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Home My WebLink About2-1-021:046U.S. DEPARTMENT of HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Mortagemont Agency Expires February 28, 2009, Nkdoflel A066 atsuranaa-..Program Important: Read the instructions on pages 1-8. and/or Bldg. Nc.) or P.O. Route and Box A4. Building Use (e.g„ Residential, Non•Resld9ndal, Addition, Accessory, eta) RESIDENTIAL A5. Latitude/Longlnrde: Let, Long A6. Attach at $98612 photographs a1 the building If the Certificate Is being used to obtain flood Insurance, Horizontal Datum: NAD 1927 ❑NAD 1983 A7. Building Diagram Number—L Ail. For a building with a crawl space or endosure(s), provide: e) Square footage of crwd apace or enclosure(&)Ail. For a building with an attached garage, provide: b) No. of permanent flood openings in the crawl apace or eq ft a) Square footage of attached garage ' aq fl entlosure(s) wells within 1A foot above adjacent grade b) No. of permanent flood openings In the attached garage e) Total net area of flood opersngs in AB.bwalls within 1.0 foot above adjacent grade eq In c) Total net area of flood openings In A9.b Sq In uam/ Ir1rWMrV1A IJUN 87. NFIP Communlry Nems 6 Communly Number B2. burly Name Hawaii CDunt 155166 Hawaii County B3. state Hawaii B4. MaplPenel Number B5. Suffer B5. FIRM Intlex B7. FIRM Panel B8. Flood Ba. Bele 1:: Elevation a 155166. 885C De$9 EffectiveNsvised Date Zones) AO, use base flood depgl�ra 4/02/04 09/16/88 B10. Indicate the source of the Base Flood Elevation (BFE) data or baseflood tlepth entarad In Item Be. ❑FIS Profile 15 ® FIRM ❑ Community Determined ❑ ONer (Describe) B11. Indicate elevation datum used for BFE in Item Be: ❑ NGVD 1929 ® NAVD 1988 ❑ Other (Describe) B12. Is the building located In a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑® Designation Date ❑ CBRS I]OPA Yes No SECTION C •BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) :1 A now l vations era based on ❑Construction Drawings- ❑ Building Under Construction• 'A new Elevation CertMcote will be required when construction of tit building is complete. ®Finiahetl Construction C2. Elevations —Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (whh BFE), AR, AR/A, ARAE, AR/At-A30, AR/AH, AR/AO. Complete Items C2.a-g below according to the building diagram specified In Item A7. Benchmark Utilized USGS BM MARKED "NO. 4" Verucel DatumNA 9 Converalon/Commenta a) Top of bosom floor (Including basement, crawl space, or enclosure Boor) Check the M-11' 17, 2 ® feet b) C) Top o1 the next higher floor Bottom of the lowest horizontal structural member NA ,—❑ feat mPgterVsa(tp�k warnto miters BRo d) e) (V Zones only) Attached garage (top of slab) Lowest elevation —❑ feet tae❑feet mP0illito t I❑S *04, }PSV@pl of machinery or equipment servicing the building (Describe type of equipment in Comments) --�� 4 ® feet ❑ meters (Puerp 0 Lowest adjacent (finlshed).grade (LAG) Highest 6 ® feet 9) adjacent (snished) grade (HAG) ❑ meters (Puerto SECTION D - S OR res cemocation is to be signed and sealed by a lend surveyor, engineer, or architect authorized b law to oe information. 1 cenlyy that the information on this Certificate represents my best extorts to interpret the data eve bleevaton I understand that any false statement may be punishable by fine orimpdsonment under 18 U. S. Code, Section 1001. Check here If comments are Pr Wded on back of form. I i Certifier's Name ROBERT T. SHIRAI License Number ale LS -5985 LAND SURVEYOR Company Neme Atltlress ISLAND SURVEY, INC. r � � . HI "' "... 96720 12/18/08 'wopnone 935-9105 =.i Wbo only) Rlifibm erld Rion only) r LitL;bl $'ED PRI:SESS.IONAL HIPAP SURVEYOR No. 5985 , February 2006 See reverse Side for continuation. Replaces all previous editions IMPORTANT: In thbee spaces, copy the corresponding Information from Section A. For Insurance Company Use: BuiWBItOel Address (Including Apt., Unit, Suite, andlorBltlg. No J or P.O. Route and Box No. Policy Number :1188 KALANIANAOLE AVE City HILO Stele ZIP Code Company'NAIC Number HI 96720 SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT cclzneu ennu rcnuruo rvni both sides of this Elevation Certificate for (1) community official, (2) Insurance agenl/company, and (3) building owner. GZ..e: ELEVATION OF TWO (2) OUTLETS 6 ONE (1) LIGHT SWITCH 12/18/08 - BUILDING - - .... -• •••• • •-•• w . c r "W1 rteuuuttc0) I -OR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete items El 'E5- If the Certificate Is Intended to support a LOMA or LOMR-F request, complete Sectors A. 8, and C. For Items Et -E4, use natural gratia. If available. Check the measurement used. In Puerto Rico only, enter makers. E1: Provide elevation Information for the following and check the appropriate boxes to show whether the elevation Is above or below he highest adjacent grade (FLAG) and the lowest adjacent grade (LAG). e) Top of bottom floor (including basement, crawl spade, or enclosure) is ❑ featB meters ® above or ® below the HAG. b) Top of bottom floor (Including basement, yawl space, or enclosure) is _ ❑teat meters above or below the LAG, E2. For Building Diagrams 6-8 with permanent food openings provided In Sedlgy4 Items B or 9 (see e 8 of Instructions), the next higher floor (elevation C2b In the diagrams) of the building is ❑teal LJ meters �ebove or LJ below he HAG. E3. Attached garage (top of slab) Is _ ❑ feet ❑ meters ❑ above or ❑ below the FLAG. E4. Top of platform of machinery and/or equipment servicing the building Is "_ ❑ feet ❑ meters ❑ above or ❑ below the WIG. E8, 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? [I Yes ❑ No ❑ Unknown. The local official must cer ft this information In Section G. -PROPERTY The property owner or owners authorized representative who completes Sections A, B, end E for Zone A (without a FEMA4saued or community -Issued BFE) or Zone AO must sign here. The statements In Sections A, B, and E are corre& to the best of_ knowledpa. ,Address City. State. ZIP Code Comments SECTION G -COMMUNITY INFORMATION (OPTIO AL) The local otficial who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, S. C (or E), and G of this Elevation Certificate. Complete the appllcable Item(s) and sign below. Check the measurement used in Items G8. end G9. G1. ❑ The Information In Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or erchitecl 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 FEMA4ssuad or community -Issued BFE) or Zone AO. G3. ❑ The following Information (Items G4.-Gg.) is provided for community floodplain management purposes. G4. Permit Number G6. Date Permit issued. -- G7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (Including basement) of the building: feet motors (PR) Datum G9. BFE or (in Zona AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum Local ORcal's Name Title Community Name Telephone Signature Date Comments FEMA Forth 81-31, February 2006 Replaces all previous editions