6-9-004:032 Addition above garage

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U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY National Flood Insurance Program ELEVATION CERTIFICATE IMPORTANT: Follow the instructions on pages 1-9. OMB No. 1660-0008 Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION ( FOR INSURANCE COMPANY USE Al. Building Owner's Name Kelly Sheahan I Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P0. Route and Box No. I Company NAIC Number: 69-1757 PUAKO BEACH DRIVE City KAMUELA State HI ZIP Code 96743 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) (3) 6-9-004-032 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/ Longitude: Lat. 19 96755 Long. -155.84618 Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1A A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) sq ft a) Square footage of attached garage 400 sq ft b) No. of permanent flood openings in the crawlspace or b) Number of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in d) Engineered flood openings? ❑ Yes ❑ No d) Engineered flood openings? ❑ Yes ❑ No sFr_TInN R - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 11. Nqg, tgommunity Number B2. County Name I B3. State HaluvaQ COuntty TY AR/A0. Complete Items B4. Map/Panel Number Bb65. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) 89. Base Flood Elevation(s) (Zone Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 7 . 2 feet ❑ meters Revised Date ❑ meters A0, use base flood depth) 0277 C APR 02, 2004 September 16, 1988 AO 2.0 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in item bu: ❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source: Bll. Indicate elevation datum used for BFE in Item 139: x❑ NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes [E No Designation Date: / / ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ❑Q Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/A0. Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: RM 32 Vertical Datum: 6.59 Feet Indicate elevation datum used for the elevations in items a) through h) below. ❑x NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 7 . 2 feet ❑ meters b) Top of the next higher floor 16 6 feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) ❑ feet ❑ meters d) Attached garage (top of slab) 7 2 0 feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 9 . 1 ❑x feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 6. 8 0 feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 9. 5 0 feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 7. 4 ❑X feet ❑ meters structural support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ❑ Check here if attachments. licensed land surveyor? ❑ Yes ❑ No p. F�EF�o If PRLAM'I AL W * SWV Y0OR yt No. 7276 / vA I I, v5. FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions.