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1520 FLOURNOY CIR, 18573 US HWY 19 NU.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION Important: Follow the Copy all pages of this Elevation Certificate and all attachments for (1) SECTION A — PROPERTY INFORMA' Al. Building Owner's Name FDC CLEARWATER PSE, LLC A2. Building Street Address (including Apt., Unit, Suite, and/or Bk Box No. 18573 U.S. HIGHWAY 19 NORTH City CLEARWATER A3. Property Description (Lot and Block Numbers, Tax Parcel Nui VUE AT BELLEAIR BUILDING 5 "REVISED" PLANS RECEIVED BY, TV. JAN 0 5 2018 PLANNING & DEVELOPMENT CITY OF CLEARWATER 1520 FLOURNOY CIR BCP2016-07636D RTC VUE AT BELLEAIR Zoning: Commercial asv e* Atlas #: 318A amber 30, 2018 building owner. OMPANY USE ber: A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27°56'26.64"N Long. 82'43'39.29'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 crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) N/A sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b N/A sq in d) Engineered flood openings? ❑ Yes Z No A9. For a building with an attached garage: a) Square footage of attached garage N/A 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/A sq in d) Engineered flood openings? ❑ Yes 0 No N/A 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 12103C0128 B5. Suffix B6. FIRM Index Date 09-18-2009 B7. FIRM Panel Effective/ Revised Date 09-03-2003 B8. Flood Zone(s) AE B9. Base Flood E evation(s) (Zone AO, use Base Flood Depth) B10. 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 B9: ❑ NGVD 1929 © NAVD 1988 0 Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes 0 No Designation Date: N/A ❑ CBRS ❑ OPA FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATEExpiration Date: November 30, 2018 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.Policy 18573 U.S. HIGHWAY 19 NORTH Number: City State ZIP Code CLEARWATER Florida 33764 Company NAIC Number SECTION C—BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) GI. Building elevations are based on: Construction Drawings* Buliding Under Construction* fl Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations — Zones A1—A30, AE, AH, VE, V1—V30, F ARA\E.AR/A1+43O.ARYAH.AR/AD. Complete Items C2.a—h below according to the building diagram spedfied in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: B-14 CLEARWATER Vertical Datum: 1988 Indicate elevation datum used for the elevations in items a) through h) below 0 NGVD 1929 21 NAVD 1988 0Other/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, ar enclosure floor) 10.70 0 feet 0 meters b) Top of the next higher floor N/A Fl feet D meters c) Bottom of the Iowest horizontal structural member (V Zones only) N/A D feet 0metero d) Attached garage (top of slab) N/A 0 feet 0metem e) Lowest elevation of machinery or equipment servicing the building 4.68 El Flm�eno �~ �� (Daophbetypecfequ|pmandond|omebnninCommenb$ f) Lowest a�next10 ��feet [�meters enent(�niohad)gnodetobui|ding(LAG) 'OO ���� g) Highest adjacent (finished) grade next to building (HAG) 10.50 E feet [l meters h) Lowest adjacent grade at Iowest elevationof deck or stairs, includingstructural support N/A 0 feet 0 meters SECTION D—SURVEYOR.ENGUNEER,OR ARCHITECT CERTIFICATION This rhfioat is to be signed and sealed by a landengineer, o architectauthorizedelevationinhonnabon. I certify that the information this represents ' best efforts to interpret the data avallable, / 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? El Yes 0 No 0 Check here if attathments. Certifier's Name License Number DAN H. RIZZUTO 522/ ^ ofte9tIti.o *" :� :�� ��Qr �r ~ »wwo**v°~ Title LAND SURVEYOR Company Name ` POLARIS ASSOC�TEG.INC. + Address -+ 2165 SUNNYDALE BOULEVARD City State ZIP Code CLEARWA Florida33765.m-mw�r' Signature Date Telephone Ext. 11'03-2017 (727) 401-6118 . official, ��all �g-�� ~ �� ~ e �� Oa������oU�m attachments��i�umn�o�����.o�(8��i���r. Comments (including type of equipmenand location, per C2(e).if applicable) 1. SURVEY MAP AND REPORT OR THE COPIES THEREOF ARE NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. ADDITIONS OR DELETIONS TO SURVEY MAPS OR REPORTS BY OTHER THAN THE SIGNING PARTY OR PARTIES IS PROHIBITED. 2. POLARIS JOB #4552 3. C2e IS ELEVATOR SUMP ELEVATION = 4.68 ELEVATOR = 6.67 4. AIR CONDITIONING PADS HAVE NOT BEEN CONSTRUCTED AND WHEN CONSTRUCTED WILL BE ABOVE GRADE 9.0 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 • 1-np.n auviI val.c. I UVe111Uer JU, ZU10 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. 18573 U.S. HIGHWAY 19 NORTH Policy Number: City State ZIP Code CLEARWATER Florida 33764 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 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. El. 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. 9 (see pages 1-2 of Instructions), ❑ above or ❑ below the HAG. ❑ above or ❑ below the HAG. ❑ above or ❑ below the HAG. with the community's this information in Section G. 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 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 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 ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 ExpraUunDate: November 3l2O18 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. 18573 U.S. HIGHWAY 19 NORTH Policy Number: City State ZIP Code CLEARWATER Florida 33764 Company NAIC Number SECTION G — COMMUNITY INFORMATION (OPTIONAL) 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 only, enter meters. 81. Fl The information in Section C was taken from other documentation that has been signed and sealed byolicensed 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. D A community official completed Section E for a budding located in Zone A (without a FEMA -issued or community -issued BFE) nrZone AO. GD. D The following information (Items G4—G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued GG. Date Certificate of Compliance/Occupancy Issued G7. This perrnit has been issued for: 0 G8 Elevation��ae-bui|�|uwoo�Ooor<indud/ngboaemon� �El G9. BFE or (in Zone A0) depth of flooding at 810. Community's design fiood elevation: New Construction Substantial Improvement �~ 0 feet El feet [� meters Datum ^~ the building site: D meters Datum [] meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) 0 Check here if attachments. FEMA Form O86-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS See Instructions for Item A6. OMB No. 1660-0008 Expiration Date: November 30. 201 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. 18573 U.S. HIGHWAY 19 NORTH Policy Number City State ZIP Code CLEARWATER Florida 33764 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 FRONT VIEW (EAST) Photo One Photo Two Photo Two Caption RIGHT SIDE (NORTH) qearPttoTwo FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS Continuation Page OMB No, 1660-0008 Expiration Date: Novem 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. 18573 U.S. HIGHWAY 19 NORTH Policy Number: City State ZIP Code CLEARWATER Florida 33764 Company NAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. 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. Photo Three Photo Three Caption REAR VIEW (WEST) Clear Photo "flume Photo Four Photo Four Caption REAR VIEW (WEST) clearPhotoff�ur FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6