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ELEVATION CERTIFICATE <br />IMPORTANT: MUST FOLLOW THE INSTRUCTIONS oN PAGES 9-,I9 <br />FOR INSURANCE COMPANY USEBuilding street Address (including Apt., unit, sulte, and/or Bldg. No.) or p.o. Route and Box No.: <br />Cityr EllensQur-g <br />3009 Dapple Gray Way <br />Slate: WA Zlp Code: 98926 <br />Policy Number;---.-'*_- <br />Company NAIG Nurnber: <br />For Zones AO, AR/AO, and A (without BFE), compleie ltems EI-ES. For ltems E1-E4, use <br />lntended to suppoil a Letterof Map Change request, complele Sections A, B, and C. Check <br />enter meters. <br />Bulldlng measurements are based on: fl Construclion Drawings" f] Buildlrg Under Construction* [ Finished Construction*A new Elevatlon Certificate will be required when conslrucllon of the bullding is complete. <br />E1. Provlde measurements (C2.a in applicable Building Dlagram) for the following and cheok the appropriate boxes to show whelher lhe <br />measurement is above or below the nalural HAG and the LAG. <br />E2. For Building Dlagrams 6-9 with permanent flood openings provldod in Section A llems 8 andlor g (see pages 1*2 of Instruclons), the <br />nexl higher lloor (C2.b in applicaNe <br />E5. Zone AO only: lf no flood depth number is available, is lhe top of the boltom floor elevated in acoordance wilh the communibr's <br />floodplain management ordinance? E yes f] No E unknown The local ofliclal must cerli$ this information in secfion G. <br />nalural grade, lf avallable, lf Cerlificate is <br />the measurement used. ln Puerto Rico only, <br />a) Top of boitom lloor (including basemenl, <br />crawlspaco, or enclosure) is; <br />b) Top of bottom floor (including basement, <br />orawlspace, or enclosure) is: <br />I feet I meters I aboveor I betowtheHAG, <br />fl feet I meters I above or f] below the LAG. <br />Building Diagram) of lhe building is: <br />E3. Attached garage (top of slab) is: <br />E4. Top of platform of machinery and/or equipmenl <br />serviclng the bulldlng ls: <br />I feet I melers <br />fl feel ! metere <br />I feet I meters <br />I above or I below the HAG. <br />fl above or I below the HAG, <br />fl above or I botow the HAG. <br />The property owner or own€r's aulhorized represenlalive who completes Se otions A, B, and E for Zone A (wilhout BFE) or Zone AO musi <br />sign here. rfe slalernenls in sectionsA, B, and E are coffect to the best of my knowledge <br />fl Check here if attaohments and descrlbe in the Commenls area. <br />Propedy Owner or Owner's Authorized Representative Narne: Scott Henson <br />City:Moses Lake <br />Date:1 / {4/.wt-l <br />nel <br />Slate: WA ZP Code: 98837 <br />Email: shenson@wpeinc. <br />Address: 1224 S. Pioneer Way <br />Comments: <br />Slgnature; <br />Telephone: (509) 765-1023 Ext.; <br />FEMA Form FF-2$6-FY-22-152 (fomerly 096-0-33) (10l22l Pago 4 of 19