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ELEVATION CERTIFICATE OMB No. 166()-0008 <br />Expiration Date: November 30, 2022 <br />IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE <br />Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number. <br />8160 SR 970 <br />City State ZIP Code Company MAIC Number <br />Cie Elum Washington 98922 <br />SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) <br />C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction* 0 Finished Construction <br />*A new Elevation Certificate will be required when construction of the building is complete. <br />C2. Elevations - Zones AI -A30, AE, AH, A (with BFE), VE, VI -V30, V (with BFE), AR, ARIA, AR/AE, Ala/A7-A30, AR/AH, AR/AO. <br />Complete Items C2.a-h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters. <br />Benchmark Utilized: 5X0877 Vertical Datum: NGVD 29 <br />Indicate elevation datum used for the elevations In items a) through h) below. <br />❑x NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: <br />Datum used for building elevations must be the same as that used for the BFE. <br />Check the measurement used. <br />a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 1880.8 Ex] feet ❑ meters <br />b) Top of the next higher floor 1884.7 ❑x feet ❑ meters <br />c) Bottom of the lowest horizontal structural member (V Zones only) NIA ❑ feet ❑ meters <br />d) Attached garage (top of slab) 1882.5 ❑x feet ❑ meters <br />e) Lowest elevation of machinery or equipment servicing the building x <br />(Describe type of equipment and location in Comments) 1882.6 ❑ feet ❑ meters <br />f} Lowest adjacent (finished) grade next to building (LAG) 1881.8 ❑x Beet ❑ meters <br />g) Highest adjacent (finished) grade next to building (HAG) 1883.1 ❑x feet ❑ meters <br />h) Lowest adjacent grade at lowest elevation of deck or stairs, including <br />structural support 1881.8 ❑x feet ❑ meters <br />SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION <br />This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. <br />1 certify that the information on this Certificate represents my best etlorts to interpret the data available. I understand that any false <br />statement may be punishable by find or imprisonment under 18 U.S. Code, Sectlon 1001. <br />Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes ❑ No ❑ Check here if attachments. <br />Certifier's Name License Number <br />Dustin L. Pierce 45503 - - <br />Tale <br />Professional Land Surveyor <br />Company Name <br />Encompass Engineering & Surveying <br />Addresster. `..' <br />407 Swiftwater Blvd. �* t S X5503 <br />, r9TV <br />CRY State ZIP Code Y -L ; WD <br />Cie Elum Washington 98922 <br />Sign s Date Telephone Ext. <br />06-05-2020 {509} 674-7433 208 <br />Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agenticompany, and (3) building owner. <br />Comments (including type of equipment and location, per C2(e), if applicable) <br />Elevation on line C2(e) Is at base of Beat Pump <br />FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 2 of <br />