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Home My WebLink About7-8-014:075Project No. 16405.3 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 077 , 2 31 Expires July 31, 2002 ELEVATION CERTIFICATE Important: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: UILDING OWNER'S NAME Policy Number _ 13 and H Rentals, LLC BUILDING STREET ADDRESS (Including Apt Unit. Suite. and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number .78-6622 Alii Drive CITY STATE ZIP CODE Kailua-Kona. Hawaii 96740 PROPERTY DESCRIPTION (Lot and Block Numbers Tax Parcel Number, Legal D Lot 6-A Kahaluu Beach Lots, TMMC: 7-8-14: OT5 {fir' Di BUILDING USE (e.g.. Residential. Non-residential. Addition. Accessory. eic. se C Residential _ LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: ( #fit° - ##' - ##.##" or ##.###W) I _ .I NAD 1927 IJ NAD 1983 etc. section if necessary.) SOURCE: "GPS (Type). 1_1 USGS Quad Map U Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP COMMUNITY NAME 8 COMMUNITY NUMBER B2.OUNTY NAME I B3. STATE — H8W811 Hawaii B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. IJ FIS Profile LJ FIRM 1_1 Community Determined L-4 other (Describe): USGS Data 611. Indicate the elevation datum used for the BFE in 89: J_X NGVD 1929 IJ NAVD 1988 JJ Other (Describe): B12. Is the building located In a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? LJ Yes LJ No Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 1_1Construction Drawings' LJBuilding Under Construction' LNFinished Construction 'A new Elevation Certificate will be required when construction of the building is complete. t,2. Building Diagram Number 5 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. if no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO Complete Items C3a-i below according to the building diagram specified in Item C2. State the datum used. if the datum is different from the datum used for the BFE in Section B. convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G. as appropriate, to document the datum conversion. Datum Conversion/Comments Elevation reference mark used I oval Rpnch MarkDoes the elevation reference mark used appear on the FIRM? I_J Yes IX No a a) Top of bottom floor (including basement or enclosure) _ ,�j>49 _ ft.Ob>� t T. yq 0 b) Top of next higher floor _ ft.(m) aCO til CXc) Bottom of lowest horizontal structural member (V zones only) 19.0 _ ft.(Xx is Q' L'ICENS ❑ d) Attached garage (top of slab)_ ft -(M) w a U PROFES 0 e) Lowest elevation of machinery and/or equipment servicing the building ft. m .82 Ot f) Lowest adjacent grade (LAG) --��•� ft.( I y 4 1 Ek g) Highest adjacent grade (HAG) 17.8 ft.jK1�C Q►• 0 h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade '9 i�qy, tJ S• 0 i) Total area of all permanent openings (flood vents) in C3h sq. in. (sq. cin) OVember 22, 2000 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 in Sections A, B. and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may y be punishable by fine or imprisonment under 18 U.S. Code. Section 1001. CERTIFIER'S NAME LICENSE NUMBER Chrystal Thomas Yamas$ki_._ LS -43 -11 -- TITLE COMPANY NAME Land Surveyor _ _. �IiES THOMAS & ASSOCTATES, INr CITY STATE ZIP CODE ' 749 Kalawa Street. Kai Iiia—Knrna u�.,��; QA71Ln_1 Al 7 Fnrm 81_41 41 Ir: QQ F ISI 6R - I+I L -<o / CFF RFVFRCF .4;Ir1F Fr1R r.ONTINI IATIr1N RFP1 Ar'FC Al I PRF\/I()l IC r-nITIr)NC IMPORTANT: In these BUILDING STREET ADDF CITY the corresponding information from Section A. (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. A For Insurance Companv Use: SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) ^opy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. MMENTS I -I Check here if attachment, SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. E1. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed – see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is 1_1-1 ft•(m)1-1_lin.(cm) 1_1 above or 1_1 below (check one) the highest adjacent grade. E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is I_I-1 ft.(m) I I lin.(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 _ floodplain management ordinance? 1_1 Yes 1_1 No f_1 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 community -issued BFE) or Zone AO must sign here. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE NATURE DATE TELEPHONE COMMENTS I_I Check 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), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1.1 I The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. 1_1 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. IJ The following information (Items G4 -G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7. This permit has been issued for: 1_1 New Construction 1_I Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: _ft.(m)Datum: G9. BFE or (in Zone AO) depth of flooding at the building site is: The 5epartmen8.4*1A%&k Works LOCAL OFFICIAL'S NAME TITLE as revlewe TURE DATE of recom f 2" s,plfl _1 Check here if attachments =AAA Gnrm 01_11 AI Ir; 00 � p=PI Ar•CC AI I ODPWIni IC PnITIMIC