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ELEVATION CERTIFICATE <br />IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGEs s-1s <br />Building Street Address (including Apt., Unit, Suite, and/or Bldg, No.) or P.O, Route and Box No. <br />3003 Dapple Gray way <br />EllensburgCity:State: WA Zlp Code: 98926 <br />FOR INSURANCE COMPANY USE <br />Policy Number: <br />Company NAIC Number: <br />SECTION H - BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES(suRvEy NoT REQUIREDI (FOR TNSURANCE PURPOSES ONLY) <br />The properly owner, owner's authorized representative, or local floodplain management oflicial may complete Section H for all flood zones <br />to determine the building's firsl floor height for insurance purposes. Seclions A, B, and I must also be completed. Enter heights to the <br />nearestlenth.of a Jool (nearest tenth of a meter in Puerto-Rico). Retere,n-ce the Foundallon Type Diagrams (at the end of Section Hlnslructions) and the appropriate Building Diagrams (at the end of Seclion I tnstructioni)'to codptete ihis section. <br />H1. Provide the height of the top of the floor (as indicated in Foundation Type Diagrams) above the Lowesl Adjacent Grade (LAG): <br />a) For Building Diagrams 1A, 18, 3, and 5-9. Top of bottom <br />floor (include above-grade floors only for buildings with <br />subgrade crawlspaces or enclosure floors) is: <br />2.00 E feet f, meters E above the LAc <br />b) For Building Dlagrams 2A,28,4, and 6-9, Top of next <br />higher floor (i,e., the floor above basement, crawlspace, or <br />enclosure floor) is: <br />fJ feet fJ meters fl above the LAG <br />H2, ls all Machinery and Equipment servicing the building (as listed in ltem H2 instructions) elevated to or above the floor indicated bv the <br />H2 arrow (shown in the Foundation Type'Diagrams al end of Section H instructions) foi the appropriate Building Diagram?fl Yes El t'to <br />sEcTloN I - PROPERTY OWNER (OR OWNER'S AUTHORTZED REPRESENTATTVE) CERT|F|CATION <br />The property owner or owner's authorized representative who completes Sections A, B, and H musl sign here. The statemenls in Secilons <br />A, B, and H are correct lo the best .of my knowledge. Note: lf the local floodplain management official completed Section H, they should <br />indicate in ltem G2.b and sign Seclion G. <br />I Check here if attachments are provided (including required photos) and describe each attachment in the Comments area. <br />Property Owner or Owner's Authorized Representative Name <br />Address; <br />City:State:ZIP Code: <br />Signature: <br />Telephone <br />Date: <br />Ext.:Email <br />Commenis <br />FEMA Form FF-2O6-FY-22-152 (formerly 086-0-33) (10122J Page 6 of 19