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U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1680-0008
Federal Emergency Management Agency Expires March 31, 2012
National Flood Insurance Program Important: Read the instructions on pages 1-9.
and/or Bldg. No.) or
Kailua-Kona
A4. Building Use (e.g.; Realdential, Non-Resldentlsl, Addition, Accessory, ek.>mestaemlal
A5. Letm,deJLonglwoe: Let. N 19 35 27.2 Long, W 155 56 .9 Horizontal Datum: NAD 1927 0 NAD 1983
A0. Attach at least 2 photographs of the building If the Certificate Is being used to obtain flood Insurance.
A7. Building Diagram Number 5
AB. For a building with a crerMspace or endosure(e): A8. For a building with an attached garage:
a) Square footage of crErMspaoe or endosum(s) _ nil sqft a) Square footage of attached garage nil eq it
b) No. of permanent flood openings In the crowlspece or b) No. of permanent flood openings In the attached gars
enclosures) within 1.0 loot above adjacent grade na within 1.0 fool above adjacent grade nil
c) Total net area of flood openings In AB.b na eq in c) Total net area of flood openings in A9.b na aq In
d) Engineered flood openings? ❑ Yea ❑ No d) Engineered flood openings? ❑ Yea No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
81. NFIP Community Name & Community Number 82. County Name B3. Siete
HAWAII 155166 Hawaii Court State of Hawaii
B4. Map/Panel Number
B5. Suffix
B8. FIRM Index
87. FIRM Panel
B8. Flood
BB. Base Food FJavetlon(e) (Zone
Benchmark Utilized USGS BM at Kailua Pier Vertical Deuan (NGVD 1929)
Date
E1fedlvelReNead Date
Zorre(s)
AO, use base flood depth)
155166 0926
E
04/02/2004
06/02/1995
'AE
12
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered In Item 89.
❑FIS Profile [Z]FIRM ❑Community Determined ❑Other (Describe)
611. Indicate elevation datum used for BFE In hem 69: ❑✓ NGVD 1929 ❑NAVD 1998 ❑Dther (Describe)
812. Is the building located Ina Coastal Barrier Resources System (C) area Otherwise Protected Area (OPA)? [3Y99❑ No
- Designation Dote 15CBRS Otherwise
C1. Building elevations are based on: L)Construcllon Drawings' LJ Building Under Construction.
Q Finished Construction
•A new Elevation Certificate will be required when construction of the building Is complete.
C2. Elevations - Zones A7 -A30, AE, AH, A (with BFE), VE, V1430, V (with BFE), AR, AWA, ARAE, AWA1-A30, AWAH, AR/AO. Complete Rema C2.a-h
below according to the building diagram specified In Item A7. Use the same datum as the BFE.
Benchmark Utilized USGS BM at Kailua Pier Vertical Deuan (NGVD 1929)
ConverelonlComments .None
Check the measurement used.
e) Top of bottom floor (including basement, crowlspaee, or enclosure fkor) 16.53 feat
8motors (Puerto Poco only)
floor
b) Top of the next higher 26.62 fast
meters (Puerto Moo only)
c) Bottom of the lowest horizontal structural member (V Zones only) nil feet
❑ meters (Puerto woo only)
d) Attached garage (top of stab) nil feel
❑ motors (Puerto Rlco only)
e) Lowest elevation of machinery or equipment servicing the bulidlni 1 5.53 feet
❑meters (Puerto Rico only)
(Describe type of equipment and location In Comments)
0 Lowest adjacent (finished) grade next to building (LAG) 144
❑ metere (Puerto Poco only)
g) Highest adjacent (finished) grade next to building (HAG) 14.9 feet
meters (Puerto Rlcc only)
h) Lowest adjacent grade at lowest elevation or deck or stairs, Including 14.2 feet
ILJj meters (Puerto Rioo only)
structural support
SECTION D - SURVEYOR. ENGINEER. OR ARCHITECT CERTIFICATION
Information. I certify Net the Information on this Cert/Ncate, represents my beat 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.
Q Check here 0 comments are provided on back of form. Were latitude and longitude In Section ARrovided by a
licensed land surveyor? E]Yes 1..1 No
Certifiers Name Nicolas K. Yamasaki License Number LS -12052
Licensed Professional Land 9u Pie>Yio ma Wes Thomas Associates
'qml "' 75-5749 Kalawa Strees. "' Kailua-Kona "' Hawaii � -- 96740
Form 81-31, Mar
See reverse
17052
all previous editions
rI's
slate
ZIP Code
N%py both sides of this Elevation Certificate for (1) community ofildal, (2) Insurance agentloompany, and (3) building owner.
Comments ��—-----�-,_ ..— -- •-- — — ---
The Photos of the exterior of the residence are attached
e Lowest ElectricalEquipment Is the Water Heater located on the First Floor.
��. ,,..,. • ov,wmw 9&=VAnvry INrVKmAIJUN (OLIKVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones AO and A (without SFE), complete Items El -E8. If Bre Certificate Is Intended to support a LOMA or LOMR-F request, complete Sections A, B,
and C. For Items Et -E4, use natural grade, If available. Check the measurement used. In Puerto Rico only, enter meters.
E1. Provide elevation Infonnetlon for the following and check the appropriate boxes to show whether 69 elevation Is above or below Bre highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement, crowlspece, or enclosure) Is—. _ ❑feel ❑maters above or ®below th HA6.
b) Top of bottom Boor (Including basement, cmwlspaoe, or enclosure) Is _. _ [3061[:]motorsabove or below the LAG.
F2. For Building Diagrams 6-9 with permanent flood openings provided In Secik;MA Iteme 9 UnWor 9 (am gggee 8.9 of InsW Wons), the next higher floor
(elevation C2.b in the diagrams) of the building to _ ❑ feet U miners LJ above or U below 8o HAG.
E3. Attached garage (lop of slab) to . _ ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building Is _ ❑ feet ❑ metere ❑ above or ❑ below the HAG.
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 floodplaln management
ordinance? I] Yes ❑ No ❑ Unknown. The local official must pertly this Informetlon In Section 6.
SECTION F • PROPERTY OWNER IOR OWNER'R REPRESFNTATIVFe neonerreTrnu
The property owner or owner's sutlhorized representative who completes Sections A, B, and E for Zane A (without a FEMA4eeued or tbnununity4esued BFE)
or Zone AO must sign here. The statements In SecBona A, B, and E are correct to the beat of my knowledge.
Property Owner's or Owner's Authorized Remeeentativda Nano
Comments
and G of this Elevation Certificate.
Kern(s) and sign below. Check the measurement used In Items 08 end Gil.
G1. ❑ The Information In Section C was taken from other documentation that two been signed and sealed by a licensed surveyor, engineer, or architect who
Is authorized by law to certify elevation Information. (Indicate the source and data of the elevation data In the Comments area below.)
62. ❑ A community official completed Section E for a building located In Zone A (wilhoul a FEMA-Iseued or oommunlly-Issued SFE) or Zone AO.
G3. ❑ The following information (items G4-09) Is provided for community floodplain management purposes. .
G7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement
68. Elevation of as-buill lowest floor (Including basement) of the building ❑ feet ❑ maters (PR) Datum
G9. BFE or (In Zone AO) depth of flooding at the building elle ❑ feet ❑ meters (PR) Datum
Gto. Community's desigihaodkolidelanent of Public Works ❑ feet ❑ metere(PR) Datum
G^ , ^^ laq W ^•t^n hoc reviawad
Local Official's Name ,L _ , _-.. _ -I Title
Signature
ivAr-Fa
°EMA Form 81-31, Mar 09 Replaces all previous editions