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ELEVATION CERTIFICATE <br />IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.{9 <br />FOR INSURANCE COMPANY USEBuildlng Street Address (including Apt,, Unit, Suite, and/or Bldg. No.) or P,O. Route and Box No.: <br />3009 Dapple Grav Wav <br />City;Ellensburq Stale: WA ZPCode: 9B926 <br />Pollcy Number; _ <br />Company NAIC Number: <br />Cl. Building elevatlons are based on: I Construotion Drawings* [ Buildlng Under Conslruotion* [ Finished Construclion <br />*A new Elevation Certificale will be required when conslructlon of the building is complete. <br />C2, Elevations - Zones A1-A30, AE, AH, Ao, A (wllh BFE), VE, V1-V30, V (wilh BFE), AR, AR/A, AFVAE, AR/A1*A30, AFyAH, AR/AO, <br />A99. Comptete lteme C2.a-h below according to lhe Buildlng Diagram speoified ln ltem A7. ln Puerto Rico only, enter meters. <br />lndicate eleve{ion datum used for lhe elevations ln ltems a) through h) below. <br />Dalum used for building elevalions must be the same as that used for lhe BFE. Gonversion factor used? <br />lf Yes, describe the source of lhe conversion factor in lhe Seclion D Comments aroa. <br />a) Top of bottom floor (includlng basement, crawlspace, or enolosure floor); <br />b) Top of lhe next higher lloor (see lnsiruciions); <br />c) Bottom of lhe lowest horizonlal slructural member (see lnslructlons); <br />d) Attaohed garage (lop of slab): <br />e) Lowest elevation of Machinery and Equipment (M&E) sewicing the buitding <br />(descrlbe type of M&E and looatlon ln Section D Comments area): <br />Q Lowest Adjacent Grade (LAG) next to bulldlng: f] Natural [J RntstreO <br />g) Highost AdJacenl Grade (HAG) next to bulldlng: I Nalural fi finisneO <br />h) Flnlshed LAG at lowest elevallon of ailached deck or staiys, including slructural <br />suppor!: <br />1,597.60 <br />1,597.40 <br />tt/*I leet I meters <br />1 597.60 <br />Benchmark Utilized: Center of S 27 TlBN R18E Vertical Datumr NAVD 1908 <br />{,597,8q <br />1,596.10 <br />[Yes ENo <br />Check the measurement used: <br />I feel I meters <br />! leet I meters <br />fl feet I meters <br />I feet f] meters <br />-----att*-tlr*- <br />@ feei I meters <br />[J leet I meters <br />[f feet I meters <br />n NGVD 1e2e E NAVD 1e88 flother: <br />o <br />This certlflcation ls to be signed and sealed by a land survoyor, engineer, or arohiteot authorized by state law to cer{ifo elevatlon <br />informalion, I certify that the lnformatlon on thls Cefliflcale represents my besl efforls lo inlerpret the data avallable. I undersland that any <br />false s(afemenl may be punlshable by fine or lmprlsonmont under 18 U.S. Code, Section 1001, <br />Were latitude and longitude in Seotion A provlded by a llcensed land surueyor? [ Yes I No <br />ICheck here if altachments and describe in lhe Comments erea. <br />Certifiels Name: Rick Sklnner Llcense Numben 43619 <br />Copy all pages of lhie Elevation Certilicate and all attachments for (1) community olficlal, (2) insurance agenUcompany, and (3) building owner, <br />Heat Pump pad was measured at the lop with the boltom of the heat pump raised <br />Tilei Professional Land Surveyor <br />Company Name: Western Pacific Engineeri ng & Survey, lnc. <br />CZ,e; end description of any <br />an additional eight inches <br />attaohments): <br />State; WA ZIP Code: 98837 <br />Commenls (including source of conversion factor ln C2; type of equlpment and location per <br />with legs <br />Addressr 1224 S. Pioneer Way <br />Emall: rskinner@wPeinc.net765-1023 <br />City: Moses <br />D"b,J/&ISignalure: <br />Telephone:Ext,: <br />FEMA Form FF-20&FY-22-152 (formerly 080-0-33) (10/22)Page 3 of 19