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ELEVATION CERTIFICATE <br />OMB No.1660-0008 <br />Expiration Date: November 30, 2022 <br />IMPORTANT: in these spaces, copy the corresponding information from Section A. <br />FOR INSURANCE COMPANY USE <br />Building Street Address (including Apt., unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. <br />Policy Number. <br />2919 Roan Drive <br />City State ZIP Code <br />Company MA -IC Number <br />Ellensburg Washington 98926 <br />SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) <br />CS. Building elevations are based on: ❑ Construction Drawings" ❑ Building Under Construction" M Finished Construction <br />"A new Elevation Certificate will be required when construction of the bcrilding Is compete. <br />C2. Elevations - Zones Ai-A30, AE, AH, A (with OFE), VE, VI-V30, V (with SFE), AR, ARIA, ARIAS, ARIA1-MO, ARlAH, AR/AO. <br />Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. <br />Benchmark Utilized: Center of S 27, T 18 N, R 18 E Vertical Datum: NAVD 1988 <br />Indicate elevation datum used for the elevations In items a) through h) below. <br />❑ NGVD 1929 ❑x NAVO 1088 ❑ Other/Source: <br />Datum used for buiding elevations must be the same as that used for titre BFE. <br />Check the measurement used. <br />a) Top of bottom floor (Including basement, crawlspec% or enclosure floor) 1600.6 0 feet ❑ meters <br />b) Top of the next higher floor NIA ❑ feet ❑ meters <br />c) Bottom of the lowest horizontal structural member (V Zones only) NIA ❑ feet ❑ meters <br />d) Attached garage (top of stab) 1600.6 d feet ❑ meters <br />ej Lowest <br />fuildon servicing the ��ing (Describe type of equipment machinery or <br />Co vnents) 1600.2 feet Q meters <br />f) Lowest adjacent (finished) grade next to building (LAO) 1599.6 []x feet ❑ meters <br />g) Highest adjacent (finished) grade next to building (HAG) 1600.0 feet ❑ meters <br />h) Lowest adjacent grade at lowest elevation of deck or stairs, including <br />N/A ❑ feet ❑ meters <br />structural support <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 />r certify that the Information on this Certfficate represents my best efforts to Werrppret the data aveNable. { understand that any fares <br />siatemenf maybe purdshable by Sao orlmprisonment under 18 U. S. Code: , oWn 1001. <br />Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes ❑ No ❑ Check here fi attachments. <br />Ceditlees Name License Number <br />Ride Skinner 43619 <br />�tM!AIW <br />'nos <br />Professional Land Surveyor <br />Ckr��r <br />- 0. <br />Company Name <br />Western Pacific Engineering 8 Survey, Inc. <br />"b Zia: <br />43619 <br />Address <br />1224 S. Pioneer Way <br />• , ... 1?.�rr'� <br />AL i.AN� <br />City State ZIP Code <br />Moses Lake Washington 98837 <br />1 <br />Sigrmture ; <br />Date Telephone Ext. <br />,. �_ ..._............. .._.....� .. ZZ41,2 (609) 76&1023 <br />Copy all p46es of this Elevation Certificate and all attachments for ( oo un official, (2) Insurance agent/cornpany, and (3) building owner. <br />Comments (including type of equipment and location, per C2(s), # applicable) <br />The elevation of the heat pump located outside of tome was measured by using a GPS and then adding the height of the legs for the <br />heat pump. <br />FEMA Form 066-0-33 (12119) Replaces all previous editions. Form Page 2 of 6 <br />