Loading...
18675 US HWY 19 N #339U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 Federal Emergency Management Agency Expiration Date: November 30, 2018 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy atl pages of this Elevation Certificate and all attachments for (1) community o�ciai, (2) insurance agenUcompany, and (3) building owner. SECTION A— PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Building Owner's Name Policy Number: DENNIS W. & BEVERLY L. WEIHE REVOCABLE LIVING TRUST A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 18675 US HIGHWAY 19 N#339 City State ZIP Code CLEARWATER Florida 33764 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 339, BAY ARISTOCRAT VILLAGE MOBILE HOM� PARK (UNRECORDED) A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27•94237 Long. -82.72481 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 8 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 1,519 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 9 c) Total net area of flood openings in AB.b 2,304 sq in d) Engineered flood openings? ❑ Yes � No A9. For a building with an attached garage: a) Square footage of attached garage NIA sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A9.b N/q sq in d) Engineered flood openings? � Yes X� No SECTION B— FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFiF Community Name & Community Number B2. County Name B3. State CITY OF CLEARWATER - 125096 PINELLAS Florida 64. tvlap/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) 69. Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 12103C0128 G 05/17/2005 09/03/2003 AE 9 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: � FIS 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 �esignation Date: [� CBRS ❑ OPA ��_ t-?-i�tA �=orm fl86-0°33 l7115} Re�laces �i{ pre+ricl�is �=�itir�ns. �orr�� Pag� :,�f � ELEVATION CERTIFICATE ExpB tion1Da e�No8ember 30, 2o�s IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 18675 US HIGHWAY 19 N#339 City State ZIP Code Company NAIC Number CLEARWATER Florida 33764 - ------ --- - - - SECTION C- BUILDiNG ELEVATION INFORMATION (SURVEY REQUIRED) C? .�ui!ding elsvations ars bassd en: ❑ Construction Drawings* � Bu�lding UndPr GonG►_ru�f�on' �1 Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. I 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 Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: FDOT PERM. REF. NETWORK Vertical Datum: NAVD 1988 IIndicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 5 8 x� feet ❑ meters b) Top of the next higher floor 10. 6 �x feet � meters c) Bottom of the lowest horizontal structural member (V Zones only) N�A. x� feet � meters d) Attached garage (top of slab) N%^. U ieei u ���e�c�s e) Lowest elevation of machinery or equipment servicing the building � �. � x� feet ❑ meters (Describe type of equipment and location in Comments) ( f) Lowest adjacent (finished) grade next to building (LAG) 5� x� feet ❑ meters j g) Highest adjacent (finished) grade next to building (HAG) 5 8 � feet ❑ meters I h) Lowest adjacent grade at lowest elevation of deck or stairs, including S 6 ❑x feet ❑ meters structural support $FC'��L1�1 Q—��i R�/FYQ�� F�jGI�E�R, �R AR�N!?�EGT GERTlFlCAT10N This certificaiion is to be signed and sealed by a land surveyor, engineer, or architecf authorized by law to certify elevation information. I certify thaf the information on this Certiircate represents my best efforts to interpret the data available. l understand that any false statement may be punishab/e by �ne or imprisonmenf under 18 U.S. Code, Section 1001. Were latitude and longitude in Sec#ior A provided by a li�ersed !ar,d surveyar? ❑X Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number JONATHAN S. BRANSON FL PLS 6845 Title �RESiDciv i � ` Company Name ACROMIC, INC. LB 8094 I Address �Rr� � 1 1116 NEEDLEWOOD LOOP City State ZIP Code OVIEDO Florida 32765 � Signatur Date Telephone 11 /02/2016 (321) 312-0787 Copy all p s of this Elevati ertificate and all attachments for (1 } community official, (2) insurance agenUcompany, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) C2. ELEVATIONS ARE REFERENCED TO THE FLORIDA DEPARTMENT OF TRANSPORTATION PERMANENT REFERENCE NETWORK USING A LEICA GS14 GPS SENSOR. C2e. IS ELEVATION OF TOP OF PLATFORM SUPPORTING AIR CONDITIONING UNIT. FEMA Form 086-0-33 (7/15) Replaces all previous editions. t-orm I�age 1 ot ti OMB No. 1660-0008 ELEVATION CERTIFICATE Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 18675 US HIGHWAY 19 N#339 City State ZIP Code Company NAIC Number CLEARWATER Florida 33764 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 ❑ 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 1-2 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 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 City State ZIP Code Signature Date Telephone Comments � ❑ C!?eck �ere if at#achments. ___.._._. __�._.._m�._.�...�.__........__._�___�_..,._ �__.�___...__.��,._.._�._._.�....,.___��._.._._..�. _ � "Ef�AA Farrn !J$6-(?-:33 f71151 Re�laces ail previous �c9iii�ns Far�n ?ac�e �� of � ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 18675 US HIGHWAY 19 N#339 City State ZIP Code Company NAIC Number GL€ARV�lA�Ek� Florida 337$4 _- ---___ SECTION G — COMMUNITY INFORMATION (O?T10�IAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C(or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico on�y, enter meters. G� .❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) �L L r�'. vviiiiiu�iiy vi��ioi �vii��icic� .c.'c�iivi� � ivi a vuiit`�iii�C'J, iVi.aicu iii �viiC n�riiillVl.il a fr'CiVIF1-I�JIJCU UI l:UI111II1111I1j�-IJ$UCU DrC� or Zone AO. G3. ❑ The following information (Items G4—G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Com�liance/Occupancy Issued G7. This permit has been issued for: � New Construction ❑ Substantial Improvement G8. Elevation of as-built Iowest floor (including basement) I of the building: . ❑ feet � meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: , ❑ feet � meters Datum I G10. Community's design flood etevation: . ❑ feet � meters Datum Local Official's Name Tiile Community Name Telephone I Signature Date Comments (including type of equipment and location, per C2(e), if applicable) � Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS ELEVATION CERTIFICATE See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. 18675 US HIGHWAY 19 N#339 City State ZIP Code CLEARWATER Florida 33764 OMB No. 1660-0008 Expiration Date: November 30, 2018 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affx at least 2 building photographs below according to the instructions for ttem A6. Identify all photographs with date taken; "Front View" and "Rear View"; 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. If submitting more photographs than will fit on this page, use the Continuation Page. sa. � i � i'� � , ��_______ \ ,►� ____--- _ `n� G t4} ,�,�'.k . � x� a j, � �,.F Photo One Caption FRONT VIEW - 11/02/2016 ••. � ,,.0 �e � � .f k t;�- � .. �`',s- ., .. . < .�.. � � � �� . � �� � , ,� .. � .2 , t �' r, ' � s � � -�__._ '? � � � �� i : " �: " � "� � �'> � � � � t �-.',." "`°:;,"�. � r � � Y � � ., � � ��_ '� � `��� "�� � "� ,� _ � r; �`-� � 't� �---�—��1� a F3�p -��s a ' � . � ,a"`"..; y � r . - s3f$� � ! 9 ��93.� A=� . +. ��0, � y � � � �. "'�.. ;� � � � ��� ¢�,. � � � .'� � � yk 1 � - � i � ;...I i $ � t' � � �I '..i .; " � . � � ' . � ���# � � �$ ���3�,. -�...,s_ .......�� ... ,,. n'^` �..�„�.�...»...+eu., . ' � � .�YJ� _e � ; . ; s �� - y.;,.�--...�..- .._. _��� b 3 � _ :�'±�oto Two Caption REAR VIEW - 11l02/2016 ��-�=UiA Form 086-0-33 !7/� 51 yfi� �ta �.t �� ''...�''" � ��" , � � �; s. � � -f ,i� is' � P�,� �. fi u .'�-: r , �3 x_ , x,. . _ .,_ , ,�.. �. . . ._ ��..�.'� �'.5'a� Photo Two 1�eplaces all ore�rious editions. _` � �, _ ..� �.= .^� ���;t � � A. �� -..S:b�� - ��,s - ' .q .a;. •'9,,,.._.>...,.o. w . Form Page 5 of 6 BUILDING PHOTOGRAPHS ELEVATION CERTIFICATE 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. 18675 US HIGHWAY 19 N#339 OMB No. 1660-0008 Expiration Date: NovPmber 30, 2O1R FOR INSURANCE COMPANY USE Policy Number: City State ZiP Code � Company NAIC Number � CLEARWATER Florida 33764 -- - if submitting more photographs than will fit on the preceding page, affix the additional phoiographs below. Identify all photographs ,�± u : : � � ��c....,� � .,,a ��o v,,.. �� ,� ;r • d �o•,.tia p,J �i•,... � a .� p pa.. v_. �n��. �•_..��_ `•� �: 2� a�ii, �v�� ✓i�rr" $��u i�cai vicrJ ; c+iiV, n ici�uiicV� ��iy��l Ji4c vicvV GitV L�II JiuC viCVv.� Vv11Ci1 CI�./FJIiWU1C� photographs must show the foundation with representative examples of the flood open+ngs or vents, as indicated i� S�ctior A8. , �> ,, $;.f . _ �-•„ ''3 _� � r' ?�!`, :�` �. _ . ,��,.� - �- . �� � -�_ _ - -��. , 'i� �`c, ��`. � � �s � �*� �; - _ µ,�.-�. � f ��.- ��� ` � > �ac' �,r,� •.��;� � � � . � �- , � - �.� �-x: , ,� • �-�. �--� �� 1� � � �� -a '� +ae w� ' �. � n' ic �� � -�, .� � .«t --�r +� � 3 t � _� � `��-.� ��. ,� � � � x y;� � � � o � r� � � sa� � ? Fa ._ i ' �� , ` �. _'�'�M�`�;s- � � z-��� , ���`�� .x� r �. _ , . ._ . -°- e Photo One Photo One Caption LEFT SIDE VIEW - 11/02/2016 F�`��� , ar� � � �� �: ��=- _ _ _-- :��. ��=� � �__---_;;--_� '°�° �'�`�.,5. � \� �� = � �, --`;F�r-_-� ,. .���`i'a,� > - �- �'`��- � �' = .-.:, �cyw� . �. �` � .Y �S;'`'"t ..: . . . '?°'+ � � �,.. �.��.�n . � � � t..�s�°„`^ �=;:+�.� .�?k'`;� ` w.y+ "- . . ... . . . Photo 7wo Photo Two Caption RIGHT SIDE VIEW - 11102/2016 FE�v1A Forin G86-0-33 (7/15) Replaces all previous editions. � •��� ' � � ' ��� Y �� ' � ----=- � � ---_._.,---- -_ � � _i � F��� Page d oi o