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IMPORTANT: In thbee spaces, copy the corresponding Information from Section A. For Insurance Company Use: BuiWBItOel Address (Including Apt., Unit, Suite, andlorBltlg. No J or P.O. Route and Box No. Policy Number :1188 KALANIANAOLE AVE City HILO Stele ZIP Code Company'NAIC Number HI 96720 SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT cclzneu ennu rcnuruo rvni both sides of this Elevation Certificate for (1) community official, (2) Insurance agenl/company, and (3) building owner. GZ..e: ELEVATION OF TWO (2) OUTLETS 6 ONE (1) LIGHT SWITCH 12/18/08 - BUILDING - - .... -• •••• • •-•• w . c r "W1 rteuuuttc0) I -OR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete items El 'E5- If the Certificate Is Intended to support a LOMA or LOMR-F request, complete Sectors A. 8, and C. For Items Et -E4, use natural gratia. If available. Check the measurement used. In Puerto Rico only, enter makers. E1: Provide elevation Information for the following and check the appropriate boxes to show whether the elevation Is above or below he highest adjacent grade (FLAG) and the lowest adjacent grade (LAG). e) Top of bottom floor (including basement, crawl spade, or enclosure) is ❑ featB meters ® above or ® below the HAG. b) Top of bottom floor (Including basement, yawl space, or enclosure) is _ ❑teat meters above or below the LAG, E2. For Building Diagrams 6-8 with permanent food openings provided In Sedlgy4 Items B or 9 (see e 8 of Instructions), the next higher floor (elevation C2b In the diagrams) of the building is ❑teal LJ meters �ebove or LJ below he HAG. E3. Attached garage (top of slab) Is _ ❑ feet ❑ meters ❑ above or ❑ below the FLAG. E4. Top of platform of machinery and/or equipment servicing the building Is "_ ❑ feet ❑ meters ❑ above or ❑ below the WIG. E8, 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? [I Yes ❑ No ❑ Unknown. The local official must cer ft this information In Section G. -PROPERTY The property owner or owners authorized representative who completes Sections A, B, end E for Zone A (without a FEMA4saued or community -Issued BFE) or Zone AO must sign here. The statements In Sections A, B, and E are corre& to the best of_ knowledpa. ,Address City. State. ZIP Code Comments SECTION G -COMMUNITY INFORMATION (OPTIO AL) The local otficial who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, S. C (or E), and G of this Elevation Certificate. Complete the appllcable Item(s) and sign below. Check the measurement used in Items G8. end G9. G1. ❑ The Information In Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or erchitecl 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 FEMA4ssuad or community -Issued BFE) or Zone AO. G3. ❑ The following Information (Items G4.-Gg.) is provided for community floodplain management purposes. G4. Permit Number G6. Date Permit issued. -- G7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (Including basement) of the building: feet motors (PR) Datum G9. BFE or (in Zona AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum Local ORcal's Name Title Community Name Telephone Signature Date Comments FEMA Forth 81-31, February 2006 Replaces all previous editions