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HomeMy WebLinkAbout7-2-010:004 Bridge Suite 1 May-18-2009 03:50pm From-TOWILL,SHIGEOKA & ASSOC.,INC. 8085379478 T-916 P.004/007 F-861 U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency Expires March 31,2012 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 Policy Number Hualalai Investors,- LLC A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No,)or P.O.Route and Box No. Company NAIC Number 72-100 Kaupulehu Drive, Suite 1 (Bridge Suite 1) _ City State ZIP Code Kai1ia-Kona, Hawaii 96745 A3.Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) TMC: 7-2-010:004 i' _ t _ n ..- , A4. Building Use(e,g.,Residential, on-Residential,'Ad•ition,Accessory,e .) Hotel . _ A5. Latitude/Longitude:Lat 19.8293° N Long. 155�2897° W Horizontal Datum: 0 NAD 1927 El 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 AS. For a building with a crawispace or enclosure(s): A9. For a building with an attached garage; a) Square footage of crawispace or enclosure(s) sq ft a) Square footage of attached garage sq ft b) No.of permanent flood openings in the crawispace 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) Total net area of flood openings In A9.b sq in d) Engineered flood openings? 0 Yes 0 No d) Engineered flood openings? 0 Yes []No SECTION 8-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 51.NFIP Community Name&Community Number B2.County Name ' 83.State _ Hawaii County 155166 . Hawaa,i County Hawaii 84.Map/Panel Number B5.Suffix 86.FIRM Index 87.FIRM Panel 88.Flood 89.Base Flood Elevations)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) ,155166478 C 4/02/04 9/16/1988 AE9.0 510. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 139. ❑FIS Profile ®FIRM Community Determined 0 Other(Describe) - 611. Indicate elevation datum used for SPE in Item 89: 1 I 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 Cil No Designation Date 0 CBRS 0 OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)_ _ Cl. Building elevations are based on: 0 Construction Drawings' ❑ Building Under Construction ] 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 NOVIZ 1929 Conversion/Comments _ Check the measurement used. a) Top of bottom floor(including basement,crawispace,or enclosure floor) 10, 95 feet ❑meters(Puerto Rico only) b) Top of the next higher floor 20 ..22 J feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) 0 feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) . ._❑feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 10,,, .®feet 0 meters(Puerto Rico only) (Describe type of equipment and location in Comments) • f) Lowest adjacent(finished)grade next to building(LAG) 10,-U®feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(NAG) _J 7;, 6.11)feet 0 meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including `❑feet 0 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. I certify that the information on this Certificate represents my best efforts to Interpret the data available, �(�T�.)+ /understand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001. ��� 40 Check here if comments are provided on back of form. Were latitude and longitude in Section A,,PProvided by a LICENSED licensed land surveyor? ]Yes L]No PROFESSIONAL. Certifier's Name License Number -'- *I LAND * Rah�C. R.Y. Lee L.S. 5075 __._. SURVEYOR Title Company Name No.5075 President Towill,rShijeoka & Associates, Inc. Address, 5tatBP Code 1, p' 7153 IQ t, ' g Street, S-i Honolulu, Hawaii 9651Y ,,,,,, 4WAIIH-'----- .. QP" Signature Date Telephone April 28, 2009 808-5383857 ._ _FEMA Form 81-31,Mar09 See reverse side for continuation. Replaces all previous edtons May-18-2009 03:51pm From-TOWILL,SHIGEOKA & ASSOC.,INC. 8085379478 T-916 P.005/007 F-861 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 Drives Suite 1 (Bridge Stzlte 1) City State ZIP Code Company NAIC Number Kailua-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 i,tni,.ts within the suites. A.ril 28, 2009 Signature ell Date - ' 0 Check here if attachments SECTION E-BUILDING EL VATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BEE) For Zones AO and A(without BFE),complete Items El-Es. 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(MAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawispace,or enclosure)is _ _ feet meters Elabove or ❑below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclosure)is ]feet [meters above or 0 below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Sectio,1LA, Items 8 and/or 9(see a es 8-9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ._D feet Li meters above or U below the HAG. E3. Attached garage(top of slab)is ; 0 feet 0 meters ©above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building ia- _ _0 feet ❑meters 0 above or 0 below the HAG. ES. 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 D 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 Owners or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments 0 Check here if attachments SECTION 0-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. 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. D The following information(Items 04-GO)is provided for community floodplain management purposes. CA.Permit Number G5. Date Permit Issued GB. Date Certificate Of Conlpllance/Occupancy Issued G7. This permit has been issued fon 0 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)depth of flooding at the building site 0 feet 0 meters(PR) Datum G10.Community's design flood elevation 0 feet 0 meters(PR) Datum„ Local Official's Name The Department of Public Works Title Community Name Engineering Division has reviewed Telephone the rcvettion Cert�fiLoIe and Signature Date r r recommends .-- - - Comments n •oes of recommend ,.;..a' .ppr"vel •----------- — s 0 c , here if attachments FEMA Form 81-31,Mar 49 Date `5/�9/a Replaces all previous editions