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Home My WebLink About7-2-010:004 Bridge Suite 6 ._,, .. e U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE I OMB No. 1660-0008 Federal Emergency Management Agency Expires March 31,20 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name Hualalai Investors LLC Policy Number A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIL Number 72-100 Kaupulehu Drive, Suite 1 (Bridge Suite 6) City State ZIP Code Kailua-Kona_, Hawaii 96745 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) TMK: 3 7-2-010:004 101 'Af,R/n `�f0 55‘ ) n A4. Building Use(e.g.,Residential,Non-R sidential,Addition,Accessory, ry,etc.) Hote . A5. Latitude/Longitude:Lat. 19.8281° N Long. 155.9920° W Horizontal Datum: ❑NAD_1927 E NAD 198 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number I A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) sq ft a) Square footage of attached garage sq ft b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b sq in c) Totnet ef d on9sq in d) Engineered flood openings? ❑Yes ❑No d) ET on ar floodaoflood openings?penigs❑in AYes.b ❑ No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 81.NFIP Community Name 8 Community Number B2.County Name B3.State Hawaii County 155166 .Hawaii Count Hawaii B4.Map/Panel Number B5.Suffix B6.FIRM Index B7. FIRM Panel 88.Flood B9.Base Flood Elevation(s)(Zone 155166478 C Date Effective/Revised Date Zone(s) AO,use base flood depth) 4/02/04 9/16/1988 AE 9.0 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. 0 FIS Profile ®FIRM Community Determined 0 Other(Describe) B11. Indicate elevation datum used for BFE in Item B9: ®NGVD 1929 0 NAVD 1988 ❑Other(Describe) 812. Is the building located in a Coastal Barrier Resources System(CBRS)area orOtherwise Protected Area(OPA)? 0 Yes ® No Designation Date 0 CBRSOPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: 0 Construction Drawings* 0 Building Under Construction' i 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,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized RM 65 Vertical Datum NGVD 1929 Conversion/Comments Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 12. 86E feet 8•�meters(Puerto Rico only) b) Top of the next higher floor 22. 840 feet LJ meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) 1-'/A ._❑feet 0 meters(Puerto Rico only) d) Attached garage(top of slab) • NIA . ❑feet 0 meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 12. 860 feet 0 meters(Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 1 7_ 5 5®feet 0 meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 17 .19_111 feet D meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including NSA ._❑feet ❑meters(Puerto Rico only) structural support 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. l certify that the information on this Certificate represents my best efforts to interpret the data available. O��T K Y I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. O Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a Q` �F ED licensed land surveyor? ®Yes 0 No LICEfSION PROFESSIONAL Certifier's Name License Number * LAND Robert K.Y. Lee L.S. 5075 SURVEYOR Title Company Name President Towill, Shigeoka & Associates, Inc. \\ , ,io.5O75 Address City State ZIP Code 2153 N. King Street, S-308 Hawaii 96819 y"Rr Honolulu, c,A Signature , O Date Telephone (I. 6" April 7• , 7009 808-5_38-3857 FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions • _ IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use: Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Policy Number 72-100 Kaupulehu Drive, Suite 1 (Bridge Suite 6) Ci State ZIP Code Company NAIC Number K'ailua—Kona, Hawaii 96745 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. • Comments Elevation listed in C2.e is for air conditioning units within the suites. — ' 28, 2009 SignatureDate ❑ Check here if attachment: SECTION E BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO 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,crawlspace,or enclosure)is •_ ❑feet meters ❑above or ❑below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclosure)is _ Ofeet ❑meters ['above or ['below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Sectio Items 8 and/or 9(see ages 8-9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is _❑feet u meters 0 above or u below the HAG. E3. Attached garage(top of slab)is 0 feet 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _0 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 ❑No 0 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. The statements in Sections A,B,and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone • 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 09, G1. 0 The information in Section C was taken from other documentation that hasbeen 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. I G4.Permit Number I G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued 1 G7. This permithas been.issued for: 0 New Construction 0 Substantial Improvement J 08. Elevation of as-built lowest floor(including basement)of the building ❑feet CImeters(PR) Datum G9. BFE or(in Zone AO)depth of flooding at the building site 0 feet 0 meters(PR) Datum G10.Community's design flood elevation ❑feet 0 meters(PR) Datum Local Official's Name Title Engineering Division has revld Community Name the Elevation Certificate and Telephone Signature recommends Date Comments ❑ docs not rccommend final approval l05/1;.%)- ❑Check here if attach rnents FEMA Form 81-31, Mar 09 Da* ��` — Replaces all previous editions