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IMPORTANT: In these spaces, copy the, corresponding Information from Section A. For Insurance Company Use:
Building Street Address (including Apt., Unit, Slyte, and/or Bldg. No.) or P.O. Route and Box No. Policy Number
66-1703 ALANEO ST. (LOT 37) _
City Slate ZIP Code ? Company NAIC Number
KAMUELA HI - 96743
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
ITEM C2.e - 50 GAL ELECTRIC WATER HEATER, RELIANCE 606 SERIES
a*1111
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 Items 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 (inducting 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 ❑ meters ❑ above or ❑ below the LAG.
E2. For Building Diagrams 6-8 with permanent flood openings provided In Sectig0a4 Items 8 and/or 9 (see image 8 of Instructions), the next higher floor
(elevation C2.b In the diagrams) of the building is _ ❑ }eet Ll maters 0 above or LJ 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 ❑ meters ❑ 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 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 owners 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. The statements In Sections A, B, and E aro correct to the best of my knowledge.
_ Property Owners or Owner's Authorized Representative's Name
IIcaress city State ZIP Code
Signature Date Telephone
❑ Check here If attachment
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who Is authorized by law or ordinance to administer the communfty's floodplain management ordinance can complete S,
and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used In Items G8. and G9.
Gt. ❑ 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 by law to certify elevation Information. (Indicate the source and date of the elevation data In the Comments area below.)
G2. ❑ 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. ❑ The following Information (Items G4. -G9.) is provided for community floodplain management purposes.
G7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters (PR) Datum
G9. BFE or (in Zone AO) (MW cDJ9p ft9A t�bidf n9WiC Works ❑ feel ❑ meters(PR) Datum
Local Official's Name-guvFuwed Title
,FlAyntkmn ('Artifirnf.[.Ad Community Name � Telephone
Co/ recy�ds
Signature f I d ns n t recommend Date
D atP 8h F3 & 5 ❑ Checc her, if attachments
FEMA Form 81-31, February 2006 Replaces all previous editions