Loading...
1018 SUNNYDALE DRU.S. DEPARTNFENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY Nationat FloodlnsuranceProgram Important: Read the instructions on pages 1-9. 245452 SECTlON A- PROPERTY INFORMATION A1. Building Owners Name RASHID ABBASHER AND EIMAN NOUR A2. Buiiding Street Address (inciuding Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. 1018 SUNNYDALE DRIVE City CLEARWATER State Fl ZIP Code 33755 A3. Property Description (Lot and Biock Numbers, Tax Parcel Number, Legai Description, etc.) OMB No. 1660-0008 Expiration Date: July 31, 2015 FOR INSURANCE COMPANY USE Policy Number. Company NAIC Number. A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENT(AL A5. Latitude/Longitude: Lat 27°59'30.Q4"N Long. 82°47'38.41"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 1A A8. For a building with a crawispace or enclosure(s}: A9. For a building with an attached garage_ a) Square footage of aawlspace or enclosure(s) WA sq ft a) Square footage of attached garage 200 sq ft b) Number of permanent flood openings in the cxawlspace b) fVumber of permanent flood openings in the attached garage or enciosure(s) within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings i� A9.b 0 sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP CommunRy Name & Community Number 62. County Name 63. State 125096 PINELLAS COUNTY PINELIAS Ftorida B4. Map/Panei Number B5. Suffix B6. F(RM Index Date 67. FIRM Panei B8. Flood B9. Base Fiood Elevation(s) (Zone 12103C0106 H 5/17/2005 Effedive/Revised Date Zone(s} AO, use base flood depth) 5/17/2005 AE (NAVD88) 11 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FtS Profile � FIRM ❑ Community Determined ❑ Oti�erlSource: B11. Indicate elevation datum used for BFE in item B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: Bi2. is the building Iocated in a Coastai Barrier Resources System (CBRS) area or Othetwise Protected Area (OPA)? ❑ Yes � No Designation Date: ❑ CBRS ❑ OPA SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Buiiding Under Consiruction' � Finished Construction `A new Elevation Certificate wiil be required when construction of the building is complete. C2. Eievations - Zones A1-A30, AE, AH, A(with BFE), VE, V1-V30, V(with BFE), AR, AR/A, AR/AE, AR/A1-A30, ARlAH, AR/AO. Complete items C2.a-h below acxording to the 6uilding diagram specifled in Item A7. In Puerto Rico oniy, entsr meters. Benchmark Utilized: EED04VSE Verticai Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h} below. ❑ NGVD 1929 � NAVD 1988 ❑ OtheNSource: Datum used for buiiding elevations must be the same as that used for the BFE. a) Top of bottom floor (including basement, crawispace, or enGosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones oniy) d) Attached garage (top of stab) e) Lowest elevation of machinery or equipment serviang the buiiding {Describe type of equipment and location in Commerrts) � Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to buiiding (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, inciuding structurai support 7_9 N/A N/A 7.5 7.9 7_2 7_8 N!A Check the measurement used. � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a iand surveyor, enctineer. or architect authorized bv law to certrtv PiP�ar��r, rcmH roRn ucsn-u-S;s (I/�[} See reverse side for continuafion. Replaces ali previous editions. lMPORTANT: In these spaces, copy the corresponding information from Section A. Buiiding Street Address (inciuding Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1018 SUNNYDALE DRIVE City CLEARWATER State FL ZIP Code 33755 FOR INSURANCE COMPANY USE Policy Number: _ Company NAIC Number. SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation CeRificate for (1) community official, (2) insurance agenUcompany, and (3) building owner. Comments GARAGE SQUARE FOOTAGE IS ROUNDED TO THE NEAREST 100 SQUARE FEET. ACCESS UNAVAIlABIE. ELEVATIONS IN SECTION C2-E ARE ELEVATIONS OF A/C SLAB. Signature � Date 12/17/20i5 SECTION E- BUILDiNG EIEVATION 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 availabie. Chedc the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for tfie foilowing 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, crawispace, or enciosure) is ❑ feet ❑ meters ❑ above o� 0 below the HAG. b) Top of bottom floor (including basement, crawfspace, or enclasure} is __ ❑ feet ❑ meters ❑ above or ❑ below the tAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages �9 of instructions), the neM higher floor (eievation C2.b in the diagrams) of the building is _❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of siab) is __ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of piatfortn of machinery and/or equipment servicing the building is __❑ feet ❑ meters ❑ above or � below the HAG. E5. Zone AO oniy: lf no flood depth number is avaitable, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local officiai 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 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's or Owners Authorized Represerrtative's Name Address Signature Comments City Date State ZIP Code Telephone fl Check here 'rf attachments. SECTION G - COMMUNITY INFORMATION (OPTIONAL) The locai official who is authorized by law or ordinance to administer the community's floodpiain management ordinance can cor of this Elevation Certificate. Complete the applicable item(s) and sign beiow. Check the measurement used in Items GS-G10. In G1. ❑ G2. ❑ G3. ❑ �ections A, B, C(or E), a Rico oniy, enter meters. 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 eleva6on information. (indicate the source and date of the elevation data in the Comments area below.) A community official compteted Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE) or Zone AO. The following information (Items G4-G10) is provided for community floodpiain management purposes. G4. Permit Number G5. Date Permit issued G6. Date Certificate Of Compiiance/Occupancy fssued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-buiit bwest floor (including basement) of the buiiding: __ ❑ feet G9. 8FE or (in Zone AO) depth of flooding at the building site: G10. Community's design flood elevation: Loca! Official's Name Community Name Signature Comments _ _ ❑ feet _ _ ❑ feet Title Telephone Date ❑ meters Datum ❑ meters Daium ❑ meters Datum ❑ Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces al! previous edi6ons. ELEVATION CERTIFICATE, page 3 guilding Photographs See Instructions for item A6. (245452) IMPORTANT: in these spaces, copy the corresponding information from Section A. Buiiding Street Address (including Apt., Unit, Suite, and/or Bldg. No.} or P.O. Route and Box No. 1018 SUNNYDALE DRIVE City CLEARWATER State FL ZIP Code 33755 FOR INSURANCE COMPANY USE . Policy Numbec 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 VierY' and "Rear Viev�i; and, if required, "Right Side Viev✓' 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 mare photographs than will fit on this page, use the Continuation Page. ������5 � ���� ; �' �* : '��`�� `�� ��,�> . r �- ,ry't ,+ '"�F ��7'�,f�4 . . � � � 'C '�' �-Y"' =�"S ' - .,, � � S: f '�1 w!� n1T^'� .�.� . FRONT VIEW SIDE VIEW FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 (245452) IMPORTANT: in these Building Photographs Coniinuation Page y the corresponding information from Section A. Buiiding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1018 SUNNYDALE DRIVE City CIEARWATER State Fl ZIP Code 33755 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number, If submitting more photographs than wili fit on the preceding page, affix the additionai photographs below. Identify all photographs with: date taken; "Front View" and "Rear VieW ; and, if required, "Right Side View" and "Left Side View." When appiicable, photographs must show the founda6on with representative examples of the flood openings or vents, as indicated in Section A8. REAR V1EW SIDE VIEW FEMA Form 086-0-33 (7/12) Replaces all previous editions.