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7-5-035:012
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4/1/2015 8:49:46 AM
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Date
4/10/2008
Type
Elevation Certificate
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IMPORTANT: In these spaces, coov the correspondina Information from Section A. I For Insurance Company Use: 1 <br />llua <br />�y both sides of this Elevation Certificate for (1) community official, (2) Insurance agent/company, and (3) building owner. <br />......... Lowest Electrical bottom of water heater in garage. Bottom of lowest horizontal structural <br />member not accessible due to the nature of the below ground portion of the structure (see photos). <br />April 10, 2008 <br />SECTION E - BUILDING ELEVATIONVLJFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) <br />For Zones AO and A (without BFE), complete Items El -E5. If the Certificate is Intended to support a LOMA or LOMB -F request, complete Sections A, B, <br />and C. For Items Et -E4, use natural grade, if available. Cherie the measurement used. In Puerto Rico only, enter meters. <br />E1. Provide elevation Information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent <br />grade (HAG) and the lowest adjacent grade (LAG). <br />a) Top of bottom floor (including basement, crawl space, or enclosure) is _ _ ❑ feet ❑ meters ❑ above or B below the HAG. <br />b) Top of bottom floor (including basement, crawl space, or enclosure) is _ ❑ feet ❑ meters ❑ above or below the LAG. <br />E2, For Building Diagrams 6-8 with permanent flood openings provided in Sectlq3.A Items 8d/or 9 (see page 8 of Instructions), the next higher floor <br />(elevation C2.b in the diagrams) of the building is _ [:]feet LJ meters i above or (_J below the HAG. <br />E3. Attached garage (top of slab) is _ ❑ feet ❑ motors ❑ above or ❑ below the HAG. <br />E4. Top of platform of machinery and/or equipment servicing the building B _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. <br />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 <br />ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. <br />SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION <br />The property owner or ownees authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -Issued or community -issued BFE) <br />or Zone AO must sign here. The statements in Sections A, A and E are correct to the best of my knowledge. <br />or Owner's Authorized Representative's Name <br />kry <br />Signature Date Telephone <br />or <br />and G of this Elevation Certificate. <br />G- <br />rrdinance to administer the community's Floodplain management ordinance can complete Si <br />the applicable item(s) and sign below. Check the measurement used in Items G8. and G9. <br />Gt. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who <br />is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) <br />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. <br />G3. ❑ The following Information (Items G4.-Gg.) is provided for community floodplain management purposes. <br />G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued <br />G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement <br />G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters (PR) Datum <br />G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum <br />Local Official's Name Title <br />Name <br />Signature <br />Telephone <br />❑ Check here if attachments <br />FEMA Form 81-31, February 2006 Replaces all previous editions <br />
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