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1 ELEVATION CERTIFICATE, page 2 .IMPORTANT: In these spaces, copythe coneoponding Informstlon from Section A. , • " FOR INSURANCE COMPANY USE Bulltling Street Address (Including Apt.; Unit, Suite, end/or Bldg.: No.) or P.O. Route and Box No. Pofiry Nwnber: 75-5918 A!1! Drive City State ZIP Code Compere NAIL Number Kallua Kona HI 96740 '. SECTION D SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) ` Copy both sides of this Elevation Certificate for (1) community official, (2) Insurance agent/compare, and (3) building owner_. Comments Original structure built circa 1982, Addition has Ibsen completed. Ilam Be and B9 were provided by Hawaii County Flood ' Item C2 a) is elevation of addition; Item C2 b) Is elevation of the original lowest level of main house. 2nd story of original structure Is at 20.8 feet.` Item 02 e) Lowest Electrloal,ls Air Conditioning Unit Pad on East aide of existing house. Item C2 h) The stairs are attached to the original structure. Signature Date 03/0512014 SECTION - BUILDING ELEVATI IN ATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT GFE) For Zones AO and A (without SFE); complete Ite . 1-E5. If the Certificate Is intended to support a LOW or LOMR-F request, complete Sections A, B,and C. For Items El-E4; use natural grade, If available. Check the measurement used. In Puerto Rico only, enter meters. Ei. Provide elevation Information for the following and check the appropriate boxes toshow 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, crawlspece, or enclosure) is Meet 'Q meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, orrMspace, or enclosure) Is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provldedln Section A Items 8 antl/or9 (see pages 8-9 of Instructions), the next higher Moor (elevation C2.D In the diagrams) of the building Is ❑ feet ❑ meters, ❑ above or ❑ below the HAG: E3. Attached garage (top of slab) Is ❑ fest ❑ meters ❑ above or ❑ below the HAG. FA: Top of platform of machinery and/or equipment servicing the bufrding is _ . ❑feet Q 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 communhya floodplain management ordinance? ❑ Yes , ❑ No ❑ Unknown. The local official must certify this Information In Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner ar ovner5 authorized representative who, completes Secants A, 8, and E for Zane A (without a FEMMssued orcammurrlb4ssued SM at Zone AO most sign here. The statements In Sections A. B, and E are correct to the beat of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here If attachments. SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the comm nWa floodplain management ordinance can complete Sections A, S. C (o E), and G of this Elevation Certificate. Complete the applicable items) and sign below. Check the measurement used In Items G8-G30. In Puerto Rico o* enter meters. G1. ❑ 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 by law to certify elevation Information. (Indicate the source and date 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 FEMAaseued or oonmunkylssued SFE) or Zone AD. G3. ❑ The following Information (Items G4-G9) is provided for community floodplain management purposes. Of. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-bullt lowest floor (Including basement) of the building: _ . _ ❑ feet ❑ meters Datum G9. SFE or (In Zone AO) depth of flooding at the building she: _ . ❑feet ❑ meters Datum G10. Community's deslgrl$te odeIavatlonart:mPnt of aublis �.� ❑feet ❑meters Datum UeoWeTIFa Local Offletal's Name f-erni.s.�..-„ �;. ._._ Title Community Name the Elevaticn Certificate and Telephone Date final approval By (1�K��11�t/[p '"'— �'"� ❑ Chock here If attachments. FEMA Form 088033 Q/tgate Replaces all previous editions. - _MAR 1