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ELEVATION CERTIFICATE <br />IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-tg <br />Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.0. Route and Box No. <br />2911 Dapple Gray Way <br />City:Ellensburg State: WA Ztp 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 <br />(suRvEY NOT REQUTRED) (FOR TNSURANCE PURPOSES ONLn <br />The property owner, owner's aulhorized represenlative, or local floodplain managemenl official may complete Seclion H for all flood zones <br />to 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 fool (nearest tenth o{ a meler in Puerto Rico). Reference the Foundation Type Dtagrams (at the end of Section H <br />lnstructions) and the appropriate Building Diagrams (at lhe end of Section I lnstructions) to compleae thr secfion. <br />H'l . Provide the heighl of the top of the floor (as indicated in Foundation Type Diagrams) above the Lowest 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 />1.30 S feet I meters @ above the LAG <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 />NJ lft n feet I meters I 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 by lhe <br />H2 arrow (shown in the Foundation Type Diagrams at end of Section H instructions) for the appropriate Building Diagram? <br />I Yes E tto <br />sEcTroN r- PRoPERTY OWNER (OR OWNER'S AUTHORTZED REPRESENTATTVEI CERT|F|CAT|ON <br />The property owner or owner's authorized representative who cornpletes Sections A, B, and H must sign here. The statements rn Sections <br />A, Q, anl H are correct to the bcsl of my knowledge. Noto: lf the local floodplain management official completed Section H, they should <br />indicale in ltem G2.b and sign Section G. <br />I Check here if attachments are provided (including required photos) and describe each altachment in the Comments area. <br />Property Owner or Owner's Authorized Representative Name <br />Address: <br />City:State:_ ZIP Gode: <br />Signature: <br />Telephone <br />Date: <br />Ext.: Email: <br />Commenls <br />FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10122')Page 6 of 19