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ELEVATION CERTIFICATE OMB No. 1660-0008 <br />Explralion Oate: November 30,2O22 <br />IMPORTANT: !n lhese spacesr copy ihe correspondlng lnformallon from Sectlon A.FOR INSURANCE COMPANY USE <br />Bullding Street Address (including Apt., Unit, Sulle, and/or Bldg. No.) or P,O. Roule and Box No. <br />3005 Dapple Gray Way <br />Pollcy Number: <br />City State <br />WashingtonEllensburg <br />ZIP Code <br />98926 <br />Company NAIC Nunrber <br />sEcTtoN c - BUTLDING ELEVATTON INFORMATTON (SURVEY REOUTRED) <br />a) Top of botlom lloor (including basement, crawlspaco, or enclosure lloor) <br />b) Top of the next hlgher lloor <br />c) Botlom of the lowesl horizontal structural member (V Zones only) <br />d) Attached garage (lop of slab) <br />e) Lowest elevallon-of machinery or equlpment servicing tho bulldlng <br />(Describe type of equipmenl and localion ln Comments) <br />f) Lowesl adJacent (finished) grade next lo building (LAG) <br />g) Hlghosl adJacenl (finished) grade next lo building (HAG) <br />h) Lowest adjacent grade al lowest elevatlon of deck or stairs, lncluding <br />slruclural supporl <br />N/A I feot ! moters <br />N/A I feel I meters <br />1s95.0 I feet I meters <br />C1. Building elevations aro based on: I Conslruction Drawings' fl Building Under Construcliont @ Finished Conslruction <br />*A new Elevation Corlificale will be required wh€n conslruction of the buildlng ls complele. <br />C2. Elevalions - Zones A1-A30, AE, AH, A (wilh BFE), VE, V1-V30, V (wilh BFE), AR, AFUA, AFUAE, AR/A1-A30, AF/AH, AR/AO. <br />Complete ltems C2.a-h below according to iho building diagram specllled in ltem A7. ln Puerlo Rico only, enter molers. <br />Benchmark Ulilized: Conler of S 27,T 1B N, R 1B E Verlical Datum: NAVD 19BB <br />lndicalo olevalion datum used for lhe elevalions in items a) through h) below. <br />fl NGVD 1929 E NAVD 19BB I Other/Source: <br />Datumusedforbuildingelevationsmustbethesamoasttr <br />Check lhe measurement used. <br />1595.0 [] feet ! meters <br />1595,1 fl feet <br />[] feet <br />[] leet <br />! meters <br />fl meters <br />f] meters <br />r593.B <br />1594.4 <br />N/A fl feet I meters <br />SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION <br />Thls.cerlificalion.is- lo be.signed..a.nd^seql-ed _by a land surueyor, englneer, or archilecl aulhorized by law lo cerlify elevalion lnformatlon. <br />I cellily lhal lhe.informelion on.lhis Ceflilicale rapresonls ryy pgst effo4s lo inlerpret lhe data avaihblo. I underiland lhal any lalse <br />stalement may ba punlshablo by line or imprisonment undcir 18 U.S. Code, Seciion 1001, <br />Were lalitude anrt longitude in Seclion A provlded by a llcensed land surveyor? E Y"" I tto I Chect< here lf attachments. <br />mlN <br />Rick Sklnner <br />License Number <br />43619 <br />Professional Land Surveyor <br />Western Pacllic Englneering & Survey, lnc.o <br />1224 S. Pioneer Way <br />Clty <br />Moses Washington <br />ZIP Code <br />98837 <br />Ext,S Telephone <br />(509) 765-1023 <br />Copy all pageb-dfth'iB Elevaiion Cedilicate and all attachmontsTollt; c6nfmunity olficial, (2) insurance agenUcompany,and (3) building owner. <br />Comments (lncluding type of equipment and localion, per C2(e), if applicable) <br />Heat pump pad was shot with GPS and lhe elevalion was calculaled wilh an addillonal 7 lnches were added lo lhe elevalion due to tho <br />heat pump belng risen with legs. <br />FEMA Form 086-0-33 (12119)Replaces all previous editions,Form Pago 2 of 6