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HomeMy WebLinkAbout6-9-003:005_wrr-ropp iois4.a O.S. DEPO.RTMBNT OF HOMELAND SECU ELEVATION CERT C �• F4derel Emergency Management Agency Exolres February 28, 2008 National Flood Insurance Program Important: Read the instructions on pages 1-8. r f / SECTION A - PROPERTY INFORMATION For Insurance Company Use: AtIlk. Building esName Qpid M Adams Revocable Trust of 2002; at. al. Policy Number . Building Street Address (ind4ding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number 69-1688 Puakd,Road city Kamuela V stats Hawaii ZIP Code 96743 A3. Property Descripption (Lot a4d Block Numbers, Tax Parcel Numbar, Legal Deacriptlen, ate.) Lot 66, Desert Beach Lots Tax Map Key: 6-9-003: 005 (3rd Division) A4. Building Use (e.g.. RepiQential, Non -Residential, Addition, Accessory, etc.) A8. Latilude/Longaude: LAC (Qe N; r Is. 09656 "Long.N/ I brsa 4 pis. G 1440lorizontel Datum: NAD 1927 © NAD 1983 A8. Attach at bast 2 photographs of the building ifthe Certificate Is being used to obtain flood Ineuronce A7. Building Diagram Number i A8. For a building with a crawl space or enclosure($), provide: A9. For a building with an attached garage, provide: a) Square footage of crawl space or enclosure(s) n/a sq It a) Square footage of attached garage . 924 sq it b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the alfa ed garage enclosure(s) walla within 1.0 foot above adjacent grade walk within 1.0 foot above adjacent grade c) Total net area of flood openings In AS.b aq In c) Total net area of flood openings in A9.b sq le SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION :I_�1i7d11 Date EtfectNelRevfsed Date Zones) AO, use base flood depth) 0277 C 04!02/2004 09/16/1988 AE 6.5 810. Indicate the source of the Base Flood Elevation (SFE) date or base flood depth entered In Item B9. ❑FIS Profile [Z]FIRMCommunity Determined QOther (Describe) B11. Indicate elevation datum used for BFE In Item B9: 0 NGVD INS [3NAVD 1989 QOther (Describe) 2. Is the bulking located In a Coastal Barrier Resources System (CBRS) areaerwise Protected Area (OPA)7 Yes 0✓ No Designation Date CBRS LJOPA- ANG ELEVATION INFORMATION C1. Building elevations are based on: U Construction Drawings' LJ Building Under Construction* W Finished Construction C2. 'A new Elevation Certificate will be required when construction of the building is complete. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1430, V (with BFE), AR, ARIA, ARAE, AR/A1-A30, AR/AH, AR/AO. below according to the bulking diagram specified In Hem AT Benchmark utilized t1SGS RM Ventral Datum Mean Sea Leval Conversion/Comments n/a Complete time CZ" SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION I This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by low to certify elev information. I certify that the information on this CertiOcale represents my best efforts to Interpret the date available. I understand that any false statement may be punishable by fine or Imprisonment under 18 U.S. Code, Section 1001. Check here H comments are provided on back of form. Certifiers Name Chrystal T. Yamasaki License Number LS -4331 Wes Thomas Associates Company Name Wes Thomas Associates Na 4931 rasa 75-5749KalawaStr t cry Kailua-Kona stale Hawaii zlPcode96740 yghrAll,V� k ID 111y 30, 2007 Telephone (808) 329-2353 July 30, 2007 0 -,,a A Form 81-31, February 2008" See reverse side for continuation. Replaces all previous Check the measurement used. a) Top of bottom floor (including basement, crawl space, or enclosure floor) 8.D1 ❑� feet ❑ meters (Puerto Rico only) b) Top of the next higher floor fent ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) �. feel ❑meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building feet ❑ meters (Puerto Rico only) (Describe type of equipment In Comments) I) Lowest adjacent (finished) grade (LAG) 6.5 feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade (HAG) 7.2 nfeet ❑ meters (Puerto Rico only) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION I This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by low to certify elev information. I certify that the information on this CertiOcale represents my best efforts to Interpret the date available. I understand that any false statement may be punishable by fine or Imprisonment under 18 U.S. Code, Section 1001. Check here H comments are provided on back of form. Certifiers Name Chrystal T. Yamasaki License Number LS -4331 Wes Thomas Associates Company Name Wes Thomas Associates Na 4931 rasa 75-5749KalawaStr t cry Kailua-Kona stale Hawaii zlPcode96740 yghrAll,V� k ID 111y 30, 2007 Telephone (808) 329-2353 July 30, 2007 0 -,,a A Form 81-31, February 2008" See reverse side for continuation. Replaces all previous or City _ _ State I — SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) IlWy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments Lowest Electrical is an nutlet in the floor of the garage. July 30, 2007 SECTION E - BUILDING ELEVATION-WFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFEI For Zones AO and A (without BFE), complete Items E1 -E5. If the Certificate Is Intended to support a LOMA or LOMR-F request, complete Sections A, B. and C. For Items Ell -E4, use natural grade, H available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation Information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (FLOG) and the lowest adjacent grade (LAG). rrr'''111 a) Top of bottom floor (Including basement, crawl space, or enclosure) Is _ _ !=r feet ❑molars above or ❑below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosureb _ u feet 1-1 motors above or ❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided Seedg9.� Items 8 or 9 (see e 8 of Instructions), the next higher floor (elevation C2.b In the diagrams) of the building is feet LJ meters LJ above or u below tit HAG. E3. Attached garage (top of slob) Is . _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. _ E4. Top of platform of machinery and/or equipment servicing the building is _ ❑ feel ❑ meters ❑ above or ❑ below the HAG. 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 ordinance? ❑ Yee ❑ No ❑ 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 FEMA4saued or community -Issued BFE) or Zone AO must sign here. The statements /n Sedlons A, B. and E are correct to the best of my Imow/edoe. State Signature Date Telephone Comments ❑ Check here K ettaehmema SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who Is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Si and G of this Elevation Certificate. 'Complete the applicable Rem(s) and sign below.' Check the measurement used In Items G8. and G9. 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 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 Seddon E for a building located In Zone A (without a FEMA -issued or community -Issued BFE) or Zone AO. G3. ❑ The following Information (Items G4. -G9.) Is provided for community floodplain management purposes. GS. Date G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-0uilt lowest floor (including basement) slotfethe building: ❑ feet ❑ metere (PR) Datum G9. BFE or (in Zone AO) dept d i7@ mat kttertTldOT Yiif111C H/Orkd— ❑ fee ❑ meters (PR) Datum Community Name not FEMA Form 81-31, February 2006 previous a7I26/zoos ^T� J^. a7I26/zoos O %/26/ n' �` °^�' �`•.� -5,"�3' .�a .sir