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ELEVATION CERTIFICATE <br />IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 <br />Building Slreel Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No,: <br />2913 Dapple Gray Way <br />City:Ellensburg State: WA Ztp Code: 98926 <br />FOR INSURANCE GOMPANY USE <br />Policy Number: <br />Company NAIC Number: <br />SECTION H - BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES <br />(suRVEY NOT REQUTRED) (FOR TNSURANCE PURPOSES ONLY) <br />The property owner, owner's authorized representative, or local floodplain management official may complete Seclion H for all flood zones <br />lo determine the building's first floor height for insurance purposes. Sections A, B, and I must also be completed. Enter heights to the <br />nearest tenth of a loot (nearest tenth of a meter in Puerto Rico), Reference lhe Foundalion Type Diagrams (at the end of Section H <br />lnstructlons) and the approprlate Buildtng Dlagrams (at the end of Sectlon I lnstructions) to complele tnis section, <br />H1, Provide the height of the top of the floor (as indicated in Foundalion Typo Diagrams) above the Lowest Adjacent Grade (LAG): <br />a) For Building Dlagrams 14, 18, 3, and 5-9. Top of bottom 1.30 B feet X meters I above the LAG <br />floor (include above-grade floors only for buildings with <br />subgrade crawlspaces or enclosure floors) is: <br />b) For Bulldlng Dlagrams 2A,2E,4, and 6-9. Top of next <br />higher lloor (i.e., the floor above basement, crawlspace, or <br />enclosure floor) is: <br />N lA n feet I merers I above rhe LAG <br />H2. .ls^all Machinery and Equipment.servidngihe building (as lis,tqd in ltem H2 instructions) elevated to or above lhe floor indicated by the <br />H2 arrow (shown in the Foundation Type Diagrams at end of Section H instructions) for the appropriate Building Diagram? <br />[Yes Eruo <br />sEcTroN I - PROPERTY OWNER (OR OWNER'S AUTHORTZED REPRESENTATTVE) CERT|F|CATION <br />The property owner or owner's aulhorized representative who completes Sections A, B, and H musl sign here. The statements in Sectrrrs <br />A, Q, and H are correct to 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 Section G. <br />I Checf here if attachments are provided (including required photos) and describe each attachment in the Comments area. <br />Property Owner or Owner's Authorized Representalive Name: <br />Address: <br />City;State:ZIP Code; <br />Signalure: <br />Telephone: <br />Date: <br />Exl.Email <br />Comments: <br />FEMA Form FFAA6-FY-22-152 (formerly 086-0-33) (10122')Page 6 of 19