7-5-018:004 & 001 - Laserfiche WebLink

Home

?Copy both sides of this Elevation Certificate for (1) community of8dal, (2) Insurance agenticompany, and (3) building owner. i� Lowest Electrical is Air Conditioner pads (2) at same elevation of 12.78 a -i Thi(c71-y-oib,cx>l W4 R•1 For Zones AO and A (without SFE), complete Rome EI -E8. If the Certificate Is Intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E11-124, use natural grade, If avallable. Check the rressurementused. In Puerto Rico only, enter mature. E1. Provide elevation Information for the following and check the appropriate boxes to show whether Bre elevation Is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAO). a) Top of bottom door (Including basement, crawlepaoe, or endowre) to _ _ ❑feet ❑meters ❑above or ®below the HAG. b) Top of bottom floor (Including basement, crawipace, or enclosure) Is _ _❑teat []meters ❑above or below the LAG. E2. For Building Diagrams 8-9 with permanent flood openings prevMed�ry Sec W. Items 8 ffor 9 (ase RBpea 8.9 of Instructions), the next higher floor (elevation C2.b In the diagrams) of the building le LJ feet U meters LJ above or lJ below IM 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 bulking Is _ ❑feet ❑ meters ❑ above or ❑ below the HAG. Eli. Zone AO only: If no Rood depth number Is available, Is the lop of the bottom floor elevated In accordance with the commrmlys floodplain management ordinance? Yes ❑ No ❑ Unknown. The local oflldel must certify this Information In Section G. fdl:i•17�:�iI•I'.' :I�.l The property owner or owners authorized representative who completes Sections A, B. and E for Zone A (without a FEMA4osued or comnuadty-laeued BFE) or Zone AO must sign here. The statements M Sections A, 8, and E are correct to the best of my lmowfecige. Property Owners or Owners Authorized Repreeentefive'e Name State Comments me local OmC at veno is eulnonzec Oy law or Orolnance to administer the COmmU0lly 61100dp1aln management ordinance can complete Sections A, B, C (Or E), and G of this Elevation Certificate. Complete the applicable Rem(s) and sign below. Check the measurement used In Items GS and G9. G1. ❑ The Information in Section C was taken from other documentation that hes been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by low to certify elevation Information. (Indicate the source and date of the elevation data M the Comments area below.) G2. ❑ A community offlalal completed Section E for a building located In Zone A (without a FEMA -Issued or community -Issued BFE) or Zone AO. 133. ❑ The following Information (Items G4-09) Is provided for community floodplain management purposes. G7. This permit has been Issued for. ❑ New Construction ❑ Substantial Improvement GS. Elevation of as -built lowest floor (Including basement) of the building ❑ feet ❑ meters (PR) Datum 09. BFE or (In Zone AO) depth of flooding at the building site ❑ feat ❑ metre (PR) Datum 010. Community's design flood elevation ❑ feet ❑ meters (PR) Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑ Cheek here If attachments FEMA Form 81-31, Mar 09 Replaces all previous editions