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HomeMy WebLinkAbout2-1-016:002U.S. DEPARTMENT OF HOMELAND SECURITYELEVATION CERTIFICATE OMB No. 1660-0008 FEDERAL EMERGENCY MANAGEMENT AGENCY Namcw, Fiord lawrame Program Expiration Date: July 31, 2015 IMPORTANT: Fallow the instructions on pages 1-9. I SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al, Building Owner's Name Reno Kai Lau Polley Number: A2. Buildin Str ei Address (including t., Unit, Suite, and/or Bldg. No.) or p0. Route and Box No. Company MAIC Number. City Hilo State Hi ZIP Code 96720 A3. Property Description (Lot and Block Numbers. Tax Parcel Number, Legal Description, etc.) Por Gr 11062 to Ah Kul Aina; Waiakea, South Hilo, Hawaii, TMK(3) 2-1-016: 002 _ A4. Building Use (e.g., Residential, Non -Residential. Addition, Accessory. etc.) Ab. Latitude/Longitude: Lat. N 1944',DLE Long. W 155-01'-46.3" Horizontal Datum: ExI NAD 1927 rj NAD 2983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain 'toad insurance. A7. Building Diagram Number 5 A8. For a building with a crawlspace or endosure(s): A9. For a bu:l&ng with an attached garage: a) Square footage of crawispace or enclosure(s) N/A sq ft a) Square footage of attached garage NIA sq ft b) No. of permanent flood openings in the crawispace or b) Number of permanent flood openings to the attached garage enclosure(s) within 1,0 foot above adjacent grade NIA within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A w_.__ sq in d) Engineered flood openings? ❑ Yes C No d) Engineered flood openings? ❑ Yes ®No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community ame A om unity N 82. County Name I B3. State Hawall Goun 66 Hawaii Count _ _ _Hawaii 84. Map/Panel Number B5. Suffix 86. FIRM index Date 67. FIRM Panel Effective/ 88. Flood Zones) 1 89. Base Flood Elevation(s) (Zone Revised Datei A0, use base flood depth) 155166 C 04/02/2004 09/16/1988 VE 21.00 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69. _1 FIS Profile CR FIRM ❑ Community Determined [3 Other/Source' B11. Indicate elevation datum used for BFE in Item 89_ ® NGVD 1929! NAVD 1988 ❑ Other/ Source: _ w..._. B12. Is the building located in a Coastal Barrier Resources System (CORS) area or Otherwise Protected Area iOPA)? Yes LX No Designation Date: / % 0 CORS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' Fl Building Under Construction, '29 Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones Ai -A30, AE, AH, A (with BFE), VE, Vi -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. in Puertc Rico only, enter meters. Benchmark Utilized: E 2 Vertical Datum: NAVD 1929 _ Indicate elevation datum used for the elevations in items a) through h) below. i8 NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 23 . 85 X feet [] meters b) Top of the next higher floor _ .._N/A . _ _ r- feet i`] ureters c) Bottom of the lowest horizontal structural member (V Zones only;, ______22 , .15 LR feet "] meters d) Attached garage (top of slab) ___ N/A_ , ...__ i._i feet ;_A meters e) Lowest elevation of machinery or equipment servicing the building 2 . 3 _._... __. (x feet -1 meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 6 . 5 X feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) _ _7_ . 2 feet E] meters h) Lowest adjacent grads at lowest elevation of deck or stairs. including __ 8 . 43 M feet (_j meters 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 elevatiin information. i certify that the information on this Certificate represents my hest efforts to tntprpretrPe data avadahie �t I understand that any false statement may be punishable by fine or irnprisunmenr under 18 U S Code Sec!toil I i01. J Check here if comments are provided on back of form. Were latitude and iongiltide in Section A Prov ded by a LI NSEO try u Check here if attachments. licensed land s irvevor? 9 Yes 7_1 No PROFESSIONAL i Certifier's Name. .-sir Sv p, r. 0, ___.�___._.�� - Wb I Shawn Christensen 12767 SURVEYOR _._.. - Title CompaayName _ tr(p, ,1,2767 LPLS MANA LAND CONSULTANTS LLC. Adoress City at? /if, r ,nr POB X 1103 J KAPAA ; HI 96746.. j �i, f ( U ,S n D� ate -eeFrro,c- ~" 104/02/2015_ i (808)430-5409 FEMA Form 086-0.33 (7/12) See reverse side for continiabon. Replaces all previous editions. ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the conespondfng Hdolmation from Section A. FOR INSURANCE COMAWY USE Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or R0. Route and Box No. Policy Number: 1693 Kalanianaole Street City State ZIP Code Company NAIC Number: Hilo Hi 96720 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 No machinery or equipment below base flood elevation. Refrigerator located at the Southwest corner of the structure, electric motor of refrigerator being 3.35 ft above the base flood elevation. Date 03/02/2015 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 ES -E5. If the Certificate is intended to support a LOMA or LOMB -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. 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 basemerti, craw►space, or enclosure) is _ feet ❑ meters U above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ,____- .[- feet -1 meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is . feet ❑ meters E❑ 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 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. 8, and E are correct to the best of my knowledge. Property Owner 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 it Items G8 -G10. In Puerto Rico only. enter meters. 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 . ,evation 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 A0. G3. ❑ 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 G 7. This permit has been issued for: Construction C Substantial Improvement G8. Elevation of as -built lowest floor (inciu.. easement) of the building: _ ❑ feet Ci meters Datum G9. BFE or (in Zone AO) depth of flooding :.:::,e building site: . 17 feet. L-1 meters Datum G10. Community's desi "veritPublicWorks_ . __.._..— _! feet ❑ meters Daturn Local Official's Name elmol"nierlra! ['rsryt p has r vitt<Wf'-d Title Community Name the E'Vo t tCri t•-litticafedot Telephone Signature Comments i FEMA Form 086.433 (7/06te Date. - ❑ Check here it attachments. Replaces all previous editions.