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IMPORTANT: ln these apaces, copy the correspondlnil lnformallon from Section A.FOR INSURANCE COMPANY USE <br />Bulldlng Street Address (lncluding Apt., Unit, Sulte, and/or Bldg, No,) or P.O. Route and Box No. <br />2919 Roan Drive <br />Policy Number: <br />cornpany NAIC NumberStale <br />Washington <br />ZIP Code <br />98S26 <br />ciry <br />Ellensburg <br />sEcroN o - ButLDtNc ELEVATTON TNFORMATTON (sURVEv REOU|REDI <br />C1. Sullding elevations are based on: ! Conslrucllon Drawlngs* f] Bulldlng Under Constructlon' [] finisneC Gonstructlon <br />*A new ElevaUon Certlficate wlll be required when construction of lhe buildlng is comptete. <br />C2. Elevatlons - Zones A1-A30, AE, AH, A (with BFE), Ve, V1-V30, V (with BFE), AR, AR/A, AFI/AE, AFUAI-A3O, AR/AH, AR/AO, <br />Gomplole ltems C2.a-h below accordlng lo lhe bullding diagram epeclfied in ltem A7. ln Puerto Rlco only, enter meters. <br />Benchmark Utlllzed: Center of S 27,T 18 N, R 18 E Vertcal Datum: NAVD 1988 <br />lndicate elevation dalum used for tho elevatlons ln ltems a) through h) below. <br />a) Top of bottorn floor (including basement, crawlspaco, or enclosure lloor) <br />b) Top of the next higher lloor <br />o) Boltom of the lowest horizontal slructural member (V Zones only) <br />d) Altached garage (lop of elab) <br />e) Lowest elevation of machinery or equipment serviclng the buildins <br />(Desolbe type of equlpment dnd location in Commanle) <br />Q Lowest adJacent (linlshed) grade nextto bulldlnS (LAC) <br />g) Hlghest adjacent (linlshed) grade next to bullding (HAG) <br />h) lowost adJacent grade at lowest €levetion of declt or stdre, includlng <br />slruclural support <br />1600.2 <br />1600.0 <br />1599.6 <br />N/A <br />Datum used for buiiding elevations must be lhe eamo as that used lor lhe BFE. <br />1600.6 I feet ! melers <br />N/A fl feet flmeters <br />N/A I leet ! moters <br />1600,6 [| feet fl meters <br />E NGVD 1929 El NAVD 1988 [ other/Source: <br />Check lhe measurement ussd. <br />flfeet fl meters <br />E feet <br />fl feet <br />Elfeet <br />I meters <br />I melers <br />! meters <br />sEcTloN D - guRvEYoR, ENG|NEER, OR ARCHTTECT CERTIF|CAT|ON <br />Thls cerlificatlon ls to be slgned and sealed by a land surueyor, engineer, or archltect aulhollzed by law to ceillff elevation information. <br />I cerllfy that lhe lnformallon on.thlg Certlficatd repesents my beqt e-lfo(s fo iqterpret lhe dala avallhble. I undere'tand thal any false <br />statementmay be punlshabte by tlne or imprlsonment undeir l8 U.S. Code Secllon 1001. <br />Were lalllude and longitude ln Seclion A provided by a llcensed land surueyor? E ves n No f] check here if attachmente. <br />Cerlllie/s Name <br />Rlck Sklnner <br />Llcense Number <br />43619 <br />Title <br />Profeselonal Land Suweyor <br />Company Name <br />Weetem Paoillc Engineering & Survey, lnc. <br />Addrcss <br />1224$. Pioneer Way <br />ctg <br />Moses Lake_.,,-1 <br />,, <br />State <br />Washlngton <br />ZIP Code <br />98837 4 <br />stgnature(r-l_t <br />ffi*\i__ <br />Telephono <br />(60e) 766-1023 <br />Date Ext. <br />e <br />Copy all pdfes of lhls Elevatlon Certilioate and all altaohmente for (f) oomfi{unlfofllclal, (2) lnsurance agenUcompany, and {3) bullding owner. <br />Comments (lnoludlng type of equlpment and looallon, per C2(e), if appllcable) <br />The elevatlon of the heat pump looated outside of home was measured by using a OPS and lhen addlng the height of the legs for lhe <br />heal purp. <br />ELEVATION CERTIFICATE OMB No.1660-0008 <br />Explratlon Date: Novemb er 3Q, 2022 <br />FEMA Form 086-0-33 (12l1Sl Replaces all prevlous edltlons.Form Pago 2 of6