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ELEVATION CERTIFICATE <br />IMPORTANT: MUST FOLLOW TIIE INSTRUCTIONS ON PAGES 9"I9 <br />FOR INSURANCE COMPANY USEBuilding StreetAddress (lncluding Apt,, Unit, Suite, andlor Bldg. No.) or p.O. Route and Box No.: <br />Ciiy:Ellensburo <br />2905 Daoole Grav Wav <br />Slate: WA Ztp Goder 98926 <br />Policy Number: _ <br />Company NAIC Number: <br />C1. Building elevations aro based on; I Constructlon Drawinger I Building Under Construcllon* [ Finished Conslruolion*A new Elevetlon Cedlficate wlll be required when oonstruotion of lhe bullding ls complete. <br />C2. Elevalions - Zones A1*A30, AE, AH, AO, A (wilh BFE), VE, V1*V30, V (wtth BFE), AR, AR/A, AR/AE, AFyAI-A90, AR/AH, AR/AO, <br />A99. Complele ltems C2,a-h below according to the Building Diagram spocified ln ltem A7. ln Puerto Rico only, enler meters. <br />lndlcate elevallon datum used for the elevalions in itoms a) through h) below. <br />fl NGVD 192e E NAVD leBB ! other: <br />Datum used for bullding elevaliona must be lhe same as thal used for the BFE. Conversion factor used? <br />lf Yes, describe the souroe of the conversion factor in the Seotlon D Comments area. <br />a) Top of boltom lloor (including basement, crawlspace, or enclosure floor): <br />b) Top of the next higher floor (eee lnstructions): <br />c) Bottom of the lowesl horizontal struotural member (see lnslrucllons): <br />d) Atlachod garage (top ofslab)t <br />e) Lowest elevation of Machlnery and Equlpment (M&E) servicing lhe bullding <br />(desoribe type of M&E and location in $ection D Comments area): <br />Q Lowest AdJacenl Grade (LAG) next to buildlng; I Naturat fu f inirn.O <br />g) Hlghesl Adjacent Grade (HAG)next to building: I Natural I finrcneO <br />h) Flnlshed LAG at lowest elevalion of attached deck or s{airs, lncluding skuclural <br />supporl: <br />1,587.10 [] feet I meters <br />1,586^10 $ feot I melers <br />Benchmark Ulllizedl Center of S 27 TlBN <br />^. -N 'r* [ feet I merars <br />. .1,587,40 <br />fti/1, <br />luih <br />1,587.40 <br />fl Yes E No <br />Check lhe measurement used;p feet I melers <br />I feet f] meters <br />il feet I meters <br />@ feet I metere <br />1,587.19 fi feet fl melers <br />R 18 E VertioalDatum: NAVD 1988 <br />oz <br />This certilicetion is to be signed and sealed by a land surveyor, engineer, or srchilecl authorized <br />lnformatlon, I ceftlfy lhat the lntormation on thls Ceftlflcate represenls my best elforts to lnteryret <br />false sfalement may be puntshable by line or imprisonment under 18 u.8. code, seclion 10a1. <br />Were latltude and longllude ln Seclion A provided by a lioensed land surveyor? [ yes ff No <br />I Check here if altachments and doscrlbe in the Gommenls ar€a. <br />Certlfie/s Name: Rlok Sklnner License Number:43619 <br />Copy all pages of this Elevatton Cedificate and all attachments fot (1) community oflicial, (2) lnsurance agenVcompany, and (3) building ownor. <br />Tiile: Professlonal Land Surveyor <br />Company Name: Western Paclflc Enolneerino & Survov , lnc. <br />attachmenls): <br />city:Moses State: WA ZlPCode; 98837 <br />Comments (includlng source of conversion factor ln C2; type of equipment and locallon per C2.e; and description of any <br />Heat Pump pad was measured at the top with the bottom of the heat pump raised an addillonal elght inches with legs <br />by stale law to certlfy elevalion <br />lhe data avallable. I undersland that any <br />Address: 1224 S. Ploneer Way <br />Signature: <br />Tolephone;765-1023 Ex[: .- Email: <br />FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10122',Page 3 of 19