HomeMy WebLinkAbout7-6-011:011 Bldg BOur Proj# 17881
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal`Emergency Management Agency
National Flood Insurance Program
A4.
A5.
A8.
A7.
A8.
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-8.
OMB No. 1660-0008
Expires February 28. 2009
SECTION A - PROPERTY INFORMATION I For Insurance Company Use:
D""""'a """ ° """` Smith Family Living Trust Dated July 10, 1999 I runty imumuer I
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. I Company NAIC Number
city Kailua Kona state Hawaii ZIP code 96740
N
Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.). MOSIC8ntl81
Latitude/Longhude: Lat N 19 37' 18.1429" Long. _ W 155 57' 28.2292"
Attach at least 2 photographs of the building if the Certificate Is being used to obtain flood Insurance.
Building Diagram Number 5
Horizontal Datum: L I NAD 1927 I V I NAD 1983
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) We sq ft a) Square footage of attached garage n/a 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 foot above adjacent grade walls within 1.0 foot above adjacent grade
c) Total net area of flood openings in A8.b sq In c) Total net area of flood openings in A9.b sq in
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Hawaii
B4. Map/Panel Number
B5. Suffix
B6. FIRM Index
B7. FIRM Panel
B8. Flood
B9. Base Flood Elevation(s) (Zone
Date
Effective/Revised Date
Zone(s)
AO, use base flood depth)
714 and 927
C / D
04/02/2004
[09/16/88&06/02/95
AE
861.8 (see comments)
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
[_]FIS Profile [Z]FIRM ❑Community Determined ❑Other (Describe)
B11. Indicate elevation datum used for BFE in Item B9: ❑� NGVD 1929 ❑NAVD 1988 ❑Other (Describe)
B}Z Is the building bated In a Coastal Barrier Resources System (CBRS) area therwise Protected Area (OPA)T ❑Yes Q No
•Designation Data ❑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, V1430, V (with BFE), AR, ARIA, ARAE, AR/AI-A30, AR/AH, AR/AO. Complete Items C2.a-g
below according to the building diagram specified in Item AT
Benchmark Utilized I1SGS Rench Mark Data Vertical Datum Mann Sea t. nynl
Conversion/Comments n/a
,,,,,,
Check the measurement used.
a) Top of bottom floor (including basement, crawl space, or enclosure floor) 869.3 r''' P,/feet ❑ meters (Puerto Rico only)
b) Top of the next higher floor n Lj feet ❑ meters (Puerto Rico only)
c) Bottom of the lowest horizontal structural member (V Zones only) njl�fset ❑. meters (Puerto Rico only)
d) Attached garage (top of slab) feet ❑ meters (Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building n/a nfeet ❑ meters (Puerto Rico only)
(Describe type of equipment in Comments)
f) Lowest adjacent (finished) grade (LAG) _ 5UMfeet 11 meters (Puerto Rico only)
g) Highest adjacent (finished) grade (HAG) 867.2r,71feet ❑ 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. I certify that the information on this Certificate represents my best efforts to interpret the date available.
/understand that any false statement maybe punishable by tine or Imprisonment under 18 U.S. Code, Section 1001.
❑✓ Check here if comments are provided on back of form. Q' LICENSED
PROFESS_Ki
Certfier's Name Chrystal T. Yamasaki _ License Number LS -4331
1rf
Wes Thomas Associates Company Name Wes Thomas Associates 4331
Aad sa75-5749 Kalawa Street cit' Kailua-Kona state Hawaii ZIP Code9674 All. V
n re '-February 14, 20�phone (808) 329-2353 February 14, 2008
ov 161
FEMA Forth 81-31, February 2006 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding Information from Section A. I For Insurance Company Use:
City
or
SECTION D -
both sides of this Elevation Certificate for (1) community official, (2) Insurance agent/company, and (3) building owner.
The base flood elevation was determined using the field location of the structure which has a calculated distance of
39 feet from the Westerly face of the Culvert (Station 76+10 with a 100 year BFE of 866.5). Using Cross-section at station 75
+60 and the location of the structure we calculated an interpolated BFE of 861.8. Cross-sections are from the North Kona
Flood Studv.
Signature Date February14.2008
, n M. -It na,a it Aean.A.rs
SECTION E= BUILDING ELEVATION IAFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT 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 nems E1 -E4, use natural grade, If 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 space, or enclosure) Is _ _ ❑ feet El meters ❑ above or below the LAG.
E2. For Building Diagrams 6-8 with permanent flood openings provided In SectIQILA Items 8 or 9 (see pjUe 8 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is _ ❑ feet LI meters U above or U 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 ❑ meter ❑ 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 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 oommunityassued BFE)
or Zone AO must sign here. The Statements In Sections A, B, and E are correct to the best of my knowledge.
Owners or Owner's Authorized Representative's Name
City State ZIP Code
Signature Date Telephone
Comments
❑ Check here' attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
local official who is authorized by law or ordinance to administer the community's noodpiam management oromance can complete bi
G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8. and G9.
31. ❑ 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 bylaw to certify elevation information. (Indicate the source and date of the elevation data In the Comments area below.)
32. ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO.
o3. ❑ The following information (Items G4. -G9.) is provided for community floodplain management purposes.
Leo
G5. Date Permit Issued
37. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement
38. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meter (PR) Datum
39. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum
Local Official's Name Title
Community Name Telephone
❑ Check here if attachments
=EMA Form 81-31, February 2006 Replaces all previous editions