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IMPORTANT: ln these spaces' copy ihe correspondi ng informallon hom $ection A.FOR INSURANCE COMPANY USE <br />Bulldlng Street Address (lncludlng Apt., Unit, $ulte, and/or Bldg. No.) or P.O. Routo and Box No. <br />3008 Dapple cray Way <br />Policy Number: <br />Clty <br />ElJensburg <br />Slate <br />Washington <br />ZIP Code <br />98926 <br />Company NAIC Number <br />$ECT|ON C - EU|LD|NG ELEVATION TNFORMATTON (SURVEY REAUIRED) <br />G1. Bulldlng elevations are based on: ! Consbuction Drawingsn I Building Under Construclionn I finistreO Construction <br />nA now Elevatlon Certificate will be roquired when construc'tion of the building is complete. <br />C2. Elevatlons - Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AF/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. <br />Complele ltems C2.a-h bolow according to the bulldlng dlagram specified in ltem A7. ln Puerto Rico only, enter meters. <br />Benchmark Utillzed: Center of S 27 T18N R 18 E Vertlcal Datum: NAVD 19BB <br />lndicate elevation datum used for the elevations in ltems a) lhrough h) below. <br />fl NGVD 1929 E NAVD lgBB ! Other/Source; <br />Datum used for bullding elevations must bo the same as that used for the BFE. <br />Cheok the measuremeni used. <br />a) Top of bottom floor (including basement, crawlspace, or enclosure floor) <br />b) Top of the nexi hlgherfloor <br />c) Bottom of iho lowost horizontal structural member (V Zones only) <br />d) Attached garage (top of slab) <br />e) Lowest elevation of machinery or equlpment seruicing the building <br />(Describe type of equipment and locatlon ln Comments) <br />f) Lowest adjacent (finished) grade next to bullding (LAG) <br />g) Highest adjaoent (finished) grade nsxt to buildlng (HAG) <br />h) Lowest adjacent grade at lowest elevation of deck or stalrs, including <br />structural support <br />159.5.2 @ feet I meters <br />N/A ! feet I meters <br />N/A I feet I metors <br />1595,2 I feet I meters <br />N/A il feet I meters <br />1595.2 <br />1594.,1 <br />1594.7 <br />Fl feel <br />fl feet <br />El laet <br />I meters <br />I meters <br />fl meters <br />SECTION D _ SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION <br />Thls cerilflcatlon ls to be slgned and sealed by a land survoyor, ongineor, or archltect authorized by law io certlfy el€vation informatlon, <br />I certlfy that the information on thls Cartificate represenfs my best efforts to lnterpret the data available. I understand thal any false <br />statement may be punishable by fine or imprtsonment under 18 U.S. Code, Section 1001, <br />Were latltude and longitudo in Sectlon A provided by a lioensed land surveyor? EIYet n ruo E Chect here if attachments.-@ <br />Certifiefs Name <br />Rick Skinner <br />Llcense Number <br />4361 I <br />,t) <br />Title <br />Professional Land Surveyor <br />Gompany Name <br />Weslem Pacific Englneerlng & Survey, lnc. <br />Address <br />12249. Pioneer Way <br />Clty <br />Moses Lake <br />State <br />Washlngton <br />ZIP Code <br />98837 <br />8lg tl Tolophono <br />(509) 765-1023 <br />Ext. <br />Cofy all pages of this Elevation Certlficate and all atlachmefits for (1) communlty officlal, (2) insurance agenVcompany, and (3) buildlng owner <br />Comments (lndudlng type of equipment and location, per C2(e), if applicable) <br />Heat pump wag on extsrior of bulldlng and on a concrete pad that was msasursd wlth gps. The bottom of the heat pump is rosting on <br />logs that raise at a mea$ured helght of 6" above the concroto pad. Tho olovation for the equlpment ls to tho bottom of the heat pump, <br />ELEVATION CERTIFICATE <br />OMB No. 1660-0008 <br />Expiration Date: November 3O, 2O22 <br />FEMA Form 086'0-33 (12119)Rsplac€6 all previous editions.Form Page 2 of B