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HomeMy WebLinkAbout6-6-004:132U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CEkTIFICATE Important: Read the instructions on pages 1-8. SECTION A - PROPERTY INFORMATION OMB No. 1660.0008 Expires February 28, 2009 Insurance Company Use: A2. Building Street Address (Including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No.I Company NAIC Number I 66-1723 ALANEO ST. (LOT 29) State A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 20-01-29.8 Long. 15542-16.5 Horizontal Datum: ❑ NAD 1927 0 NAD 1983 A6. Attach at least 2 photographs of the building H 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: A8. For a building with an alldied garage, provide: a) Square footage of crawl space or enclosure(s) WA sq ft a) Square footage of attached garage 576 sq ft b) No. of permanent flood openings In the crawl space or b) No. of permanent flood openings In the attached garage enclosures) walls within 1.0 foot above adjacent grade WA wells within 1.0 foot above adjacent grade NIA c) Total net area of flood openings In A8.b WA sq In c) Total net area of flood openings In A9.b WA sq In SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NRP Community Name 6 Community Number B2. County Name 83. State HAWAII COUNTY / 155166 1 HAWAII HI 64. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood ElevaU rile) (Zone 0164 D Date Efleclve/Revised Date Zone(s) AO, use base food deptlh) Check the measurement used. 04/02/2004 07/16/1990 A 2339.1 B10. Indicate the source of the Base Flood Elevation (BFE) date or base fiood depth entered In Iters 89. F G max. /•lo, ❑ FIS Profile ❑ FIRM ❑ Community Determined ❑® Offer (Describe)r -09. 1 6 z4 G BI 1. Indicate elevation datum used for BFE in Item B8: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) B12. Is the building located Ina 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'■❑ Finished Construction 'A new Elevation Certificate will be required when construction of the building Is complete. C2. Elevations - Zones At -A30, BFE), VE, V1 -V30, V (with BFE), AR, ARIA, ARAE, AR/Al-A30, AR/AH, AR/AO. Complete Items C2.a g AH, A (wiram building itth ecified In Item A7. below according tot I DEPT OFiaTitANSP BM ON KAWAIHAE RD Benchmark Utilized Vertical Datum NGVD 1929 Conversion/Comments Check the measurement used. a) Top of bottom floor (including basement, crawl space, or enclosure floor) 2342. 79 0 feet ❑ meters (Puerto Rico only) b) Top of the next higher floor N/A. ❑ feet ❑ meters (Puerto Rico only) c) Bosom of the lowest horizontal structural member (V Zones only) WA _❑ feel ❑ meters (Puerto Rico only) d) Attached garage (top of slab)2342 . ®❑ feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 2342 .]$Q feet ❑ meters (Puerto Rico only) (Describe type of equipment In Comments) f) Lowest adjacent (finished) grade (LAG) 2341 . 96 ❑Y feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade (HAG) 2342. 17 K feet ❑ meters (Puerto Rico only) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION oris cenmcaaon is io De signea ana seama Dy a lana surveyor, engineer, or arcmtecr autnonzea by raw to cemry elev information. I certify that the information on this Certificate represents my best efforts to Interpret the data available. / 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. Certifler's Name License Number FEMA Forr}f81-31, See reverse side for continuation. vY� It. W Licensed Professional Engineer No.8.3.36-C 'IGM UA. Replaces all previous editions imrum n Ar n : in tnese spaces, copy the corresponding information from Section A. I For Insurance Cmmnarw I I.a• 66-1723 ALANEO ST. (LOT 29) City State ZIP Ce KAMUELA HI 96743 SECTION D - SURVEYOR, ENGINEER. OR ARCHITECT CERTIFICATIn Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) building owner. ITEM C2.e - 50 GAL ELECTRIC WATER HEATER. RELIANCE 606 SERIES NOT REQUIRED) FOR ZONE AO AND For Zonas AO and A (without BFE), complete Items E1 -E5. H the Certificate Is Intended to Support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items EI -E4, use natural grade, 8 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 (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 apace, or enclosure) Is _ _ ❑ feel ❑ meters ❑ above or ® below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Sectlgo A Items 8gpQ/or 9 (see ggge 8 of Instructions), the next higher floor (elevation C2.b In the diagrams) of the building Is . _ [Ifeet LJ meters Lj above or LJ below the HAG. E3. Attached garage (top of slab) Is _ ❑ lest ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _ ❑ feet ❑ meters ❑ above or ❑ below gra HAG. E5. Zone AO only. If no flood depth number Is available, Is the top of the bottom floor elevated in accordance with the communitys 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 communily-Iasued BFE) or Zone AO must sign here. The statements In Sections A. B, and E are correct to the best of my knowledge. or Signature Date Telephone Comments SECTION G - I ne iocai omuan mo is aumonzea Dy raw or ordinance to administer the community's floodplain management ordinance can complete Sections A. B, C (or E), and G of this Elevation CerBflcate. 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. ❑ 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 (Hems 134,139.) Is provided for community floodplain management purposes. G4. Permit Issued I G6. Dale G7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-bulfl lowest floor (Including basement) of the building ❑ feet ❑ meters (PR) Datum G9. BFE or (in Zone AO) depTWfi4"ptK4@�hfldb§ SiNblic Work, ❑ feet ❑ meters (PR) Datum Local Official's Name Titie Name FEMA Form 81-31, February 2006 Replaces all previous editions