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CI <br />Hsrard 1ltirlgation Grant Program Shelter Projects Only Renetit Cost Data Collection form <br />A. Project Information <br />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 T yes J no <br />Attach completed LRDNI 'cable and Survey Checklist ,/ ycs no <br />B. Building Data <br />Select Building Type (Before Mitigation) <br />Lightly Engineered <br />Fully Engineered J <br />Building Site (Miles Inland) 4 <br />Number of Stories above Grade 1 <br />Construction Date 1981 <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 04.887" (sf) <br />Area occupied by owner or PubliclNon-profit Agenctes - 64.887 (sf) <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 Facility <br />0 <br />J 1,800 <br />4,560 <br />Host Shelter <br />4„560 <br />Hurricane Evacuation Shelter (HES) <br />0 <br />1,800 <br />Primary Host Shelter <br />0 <br />1,800 <br />Recovery Shelter <br />_ 4,860 <br />4,660 <br />Refuge <br />0 <br />1,800 <br />Risk Shelter <br />- 0 <br />1,800 <br />Secondary Host Shelter <br />N/A <br />NIA <br />Other (attach explanation) <br />D. Building Value <br />Building Replacement Value $1 million <br />Page 14 of 15 <br />