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Home My WebLink About7-2-010:004 Suite 1 - Bungalows 2 & 3 U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency I Expires February 28.2009 (C National Flood Insurance Program Important:- Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For Insurance Company Use: Al.MAt l.MAga lame]rwrae- 'I 1...t.4. Policy Number . A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number c2--trio u9u 1rE( c7 tom, 5�r-r�E..* 1 (esa t [s 243) ity t uSa►-t.� ► to ZIPcoa_�., �. u1& t (P,Qe: lit t) 96- 9-i A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) T' MJc., 7- 2-tc% 4 ' a3.t�," 10 i � 44‘1,111 15 5 ./ A4. Building Use(e.g.,Residential,Non- side tial, dition,Accessory,etc.) - aO.- r A5. Latitude/Longitude:Lat.'1t.11.12a4:11. Long. - Horizontal Datum: ❑NAD 1927 ►,1 NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number A8. For a building with a crawl space or endosure(s),provide: A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s) sq ft a) Square footage of attached garages9 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 A9.b scl in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION ' B1.NFIP Community Name&Community Number B2.County Name B3.State Hawaii County 155166 Hawaii County Hawaii B4.Map/Panel Number 85.Suffix 86.FIRM Index B7.FIRM Panel 68.Flood B9.Base Flood Elevation(s)(Zone Date E ctive/Revised Date Zone(s) AO,use base flood depth) 1551664`0' . G 4/02/04 140/1 fP2e7 Ae ci.o B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. . 0 FIS Profile EXFIRM 0 Community Determined 0 Other(Describe) B11. Indicate elevation datum used for BFE in Item B9:54 NGVD 1929 0 NAVD 1988 0 Other(Describe) 812. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)?• 0 Yes ® No 0 Designation DateCBRS OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: 0 Construction Drawings* 0 Building Under Construction' 14 Finished Construction •A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE.V1-V30,V(with BFE),AR,AR/A,ARAE,AR/Al-A30.AR/AH,AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item A7. `, Benchmark Utilized gm Vertical Datum NGV t7 ICY2 Conversion/Comments - - - - - -- - N.A. eCheck the measurement used. .�-s a) Top of bottom floor(including basement,crawl space,or enclosure floor) (0 ` IN feet 0 meters(Puerto Rico only) b) Top of the next higher floor Zv .91181 feet 0 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) 0 feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building. (Q . [ilfeet 0 meters(Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent(finished)grade(LAG) 10 III feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade(HAG) 10 feet ❑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 data available. I understand that any false statement maybe punishable by fine or imprisonment under 18 U.S.Code, Section 1001. 0��, R. "`IB XCheck here if comments are provided on back of form. F\, • REGISTERED Certifiers Name * pQ3SIONAL i t . �_p�.p �.,,.�cr License Number T�GT� �L-�C� AiCffiTFCT } * 1 T' � C a Na a /` / �' - C L EI��L rt S. No.•34(14 Address , Z. Ci It.b [ttate 6 e� �;•ts• �_u s- ...: Signature 'l��i /�1� Telephone .'ts2-10 An •.. FEMA Foi 81- ,February 2006 See reverse side for continuation. Replaces allP revious editions ,.,,r yrs I PN... is. uieae apa..ea,uupy we corresponuing inrormation rrom aecuon A. i-or insurance company Use: Building Street Address(including Apt. Unit,Suite,and/or Bldg.No.)or P. o to and Box No. Policy Number ASA1,44 tL Al l 1 LE5v140�S 1 Lt..G , Irl giNG- h15 143) ' . City State ZIP ode Company NAIC Number 7''^i ' PL 2 w.. -t 1Ar�lstst1 (ro.I411t9) WI5 SECTION D SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) , ,:opy both sides of this Elevation rCertificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments [ Q c l Jiti cmc ia1 --+•1 "1..4:; ‘,F- a j Signature :I.r,(71)(ISL> Date /Z f( /C$ , 0 Check here if attachments SECTIO -BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED)FOR ZONE AdAND ZONE A(WITHOUT BFE) For Zones AO a and A(without BFE),complete Items El-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items El-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters. El. 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 0 meters 0 above or below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is _[3feet 0 meters 0 above or below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Sectin Items 8 and/or 9(see age 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is _0 feet meters 0 above or U below the HAG. E3. Attached garage(top of slab)is ❑feet 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _❑feet 0 meters 0 above or 0 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? 0 Yes 0 No ❑Unknown. The local official must certify this information in Section G. j 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 are correct to the best of my knowledge. Prade.Owner's orsAu,ovrrized �s�ntaGs }�m� '&tress RQ�-►� ems'--'_'..'fA. }ttte ��i7 � Signature Datlahsbg Tele h� `jam 77��• Comments ❑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. Check the measurement used in Items G8.and G9. G1. 0 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. 0 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. 0 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: 0 New Construction 0 Substantial Improvement GB.Elevation of as-built lowest floor(including basement)of the building: 0 feet 0 meters(PR) Datum G9.BFE or(in Zone AO)depth of flooding at the building site: 0 feet 0 meters(PR) Datum • Local Official's Name Title Community Name Telephone Signature , ENGtNEE10; D! Date Rev;e*ed • ` ' Comments ` 'Dote i /Z// 7/08 Approved ❑�Lco ' :‘,' 0 Approved as Noted ❑Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions