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HomeMy WebLinkAbout7-6-017:027. _ _ _ _-• - -••• •-..r--1-•,r---•,rr - r,VV-�, r„V VVVVVI V11 V U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE Federal Emergency Management Agency National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A - PROPERTY INFORMATION Al. Building Owner's Name Hale Kai o' Kona AOAO Building Street Address (including ApL, Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. 76-6204 All Drive: Units 3 it a city Kailua-Kona state Hi ZIP code 96740 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc,) TMK: (?17-6-017: Por. 027 VVV 1VVi/VVV 1 VVV OMB No. 1660.0008 Expires February 28. 2009 Fot Inskirana@ Compamr. Use: Folicy:fJ4m , r •• .: ; A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. LathudelLongiwde: Lat. 19036'35.536" N Long.155°58'44.Sdx6g1V Horizontal Datum; ❑ NAD 1927 ® NA01983 A6, Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 5 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) sqft a) Square footage of attached garage 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 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 A9rb sq in SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Community Name 8 Community Number 82. County Nama133• State Hawai County 155166 Hawaii Hawaii 84. Map/Panel Number 85, Suffix 86, FIRM Index 67. FIRM Panel 88. Flood S. 0ese Flood Elevations) (Zone ® feet ❑ meters (Puerto Rico only) Date Effective/Revised Date Zone(s) AO, use base %cod depth) 155, 0926 E June 2, 1895 June 2,1995 AE 11.0 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in hem B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe) Bit, Indicate elevation datum used for BFE in item 88; ® NGVD 1928 ❑ NAVD 1988 ❑ Other (Describe) 612. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)9 []Yes ®No Designation Date ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Comaructlon' ® 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, AR/AE. A;UAt-A30, AR/AH, AR/AO. Complete Items C2.5-9 below according to the building diagram specified in Item A7, Benchmark Utilized BM No.B 1971 Vertical Datum NGVD 1929 Conversion/Comments SECTION 0 - SURVEYOR ENGINEER, OR ARCHITECT CERTIFICATION i This certification is to be signed and seated 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 rhe data available. I understand that any false statement maybe punishable by fine or imprisonment under 18 U,Sr Code, Section 1001, ® Check here if comments are provided on back of form, Certifiers Name Robert K.Y. Lee License Number LS 5075 Title President Company Name Towill, Shigeoka & Assoc., Inc. r ss 2153 N. King St., Ste. 308 City Honolulu state H1 ZIP Code 96819 Signature u` r Date April 3, 2009 Telephone (808) 538-3857 LICEN�Efl PROF ONAL SURVEY6FI No. 5075 SP y"��fiII.V. EMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions Check the measurement used. i) Top of bottom floor (including basement, crawl space, or enclosure floor) Q1_ ® feet ❑ meters (Puerto Rico only) b) Top of the next higher floor 222.87 ® feet ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) ❑ feet ❑ 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 12,18 ® feet ❑ meters (Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent (finished) grade (LAG) —1.4_ ® feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade (HAG) —1.9 ® feet ❑ meters (Puerto Rico only) SECTION 0 - SURVEYOR ENGINEER, OR ARCHITECT CERTIFICATION i This certification is to be signed and seated 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 rhe data available. I understand that any false statement maybe punishable by fine or imprisonment under 18 U,Sr Code, Section 1001, ® Check here if comments are provided on back of form, Certifiers Name Robert K.Y. Lee License Number LS 5075 Title President Company Name Towill, Shigeoka & Assoc., Inc. r ss 2153 N. King St., Ste. 308 City Honolulu state H1 ZIP Code 96819 Signature u` r Date April 3, 2009 Telephone (808) 538-3857 LICEN�Efl PROF ONAL SURVEY6FI No. 5075 SP y"��fiII.V. EMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions r.vvaruva r-vva IMPORTANT: In these spaces, copy the corresponding information from Section A. Fri 1n¢urartce.Company UW.'. :• Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Aolicy Numbe r. 76.6244 Alii Drive; Units 3 ! 4 City Kailue-Kona State Hi ZIP Code 96740 Comwa NAIC•Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenvcompany, and (3) building owner. comments Elevation listed on C2.e) is for air conditioning units. Signature I Date 4. p 3 Z0� 06;4,"�'l""� , g © Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUI ) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFT', complete hems E1 -E5. It the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, @, and C. For Koms Et -E4, use natural grade, If available. Check the measurement used. In Puerto R'rco 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 i] meter: ❑ above or ❑ below the HAG, b) Top of bottom floor (Including basement, crawl space, or enclosure) is ❑ feet EJ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A hems 8 and/or 9 (see page 8 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet O meters ❑ above or ❑ 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 0 meters ❑ above or E] 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 8, and E for Zone A (without a FEMA-isbued or community4ssued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are corr®ct to the best of my imowfedge. wrty Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments k here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) the local official who Is authorized by law or ordinance to administer the community s floodplain management ordinance can complete Sections A. B. C (or E), ind G of this Elevation Certificate, Complete the applicable item(s) and sign below. Check the measurement used in hems 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 arehitectwho is authorized by law 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 community4ssued BFE) or Zone AO. 33. ❑ The following information (Items G4.49.) is provided for community floodplain management purposes. G4, Permit Number GS. Date Permit Issued 06. Date Certificate Of CompliancetOccupancy Issued 37. This permit has been issued for: E] New Construction [3 Substantial Improvement W Elevation of as -built lowest floor (including basement) of the building: _❑ feet meters (PR) Oetum 69. SFE or (n Zone AO) depth of flooding at the building site: U feet D meters (PR) Datum Local Official's Name Title Community Name Telephone Signature Data C ents ❑ Check here it angchments