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imrum n Ar n : in tnese spaces, copy the corresponding information from Section A. I For Insurance Cmmnarw I I.a• 66-1723 ALANEO ST. (LOT 29) City State ZIP Ce KAMUELA HI 96743 SECTION D - SURVEYOR, ENGINEER. OR ARCHITECT CERTIFICATIn Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) building owner. ITEM C2.e - 50 GAL ELECTRIC WATER HEATER. RELIANCE 606 SERIES NOT REQUIRED) FOR ZONE AO AND For Zonas AO and A (without BFE), complete Items E1 -E5. H the Certificate Is Intended to Support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items EI -E4, use natural grade, 8 available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation 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, crawl space, or enclosure) Is _ _ ❑ feet ❑ meters ❑ above or below the HAG. b) Top of bottom floor (including basement. crawl apace, or enclosure) Is _ _ ❑ feel ❑ meters ❑ above or ® below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Sectlgo A Items 8gpQ/or 9 (see ggge 8 of Instructions), the next higher floor (elevation C2.b In the diagrams) of the building Is . _ [Ifeet LJ meters Lj above or LJ below the HAG. E3. Attached garage (top of slab) Is _ ❑ lest ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _ ❑ feet ❑ meters ❑ above or ❑ below gra HAG. E5. Zone AO only. If no flood depth number Is available, Is the top of the bottom floor elevated in accordance with the communitys 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 or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -Issued or communily-Iasued BFE) or Zone AO must sign here. The statements In Sections A. B, and E are correct to the best of my knowledge. or Signature Date Telephone Comments SECTION G - I ne iocai omuan mo is aumonzea Dy raw or ordinance to administer the community's floodplain management ordinance can complete Sections A. B, C (or E), and G of this Elevation CerBflcate. Complete the applicable Item(s) and sign below. Check the measurement used in Items G8. and G9. 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 FEMA -Issued or community -Issued BFE) or Zone AO. G3. ❑ The following Information (Hems 134,139.) Is provided for community floodplain management purposes. G4. Permit Issued I G6. Dale G7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-bulfl lowest floor (Including basement) of the building ❑ feet ❑ meters (PR) Datum G9. BFE or (in Zone AO) depTWfi4"ptK4@�hfldb§ SiNblic Work, ❑ feet ❑ meters (PR) Datum Local Official's Name Titie Name FEMA Form 81-31, February 2006 Replaces all previous editions