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ELEVATION CERTIFICATE OMB No 1660 0008 <br />Exprralron Dale November 30 ?.02?, <br />IMPORTANT: ln thege Bpece!, copy lhe correspondlng lnformstlon from Secllon A FOR INSURANCE COMPANY USE <br />Buildrng stre€t Address (includrng Apl , unit. suile, and/or Bldg No ) or P o Roule and Box No <br />18401 Salmon la Sac Road <br />Slate <br />Washington <br />ZIP Code <br />98940 <br />C'ty <br />Ronald <br />Policy Number <br />eompany ruAiC ttumuer <br />sEcTroN c - BUtLD|NG ELEVATTON TNFORMATTON (SURVEY REQUTRED) <br />C1 Buildrng elevaltons are based on. n Construction Drawings' I Building Undsr Conslructton' fi] Frnished Construction <br />'A new Elevslion Cerlilicate wll be required when conslruclion ol lhe building is complete. <br />c2 Elevalions - Zones A1-A30. AE, AH, A (wirh BFE), vE, v1-v30, v (with BFE), AR, AFyA, AR/AE. AFyAI-A30, AR/AH AR/AO <br />Complele llems C2 a-h below according to the building diagram specified in ltem A7. ln Puerlo Rico only, enter melers <br />lncl'cete elevalion dalum used tor the elevations in items a) through h) below, <br />Dalum used lor buildrng elevations must be the same as that used for the BFE <br />a) Top ol bottom Roor (induding basement, crawlspace, or enclosure froor) <br />b) Top of lhe nexl higher lloor <br />c) Bonom ol lhe lowesl horizontal structural member (V Zones only) <br />d) Attached garage (top of slab) <br />e) L_owest elevalion of machinery or equipmenl servicing the building' (Describe type of equipment ind locbtion in Comm€n-ts) <br />0 Lowest adjacent (finished) grade nexl to building (l3G) <br />gl Highest adjacent (linished) grade nexl to building (HAG) <br />h) Lo^resit adjacent grade at lowesi elevation of deck or stairs, lncluding <br />slructural support <br />2297.8 <br />2286.0 <br />2299.0 <br />2286.0 <br />2289.7 fi leet fl meters <br />2299.9 ffi feel E m€ters <br />N/A I feet I metrs <br />2289,7 fit feel ! meters <br />Benchmark Ulilrzed WSRN Verlical Daium: NAVD 88 <br />n NGVD 1929 E NAVD 1988 [ Other/Source: <br />Check the measurement used <br />fi feet n mete6 <br />filteet <br />fi feet <br />fi feet <br />I meters <br />I meten <br />I meters <br />sEcnoN D - suRvEYoR, ENG|NEER, OR ARCHITECT CERT|FICATION <br />Thrs certification is to be signed and sealed by a land surveyor, engineer. or architec{ authorized by law lo certify elovation rnformation <br />I @dny hal the inlormalioi on lhis C,edificatei represenls my besl dlo4s lo interprdt the datd avait'dble. t undedland that any lalse <br />si,atemenl may be punishable by line or imprisonment under 18 U.S. Codd, Sedion 1(NI. <br />WerelattudeandlongitudeinSedionAprovidedbyalioensedlandsurveyor?EvesENo@ <br />/ <br />t <br />Cornments (rnduding type ol equipm€nl and localioil, per C?(e), ll appllcal)lol <br />The typ€ of machln€ry *rvicrng the bulldrng, rn Eec{ron CZe , ls a lrvac unrl located ott lho oulstdd rtl lho rlotlhortl butlrlttlg rvall <br />Number <br />528/.3 <br />Waehington <br />Name <br />Samuel R Ward <br />Name <br />Prolessional Land Surveyor <br />rte <br />APS Survey E Mapping <br />ZIP Code <br />9800s <br />StaloCity <br />Bellevue <br />Srgnature <br />?-b <br />Address <br />13221 SE 26th Sueet, Su(e A <br />Date <br />10"13.2022 <br />Tolophono Exl <br />(4251 746 32oo il r <br />FEMA Fom 086-0-33 (12l1S)Replaces all ptovtout odtllons Fornr Page 2 of 6