Laserfiche WebLink
ELEVATION CERTIFICATE <br />OMB No 1660.0008 <br />Expiration Date Novembe►.3 2022 <br />IMPORTANT: In these spaces, copy She corresponding Information from Section A. <br />FOR INSURANCE COMPANY USE <br />Building Street Address jincluding Apt Unit. Suite, and/or Bldg Noy or P O Route and Box No <br />Policy Number <br />18401 Salmon Is Sac Road <br />City State ZIP Code <br />Company NAIC Number <br />Ronald Washington 98940 <br />SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) <br />C1 Building elevations are based on: ❑ Construction Drawings* [] Building Under Construction" ® Finished Construction <br />'A new Elevation Certificate will be required when construction of the building is complete. <br />C2 Eievations -Zones Al-A30. AE, AH, A (with BFE), VE, V1-V30, V (with EFE), AR, ARIA, AR1AE, ARIA1-A30, AR/AH, ARIAO <br />Complete Items C2 afi below according to the building diagram specified in Item AT In Puerto Rico only, enter meters <br />Benchmark Utilized. WSRN Vertical Datum: NAVD 88 <br />Indicate elevation datum used for the elevations in items a) through h) below. <br />❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: <br />Datum used for building elevations must be the same as that used for the 8FE. <br />Check the measurement used <br />a) Top of bottom floor (including basement, crawispace, or enclosure floor) 2289.7 ® feet ❑ meters <br />b) Top of the next higher floor 2299.9 feet ❑ meters <br />c) Bottom of the lowest horizontal structural member (V Zones only) N/A © feet ❑ meters <br />d) Attached garage (top of slab) 2289.7 ® feet ❑ meters <br />e) Lowest elevation of machinery or equipment servicing the building 2297.8 lest ❑ meters <br />jDescnbe type of equipment and locabon in Comments) - <br />f) Lowest adjacent (finished) grade next to building (LAG) 2286.0 ® feet ❑ meters <br />g) Highest adjacent (finished) grade next to building (HAG) 2299.0 m feet ❑ meters <br />h) Lowest adjacent grade at lowest elevation of deck or stairs, including 2286.0 0 feet ❑ meters <br />structural support <br />SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION <br />This c artiflcation is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information <br />f certify that the inframabort on this CerMcate represents my best efforts to interpret the data available. I understand that any false <br />statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. <br />Were latitude and longitude in Section A provided by a licensed land surveyor? ®Yes ❑ No <br />Certiffer's Name License Number <br />Samuel R Ward 52843 iyO <br />-_ <br />_ 7Rle <br />Professional tend Surveyor <br />Company Name <br />APS Survey & Mapping <br />13221 SE 26th Street, Suite A <br />HAL <br />city Stain ZIP code L11tzD <br />Bellevue Washington 98005 <br />Signature pale Telephone End <br />13.2022 (425) 148 3200 i t t <br />Copy all pages of lilts Elevation Certitats and all attachments for (1) c timunily Official, (2) Irtsuranf.•d aWlitrrpiiriianv. ani i1) boikttny o%ner j <br />Comments (induding type of equipment and location, per C2(e), of applicable) <br />The type of machinery servicing the building, on section C2a , rs a hvac unit located an the autsrdd ul the noitham buikiiny wail <br />L".m I]l G <br />FEMA Form 086-0.33 (12/19) Replaces all previous eanions - -V <br />