7-2-010:004 Bridge Suite 1 - Laserfiche WebLink

Home

May-18-2009 03:51pm From-TOWILL,SHIGEOKA & ASSOC.,INC. 8085379478 T-916 P.005/007 F-861 IMPORTANT: in these spaces,copy the corresponding information from Section A. For insurance Company Use:_ Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number 72-100 Kaupulehu Drives Suite 1 (Bridge Stzlte 1) City State ZIP Code Company NAIC Number Kailua-Kona, Hawaii 96745 SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments Elevation listed in C2.e is for air conditioning i,tni,.ts within the suites. A.ril 28, 2009 Signature ell Date - ' 0 Check here if attachments SECTION E-BUILDING EL VATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BEE) For Zones AO and A(without BFE),complete Items El-Es. If the Certificate is intended to support a LOMA 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. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation Is above or below the highest adjacent grade(MAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawispace,or enclosure)is _ _ feet meters Elabove or ❑below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclosure)is ]feet [meters above or 0 below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Sectio,1LA, Items 8 and/or 9(see a es 8-9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ._D feet Li meters above or U below the HAG. E3. Attached garage(top of slab)is ; 0 feet 0 meters ©above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building ia- _ _0 feet ❑meters 0 above or 0 below the HAG. ES. 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? 0 Yes 0 No D 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 community-issued BFE) or Zone AO must sign here. The statements in Sections A,B.and E are correct to the best_of my knowledge. Property Owners or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments 0 Check here if attachments SECTION 0-COMMUNITY INFORMATION(OPTIONAL) _ The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E). and G of this Elevation Certificate. 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. 0 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. D The following information(Items 04-GO)is provided for community floodplain management purposes. CA.Permit Number G5. Date Permit Issued GB. Date Certificate Of Conlpllance/Occupancy Issued G7. This permit has been issued fon 0 New Construction Substantial Improvement G8. Elevation of as-built lowest floor(Including basement)of the building ._ ❑feet ❑meters(PR) Datum G9. BFE or(in Zone AO)depth of flooding at the building site 0 feet 0 meters(PR) Datum G10.Community's design flood elevation 0 feet 0 meters(PR) Datum„ Local Official's Name The Department of Public Works Title Community Name Engineering Division has reviewed Telephone the rcvettion Cert�fiLoIe and Signature Date r r recommends .-- - - Comments n •oes of recommend ,.;..a' .ppr"vel •----------- — s 0 c , here if attachments FEMA Form 81-31,Mar 49 Date `5/�9/a Replaces all previous editions