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IMPORTANT: In these spaces, copy the corresponding Information from Section A. ,F,o�;lnel rance`Compan� Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. rP,�bllcv Nu be .dA".1 HILO —1. HI 96720 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIF Copy both sides of this Elevation Certificate for (1) community official, (2) Insurance agent/company, and (3) building owner. C2.e. Water heater inside water heater room attached to carport 02/22/11 SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REOUIREDI FOR ZONE AO AND ZONE A (WITHOUT BFEI 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. E1. Provide elevetlon 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, crawispace, 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. E2. For Building Diagrams 6-9 with permanent flood openings provided In SectigpJl Items 8 gp,�/or 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b In the diagrams) of the building Is _ ❑feet LI meters �J above or LJ below the HAG. E3. Attached garage (top of slab) Is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building Is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number Is available, Is the top of the bottom floor elevated In accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑Unknown. The Ipcal offipial must certify this Information In Section G,. OWNER'S The property owner or owner's 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. - Owner's or Owner's Authorized Representative's Name ,Address City State ZIP Code relephone SECTION G - I ne local official who Is authorized by law or ordinance to administer the community's floodplain management ordinance can complete £ and G of this Elevation Certificate. Complete the applicable Item(s) and sign below. Check the measurement used in Items G8 and G9. 01. ❑ The Information In Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who Is authorized bylaw to certify elevation Information. (indicate the source and Clete of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located In Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. G3. ❑ The following Information (Items G4 -G9) is provided for community floodplain management purposes. G4. Permit Number I G5. Date Permit Issued I G6. Date Certlflcate Of ComDliance/Occuoanov Issued G7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building G9. BFE or (in Zone AO) depth of flooding at the building site G10. Community's design flood elevation wcai Vmcial s Name Engi e67ll;fp Division has reviewed Iits Name Signature tL'c"m'tt"r"' Date [] doe -.s ricT recommend Comments final ar-proyal .. 1 "Mm FEMA Form 81-31, ❑ feet ❑ meters (PR) ❑ feet ❑ meters (PR) ❑ feet ❑ meters (PR) Datum Datum Replaces all previous editions