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Home My WebLink About7-5-005:092X U y Project No. 16553.61 FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 • NATIONAL FLOOR INSURANCE PROGRAM ELEVATION CERTIFICATE Expires: December 31, zoos MAP (FIRM) INFORMATION 1 155166 0694 1 G I 04/U2JU4 I aePl 10, IaOO I AC I lu I 8/0. Indicate the source of the Base Flood Elevation (SFE) dam or base food depth entered In B9. 1_1 FIS Profile W FIRM I -I Community Determined L_1 Other (Describe): Off. Indicate the elevation datum used for the BFE In B9: L&I NGVD 1829 L_I NAV01988 L_1 other (Describe): B12. Is the building located Ina Coastal Banter Resources System (CBRS) arae or Otherwise Protected Arae (OPA)7 LJY88 L -I No Designation Dem:_ . • SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: L_(Construcflon Drawings' L_IBullding under Construction* L^1Finbhad Construction 'A new Elevation CorMicete will be required when construction ofthe building is complete. C2. Building Diagram Number 5 (Salad the building diagram most sanRer to the building for which this certificate Is" oomphted -see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or phdogreph.) C3. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, VI -V30. V (wlm BFE). AR, ARIA, ARAE, ARIAII-A30, ARIAH, ARIAO Complete Nems 03.a4 below according to the building diagram specified In Item C2. Stam the datum used. If the datum Is di ferern from the datum used for the BFE In Section S, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use She apace provided or the Comments area of Section 0 or Section G, as appropriate, lo documenl the datum conversion. Datum ! _ ConvemloNCommenM Elevationreference mark used_ LJSG9 Does thef elevation reference mark used appear on Sha FI Yee I x l No O a) Top of bottom moor (Including basement or enclosure) 11..05 fL(m) g O b) Top of next higher floor 9-t,'An R"(m) O e) Bottom d lowest horizontal structural member (V zones only) .n/a ft. (m) rQ' LICENSED O d) Attached garage (tap of slab) + 1,05 fl.(m) CS PROF O a) Lowest elevation of machinery and/or equipment serAdng the building (Describe Ha comments area) —11.. 36 R(m) O Q Lowest adjacent (finished) grade (LAO) $.3 fL(m) V No. 4331 O g) Highest adjacent (finished) grade (HAG) .Q IL(m) O h) No. of permanent openings (flood vents) within 1 R above adjacent grade O i) Total ema d al p. m meritopedngs (flood vent) in C3.h n/a sq. i L (sq. cm) O . Fe 05 r "-" " SECTION 0 -SURVEYOR, ENGINEER, OR ARCHITECTCERTIFICATION This certification Is to be signed and sealed by a lend surveyor, engineer, or arrhited authorized by law to certify elevation Informeflon. I cerh7y that the Information in Sections A. B, and C on MIs cartC/cate represents my best eHata to Interpret the dam eva9abfa 1 understand that = false statement may unl*wbfe by Me or Imprisonment under 19 U.S. Code Section 1001. as Yamasaki L 121Mnsed Professional Land Surveyor COMPANY NME WES THOMAS ASSOCIATES • 9 V?49 Kalawa treet, Kailua Kona, Hawaii 96T40 -MFuary 7, 2005 TLEP LLI `(Mr- J-5-005:052- • k:Opy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUoompany, and (3) building owner. COMMENTS"-- ....._ For Zone AO and Zone A (without BFE), complete Items Et through E4. If ft Elevation Cert/fkcate is Intended for use as supporting information for a LOMA or LOUR -F. Section C must be oompfeted. E7. Building Diagram Number _ (Select the building diagram most similar to the building for which this certificate is being completed – see pages 8 and 7. If no diagram accurately represents the building, provide a sketch or pholograri) E2. The top of the bottom floor (Including basement or enclosure) of the building Is 1 1 1 ft -(m) I_L In•(cm) IJ above or L( belo (check one) the highest adjacent grade. E3. For Building Diagrams 8-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building Is I _I l R.(m) I I Iin.(cm) above the highest adjacent grade. E4. For Zone AO only. If no flood depth number is available. Is the top of the bottom floor elevated in accordance with the community's 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 FEMA4ssued or community -Issued BFE) or Zone AO must sign here. PROPERTY• • .,. • .a. - ADDREW CITY STATE dP*S11.E SIGNATURE TELEP—HQNE--- COMMENTS I Check here If attachmer SECTION O • COMMUNITY INFORMATION (OPTIONAO The local official who is authorized by law or ordinance to administer the communitys floodplain management ordinance cancomplete Sections A, B, C (or Q. and G of this Elevation Certificate. Complete the applicable Rem(s) and sign below. G1. U The information in Section C was taken from other documentation Ural has been signed and embossed by a licensed surveyor, engineer, or architect who Is authorized by stale or kcal law lo.certity elevation information. (Indicate the source and date of the elevation data In the Comments area below.) G2. Lj A community official completed Section E for a building located In Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. 03: LI The following information (hems G4 -G9) is provided for community floodplain management purposes. G7. This parit has been issued for: IJ New Construction I._.I Substantial Improvement G8. Elevation of as-bullt lowest floor (including basement) of the building is: _ fL(m)Datum: G9. BFE or (In Zone AO) depth of flooding at the building site Is: �ft.(m)Datum: LOCAL OFFICJWS NWvDepartment of feubije Ween.• TRE COMMUNITY NAME engineering Division elan, reviewed TELEPk1pNE SIGNATURE 110 irywtl 1, Carr ee w. .,.�