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ELEVATION CERTIFICATE <br />OMB No. 1OW-0003 <br />Expiration Date: November 30, 2022 <br />IMPORTANT: In these spaces, copy the corresponding Information from Section A. <br />FOR INSURANCE COMPANY USE <br />Budding Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Sox No. <br />Policy Number. <br />3008 Dapple Cray Way <br />City State ZiP Code <br />Company NAIL Number <br />Ellensburg Washington 98926 <br />SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) <br />01. Building elevations are based on: ❑ Construction Drawiings* []Building Under Construction* ❑x Finished Construction <br />*A now Elevation Certificate will be required when oonstructlon of the building Is complete. <br />C2. Elevatlons --Zones Al-A30, AE, AH, A (with SFE), VE, Vf-V30, V (with BFE), AR, AR/A, AR/AE, AWA1 A30, AR/AH, ARIAO. <br />Complete Items C2.a-h below ac oording 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 NAVD 1988 ❑ Other/Source: <br />Datum used for building elevations must be the some as that used for the BPE. <br />Check the measurement used. <br />a) Top of bottom floor (including basement, crawlspaoe, or enclosure floor) , 1595.2 ❑rr feet ❑ meters <br />b) Top of the next higher floor WA ❑ feet ❑ meters <br />c) Bottom of the lowest horizontal structural member (V Zones only) WA ❑ feet ❑ meters <br />d) Attached garage (top of slab) 1595.2 rr❑ feet ❑ meters <br />e) Lowest elevation of machinery or equippment servicing the building x feet meters <br />(Describe type of equipment and loca#lo1595.2 <br />n In Comments) d ❑ <br />9 Lowest adjacent (finished) grade next to building (LAG) _ 1594.3 at❑ feet ❑ meters <br />g) Highest adjacent (finished) grade next to building (HAG) 1594.7 0 feet ❑ meters <br />h) Lowest adjacent grade at lowest elevation of deck or stairs, including <br />NIA ❑ feet ❑ meters <br />structural support <br />SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICA11ON <br />This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by IAw to certify elevation informatlon, <br />l certify that the Information on th/s Certificate represents my beef efforts to lnferrMpret the data available. l understand that any false <br />statement may be purr/&*able by fine or imprisonment under 18 U.S. Code, SecBon 1001. <br />Were latitude and longitude in Seclon A provided by a licensed land surveyor? ffl Yes ❑ No ❑ Check hare If attachments. <br />C114�Lt <br />Certifier's Name License Number <br />Rick Skinner 43619 ZsM!VV <br />\VAS��T' <br />Tithe <br />Land <br />Professional Surveyor M <br />Company Name I xj� <br />Western Pacific Engineering & Survey, Inc. oG <br />t <br />f <br />Address ti113� <br />1224 S. Pioneer Way � �l <br />City state ZIP Code <br />Moses Lake Washington 98837 <br />l.r. Y. Mr,i.11lJai�}i <br />Sig Date Telephone EA. <br />(509)765-1023 <br />CoN all pages of this Elevation Certificate end all attachmen& for ) community official, (2) insurance agenticompany, and (3) building owner. <br />Comments (including type of equipment and location. per 02(s), If applicable) <br />Heat pump was on exterior of bullding and on a concrete pad that was measured with gps. The bottom of the heat pump Is resting on <br />legs that raise at a measured height of 8" above the concrete pad. The elevaton for the equipment Is to the bottom of the heat pump. <br />FEMA Form 080-0-33 (12119) Replaces all previous editors. Form Page 2 of B <br />