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ELEVATION CERTIFICATE <br />IMPORTANTI MUST FOLLOW THE INSTRUCTIONS oN PAGE$ 9.I9 <br />Bullding Streel Addross (tncludhrg Apt., Untt, $ulte, and/or Btdg. <br />Clty:Ellonsburg <br />No.) or F.O. Roule and Box No.: <br />2911 Gray Way <br />Slate: WA ZIP Code: 98926 <br />FOR INSURANCE COMPANY USE <br />Policy Numbor: ___..,,,_ <br />Company NA|O Number; <br />Bullding measuromonls are based on: I' l Construcllon Drawings' fJ Building llnder Construclion' f] Flnished ConstruclionrA new Elevallon Ce{iflcale will be required whsn construcllon of lhe b;lldlng ie comptete <br />E1' Provide mea$uretn€nls (C,Z,a ln appticablo Building Dlagram) for the followlng and chock tho approprlats Soxes to ehow whether lhemeasuremenl ls above {)r below the nalurol HAG and ihe LAc, <br />crawlspece, or enclosure) is: fJ feet lf melers I abovo or I below lhe LAG, <br />E2. For Building Diagrants 6-0 wlth pormanent flood openlngs providod ln Sectlon A ltems 8 and/or g (eee pages 1-2 of lnslruclons), lhenoxl higher lloor {C2.b tn appllcable <br />[_J leet f] metars I abovo or I betow the HAG. <br />E5. Zons AO only: lf no llood deplh number ls avallable, is lhe iop of tho botlom floor elevalsd ln accordance wi(h lhe communll/s <br />floodplaln msnagomonl ordlnanoe? [-l Yes l-l tlo I Unknown The local oIfictal musl cerilgr thls lnformatlon in Section G. <br />For Zones andAFYAO,AO,A (wilhout llems ForE1-E5,El!6ms usc nalur6tBFE),completo 1*E4,av€rfllable.thegrada,Gerllficate lstolntendcdSUgofLellerpportChangeMapSecllonsandGheckc.complelerequesl,A,B,moasurom6ntlhe u$ed.ln RicoPuorto nly,meters.enler <br />Buildlng Dlagram) of lhe bulldlng ls: <br />a) Top of bollom lloor (lncludlng basemenl, <br />crawlspace, or enciosuro) is:. <br />b) Top of botlom floor (induding basemonl, <br />fl feol fl maters I above or [_J betow the HAG, <br />I feel I meters I above or f] bolow the HAG. <br />E3. Allached garago (top of slab) is: <br />E4. Top of plalform of machlnery and/or equipmont <br />sorvlclng lhe buildlng ls:I feot I meters I above or [] botow the HAG. <br />completes Saclione A, B, ond E for Zone rd (without BFE) or Zone AO musl <br />lo lhe best ol my knowledge <br />l] Check here lf al,tachmenls and dsscribo in the Commenls area. <br />Properly Owner or Owne/s Aulhorized Repreoentativs Name: Scot{ Hgnson <br />Moses Lake <br />Ext. <br />Clty:Stale: WA Zp Code: gBB37 <br />The property ownor or ownor's aulhorizod representalive who <br />s'gn here. Ihe slalemonls in Secllons /, B, and E ara corroct <br />Commenls; <br />Emall: shenson@wp6lnc,not <br />Arldressr 1224 8. Pioneer Way <br />Telephone: {509) 765-1 023 <br />Slgnature:Dsto: (,/tt <br />FEMA Forrn F F -206-F Y -22-1 52 (fonnerty 080-0-g g) ( 1 0/22)Page 4 of ',l9