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7-5-005:096
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Last modified
4/1/2015 8:48:12 AM
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4/8/2014 10:58:42 AM
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Document Description
Date
12/17/2008
Type
Elevation Certificate
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Building Street Address (Including Apt., unit, sues, arrow unog. no.r or r.v. Koure dna eoa no. roacy rnumwr <br />75.5572 Kona Bay Drive p98 - <br />CiyKailueKonw State Hawaii ZIP Code 96740,. - ..__ .Company NAIC'Number ",... <br />SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) <br />both sides of MIs <br />wenliftomparily, and (3) building owner - <br />SECTION E - BDILDING ELEVATION INFORMATION (SURVEY'NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT: BFE) <br />For Zones AO ane A (wplwlR BFE), oanpbte hens EI�E& a the CerBRcata is knternded to supporta LOAM orLOMR-F request; con I' SectIM A B, <br />and C. For Werra EVE4, use natural grade, If available. Check the measurement used. in Puerto Rioo only, erdwmeters- A� . <br />Et. Provide elevation Information ler the ban * and, the appropriate boxes to show whetlner the elevation is above or below the IQ' aoicerd <br />grade (HAG) and the lowest akgeceN grade &A% ,.. ... <br />a) Tap. of bottom floor (including, basement crawl space, w enclosure) Is_._ ❑ feet [I meters [3 above or ❑ below the HAG. <br />b) Top of bottom floor (including basement, crawl space, or enclosure). is — ❑ feet ❑ meters ❑'above or ❑ below On LAG. <br />E2. For Building Diagrams 8-b with permanent flood openings provided In Section A home 6 andfor 9 (see��9ee 8 of Instructions), the next higher flow <br />(elevation C2.b In the diagrams) of the building is _._ ❑ feet ❑ meters ❑ above or [3 below the HAG, <br />E3. Attached garage (top of slob) Is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. ... <br />E4. Top of platform of _ the HAG. <br />ES. ZoneAD M Ono �deahNo � Dern available <br />Is the top of to must ottom thisor elevated <br />in <br />n8ection G. community's floodplain management <br />ordin <br />SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION <br />The property owner or owner's authorized representative who co npletes Sedlare A B. and E for Zone A (without a FE11110"nued or communfly-Iesued SFE) <br />or Zone AO must sign here. The statements in SecUansA, 8, and E am conect6o the bed of my knowledge. _ <br />Property Owner's or Owners Audmxtwd Represenleevds Nana <br />._._ City State mcode <br />Signature Dale Telephone <br />SECTION G - COMMUNITY INFORMATION (OPTIONAL) <br />The local official who to authorized by law or ordinance to admkdster the corrarak We 0 it I in management ordhmnos can complete Sections A, B. C (w E), <br />and G of this Elevation Certificate. Complete the appIkable hern(e) and sign below. Check the mesaraemera used In NO s G8. and 09. - <br />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 <br />is authorized by law to certify ebvollon information. (Indicate the source and data of the elevation date in the Commends area below.) <br />G2. ❑ A community official completed Section E for a building located In Zane A (withouta FEMA -issued or community -Issued SFE) or Zone AO. <br />G3. ❑ The following Information (hems G4. -G9.) is provided for community floodplain management purposes.. <br />I I I I <br />G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement <br />G8. Elevation of as -built lowest floor (including basement) of Me,buBding: _ _ -0 feet ❑ meters (PR) Datum <br />G9. BFE or (in Zone AO) depth °fA Qt�n�NFub1,C Wends-'— []too ❑ meters (PR) Datum _ <br />vity,Name <br />a <br />>le .. <br />FEMA Form 81-31, February 2006 Replaces all previous <br />
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