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964 ELDORADO DR, ' U.S. DEPARTi�tENT OF HOMELAND SECURITY ON16 No. 1660-0008 Federal Emergency Management Agency Expiration Date: November 30, 2018 Naticnal Flood insuranc2 Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agenUcompany, and (3) building owner. SECTION A— PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Building Owner's Name Policy Number THOMAS W. CAREY A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 964 ELDORADO DRIVE Ciry State ZIP Code CLEARWATER Florida 33767 A3. Property Description (Lot and Biock Numbers, Tax Parcel Number, Legal Description, etc.) LOT 7, BLOCK 61, MANDALAY SUBDIVISION, PB 14 PG 32, PINELLAS COUNTY, FLORIDA A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 28°00'02"N Long. 82°49'38"W 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 6 A8. For a building with a crawispace or enciosure(s): a) Square footage of crawlspace or enclosure(s) 0 sq ft R E C E I V E D b) Number of permanent flood openings in the crawispace or enclosure(s) within 1.0 foot above adjacent rade 0 c) Totai net area of flood openings in A8.b 0 sq in �� ' d) Engineered flood openings? ❑ Yes ❑x No Planning & Development Departnie t. A9 For a building with an attached garage: City Of CleBfwatel" a) Square footage of attached garage 822 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 0 sq in � d) Engineered flood openings? � Yes �x No SECTION B— FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61 NFIP Communiry Name & Community Number 62 County Name 63 State CITY OF CLEARWATER 125096 PINELLAS Florida B4 Map/Panel 65 Suffix 66. FIRN1 index 67 FIRM Panel B8. Flood Zone(s) 69 Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 12103C0064 G 08/18/2009 09/03/2003 VE 13' B1G Indica.a the source ef the Base Flocd Elevation (8FE) data or bas2 ficod depth antar2d in It2m B9: � FIS Profile Ox FIR�A � Community Determined � Other/Source: B11 Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 Q N�VD 1988 ❑ Other,�Seurce B 12 Is the building located in a Coastal Barrier Rescurc°s System (CBRS) area or Otherwise Protected Area (OPAj� � Yes 0 No Designation Data � CBRS � OP� FEiLI� Form 086-0-33 (7i15) Replaces all previous editiors Form Page 1 of o ELEVATION CERTIFICATE OMB No �sso-000s ' Expiration Date. November 30. 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (inciuding Apt., Unit, Suite. and/or Bldg. No.) or P O. Route and Box No Policy Number 964 ELDORADO DRIVE ��Y State Z!P Code Company NAIC Num�er CLEARWATER Florida 33767 SECTION C— BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1 Building elevations are based on: ❑ Construction Drawings* � Buiiding Under Construction* �x 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, ARlA, ARlAE, AR/A1—A30, AR/AH, AR/A0. Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: CLEARWATER BM 238A VeRical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. � NGVD 1929 Q 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, crawispace, or enciosure floor) � 4 2 � feet ❑ meters b) Top of the ne� higher flaor N�A. �x feet � meters c) Bottom of the lowest horizontal structural member (V Zones only) � 3 � �x feet ❑ meters d� Attached garage (top of slab) 6. 2 �x feet � meters e) Lowest elevation of machinery or equipment servicing the building 14 � �x feet � meters (Describe type of equipment and location in Comments) � Lowest adjacent (finished) grade next to building (LAG) 6 � �x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 6. 3 Ox feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including N�A � feet � meters structural support SECTION D— SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION Tnis certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information I certify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 tJ S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑x Yes ❑ No �x Check here if attachments. Certifier's Name License Number , _ J. MICHAEL FUQUA 4192 ' . � Title L'� ��'~ ��,.. s-- . PSM . `'C.� I�� 1 Company Name '��'� � °l�;c�k�` DAVID L SMITH SURVEYING & MAPPING, INC � �'�i Address ��i�� 1406 W. LINEBAUGH AVENUE \ �\\ City State ZIP Code � TAMPA Flcrida 33612 -� Signature f j' 1 Date ! Telephone ry� ��,�L�(�Ly"i,.:�l.��`( ��r'c:�: — � ! �� f � 1( �' ., � Copy ail p ges of this E!evation Certificate and all attachments for (1) community official, (2) insurance agenUcompany, and (3i building owrer. Comments (including type of equipment and location, per C2(a), if applicable) SECTION C2A REPRESENTS THE FINISH FLOOR SECTiON C2D REPRESENTS THE GARAGE FLOOR THERE APPEARS TO BE NO OTNER ENCLOSURES BELONJ THE �lAi� F100R EXCEPT THE GARAGE. SECTION C2E REPRESENTS THE AiC PAD THE ATTACHNIENTS REPRESENTS THE PICTUR`S ON PAGE 5(NO PICTURES ON PAGE 6) FEN1A Fcrm 086-0-33 (7/15) Rapiaces all previous editions Form Page 2 of o OMB No. 1060-0008 ELEVATION CERTIFICATE Expiration Date: November 30, 2o�a IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt . Unit, Suite and/or Bidg No.) or P.O. Route and Box No Policy Number 964 ELDORADO DRIVE City State ZIP Code Company NAIC Number CLEARWATER Florida 33767 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 Et—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 a�d check the appropriate boxes to show whether the elevation is above or belcw 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, 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 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 platforrrt of machinery and/or equipment servicing the buiiding is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: !f 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. PropeRy Owner or Owner's Authorized R2presentative's Name Address City Stat2 ZIP Code Signature Date Telephone Comments ❑ Checic here if attachmerts FEN1A Form 086-�-33 (�!15) R2piac2s all previcus editicns Form °age 3 of o ELEVATlON CERTIFiCATE ONi6 No 1660-0008 - Expiration Date: November 30. 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE CONIPANY USE Bui�ding Street Address (including Apt. Unit, Suite, and/or Bldg No.) or P.0 Route and Box No. Policy Number: 964 ELDORADO DRIVE City State ZIP Code Company NAIC Number CLEARWATER Florida 33767 SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the communitys 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 only, 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 ccmmunity-issued BFE) 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 Compliance/Occupancy 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 Datum G9. BFE or (in Zone AO) depth of Flooding at the building site: ❑ feet � meters Datum G10 Community's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (induding type of equipment and location. per C2(e), if appiicabie) U Check here if attachments FEN1A Form 086-0-33 (7r15) Replaces all pravious editions Form Page 4 cf 6 BUILDING PHOTOGRAPHS ON18 No 16oC-0OG8 � � ELEVATION CERTIFICATE Continuation Page Expiration Date November 3G, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE CONIPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg No.) or P.0 Route ard Box No Policy Number: 964 ELDORADO DRIVE Cit�j State ZIP Code Company NAIC Number CLEARWATER Florida 33767 If submitting more photcgraphs than will fit on the preceding page, affix the additicnal photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "L2ft Side View." When applicable, photegraphs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. ►��nio �r�� Phoro One Photo One Caption N/A � �? � i � 3 'art :� e: ?�otu T.,vo Phoro Two Caotiun Nr'A FEti1.4 Form Or3^o-0-33 (7%15j Raplac�s all previous editions F�rm Page 6 of o BUILDiNG PHOTOGRAPHS oN�s No is�o-ccca ELEVATION CERTIFICATE Sae Irstr,:c',iens fcr Item Ac Expiraticr Da±e: Ncvemcer 3G, 2G'3 iMPORTANT: in these spaces, copy the corresponding information from Secticn A. FOR INSURANCE CC��1P,�i�iY USE Buildir,g Str2et Addr�ss (including Aot., Urit. Suite. ardior B;cg �Ic ) or P 0 Routa ard oox No. Pclicy Numoer 964 ELDORAGO DRlVE City Stat� ZIP Ccde Comparn� tiAiC N�.m�er CLEAR!�iATF;� Florida 33757 If using the Elevaticn C2r'ifica�e tc ebtain NFiP flood ir,surance, affix at least 2 building photcgrapns belcw according tc the instructiors for Item Ao. Idertif�j all photc�raphs with date taken; "Frcnt View" ard "Rear View"; ard, if reGuir�d, "Right Side Vievv" ard "Left Side View." Wher applicaoie photegraphs must shew the foundaticn with representative examples of the flcod openings or ver,ts as �r,dicai�d in Sac^cr Aa. 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