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FOR INSURANCE COMPANY USEIMPORTANT: ln these epaoes, copy the oorrespondlng lnformalion from seclion A, <br />Building Street Address (ncluding Apt,, Unil, $ulta, and/or Bldg, No.) or P,O. Route and Box No, <br />2915 Roan Drive <br />Pollcy Number: <br />Company NAIC Numberstate <br />Washington <br />zlP code <br />98926 <br />city <br />Ellensburg <br />SEGTTON C - BUILDING ELEVATTON TNFORMATION (SURVEY REOUIRED) <br />C1. Buildlng elevalions are based on: f] Constructlon Drawings* [ Buildlng Under Conslruotion* [] Finlshed Conslrucllon <br />'A new Elevation Certificate will be requlred when construclion of the bullding ls complete, <br />C2. Elevalions - Zones A1-A30, AE, AH, A (wilh BFE), VE, V{-V30, V (wlth BFE), AR, AR/A, AR/AE, ARfAI-A3O, AR/AH, AR/AO. <br />Complelo ltems C2.e-h below according to lhe bulldlng dlagram epecllled ln ltem A7, ln Puerto Rlco onln enter rnster$. <br />lndicate elevation datum used forthe elevations ln iteme a) through h) below. <br />E NGVD 1929 El NAVD 1988 flother/Sourco: <br />Datum used for bullding elevations must be the same as that used for the BFE. <br />Check the measurement uged, <br />a) Top of botlom lloor (includlng basement, crawlspa@, or enolosure floor) <br />b) Top ofthe nexthlgherlloor <br />c) Bottom of the lo!,ost horlzontal slruclural member (V Zones only) <br />d) Attached gerage {top of slab) <br />e) Lowest elevation of machinery or equipment serviclng lhe bulldlng <br />(Describe type of equipment and localion in Comments) <br />f) Lowest adjacent (flnlshed) grad6 next lo bulldlng (LAc) <br />g) Highest adJacent (llnlshedlgrade next to bulldirtg (HAG) <br />h) Lowest adjacent grade al lowest elerration of deck or staks, lncluding <br />slructural suppolt <br />1601.6 <br />N/A <br />N/A <br />1600.0 <br />Benchmark Ulilized: Center of S 27 T18 <br />N/A <br />1601.2 <br />l60t <br />,._ . ., 1600.9 [J feet f] meters <br />I feat fl meters <br />E]feet I meters <br />@ feet I meters <br />R 18 E Vettlcal Datum: NAVD 1988 <br />@ feel <br />I feet <br />flfeet <br />fi feet <br />I meters <br />I meters <br />I meters <br />I meters <br />sEcTtoN D - 9URVEYO& ENGINEER, OR ARCHITECT CERT|F|CATION <br />Thls cerllllcation ls to be signed and sealed by a land suruoyor, ongln€6t, or archltect authorlzed by law to ceruFy elevation informatlon. <br />I ceillfy that lhe lnformatioi on lhls Certiflcatd represents my best effortd to lnterprel lhe data available. I understand that any lalse <br />slalerhent may be punishable hy line or lmprisonment under t8 U.S. Code, Sectlan 1001. <br />Were lalltude and longllude ln $eotion A provlded by a licensed land surveyor? E Ves n No I ctreck here if attachmenls, <br />Llcense <br />43819Rick Sklnner <br />Name <br />Professlonal Land Surveyor <br />Western Pacific Engineedng & Survey, Inc. <br />1224S. PloneerWay <br />ZIP Code <br />98837Moses Lake Washington <br />(50e) 765.1023 <br />Date Ext. <br />all of and all atlachmenls (1)officlal, (2) lnsurance agenUcompany, and (3) building owner. <br />The elevation of the heat pump located outside of home was meesured by uslng a GPS and then addlng the helght of the legs for the <br />heat pump. <br />Commenls (includlng iype of equlpment and locallon, per applicable) <br />ELEVATION CERTIFICATE OMB No. 1660-0008 <br />Expiration Date: Novemb er 30, 2022 <br />FEMA Form 086'0-33 (A191 Replaces all prevlous editions.Form Page 2 of0