.d land:urveyo� � Yes p No
CBrtitie�8 N8rt18 LEiANC) F. [?Y`�AR.C.�
TiHQ r .L.S.
Atfdress �884 PRE3�R�S5
Signatrme
/ �",�.
FEAAA �m t719:
[t.•.•�'^i-'':'-1:�T"lu,�,: : •.,.
Campany t�Fame FtA StJRV�YS CqRP.
,#iC� City NAPLE�° State Ft. ZIP Code 3�49�4
�e t73/3"u�2t3'� 6 Telephofle 23�-403-? 6�0
See reverse side for continuation.
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L1
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Reptaces �1 pnevio�s editions.
IMPORTANT: fn ttwse �paces, copy the co�respo�eding i�sfarrrtation trom Secfion /k.
Buikiing Str�et Addtess (+ndudin9 Apt. Un�� SuiAe. andlor Bkfg. No.) o� F.O. Route and Bax No.
? Q�%1 � ���_ `4°:t',C3�i ftbFE.
Ctty �'�.�.fi��"c+e�'AT�F� Stats r'_C��i�?,�. Z1P Cod@ 337t�%
F4R M6SURANCE COMPANY USE
Policy N�ahber
Cotnpacty NAIC Number. Y,
SECTlON D- SURYEYOR, ENGINEER, OR ARCHITECT CERTlFICATlON (CONTINEJED)
Copy batl� side�a d ttds Eleva�oa CertEficate far (1? c�rru�wnilY o�ic3al, (� ir�siusu�ae ayent/oort�anf+, and (3) b�d"mg ownar.
Comments GPS CC70RDINATES WERE 1"AKEN FRC3M GOC}GLE EARFf�i. NQT FOR CCatdSTi2iJCTIOfY. IvC3T FOR qES{GN. Fl.C3�Q ZL3NE
�ETERMtNATit?N FRQVIRED BY FLOOd INSiGNTS. iNiS DF�iA Vi11�S �f2E�Pl��ED F�R FL�CiC IfgtSU�tA�CE PURPU5E5 t3NLY.�;�fE EQUfPi�4Ehd"E'
US�D fS GPS. THERE EX1S75 A t}.2' (TY1f0 TENTti5} PLUS C>fd NlihlUS i'F2�CtSIC)�Pd. f'TEMI LiSTED !ht C2{ej }S T�iE COMCi2EiE A!R Gt7hipii'fC?NiNG
PAD. TNE EI.�VAT1C}P! OFwTF#E PC?�1_}EQUIPMEMf PAD !S 5.6'. DAi� C3f' �IELQ U`J4EtK: �3J3UI2�i6
f ."' Ti�►K!trrZ�Ti C.'
SEC710N E- BUitDMlG ELEVAT�N lNFORMATION (StiRVEX NQi REQU(RED) FOR ZOI�IE IW AND �f3NE A�iMTF10UT �Ej
Fa' Zones AO end A(Mritlwet BFq, oaaplete Nems E1-E5. � 1f� Ce�e ia ir�Kled ta suppurt a IOAM � lAMFt-F reQuest. oompie�a Sec#o� A. B,
and C. For 11ems E1-E4, use n�urd grede, # ava�ble. Chedc 1he mea�ttert�M used. ln Ptwrbo Ftioo oMy, enber mebe�s.
E1
0
F3.
E4.
Pmvlde de�raHon ir�fom�atlon far tne foNowirp ancs cheac tne appropr�ie bmaes M srroM► wn� tl,e elev�ior, is above or below nie hi�est adjaoe�t
grade p�tAti) and ihe bw�est a�ent grade (LAG).
a) Tcp af bMEom floor (hd�y bsaert�ent, a�awl�oe. or er�su�e) is ❑ f+eat ❑ meEera � a[sove or � bsbw tbe liAG.
b) Top ot bot�om tioor {�du�g b�, crswi�oe. er e�x�a�sune) i� ❑ iaet C] mebers D�ave ar❑ betow ttie LAti.
For 8t�din� O�ra �-9 wWt pam��net�t Aood opemtqs pr�ided h Sedlon A Nems 8 atdlor 9(see��__pegea 8-6 M t�ions). tt�e next hiDher t�oor
(elevafion {�.b in �e d�grarr�s) dthe 4�p is [� teet ❑ me�s ❑ sabonia or ❑ beiow tlse W►G.
A#tad�ed �rage (bop af siabj is ❑ feet 0 n�ts ❑ abcw� tx ❑ below !he HAG.
TaP oi �bm� ot rt�r ancf/or eqt�ment senddng t�+e b�g is ❑ feet !3 me�s ❑ above or D eeiow #�s t�l1G.
E5. Zocre AO onl�r, tE no flood dept!► r�ber is ava�abie. ts the mp otthe bolCom tloor elevabed in aooadanoe wNh d�+rArt�jra fbodptafn �
ordt�ance? [3 Yes � Na � Wqcncwn. T'� bcaf a�ial �r�utt ae�if�rlhi� ia�Ortn�ion in Sedion G.
�ON F- PROPERTY O�WNF.:t (OR tYWNER`8 REPR�ltTA�'fVEj CER71F'tCAT10N
The prcpart�t+ow��er or owners autiwrixsd ��p�ser�EaWe wt�t► oa�pteles Ssdbrr 11. B. and E for Z�e A(wiMaut A F�W4�ued or cxxrvn�mm�ssued BFE}
a 7�e AO mwt aipn he� The a�emants h 8ec�ions A. B, and E ane owrect ia fhe bast of m�r Imo�wbdge•
PropaRy ()wnef� a Owne�s Auqtiais�sd �'a Narne
11�d�he:6s C�j► Staie Z� C.a�de
� � Te�P�
Caenments
fl
s�c°r�aN o -coMwwwrnr �u� �oanor�y
'i'!+� bcad of6ciaf who t� autho�ed hS► E�wr or a��oe b�the oorrrt�urdlYs Aoo�iedn tr�err�t o�fhenoe can t�mpieie Sedions A, B. C(or E}. ar�d G
of Ws Efu�+etlor� C.e�p'�caia. Cam�l�ie 9hs appiabie ie�rK� aM eipn bslow t�edc ihe n�r�m� used b lians GS-(3�0. In Pnarb Rio� a�ly, etiler me6e�a.
Gt. ❑ Tha ir�o�rn�tlon in Ssc�on C w�ss taken Ttan olher doarnentatlon 1Mt iws bsan Nprwd and ssaled Dyr a�oer»sd sw+�e�yar, enpine�� or ancfiitect who
is au�torixed by low b caertpjt eb+atlon k�o�ma�on. (lndicabe Ehe �atmee and dels of tl�e ekvalfort dam in the C.onxrrents anet belo�w.)
G2. � A oornnuMty ofE�l compialed Sedion E far a bu�g located fn Za�e A(� a FEM�►-if�ued or c�dnnumll�i�ue0 � or Zare AO.
G3. ❑ i'he ioNnwing inbmtatlon (Nen►s G4-t'10) is providad kx oor�wnun%r tloodpt�n management W iP�-
G5. Daie Ae� hisued
Q
G7. Thi� pem�it has been issued br. ❑ New Construc�on ❑ S�t tmWo�ement
(�8. Ebvatlon oF es-built iowest llo0r ('mdudinp bassmar►t) af tlte bu�dinq: ❑ feet ❑ meEers
O9. BFE or (in Zone 140) depth of 11ood'a+g at the build"atg a�e: � fied [] metera
G10_ Coexnurbty's deaign t�ood eb+ratfon: ❑ feet Q meiera
La;�l OfficxaPs Name
Comrt�Ky t�eme
Signature
�.�6{it6
Trtb
Telephone
��1'Tt�
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.�
,•.�,
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- � � _'. �._�: !'.���lL•_ilL"-
FEaAa Fom, o86-a33 (7n2} Replaoes aN previ«,s eaitions.
ELEVATION CERIIF�CATE, page 3 Building Photographs
� See Insttuctions far item A6.
I�I[PORTANT: !n these space�� copy the comesponding i�ortt�ation from Secdon A
Buadfig Streec nddress (nduding A�-. unif. s�dEe, arMla Bidg. No.) or P.o. R�ute and sox No.
1001 EIDORADO AVE
City CLEARWAT�R ''ata6e �=l_�,:si�lt�� ZtPCode 33767
POR lfa.SUfiANCF CpMpMlY tJSE
Pdu,y N�
CampanY t�fAiG N�aribet
�f using the Elevatiort Cetiificate to obt� NFIP fbod ir�uance, af�x at leasi 2 bu�n8 P�9� beto�w according �o the instnx�iorts
#or ttem A6. IdeMtiy aN phoEogrephs witfi da6e t�lcen; 'Front Y�aW' and "Rear Y�'; arM, if required, "Right Side Vie�' and 'lsft Side
V(ew.' When a�le, pho#o9raphs must show fhe foundadon w�h repreae� e�r�les of tl�e fiood vpenings or v�eM�s� as
indic�rted iri Sedbn AS. If aubmiltinc,} mar�e phaEographs than wiN fit on tt� pa�e, �.�e the Cattinuatian P�ge-
FRC?�JT V(EW
F�tGH�(` SfDE VIEV41 �".'." . 4 �:
FEMA Fotm 088-0-33 (71'!2) Replsoes aN previous editions.
ELEYATFON CERTiFtCATE, page 4 guilding Pho#ographs
, � Continuatian Page
l�1iPORTANT: In ffiese spaces, copy the corresponding imfonnation from Section A.
Buiid� 3tregt Address (indu�r� %�pt-, lk�t. SuiDe. and/or Bidg. No.) or P.O. Rou6e arM Box No.
10ti1 EIDQRf�i�C� AUE
City CLEfa��fVA'i`�R $ta�D FLCRSL?A Z�'Code 33767
FdR INSURMICE Cf�IPANY t1S�
Podcp tVir►�ber. . . �
Corr�any NAtC Nunbet
� •.
ff submitting more �Ftu#ographs than wiN fit on the preoeding page, affoc the additior�al pha4ogr�t�s I�elow. Iderttify sa phoiagraphs
with: tlate t�cen; "Frart VieM/' and `R� V'�'; and, if req+�red. 'Rigirt Side lrew" a�d "Left Side V'�ew.' When appticable.
pito�to�graphs must sfiow Ehe � w�h nepr�esentativ�e exampies of the 800d oper�gs or v�e�rts, as i�ted in Section A8.
FR�NT VtE�tii D3/30/2016
ftEAR VIEW 03/3t}12015
i
FEMA Fortn 088�-�-33 (7/f2) Repiaces atl pnevious editions.