The URL can be used to link to this page

Home My WebLink About2-1-017:071P. 02 O,M.B. NO. 3067.4077 ELEVATION CERTIFICATE Expires May 31,1996 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL. FLOOD INSURANCE PROGRAM ATTENTION: use of this certificate does not provide a waiver of the flood Insurance purchase requirement. This form4s used only to provide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to detarmine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or --.OMR), Instructions for completing this form can be found on the following pages, SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE BUILDING OWNER'S NAME POLICY NUM8ER _ _- T,ot, ? g.,., J . and He ena_.. C . Dae tmati _ STREET ADDRESS (Including Apt., Unit, Sults and/or Bldg. Number) OR P.0, ROUTE AND BOX NUMBER COMPANY NAIC NUMBER 19A3 Kai,-Liaiananle Ave OTHER DESCRIPTION (Lot and Block Numbers, etc.) CITY STATE ZIP CODE Hawaii SECTION B FLOOD INSURANCe RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ NGVD '29 ❑ Other (describe on back) S. For zones A or V. where no BPE is provided on the FIRM, and the community has established a BFE for this building sites, indicate the community's BFE: I I L..._IJ_I -L feet NGVD (or other FIRM datum -see Section B, Item 7), SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicat the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference leve] _ . 2(a), FIRM Zones AI -ASO, AE, AH, and A (with BFI"). The top of the reference level floor from the selected diagram is at an elevation of Li _LLL . LJ feet NGVD (or other FIRM datum -see Section B, Item 7). (b). FIRM Zones V1 -V30, VE, and V (with SFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of iI-l�I 161 feet NGVD (or other FiRM datum -see Section B, Item 7). (c). FIRM Zone A (without 8FE). The floor used as the reference level from the selected diagram is L j 1. iJ feet above U or below 0 (check one) the highest grade adjacent to the building. (d). FiRM Zone AO. The floor used as the reference level from the selected diagram is LJJ .H feet above ❑ or below U (check one) the highest grade adjacent to the building. It no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No 0 Unknown 3. indicate the elevation datum system used in determining the above reference level elevations: ❑ NGVD '29 ❑ Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different then that used on the FIRM (see Section B, Item 71, them convert the elevations to the datum system used on the FIRM and show the conversion gqciation under CommOMS on Page 2.) 4. Elevation reference mark used appears on FiRM: YJ Yes [3 No (See instructions on Page 4) 5. The reference level elevation is based on. .gZ actual construction F] construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate will be required once constructiotl is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is: L1I 11.1L i . J,d feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION D COMMUNITY INFORMATION t. if the community official responsible for verifying building elevations specifies that the reference level Indicated in Section C, atom 1 Is not she "lowest floor" as defined In the community's floodplain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is: L1 � _L—LJ.1L-. feet NGVD (or other FIRM datum -see Section 6, Item 7). r,,;- m tl,A --tart of construction or substantial improvement r $/ t, COMMUNITY NUMBER 2. PANEL NUMBER 3, SUFFIX 4. DATE OF FIRM INDEX 5. FIRM ZONE S. BASE FLOOD ELEVATIoN (in AO Zones, use depth) 15516 0885 G 9116/88 VE 23 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ NGVD '29 ❑ Other (describe on back) S. For zones A or V. where no BPE is provided on the FIRM, and the community has established a BFE for this building sites, indicate the community's BFE: I I L..._IJ_I -L feet NGVD (or other FIRM datum -see Section B, Item 7), SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicat the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference leve] _ . 2(a), FIRM Zones AI -ASO, AE, AH, and A (with BFI"). The top of the reference level floor from the selected diagram is at an elevation of Li _LLL . LJ feet NGVD (or other FIRM datum -see Section B, Item 7). (b). FIRM Zones V1 -V30, VE, and V (with SFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of iI-l�I 161 feet NGVD (or other FiRM datum -see Section B, Item 7). (c). FIRM Zone A (without 8FE). The floor used as the reference level from the selected diagram is L j 1. iJ feet above U or below 0 (check one) the highest grade adjacent to the building. (d). FiRM Zone AO. The floor used as the reference level from the selected diagram is LJJ .H feet above ❑ or below U (check one) the highest grade adjacent to the building. It no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No 0 Unknown 3. indicate the elevation datum system used in determining the above reference level elevations: ❑ NGVD '29 ❑ Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different then that used on the FIRM (see Section B, Item 71, them convert the elevations to the datum system used on the FIRM and show the conversion gqciation under CommOMS on Page 2.) 4. Elevation reference mark used appears on FiRM: YJ Yes [3 No (See instructions on Page 4) 5. The reference level elevation is based on. .gZ actual construction F] construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate will be required once constructiotl is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is: L1I 11.1L i . J,d feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION D COMMUNITY INFORMATION t. if the community official responsible for verifying building elevations specifies that the reference level Indicated in Section C, atom 1 Is not she "lowest floor" as defined In the community's floodplain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is: L1 � _L—LJ.1L-. feet NGVD (or other FIRM datum -see Section 6, Item 7). r,,;- m tl,A --tart of construction or substantial improvement r $/ P. 04 SECTION E CERTIFICATION This certification is to be signed by a land surveyor, engineer, or arChlreut who is authorized riy stale or local law to 46rtity eie atiCC; information when the elevation information for Zones Al—A30, AE, AN, A (with BFE),V1—V30,VE, anti V (with BFE) is required. Community officials who are authorized by local law or ordinance to Prov oe floodplain management information, may also sign the corli`icstion. In the case of Zones AO and A (without a FEMA or � crnmunily issued BFE), a building official, a proper-ty owner, of an owripr'� repr?sPntative may also sign the cerlifi,alion. Reference level diagrams 6, ; and 8 Distinguishing Features—tt the certifier is unable to certify to enclosure size., location of servicing equipment, area use, watt openings, or unfinished area Feature(s), then list the included in the certification under Comments below. The diagram number, Section C, Item 1, must stili be entered, C ertify that the information in Sections 8 arse' Can this certificate represents my best ettorls to rnt&rpret the dsta av, ;oU;_. ? understand that any fa.tso statement maybe punishable by fine or imprisonment under 18 US- Gode, Section 100 i - a �_ -k V tib t� '►.S%i� s TIf ItF?'S NAME L CEN$l :: NUMBER (,:r AffixS _a to V7,1 N ---- — 7tlt_E Cr3Mf=ANY NAME -` -7v .-- AGL�riE�$ � C-i7Y &GNAT'jAE --- aa.7Ek{— r ern Copies should be made of this Certificate tar: 1) community official, 2) Insurance agcn �r�tr1��3Yy, ` Arne' COMMENT'S: _ ... oN w0 h ... SLABRA�SFMirN? V A 8£r[qEW E IVIE' TAI gO_r,tr,: 11 LF�- No. 6484 r ��f C> 1; j; fi• - The diag—Mals above illustrale the points al vv" ;4Gh tt;R eieV4 1�0nt - Elevc'itions for ell! A zone. Shouid be measUrec," nj the i -N of the rEs'B'Cil::;c = Elevations for a w � should L' aZ %h b i 09 u �ti?r e_,,,tom of !hc