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ELEVATION CERTIFICATE <br />IMPORTANT: MUST FOLLOW THE INSTRUCT]ONS ON PAGES 9.1S <br />FOR INSURANCE COMPANY USEBualdlng Street Address (including Apt., Unlt, Sulte, and/or BldS, No.) or P.O. Route and Box No.: <br />Q003 Dapple Gray Way <br />City; Ellensburg slate; WA ZP Code: 98926 <br />Policy Numben <br />Gompany NAIC Number: <br />C1. Buildlng elevalions are based on: fl Constructlon Drawlngs' I Bullding Under Conskuolion* [] Flnished Construollon <br />*A new Elovalion Cerlificate will be required when construolion of the building ls complete. <br />C2. Elevallons - Zones A1-A30, AE, AH, AO, A (wllh BFE), VE, V1-V30, V {with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AFyAO, <br />A99. Gomplete ltems C2,a-h below according to the Bullding Diagram specified in ltem A7. ln Puerto Rico only, enter meters. <br />lndicate elevatlon datum used Jor lhe elevallons ln llems a) through h) below. <br />Datum used for bulldlng elevallons must be the same as lhal used for the BFE, Conversion faclor used? <br />lf Yes, describe lhe source of the converslon factor ln the Sectlon D Comments area. <br />a) Top of boltom floor (including basement, crawlspace, or enclosure lloor): <br />b) Top of lhe next h$her floor (see lnskuctions): <br />c) Botlom of lhe lowest horizonlal structural member (see lnstructions): <br />d) Attaohed garage (top of slab): <br />e) Lowest elevation of Machlnery and Equlpment (M&E) servlcing the building <br />(describe type of M&E and locatlon ln Seclton D Comments area): <br />f) Lowesl Adjacent Grade (LAG) next to building: I Natural [J Finished <br />g) Highest AdJacenl Grade (HAG) next to buildlng: I Natural I Finished <br />h) Finlshed LAG at lowest elevation of altachsd deck or stalrs, includlng structural <br />supportl <br />1,594.10 <br />'1,594.10 <br />fl feel ! metersAI /L <br />1.593.70 I feet f] meters <br />[] feet I meters <br />[] feet I meters <br />Benchmark Utillzed: Center of S 27 TlBN <br />n NGVD 1e2e E NAVD les8 [ other <br />Nt'4 <br />N1+ <br />1,592.10 <br />1,593.60 <br />[Yes ENo <br />Checl< the measurement used: <br />[f feet I meters <br />I feet f] melers <br />f] leet I meters <br />I feet ! meters <br />R 1B E Vertical Datum: NAVD 1988 <br />4361 <br />Thls certiflcation is 1o be signed and sealed by a land surveyor, engineer, or archltecl authorized by state law lo cerllfy elevation <br />informatlon. I cedlfy thatthe lnformatlon on lhis Certitlcate represents my best efforts to Inlerpret lhe dala avallable. I understand thal any <br />false statemenl may be punlshable by llne or lmprlsonmenl under 18 U. S. Code, Sectlon 1001 . <br />Wore latitude and longitude in Section A provided by a licensed land surveyor? @ Yes fl No <br />ICheck hore if attacfiments and descrlbe in the Comments area, <br />Certifier's Name: Rick $kinner Llcense Number:43619 <br />Copy all pages of lhis Elevation Certifioate and all attachmenls for (1) community ofliclal, (2) insurance agenVcompany, and (3) building owner <br />Comrnenls (including source of conversion faolor in C2; lype of equipment and looation per C2.e; and description of any altachments): <br />Heat Pump pad was rneasured at the top with the bottom of the heat pump raised an addilional eight inches with legs <br />Tilb: Professional Land Surveyor <br />1,,' <br />Company Name:Western Paclflo Englneerlng & Survey, lnc. <br />City:Moses Stale: WA ZP Code; 98837 <br />Email: rsklnner@wpoino.net <br />Date: <br />Address: 1224 S, Pioneer Way <br />765.1023 Ext.: <br />Slgnature: <br />Telephone: <br />FEMA Form FF-2O6-FY-22-152 (formerly 086-0-33) (10/22)Page3of19