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IMPORTANT: ln 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 <br />1803 SR 970 <br />Policy Number: <br />City <br />Cle Elum <br />State <br />Washington <br />ZIP Code <br />98922 <br />Company NAIC Number <br />sEcTtoN E - BUTLDTNG ELEVATTON TNFORMATTON (SURVEY NOT REQUTRED) <br />FOR ZONE AO AND ZONE A (W|THOUT BFE) <br />For Zones AO and A (without BFE), complete ltems E1-E5. lf the Certificate is intended to support a LOMA or LOMR-F request, <br />complete Sections A, B,and C. For ltems E1-E4, use nalural grade, if available. Check the measurement used. ln Puerto Rico only, <br />enter meters. <br />E1. Provide elevation information for the following and check the appropriate boxes to show whelher the elevation is above or below <br />the highest adjacent grade (HAG) and lhe lowest adjacent grade (LAG). <br />flood openings provided in Section A ltems 8 and/or 9 (see pages 1-2 of lnstructions), <br />E5. Zone AO only: lf no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's <br />floodplain management ordinance? [ Yes I No ! Unknown, The local official must cerlify lhis information in Seition G. <br />2.O <br />2.0 <br />1.0 I feet ! meters ! above or $ betow rhe HAG <br />3.0 <br />0.5 Elfeet ! meters n above or $ betow the LAG. <br />E2. For Building Diagrams 6-9 with permanent <br />the next higher floor (elevation C2.b in <br />the diagrams) of the building is <br />E3. Attached garage (top of slab) is <br />Elteet f, meters E above or [betow the HAG. <br />I feet I meters I above or I below the HAG. <br />ffifeet I meters [] above or flbebw the HAG. <br />E4. Top of platform of machinery and/or equipment <br />servicing the building is <br />a) Top of bottom floor (including basemenl, <br />crawlspace, or enclosure) is <br />b) Top of bottom floor (including basement, <br />crawlspace, or enclosure) is <br />sEcTlON F - PROPERTY OWNER (OR OWNER',S REPRESENTATIVE) CERT|F|CAT|ON <br />The property owner or owner's aulhorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or <br />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. <br />Properly Owner or Owner's Authorized Representative's Name <br />Jeff Smallwood <br />Address <br />PO BOX 154 <br />City <br />Ronald <br />State <br />Washinglon <br />ZIP Code <br />98940./. t/') <br />Telephone <br />(206) 650-0227 <br />Signature <br />-J- -Zct2o <br />Date <br />n Cne* here if attachmenls. <br />ELEVATION CERTIFICATE OMB No, 1660-0008 <br />Expiralion Date: November 30,2022 <br />FEMA Form 086-0-33 (12t19)Replaces all previous edilions.Form Page 3 of 6