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1260 ENGMAN ST BLDG CFEB 2 3 2017 PLANNING & DEVELOPMENT DEPT CITY OF CLEARWATER 1260 ENGMAN ST, BLDG BCP2017-01073 ELEVATION CERT -IEP BATY VILLAS (BUILDING A) !oning: Commercial Atlas #: 269B ' U.S. DEPARTMENT OF HOMELAND SECIJRITY Federal EmManagement Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instrucUons on pages 1-9. OMB No. 1660-0008 Expiration Date: November 30, 2018 Co all a es of this Elevation Certificate and alt attachments for (1) community officiat, (2) insurance agent/company, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Bullding Owner's Name EVERYBODYS TABERNACLE INC Policy Number: A2. Building Street Address (including Apt. Unit, Suite, andlor Bldg. No]orp.D.Route and Box No. 1260 ENGMAN STREET, BUILDING C 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 teast A7. Building Diagram A8. For obuilding a) Square footage b) Number of c) Total net area d) Engineered A9. For a building with a) Square footage b) Number of c) Total net area d) Engineered Ranidenda|, Non -Residential, Addition, Accessory, etc.) Lat. 27D5B'40^N Long. 82D47'08''VV RESIDENTIAL Horizontal Datum: obtain flood insuran�. 1.0 foot above adjacent above adjacent grade FlNAD 1S27 grade 0NAD 1S83 10 2 photographs of the buliding if the Number 8 Certificate is being used to 3,814 sq ft with oc,mwnpaoeorandoounn(m): of crawlspace permanent flood of fiood openings flood openings? an attathed of attached permanent flood of fiood openings flood openings? or enclosure(s) openings in the crawlspace in A8.b 4.997 sq or endosure(s) within in sq ft within 1.0 foot sq in ID Yes []No garage: garage openings in the attached garage in A9.b FlYes []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.KAap/Pano| Number 12103C0108 B5. Suffix H 86. FIRM Index Date 09/03/2003 B7. F RM Panel Effective/ Revised Date 05/17/2005 88.Flood Zonm(s) AE B9, Base Flood Elevatiori(s) (Zone AO, use Base Flood Depth) 10 B10. lndicate the source F� FIS Profile 811. lndicate elevation B12. Is the building Designation Date: of the Base Flood Elevation (BFE) 0 FIRM Fl Community Determined datum used for BFE in Item B9: located in a Coastal Barrier Resources Fl CBRG data [] 0NGVD1929 System or base fiood depth entered in ttem B9: Other/Source: nN/A/D1g88 [] Other/Source: (CBRS) area or Otherwise Protected 0 OPA Area (OPA)? Yes 0 N FEMA Form 086-0-3 (7/ 5) Replaces alt previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No1660'0008 Expiration Date: : Nov r IMPORTANT: In these spaces, copy the corresponding information from Section A. • , FOR INSURANCE COMPANY USE Building Street Address yn�udingA�Unit, �.8ude.an�No.) Route orB|�g�urP�O�ondBoxNu 1260 ENGMAN STREET, BUILDING C Policy c9Numbe City State ZIP Code CLEARWATER Florida 33755 Company NAIC Number SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 0 Construction Drawings* 0Building 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 BFEAR, AR/AE.AR/A1+A3V.AR/AM.4RAAO, 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 enter meters. Indicate elevation datum used for the elevations in items a) through h) below. 0 NGVD 1929 0N4VD1988 Other/Source: Datum used for building elevations must be the same as that used for the BFE, Check a) Top of bottom ftoor (including basement, crawlspace, or enclosure Boor) 11 59 x the measurement used. feet meters b) Top of the next higher fioor 21 30 0 feet Fl meters c) Bottom of the lowest honzontal structural member (V Zones only) 0 feet meters d) Attached garage (top of stab) 0 feet Flmetero e) Lowest elovation of machinery or equipment servicingthe building 10 3 0feet Flmeters (Deochbatype cfequipment and /ncmUoninComme�s)^~ f) Lowest adjacent (finished) grado next to building (LAG) 8.4 0 feet El meters g) Highest adjacent (fintshed) grade next to bultding (HAG) 8.7 0 feet [] meters h) Lowest adjacent grade Lowest adjacent grade at Iowest etevation of deck or stairs, including 8.8 0 feet [] meters structural support SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This rUfib is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certi elevationinoonnotinn. ' certify that the information on Thisuertncate represents my best efforts to interpret the data available/ungers and that any false statement may be punishable by fine or impnsonment under 18 U. S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? CI Yes 0 No ['Checkattachments. honoif — ,'I' Certifiers Name License Number JOHN J. BELAND 7004 '~ ^ ^v////'' ." � . -7 "" - �Q� � ' ' �'.� � ,,•'.,,','; ..7 �y ` -,^,.~�+' `` *^��- �{e,,�� pr •.-''',` �" '''/''``'` Title PROJECT MANAGER Company Name SUNCOAST LAND SURVEYING . Address 111FOREST LAKES BLVD. City State ZIP Code OLDSMAR Florida 34677 Signature Date Telephone 09/22/206 (813) 854-1342 Copy all pmgasiof8`/ Elz ,ation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (indudin.,' pe of equipment and location, per C2(e), if applicable) NC UNIT ON WO PLATFORM ON NORTH SIDE OF BUILDING. THERE ARE ALSO VENT UNITS AT GRADE LEVEL ON FOUR CORNERS OF BUILDING TO VENT AIR IN CRAWL SPAGE. FEMA Form 086-0-3 (7/15) Replaces alt previous editions. Fo 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, ancVor Bldg. No.) or P.O. Route and Box No. 1260 ENGMAN STREET, BUILDING C 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. [3above 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 0 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 0 feet 0 meters E4. Top of platform of machinery and/or equipment servicing the building is 0 feet 0 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 No 0 Unknown. The local official must 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 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 BUILDING PHOTOGRAPHS ELEVATION CERTIFICATE 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 C Policy Number: City CLEARWATER State Florida ZIP Code 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. Photo One Photo One Caption LOOKING SOUTHWEST Photo Two Caption LOOKING EAST FEMA 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 C 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 with 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 27D58'46" N Long. 82D47'06" Accessory, etc.) RESIDENTIAL W Horizontal Datum: D obtain flood insurance. 1.0 foot above adjacent above adjacent grade NAD 1927 grade x NAD 1983 10 2 photographs of the building if the Certificate Number 8 is being used to 3,814 sq ft a crawlspace of crawlspace flood of flood openings flood openings? an attached of attached flood of flood openings flood openings? or enclosure(s): or enclosure(s) openings in the crawlspace in A8.b 4,997 sq or enclosure(s) within in ft within 1.0 foot sq in 0 Yes 0 No garage: garage sq openings in the attached garage in A9.b 0 Yes 0 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 0 FIS Profile 1311. Indicate elevation B12. Is the building Designation Date: of the Base Flood Elevation (BFE) 0 FIRM 0 Community Determined datum used for BFE in Item B9: located in a Coastal Barrier Resources 0 CBRS data 0 NGVD System or base flood depth entered in Item B9: 0 Other/Source: 1929 0 NAVD 1988 0 Other/Source: (CBRS) area or Otherwise Protected Area (OPA)? 0 OPA 0 Yes 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 C Policy Number: City State ZIP Code CLEARWATER Florida 33755 Company NAIC Number SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations *A new Elevation C2. Elevations Complete Benchmark Indicate elevation 0 Datum used a) Top of b) Top of c) Bottom d) Attached e) Lowest (Describe f) Lowest g) Highest h) Lowest structural are based on: 0 Construction Drawings* 0 Building Under Construction* 0 Finished Construction Certificate will be required when construction of the building is complete. - 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. Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Utilized: CITY OF CLEARWATER "G -0T' Vertical Datum: NAVD 88 datum used for the elevations in items a) through h) below. NGVD 1929 0 NAVD 1988 0 Other/Source: for building elevations must be the same as that used for the BFE. Check the measurement used. bottom floor (including basement, crawlspace, or enclosure floor) 11 59 0 feet 0 meters the next higher floor 21 30 Ej feet 0 meters of the lowest horizontal structural member (V Zones only) [] feet 0 meters garage (top of slab) 0 feet 0 meters elevation of machinery or equipment servicing the building 10 3 0 feet 0 meters type of equipment and location in Comments) adjacent (finished) grade next to building (LAG) 84 . 0 feet Ej meters adjacent (finished) grade next to building (HAG) 87 . 0 feet 0 meters adjacent grade at lowest elevation of deck or stairs, including 8. 8 0 feet 0 meters support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CE-RTIFICATION This 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. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? g Yes 0 No 0 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) 854-1342 Copy all pag- ofthi El; , a ion Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (includin yi pe of equipment and location, per C2(e), if applicable) , NC UNIT ON WO IA PLATFORM ON NORTH SIDE OF BUILDING. THERE ARE ALSO VENT UNITS AT GRADE LEVEL ON FOUR CORNERS OF BUILDING TO VENT AIR IN CRAWL SPACE. FEMA 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 Budding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1260 ENGMAN STREET, BUILDING C 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 D 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, crawispace, or enclosure) is 0 feet 0 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 [Jfeet 0 meters E3. Attached garage (top of slab) is 0 feet 0 meters E4. Top of platform of machinery and/or equipment servicing the building is D feet 0 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 owners 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 C 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. • *t k { • • Photo One Photo One Caption LOOKING SOUTHWEST "` .. :!' IXC ".i i.t • �(j,I f .I y ILL, ,i fluJfflfflh1liIll" 11 III tii' 1111 111.1111 ,,. }. II Two I ,�� l��li�.; Photo Photo Two Caption LOOKING EAST FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 . r 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 A1. Building Owner's Name Policy Number: EVERYBODY'S TABERNACLE INC A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number: 1260 ENGMAN STREET, BUILDING C 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., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27D58'46" N Long. 82D47'06" W 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 enGosure(s): a) Square footage of crawlspace or enGosure(s) 3,814 sq ft b) Number of permanent flood openings in the crawlspace or enGosure(s) within 1.0 foot above adjacent grade 10 c) Total net area of flood openings in A8.b 4,997 sq in d) Engineered flood openings? ❑x Yes ❑ No A9. For a building with an attached garage: a) Square footage of attached garage Sq {� b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade c) Total net area of flood openings in A9.b sq in d) Engineered flood openings? � Yes � No SECTION B— FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP Community Name & Community Number B2. County Name B3. State CITY OF CLEARWATER, 125096 PINELLAS Florida B4. Map/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) 12103C0106 H 09/03/2003 05/17/2005 AE 10 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: ❑ FIS Profile ❑x FIRM � Community Determined � OtherlSource: 611. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 � OtheNSource: 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 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 INSURAIVCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 1260 ENGMAN STREET, BUILDING C ��ty State ZIP Code Company NAIC Number CIEARWATER Florida 33755 SECTION C— BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings" � Building 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, 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: CITY OF CLEARWATER "G-07" Vertical Datum: NAVD 88 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 � NAVD 1988 � OtheNSource: 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 59 b) Top of the next higher floor 21 30 c) Bottom of the lowest horizontal structural member (V Zones only) , d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building 10 3 (Describe type of equipment and location in Comments) � fl �owest adjacent (finished) grade next to building (LAG) 8 4 g) Highest adjacent (finished) grade next to building (HAG) 8 7 h) Lowest adjacent grade at lowest elevation of deck or stairs, including 8. $ structural support Check the measurement used. ❑x feet � meters ❑x feet � meters x� feet � meters �x feet � meters �X feet � meters OX feet � meters �x feet � meters �x feet � meters SECTION D— SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This 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 inteipret the data available. l understand that any fa/se statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyoi'? ❑X Yes ❑ No ❑ Check�here if attachments. Certifier's Name JOHN J. BELAND PROJECT MANAGER c;ompany Name SUNCOAST LAND SURVEYING 111 FOREST LAKES BLVD. OLDSMAR 7004 State Florida " ��114l11�� � �'� ���at�- ,,> .� �„ � �, ', , � +` ; ^ �� ��,�.+�_���°�,.,,�'� %, - ��.! , ,�� : ; � � Q _ ., �, :�W �a � � �i ' ,i' � �= d�,� "I�re � �- ,, � � �� �`��) ''° � ;� ' �;�'t ` � �;�` �' �• : , ZIP Code �°�, � • . Pf '"'� '�. ti ;• 34677 �''+����+�' ,4 Signature Date Telephone 09/22/2016 (813) 854-1342 Copy all page of thi EI ation Certficate and all attachments for (1) community official, (2) insurance age�Ucompany, and (3) building owner. Comments (includin pe of equipment and location, per C2(e), if applicable) A/C UNIT ON WO PLATFORM ON NORTH SIDE OF BUILDING. THERE ARE ALSO VENT UNITS AT GRADE LEVEL ON FOUR CORNERS OF BUILDING TO VENT AIR IN CRAWL SPACE. 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 C City OMB No. 1660-0008 Expiration Date: November 30, 2018 FOR INSURANCE COMPANY USE Policy Number: State ZIP Code Company NAIC Number CLEARWATER Florida 33755 SECTION E— BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(1MTHOUT 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 b) Top of bottom floor (including basement, ❑ above or ❑ below the HAG. crawlspace, or enGosure) 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 Comments City Date FEMA Form 086-0-33 (7/15) Replaces all previous editions. State Telephone ZIP Code ❑ Check here if attachments. Form Page 3 of 6 BUILDING PHOTOGRAPHS ELEVATION CERTIFICATE 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 Bidg. No.) or P.O. Route and Box No. Policy Number: 1260 ENGMAN STREET, BUILDING C 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 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 � � �nq. � �' ,:t t h . ... � � � : �(��- . � .... .. � �� . � �� � i '°' .., � ji � � ��� a � � ,.. � . , , . w * Psae ` i'. w.,,� ,. . - . . , " f � � t� < � " . . 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