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OMB No. 1660-0008 <br /> ELEVATION CERTIFICATE Expiration Date: November 30,2018 <br /> IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE <br /> Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Policy Number: <br /> �6165 9th avenue <br /> City State ZIP Code Company NAIC Number <br /> Zephyhills Florida 33542 <br /> SECTION C—BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) <br /> C1. Building elevations are based on: ❑ Construction Drawings* ❑x Building Under Construction* ❑ Finished Construction <br /> *A new Elevation Certificate will be required when construction of the building is complete. <br /> C2. Elevations—Zones Al—A30,AE,AH,A(with BFE),VE,V1—V30,V(with BFE),AR,ARIA,AR/AE,AR/A1—A30,AR/AH,AR/AO. <br /> Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only,enter meters. <br /> Benchmark Utilized: N.G.S. AL6442 Vertical Datum: NAVD 1988 <br /> Indicate elevation datum used for the elevations in items a)through h)below. <br /> ❑ NGVD 1929 0 NAVD 1988 ❑ Other/Source: <br /> Datum used for building elevations must be the same as that used for the BFE. <br /> Check the measurement used. <br /> a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 79 1 ❑x feet ❑ meters <br /> b) Top of the next higher floor NSA. ❑x feet ❑ meters <br /> c) Bottom of the lowest horizontal structural member(V Zones only) NSA. ❑x feet ❑meters <br /> d) Attached garage(top of slab) NSA. ❑x feet ❑ meters <br /> e) Lowest elevation of machinery or equipment servicing the building NSA. ❑x feet ❑ meters <br /> (Describe type of equipment and location in Comments) <br /> f) Lowest adjacent(finished)grade next to building(LAG) NSA ❑x feet ❑ meters <br /> g) Highest adjacent(finished)grade next to building(HAG) NSA. 0 feet ❑ meters <br /> h) Lowest adjacent grade at lowest elevation of deck or stairs, including NSA. ❑x feet ❑ meters <br /> structural support <br /> SECTION D—SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION <br /> This certification is to be signed and sealed by a land surveyor,engineer, or architect authorized by law to certify elevation information. <br /> I certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false <br /> statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. <br /> Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes ❑No x❑Check here if attachments. <br /> Certifier's Name License Number <br /> Harry B. Rogers III 6418 <br /> Title <br /> Professional Surveyor&Mapper : e )V� <br /> Company Name 6418 <br /> J s.. L <br /> Terminus Surveying LLc <br /> OF- Q'- <br /> STATE <br /> Address %��- ; ��OR1D A. 4 <br /> 2752 Jason Street <br /> City State ZIP Code � e\Q� <br /> k <br /> / ury ! <br /> Tampa Florida 33619 i I011�� <br /> Signature Date Telephone <br /> 06/19/2018 (813)681-4481 <br /> Copy all page o this EI at' Certificate and all attachments for(1)community official,(2)insurance agent/company,and(3)building owner. <br /> Comments(i uding type of equipment and location,per C2(e), if applicable) <br /> A5)Latitude and Longitude were provided by Google Earth. <br /> C2 a)Elevation taking from top of form boards. <br /> N.G.S.-National Geodetic Survey <br /> FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 2 of 6 <br />