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L. I <br />40 <br />hazard Mitigation [grant Program Shelter Projects Only Benefit Cost Data CnllecElon Form <br />A. Project Informalion <br />Complete <br />A separate worksheet is required for each stmcturc βœ“ yes β€” no <br />Photographs of all elements of the building to be retrofitted yes J no <br />Engineer's certification for level of protection proposed β€”yes. no <br />Attach completed LRDM `rabic and Survey Checklist J yes no <br />B. Building Data <br />Select Building Type (Before Mitigation) <br />Lightly Engineered <br />Fully Engineered J <br />Building Site (Miles Inland) 3.5 <br />Number of Stories above Grade 1 <br />Construction Date 1987 <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 Pducalian. <br />Total floor area 55.926 (sf) <br />Area occupied by owner or PubliclNan-profit Agencies 55 926 (st) <br />For the following, enter the square <br />feet for the applicable <br />Building <br />Existing (SF) <br />Area to be used <br />Proposed (SF) <br />Critical Facifity <br />0 <br />24,500 <br />4600 <br />24,500 <br />Host Shelter <br />4600 <br />Hurricane Evacuation Shelter (HES) <br />0 <br />Primary Host Shelter <br />0 <br />4600 <br />24,500 <br />– Recovery Shelter <br />4600 <br />Refuge <br />0 <br />24,500 <br />Risk Shelter <br />0 <br />24,500 <br />Secondary Hast Shelter <br />NIA <br />NIA <br />Other (attach explanation) <br />D. Building Value <br />Building Replacement Value $1 million <br />Page 14 of 15 <br />