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1260 ENGMAN ST BLDG AU.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. OMB No. 1660-0008 Expiration Date: November 30, 2018 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name EVERYBODY'S TABERNACLE INC Policy Number: A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1260 ENGMAN STREET, BUILDING A an Com Company NAIL Number. City State ZIP Code CLEARWATER Florida 33755 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOTS 1 & 2, BLOCK A, FAIRBURN SUBDIVISION, PLAT BOOK 9, PAGE 97, PINELLAS COUNTY, FLORIDA A4. Building Use (e.g., A5. Latitude/Longitude: A6. Attach at least A7. Building Diagram A8. For a building a) Square footage b) Number of c) Total net area d) Engineered A9. For a building with a) Square footage b) Number of permanent c) Total net area d) Engineered Residential, Non -Residential, Addition, Lat 27D58'46" N Long. 82D47'06" Accessory, etc.) RESIDENTIAL W Horizontal Datum: obtain flood insurance. 1.0 foot above above adjacent adjacent grade • NAD 1927 grade x NAD 1983 10 2 photographs of the building if the Number 8 Certificate is being used to 2,502 sq ft with a crawlspace of crawlspace permanent flood of flood openings flood openings? an attached of attached flood of flood openings flood openings? or endosure(s): or endosure(s) openings in the crawlspace in A8.b 3,663 sq or endosure(s) within in sq ft within 1.0 foot sq in x Yes ❑ No garage: garage openings in the attached garage in A9.b ❑ Yes ❑ No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number CITY OF CLEARWATER, 125096 B2. County Name PINELLAS B3. State Florida B4. Map/Panel Number 12103C0106 B5. Suffix H B6. FIRM Index Date 09/03/2003 B7. F RM Panel Effective/ Revised Date 05/17/2005 B8. Flood Zone(s) AE B9. Base Flood Elevation(s) (Zone AO, use Base Flood Depth) 10 BI0. Indicate the source ❑ FIS Profile B11. Indicate elevation B12. Is the building Designation Date: of the Base Flood Elevation (BFE) ❑ Community Determined for BFE in Item B9: Coastal Barrier Resources ❑ CBRS data ❑ NGVD System or base flood depth entered in Item B9: ❑ Other/Source: x FIRM datum used located in a 1929 p NAVD 1988 • Other/Source: (CBRS) area or Otherwise Protected ❑ OPA Area (OPA)? ❑ Yes x No FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 T1 FEB 2 3 2017 1 PLANNING & DEVELOPMENT DEPT CITY OF CLEARWATER 1260 ENGMAN ST, BLD( BCP2017-01073 ELEVATION CERT -IEP BATY VILLAS (BUILDING A) ?oning: Commercial Atlas #: 269E ChPACI a ELEVATION CERTIFICATE OMB No. 1660-0008 • 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. 1260 ENGMAN STREET, BUILDING A Policy Number: City State ZIP Code CLEARWATER Florida 33755 Company NAIC Number SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under 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, AR/A, AR/AE, AR/A1-A30, Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, Benchmark Utilized: CITY OF CLEARWATER "G-07" Vertical Datum: NAVD 88 x Finished Construction AR/AH, AR/AO. enter meters. Indicate elevation datum ❑ NGVD 1929 used x for the elevations in items a) through h) below. NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 11 56 x the measurement used. feet ❑ meters b) Top of the next higher floor 21 32 x feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) IM feet • meters d) Attached garage (top of slab) p feet • meters e) Lowest elevation of machinery or equipment servicing the building 10 32 x feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 8.4 p feet • meters g) Highest adjacent (finished) grade next to building (HAG) 9. 1 p feet • meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 8.8 x feet ❑ meters structural support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect I certify that Me information on this Certificate represents my best efforts to interpret statement may be punishable by fine or imprisonment under 18 U.S. Code, Section Were latitude and longitude in Section A provided by a licensed land surveyor? x authorized by law to certify elevation information. the data available. / understand that any false 1001. Yes ❑ No ❑ Check here if attachments. Certifiers Name License Number JOHN J. BELAND 7004 Place Seal Here Title PROJECT MANAGER Company Name SUNCOAST LAND SURVEYING Address 111 FOREST LAKES BLVD. City State ZIP Code OLDSMAR Florida 34677 Signature Date Telephone 09/22/2016 (813) 8541342 Copy all pages of this I tion rtificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including pe of equipment and location, per C2(e), if applicable) NC UNIT ON WOOD PLATFORM ON SOUTH SIDE OF BUILDING. Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 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. 1260 ENGMAN STREET, BUILDING A Policy Number: City State ZIP Code CLEARWATER Florida 33755 Company NAIC Number 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 complete Sections A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is 0 feet 0 meters LOMA or LOMR-F request, used. In Puerto Rico only, the elevation is above or below 0 above or 0 below the HAG. 0 above or 0 below the LAG. 9 (see pages 1-2 of Instructions), 0 above or 0 below the HAG. 0 above or 0 below the HAG. 0 above or 0 below the HAG. with the community's certify this information in Section G. b) Top of bottom floor (including basement, crawlspace, or enclosure) is 0 feet meters meters E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or the next higher floor (elevation C2.b in the diagrams) of the building is 0 feet 0 meters E3. Attached garage (top of slab) is D feet El meters E4. Top of platform of machinery and/or equipment servicing the building is 0 feet D meters E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance floodplain management ordinance? 0 Yes 0 No 0 Unknown. The local official must 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 0 Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS See Instructions for Item A6. 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. 1260 ENGMAN STREET, BUILDING A Policy Number: City State ZIP Code CLEARWATER Florida 33755 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 View" and "Rear Vew' ; 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. _ Photo One Photo One Caption LOOKING NORTHWEST r...."''',.,..... �, Photo Two Photo Two Caption LOOKING SOUTHEAST EMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. OMB No. 1660-0008 Expiration Date: November 30, 2018 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name EVERYBODY'S TABERNACLE INC Policy Number: A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1260 ENGMAN STREET, BUILDING A Company NAIC Number: City State ZIP Code CLEARWATER Florida 33755 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOTS 1 & 2, BLOCK A, FAIRBURN SUBDIVISION, PLAT BOOK 9, PAGE 97, PINELLAS COUNTY, FLORIDA A4. Building Use (e.g., A5. Latitude/Longitude! A6. Attach at least A7. Building Diagram A8. For a building a) Square footage b) Number of permanent c) Total net area d) Engineered A9. For a building with a) Square footage b) Number of permanent c) Total net area d) Engineered Residential, Non -Residential, Addition, Lat. 271358'46" N Long. 82D47'06" Accessory, etc.) RESIDENTIAL W Horizontal Datum: obtain flood insurance. 1.0 foot above above adjacent adjacent grade • NAD 1927 grade x NAD 1983 10 2 photographs of the building if the Number 8 Certificate is being used to 2,502 sq ft with a crawlspace of crawlspace flood of flood openings flood openings? an attached of attached flood of flood openings flood openings? or enclosure(s): or endosure(s) openings in the crawlspace in A8.b 3,663 sq or endosure(s) within in sq ft within 1.0 foot sq in x Yes ❑ No garage: garage openings in the attached garage in A9.b ❑ Yes ❑ No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number CITY OF CLEARWATER, 125096 B2. County Name PINELLAS B3. State Florida B4. Map/Panel Number 12103C0106 B5. Suffix H B6. FIRM Index Date 09/03/2003 B7. FIRM Panel Effective/ Revised Date 05/17/2005 B8. Flood Zone(s) AE B9. Base Flood Elevation(s) (Zone AO, use Base Flood Depth) 10 B10. Indicate the source ❑ FIS Profile B11. Indicate elevation B12. Is the building Designation Date: of the Base Flood Elevation (BFE) ❑ Community Determined for BFE in Item B9: Coastal Barrier Resources ❑ CBRS data or base flood depth entered in Item B9: ❑ Other/Source: p FIRM datum used located in a 1988 ❑ Other/Source: or Otherwise Protected • NGVD 1929 IM NAVD System (CBRS) area ❑ OPA Area (OPA)? ❑ Yes x No FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 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. 1260 ENGMAN STREET, BUILDING A Policy Number: City State ZIP Code CLEARWATER Florida 33755 Company NAIC Number SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under 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, AR/A, AR/AE, Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Benchmark Utilized: CITY OF CLEARWATER "G-07" Vertical Datum: NAVD 88 x Finished Construction AR/A1—A30, AR/AH, AR/AO. Rico only, enter meters. Indicate 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. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 11 56 Check the measurement used. x feet ❑ meters b) Top of the next higher floor 21 32 x feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) x feet ❑ meters d) Attached garage (top of slab) x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 10 32 x feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 8. 4 x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 9. 1 p feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 8. 8 x feet ❑ meters structural support SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by I certify that the information on this Certificate represents my best efforts to interpret the data available. statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. law to certify elevation information. I understand that any false ❑ Check here if attachments. Were latitude and longitude in Section A provided by a licensed land surveyor? x Yes ❑ No Certifiers Name License Number JOHN J. BELAND 7004 040131), ; +° >ia .... , , - .'••4c,E� , ••.,• ra %' - w • •.a'` Place a 6 v ? -' Sial. Q L Q 62 < -Af •.j - ; y0.., •3/ ,' ; '>, PRefe9 °°° 101,„,..4° Title PROJECT MANAGER Company Name SUNCOAST LAND SURVEYING Address 111 FOREST LAKES BLVD. City State ZIP Code OLDSMAR Florida 34677 Signature Date Telephone 09/22/2016 (813) 854-1342 Copy all pages of this ation ertificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including pe of equipment and location, per C2(e), if applicable) A/C UNIT ON WOOD PLATFORM ON SOUTH SIDE OF BUILDING. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration D 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. 1260 ENGMAN STREET, BUILDING A Policy Number: City State ZIP Code CLEARWATER Florida 33755 Company NAIC Number 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 complete Sections A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters LOMA or LOMR-F request, used. In Puerto Rico only, the elevation is above or below ❑ above or ❑ below the HAG. ❑ above or ❑ below the LAG. 9 (see pages 1-2 of Instructions), b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ■ above or ❑ below the HAG. ❑ above or ❑ below the HAG. ❑ above or ❑ below the HAG. with the community's this information in Section G. E3. Attached garage (top of slab) is ❑ feet ❑ meters E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify 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 ❑ Check here if attachments. rm Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS See Instructions for Item A6. 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. 1260 ENGMAN STREET, BUILDING A Policy Number: City State ZIP Code CLEARWATER Florida 33755 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 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. i l _ ( �i , , .1 .,: � llhi`i ill' 11 i J � Y . - ••- fie.. ..r. I�' _ _ .. ` �^�r., - '-._- _ .. �� _ Photo One Photo One Caption LOOKING NORTHWEST 3 � 1 t Photo Two Photo Two Caption LOOKING SOUTHEAST FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 0 U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency OMB No. 1660-0p08 National Flood Insurance Program Expiration Date: November 30, 2018 ELEVATION CERTIFICATE Important: Foliow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for f11 commun�tv �t��ai r�� M.,..o ,,.e.,.�......,......., .._� ,.,. �..:,�__ __ _ • . �i -----"-'"r �-i """--•�...... �.yv.�vw��ra�� OI�V 1J� VUIIUIIII� UWIIf."I. SECTION A— PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Building Owner's Name Policy Number: EVERYBODY'S TABERNACLE INC A2. Building Street Address (inGuding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number. 1260 ENGMAN STREET, BUILDING A City State ZIP Code CLEARWATER Florida 33755 A3. Property Description (l.ot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOTS 1& 2, BLOCK A, FAIRBURN SUBDIVISION, PLAT BOOK 9, PAGE 97, PINELLAS COUNTY, FLORIDA A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat 27D58'46" N Long. 82D47'06" W Horizo�rtal Datum: � NAD 1927 �x NAp 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 endosure(s): • a) Square foo�ge of aavvlspace or enGosure(s) 2,502 sq ft b) Number of permanerrt flood openings in the crawlspace or endosure(s) within 1.0 foot above adjacent grade 10 c) Total net area of flood openings in A8.b 3,663 sq in d) Engineered flood openings? 0 Yes ❑ No A9. For a building with an attached garage: a) Square f�tage of attached garage sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade c) Total net area of flood openirigs in A9. b sq in d) Engineered flood openings? � Yes ❑ No SECTION B— FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number 62. CouMy Name B3. State CITY OF CLEARWATER, 125096 PINELLAS Florida B4. Map/Panel 65. Suffix B6. FIRM Index 67. FIRM Panel 68. Flood Zone(s) 69. Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 12103C0106 H 09/03/2003 05l17/2005 AE 10 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69: ❑ FIS Profile �x FIRM � Community Determined � OtheNSource: B11. Indicate elevation datum used for BFE in ttem 69: ❑ NGVD 1929 0 NAVD 1988 � OtheNSouroe: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Othervvise Protected Area (OPA)? � Yes �x No Designation Date: � CBRS � OPA rcrvin runu voo-v-J.� (�� ) Kepiaces ail previous editions. Form Page 1 of 6 °.�, - ELEVATION CERTIFICATE OMB No. 1660-Oppg Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (induding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 1260 ENGMAN STREET, BUILDING A CLEARWATER State ZIP Cc Florida 33755 SECTION C— BUILDtNG ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* � Building Under Construction* �]x Finish� Construc6on 'A new Elevation Certificate will be required when construcfion of the building is complete. C2. Elevations — Zones A1—A30, AE, AH, A(with BFE), VE, V1 N30, V(with BFE), AR, AR/A, AR/AE, 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: CITY OF CLEARWATER "GOT' Vertical Datum: NAVD 88 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ❑x NAVD 1988 � OtheNSource: Datum used for building elevations must be the same as that used for the BFE. a) Top of bottom floor (inGuding basement, crawlspace, or endosure floor) b) Top of the next higher floo� c) Bottom of the lowest horizorrtal strudural member (V Zones only) d) Attached garage (top of stab) e) Lowest elevation of machinery or equipmerrt servicing the building (Desaibe type of equipmerrt and location in Commerrts) fl Lowest adjacerrt (finished) grade next to building (LAG) g) Highest adjacerrt (finished) grade next to building (HAG) h) Lowest adjacerrt grade at lowest elevation of dedc or stairs, inGuding structural support 11 56 21 32 10_ 32 8 4 9 1 8 8 Chedc the measurement used. _ x� feet ❑ meters _ Ox feet � meters - �x feet � meters _ �x feet � meters x0 feet � meters � feet ❑ meters x� teet � meters Ox feet � meters SECTION D— SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or archited authorized f�y Iaw to certity elevation information. I certify 6hat tf►e infi�nnaGian on this Certficate �ep�eserns my best efl`orts to interpret the data available_ l understand tt�at any fa/se statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. Were latitude and longitude in Sedion A provided by a licensed land surveyor'? ❑X Yes ❑ No ❑ Chedc here if attachmerrts. JOHN J. BELAND TiUe PROJECT MANAGER Company Name SUNCOAST LAND SURVEYING �� Pl�ce ; Seal ' H��e �� ; 111 FOREST LAKES BLVD. City State ZIP Code OLDSMAR Florida 34677 Signature Date Telephone 09/22/2016 (813) 854-1342 Copy all pages of this I ation ertificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including pe of equipment and location, per C2(e), if applicable) A!C UNIT ON WOOD PLATFORM ON SOUTH SIDE OF BUILDING. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (inGuding Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1260 ENGMAN STREET, BUILDING A OMB No. 1660-0008 Expiration Date: November 30, 2018 FOR INSURANCE COMPANY USE Policy Number: `'"y State ZIP Code Company NAIC Number CLEARWATER Florida 33755 SECTION E— BUILDING ELEVATION INFORAAATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(IMTHOUT 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 measuremerrt 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 (inGuding basement, crawlspace, or endosure) is . ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basemerrt, crawlspace, or enGosure) is . ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams Cr9 with permanent flood openings provided in Sec6on A Items 8 and/or 9(see pages 1 2 of Instrvctions), 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 serviang 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 acxordance 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 owners authorized representative who completes Sections A, B, and E for Zone A(without a FEMA issued or communiry-issued BFE) or Zone AO must sign here. The statements in Sedions A, B, and E are correct to the best of my knowledge. Property Ovmer or Address Comments FEMA Form 086-0-33 (7/15) Name Date Replaces all previous editions. State ZIP Code ❑ Check here if attachments. Form Page 3 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30. 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Buiiding Street Address (inGuding Apt., Unit, Suite, and/or Bldg. No.) or P.O_ Route and Box No. Policy Number: 1260 ENGMAN STREET, BUILDING A City State ZIP Code Company NAIC Number CLEARWATER Florida 33755 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 vevV" and "Rear vew"; and, if required, "Right Side Vew" and "Left Side vew." 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. - F a , £ ,, `� � �. �' a'` � �� ' ��' �'' .,5� � � I �s"M � 3'': f ) �. •� j.� l ry =i.'�4.'G�.��v -�,_`� _ Sjj{{ � � ; �� ..��+,'r"a -+v� : 4,� -.ny. �� ,�, '.■�re� �-�-• ��.� .. 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Route and Box No. Policy Number: 1260 ENGMAN STREET, BUILDING A City State ZIP Code Company NAIC Number CLEARWATER Florida 33755 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identiy 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. .. � . � . :T �:�. . . � ... i�� p . � � � :�� %�" �- ' ' , � � . �� . f ,,�.� r �� Y� F. P' t 1.� . .. T�:.; . �� 1 ��; '` 2L � . . � 'F� f. � � ''' f�� s�� , _ }t . � �. _ 1 q � ��" �> � � 0E +v` � � �� 1�IIi ..'' �;i�l l�l�'�7�'/ r� �l�, �yi j i . y?�� . „':�". 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