HomeMy WebLinkAbout6-6-004:135U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-8.
A -PROPERTY
OMB No. 1660-0008 J'
Expires February 28, 2009 U
For Insurance
A2' BuildingStreetAddress (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number
66-1711 ALANEO ST. (LOT 32)
city State ZIP Code
KAMUELA HI 96743
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description. etc.)
TMK: 6-6-004:135
A4. Building Use (e.g.. Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Lalltude/Longttude: Lat. 20-01-30.3 Long. 15542-13.7 Horizontal Datum: ❑ NAD 1927Y❑ NAD 1983
A8. Attach at least 2 photographs of the building if the Certificate, Is being used to obtain flood Insurance.
A7. Building Diagram Number 1 _
A8. For a building with a crawl space or enclosure(s), 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 576 sq it
b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings In the attached garage
enclosure(s) walls within 1.0 fool above adjacent grade N/A walls within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings In A8.b N/A aq In c) Total net area of flood openings in A9.b NIA sq in
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Bl. NFIP Community Name & Community Number
B2. County Name
B3. State
HAWAII COUNTY / 155166
1 HAWAII I
HI
84. MaplPanel Number
B5. Suffix
B6. FIRM Index
87. FIRM Panel
88. Flood
89. Base Flood Elevation(s) (Zone
0164
D
Date
Effective/Revised Date
Zone(s)
1
AO, use base flood depth)
04/02/2004
07/16/1990
A
2345.1
610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑FIS Profile []FIRM ❑ Community Determined W Other (Describe) CLOMR- F! Cjso t4 0'$-01) L4G
Bit. Indicate elevation datum used for BFE In Item B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe)
�12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)7 ❑ Yes Q No
Designation Date ❑ CBRS ❑ OPA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. 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, ARIA, ARAE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-g
below according to the building diagram spdcifled in Item A7.
Benchmark Utilized HI DEPT OF TRANSp BM ON KAWAIHAE RD Vertical Datum NGVD 1929
Conversion(Comments
Check the measurement used.
a) Top of bottom floor (including basement, crawl space, or enclosure floor) 2356 . 32 ®❑ feet ❑ meters (Puerto Rico only)
b) Top of the next higher floor N/A. -El feet ❑ meters (Puerto Rico only)
c) Bottom of the lowest horizontal structural member (V Zones only) N/A._E] feet ❑ meters (Puerto Rico only)
d) Attached garage (top of slab) 2356 ._O_Q feet ❑ meters (Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building 2356. 35, feet ❑ meters (Puerto Rico only)
(Describe type of equipment in Comments)
0 Lowest adjacent (finished) grade (LAG) 2355. 49 Q feet ❑ meters (Puerto Rico only)
g) Highest adjacent (finished) grade (HAG) 2355. 70 Q feet ❑ meters (Puerto Rico only)
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 date available.
K NFy
-
Licensed
I understand that any false statement may be punishable by fine or mprisonment under 18 U.S. Code, Section foot.
0 Check here If comments are provided on back of form.
Professional
Engineer
Certifier's Name License Number
BRUCE K. MEYERS 8336-C
Title Company Name
IVIL ENGINEER OKAHARA&ASSOCIATES INC
No.8336-C
ress City State ZIP Code
00 KOHOLA ST. HILO HI 96720
9
WAIT, UA.
Signature Date Telephone
08-11-09 808.961-5527
FEMA Fo 81-31, February 2006 See reverse side for continuation. Replaces all previous editions
88-1711 ALANEO ST
Cly
KAMUELA
spaces, copy the corresponding Information from Section A.
:luding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
32)
State ZIP Cc
HI 96743
For Insurance Company Use:
both sides of this Elevation Certificate for (1) community official, (2) Insurance'agent/company, and (3) building owner.
ITEM C2.e - 50 GAL ELECTRIC WATER HEATER RELIANCE 606 SERIES
sec I PON e - t%ylLUrN46fPCL4eVATIUN INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (IMTHOUT BFE)
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 E1 -E4, use natural grade, If available. Cherie the measurement used. In Puerto Rico only, enter meters.
E7. Provide elevation Information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (Including basement, crawl space, or enclosure) is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG.
b) Top of bottom floor (including basement, crawl space, or enclosure) Is _ _ ❑ feet ❑ meters ❑ above or ❑ below the LAG.
E2. For Building Diagrams 6-8 with permanent flood openings provided in SectlgDLA Items 8 anWor 9 (see p,1ge 8 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is _ ❑ feel U meters }_} above or LJ below the HAG.
E3. Attached garage (top of slab) is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is _ ❑ feet ❑ 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? ❑ Yes ❑ 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 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
dress CIH State ZIP Code
Signature Date Telephone
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The kraal official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, e, 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.
GI. ❑ 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 Section 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.
G4. Permit Number
G5. Date Permit Issued
G6.
Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (Including basement) of the building:
G9. BFE or On Zone AO) ds ti ofApoding at the building site:
e opartment of Public Wnrlp
❑ feet ❑ meters (PR) Datum
El feet El meters (PR) Datum
Local Officials Name vilamo,3ring DlYlslOn slat re Title
YIewed
Community Name 'n ertl,icate and Telephone
Date
Signature F1 rl 06s nrn rnconlrIencl
Comments r22
Limit- --`'Y � ar y
❑ Che k here if attachments
0 1o I. rem uary cuuo Replaces all previous