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ELEVATION CERTIFICATE <br />IMPORTANT; MUST FOLLoW THE INSTRUCTIONS ON PAGES 9-ie <br />FOR INSURANCE COMPANY USEBuilding StreetAddress (lncluding Apt., Unlt, Suite, and/or Bldg. No,) or p.O. Route and Box No,: <br />City:Ellensburg <br />2916 Oapple Gray Way <br />Ststs: WA ZIP Code: 98926 <br />Polioy Number; <br />---Company NAIC Number; <br />C1. Building elevations are based on: f] Conetruotlon Drawings" f] Building Under Conslruotion* [] Flnlshed Construcflon*A new Elevalion Certiflcale will be required when conskuction of lhe building ls oomplele, <br />C2. Elevailons - Zones A1-A30, AE, AH, Ao, A (with BFE), VE, V1*V30, V (wlth BFE), AR, AR/A, AR/AE, ARfAI-A30, AR/AH, AR/Ao, <br />A99. Complete ltems C2.a-h below according to the Buildlng Diagram specified in ltom A7. ln Puerto Rico only, enier melers. <br />lndicale elevation datum ueed for lhe elevations in ltems a) through h) below. <br />n NGVD 1e29 m NAVD less fJother: <br />Datum used for building elevatlons must be {he same as that used for the BFE. Conversion factor used? <br />lf Yes, describe lhe source of lhe conversion factor ln lhe Seotlon D Comments area. <br />e) Top of bottom lloor (inoludlng basement, crawlspace, or enolosure floor): <br />b) Top of lhe next hlgher floor (see lnstructlono); <br />o) Bottom of lhe lowest horizontal slructural member (see lnstruotions); <br />d) Attached garage (lop of slab): <br />e) Lowest elevatlon of Machlnery and Equlpment (M&E) seMclng the building <br />(describe type of M&E and bcation in Section D Gomments area): <br />fl Lowest Adjacent Grado (LAG) nexl to building; f] Naturat [] Finished <br />g) Highesl Adjaoent Grade (HAG) naxt to buitdingr fJ Natural I rinisheO <br />h) Flnlshed LAG al lowest elevation of attached deck or stairs, lnoluding structural <br />supporl:I feet I meters/u/k <br />ilir*^f, feet fl meters <br />N /.k fl feet I metere <br />1,590,00 fl feet I meters <br />Benchmark Utilized: Center of S 27 T18N <br />. :1,5.90:10 <br />1,588.B0 <br />1,589.90 <br />I feel I meters <br />p feet ! melers <br />fl leet I moters <br />[Yes ENo <br />Check lho measuroment used; <br />1,590.00 @leet Imeters <br />R 1B E VerlicalDatum: NAVD 1988 <br />This certificatlon is to be signed and sealed by a land surveyor, engineer, or architect aulhorized <br />lnformatlon. I ceilify that lhe lntormatlon on thls Ceilflcate represents my best etforls to lnterpret <br />false statement may be punlsltable by lino or lmprlsonment under 1B lJ.$. Code, Secllon 1001, <br />Were latitude and longitude in Section A provided by a licensed land surveyor? [ yes f] No <br />I Cheok here if altachmenls and desoribe in the Commenls area. <br />Certlfle/s Name: Rlck Sklnner License Number:43619 <br />pages of this Elevation Cerlilicate and all attachments lor (1) community official, (2) insurance agenUcompany, and (3) bullding owner. <br />Tifle: Professlonal Land Surueyor <br />company Name: Western Paclfic Englneerlng & Survey, lnc. <br />City;Moses Stale: WA ZtP Code: 98837 <br />Gommenls (tncludlng source of conversion factor in C2; type of equipment and loaation per C2.e; and description of any atlachm€nts): <br />Heat Pump pad was measured at lhe top with the bottom of the heat pump raised an additional eight lnches with legs <br />by slate law to oertify elevation <br />the data available. I understand that any <br />Copy all <br />Address: 1224 S, Pioneer Way <br />Slgnature: <br />76s'1023Telephonel Ext,r Emall: <br />FEMA Form FF-206-FY-22-152 (formerly 086.0-33) (1OI2z)Page 3 of 19