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11 <br />!1 <br />a <br />40 <br />HIazard Mitigation Grant Program Shelter Projects Only Benefit Cost Data Collection Form <br />A. Project Information Complete <br />A separate worksheet is required for each structure ✓ yes_ no <br />Photographs of all elements of the building to be retrofitted _ yes ✓ no <br />Engineer's certification for level of protection proposed yes ✓ no <br />® <br />Attach completed LRDM Table and Survey Checklist ✓ yes _ no <br />B. Building Data <br />Select Building Type (Before Mitigation) <br />Lightly Engineered <br />Fully Engineered <br />Building Site (Miles Inland) 2 <br />Number of Stories above Grade 1 <br />Construction Date 1976 <br />Historic Building Controls <br />Disaster Number FEMA -1300 -DR -FL <br />C. Building Size and Use <br />Describe the normal day-to-day function of the facility: Public Education <br />Total floor area 125.356 (sf) <br />Area occupied by owner or Public/Non-profit Agencies 125,356 (sf) <br />For the following, enter the square feet <br />for the applicable <br />Building <br />Existing (SF) <br />Area to be used <br />Proposed (SF) <br />Critical Facility <br />0 <br />_ 17,100 <br />Host Shelter <br />15,240 <br />15,240 <br />Hurricane Evacuation Shelter (HES) <br />0 <br />17,100 <br />Primary Host Shelter <br />0 <br />17,100 <br />Recovery Shelter <br />15,240 <br />15,240 <br />Refuge <br />Risk Shelter <br />0 <br />17,100 <br />0 <br />17,100 <br />Secondary Host Shelter <br />N/A <br />_ N/A <br />Other (attach explanation) <br />-- <br />NIA <br />D. Building Value <br />Building Replacement Value $1 million <br />Page 1n of 15 <br />