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ELEVATION CERTIFICATE <br />OMB No. 1660-0008 <br />Expiration Date: November 30, 2022 <br />IMPORTANTs 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 />3006 Dapple Gray Way <br />City State ZIP Code <br />Company NAIC Number <br />Ellensburg Washington 98926 <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 Al—A30, AE, AH, A (with BFE), VE, Vi—V30, V (with BFE), AR, AR/A, AR/AE, AR/A1— ill, ARIAH, AR1AO. <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: Center of S 27. T 18 N, R 18 E Vertical Datum: NAVO 1988 <br />Indicate elevation datum used for the elevations In Items a) through h) below. <br />❑ NGVD 1929 ❑x NAVD 1988 ❑ OtherlSource: <br />Datum used for building elevations must he 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) 1594.8 ❑x feet ❑ meters <br />b) Top of the next higher floor N/A ❑ 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) 1594.8 ❑x feet ❑ meters <br />servicing the building x <br />e) Lowest elevation of machinery or equip1594E feet meters <br />(Describe type of equipment and location In Comments) ❑ ❑ <br />f) Lowest adjacent (finished) grade next to building (LAG) 1593A ❑x feel ❑ meters <br />g) Highest adjacent {finished) grade next to building (HAG) 1593.9 (] feet ❑ meters <br />h) Lowest adjacent grade at lowest elevation of deck or stairs, including <br />structural support N/A ❑ 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 />I certify that the Information on this Certificate represents my best efforts to Interpret the date available. I understand that any false <br />statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. <br />Ware latitude and longitude In Section A provided by a licensed land surveyor? ElYes ❑ No ❑ Check here if attachments. <br />Certiflees Name License Number <br />Rick Skinner 43619 <br />S <br />f 4IIA51y� <br />Title <br />Professional Land Surveyor <br />rt O; <br />Company Name <br />Western Pacific Engineering & Survey, Inc. <br />Z aC <br />+� 61 <br />I <br />Address <br />1224 S. Pioneer Way <br />City Slate ZIP Code <br />Moses Lak 7Washington 98837r <br />� <br />Signature <br />ate Telephone Ext. <br />(509) 766-1023 <br />Copy all Nges of this Elevation Certificate and all attachm is for (1) community official, (2) insurance agent/company..and (3) building owner. <br />Comments (including type of equipment and location, per C2(e), if applicable) <br />The elevation of the heal pump located outside of home was measured by using a GPS and then adding the height of the legs for the <br />heat pump. <br />FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 2 of 6 <br />