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HomeMy WebLinkAboutResolution_RatifyChairSignature_CRSReportingKITTITAS COUNTY DEPARTMENT OF PUBLIC WORKS AGENDA DATE: ACTION REQUESTED: AGENDA STAFF REPORT October 17, 2023 Request to Approve a Resolution Ratifying the Chair's Signature on Community Rating System Annual Recertification Form CC-213. BACKGROUND: The Community Rating System is a program offered by the National Flood Insurance Program which rewards communities that implement certain activities to reduce the impacts of flooding with lower flood insurance rates. INTERACTION: Kittitas County was accepted into the program in 2014 as a Class 6 community and this rating was maintained during the 2019 program audit. Due to the County's participation in the program, residents receive a 20% discount on standard flood insurance policy rates. Every year the County is required to verify the activities for which points are received are still being implemented. The verification form requires the signature of the Chief Executive Officer of the jurisdiction. Public Works - Flood Control Zone District RECOMMENDATION: Approve the Resolution to Ratify the Chair's Signature on Federal Emergency Management Agency Annual Community Rating System Report Documents HANDLING: Return a copy of the Resolution to Public Works, Flood Control Zone District ATTACHMENTS: Resolution Recertification Form CC-213 LEAD STAFF: Arden Thomas, Water Resource Manager BOARD OF COUNTY COMMISSIONERS COUNTY OF KITTITAS STATE OF WASHINGTON RESOLUTION NO. 2023 - RATIFYING THE CHAIR'S SIGNATURE ON FEDERAL EMERGENCY MANAGEMENT AGENCY ANNUAL COMMUNITY RATING SYSTEM REPORT DOCUMENTS WHEREAS: Kittitas County is enrolled in the Federal Emergency Management Agency (FEMA) Community Rating System (CRS); and WHEREAS: This Federal Program lowers flood insurance premiums for all county residents receiving federal flood insurance; and WHEREAS: The County is required to report annual activities to FEMA consistent with maintaining its CRS rating; and WHEREAS: FEMA required the Chair's signature by October 16, 2023, ahead of full Board of County Commissioner action; NOW, THEREFORE BE IT RESOLVED that the Board of County Commissioners, in the best interest of the public, does hereby ratify the Chair's signature on the 2023 FEMA CRS reporting documents. DATED this 17th day of October 2023, at Ellensburg, Washington. Attest: ❑ Clerk of the Board- Julie Kjorsvik ❑ Deputy Clerk of the Board- Mandy Buchholz BOARD OF COUNTY COMMISSIONERS KITTITAS COUNTY, WASHINGTON Cory Wright, Chairman Brett Wachsmith, Vice -Chairman Laura Osiadacz, Commissioner DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency OMB Control Number: 16130-0422 CRS COiifiMLNITY CERTIFICATIONS Exolration: 1013112023 Community Kiffitas County State WA CID 530095 4..� (64git NFIP Community Identification Number) Note. Please cross out any incorrect items; below, as needed; and insert the updated information. CC-213 Recertificaboa Recertification due date October 16, 2023 Chief Executive Officer CRS Coordinator Name Cory Wright Arden Thomas Title Chairman, Boardof Kittitas County Water Resources Program Manager Address 205 West 5th Avenue, Suite 108 411 Ruby Street, Suit® 1 Ellensburg, WA 98926 Ellensburg, WA 98926 Phone number (5M) 962-7508 (609) 962-7690 E-mail address cory.wright@co.kittitas.wa.us arden.thomas(geo.kittitae.wa.us I hereby certify that Kitiitas County _ [community name] is implementing the following activities on the attached pages as credited under the Community Rating System and described in our original application to the CRS and subsequent modifications. I hereby certify fhat, to the best of my knowledge and belief, we are in full compliance with the minimum requirements of the NFIP and we understand that we must remain in full compliance with the minimum requirements of the NFIP. We understand that at any time we are not to be in full complianoe, we will retrograde to a CRS Class 10. I hereby ceirtify that we will continue to maintain FEMA Elevation Certificates on all new buildings and substantial improvements constructed in the Special Flood Hazard Area following the date at which we joined the CRS. I hereby certify that if there are one or more repetitive loss properties in our community that we must take certain actions that include reviewing and updating the list of repetitive loss properties, mapping repetitive loss areas, describing the cause of the losses, and sending an oulreach. project to those areas each year, and if we have fifty (50) or more unmitigated repetitive loss properties we must earn credit under Activity 510 (Floodplain Management Planning) for either a repetitive loss area analysis (Ri AA) or a floodplain management plan (FMIJ). I hereby certify that, to the best of my knowledge and belief, we are maintaining in force flood insurance pollcies for insurable buildings owned by us and located in the Special Flood Hazard Area (SFHA) shown on our Flood Insurance Rate Map. I further understand that disaster assistance for any community -owned building located in the SFHA is reduced by the amount of National Flood Insurance Program (NFIP) flood insurance coverage (structure and contents) that a community should be carrying on the building, regardless of whether the community is carrying a policy. Signature (Chief Executive Officer) Date CC-213-1 [continued on next page] FEMA FORM 086-0-35A (10123) Page 2 of 11 Community Kittitas County State WA CID 530095 " (6-digit NFIP Community Identification Number) CRS Program Data Table A. In the SFHA B. In a regulated floodplain outside the SFHA C. In the rest eht community ' 1. Last report's number of buildings in the SFHA (bSF") (line 6, last report) 1,304 2, Number of new buildings constructed since last report. + 23 3. Number of buildings removed/demolished since last report 0 4. Number of buildings affected by map revisions since last report (+ or -) -16 5. Number of buildings affected by corporate limits changes (+ or -) -3 - - - — - 6. Current total number of buildings in the SFHA (bSF) (total lines 1-5) 1,30$ 7. Number of substantial improvement/damage projects since last report 0 8. Number of repetitive loss properties mitigated since last report 0 - 9. Number of LOMRs and map revisions (not LOMAs) since last report 0 .. . 10. Acreage of the SFHA (aSFHA) as of the last report (line 13, last report) 21,207.8 11, Acreage of area(s) affected by map revisions since last report (+ or -? 0 12. Acreage of area(s) affected by corporate limits changes (+ or -) -77.8 13, Current acreage of the SFHA (total lines 10-12) 121,130 14. Primary source for building data: Risk map building information and County building and floodplain permit data 15. Primary source for area data: DFIRM database +1 Period covered: 10-15 2022-10-15-2023 Cuffent FIRM date 09i2412021 If available, the following.data would be useful. I 17. Number of new manufactured homes installed since last report 0 18. Number of other new 1 -4 family bindings constructed since last report 23 19. Number of all other buildings constructedlinstalled since last report 0 Comments: Please note the number of the line to which the comment refers. CC-213-2 [continued on next page] FEMA FORM 086-0-35A (10/23) Page 3 of 11 Community Kittitas County stare WA CIO 590006 (6-digit NFIP Community Identification Number) Instructions At the first verification visit after the effective date of the 2013 CRS Coordinators Manual, ONLY LINES 6 AND 13 NEED TO BE COMPLETED. These lines form the baseline data about the number of buildings and area of the SFHA for when the table is completed as part of the next annual recertification. The "period covered" entered in line 16 is the date that lines 6 and 13 are first completed. At all subsequent annual recertification and cycle verification visits, the entire table is completed_ The information in lines 6 and 13 from the last report is transferred to lines 1 and 10 in the next. report. Instructions for the Columns Column A numbers are for the SFHA (the A and V Zones shown on the Flood Insurance Rate Map) (FIRM)). Use the FIRM currently in effect, naa draft or pending revision. Column 8 is completed. only if the community receives CRS credit for regulating floodplain development outside the SFHA under Activity 410 (Floodplain Mapping) or Activity 430 (Higher Regulatory Standards), Column C numbers help relate what happens in the floodplain to what is happening in the rest of the community. Enter "0" if there are no numbers to report for this period. Do not leave a tali blank. Do not fill in the shaded boxes. Instructions for the Lines Lines 1-7 deal with buildings. o Section 301.a of the CRS Coordinator's Manual defines what constitutes a "building" and lists examples of structures that are not counted as "buildings" by the CRS. o Section 302.a of the CRS Coordinator's Manual describes how the CRS counts buildings. For example, accessory structures are not counted. o As noted in Section 302.a, to determine building counts, communities may use any method that yields reasonably good estimates of the number of buildings. Examples of acceptable methods are listed in Section 302_a. Precision is less important for large numbers. For example, the impact of the numbers will not change much if there are 10,000 buildings or 10,100 buildings. a If a building is out of the SFHA, but in a parcel that is partly in the SFHA, it is not counted in column A —In the SFHA. o In line 14, note how the building counts were obtained or estimated. Use the comments area, if needed. Line 4 refers to map revisions. These include physical map revisions, Letters of Map Revision (LOMR), and Letters of Map Amendment (LOMA). If a building is removed from the SFHA by FEMA through a LOMA, but the community still administers its floodplain management regulations on the property, the building should not be included in the line 4 count in column A —In the SFHA. However, communities that still regulate areas removed by LOMAs can receive credit under Activities 410 or 430. If the community is receiving such credit, the building should be counted under column B —In a regulated floodplain outside the SFHA.. Line 7 is for the total number of buildings that were substantially improved plus the number of buildings that were substantially damaged during the period covered. Lines 10 -13 deal with areas. o These areas are based on the areas shown on the community's FIRM including LOMRs or LOMAs. Section 403.b discusses those portions of the SFHA that are subtracted from fhe area of the SFHA to calculate the community's aSFHA used in credit calculations. o Section 403.e of the CRS Coordinator's Manual discusses calculating areas for CRS purposes. o Section 403.a notes that communities "should not spend an inordinate amount of time measuring areas' As with buildings, communities may use any method that yields reasonably good estimates. Examples of acceptable approaches are listed in Section 403.e. o Line 13 asks for the current acreage of the SFHA. The best source for this number is a GIS layer that shows the SFHA. If the community does not have GIST the county, regional agency, or state NFIP mapping office may have SFHA layers and may be able to provide the data. If the community has a relatively recent FIRM, the study contractor or consulting engineer may have the data. o In .line 15, note how the area calculations were obtained or estimated. Use the comments area, if needed. Lines 17 -19 arevoluntary, if the numbers are readily available. o Line 17 includes replacing an existing manufactured home with a new one. The newly placed manufactured home is counted as a new, post -.FIRM, building. o The total of lines 17 -19 should equal the value entered in line 2. CC-213-3 FEMA FORM 086-0-35A (10/23) Page 4 of 11 Community Kitfitas County State WA CID 530095 County Kittitas COMMUNITY RATING SYSTEM ANNUAL_ RECERTIFICATION Your community has been verified as receiving CRS credit for the following Activities. If your community is stilt implementing these activities the CRS coordinator is required to put his or her initials in the blank (do not use a checkmark or an "X") and attach the appropriate items. A blank with no initials indicates you are not implementing that Activity anymore, and will result in loss of points (and possible CRS Class). If the word "attached" is used you must provide the requested documentation for that Activity. If no documentation has been acquired for that Activity, please explain why there is no documentation from the past year. 4 310 EC: We are maintaining Elevation Certificates, Floodproofing Certificates, Basement Floodproofing Certificates and V Zone design .certificates on all new con- struction and substantially improved buildings in our Special Flood Hazard Area (SFHA) and make copies of all Certificates available at our present office location. I ] Initial here is you have had no new construction or substantial improvement in the SFHA in the last year.. 310 EC: Attacaed is the permit list for on y now or substantially imaroved structures in the SFHA that have been completed In the last year. We have permitted new building and substantial improvements in the SFHA during this reporting period. 310 EC: Attached are all the Certificates for new or substantially improved structures that have been completed during this reporting period that are in- cluded on fihe above permit list. (Note: The total number of Elevation and Flood - proofing certificates should match the number of permits issued and completed within the reporting period defined above. All permits issued for new construction or sub- stantial improvement within the V zone should have both an Elevation Certificate and a V Zone Certificate, and all buildings with basements within the basement exemp- tion communities should have both an Elevation Certificate and a Basement Flood - proofing Certificate). 320 .MI 1: We are providing basic flood information to inquirers. We also continue to provide the following to inquirers: ?`'I MI 2 additional FIRM information _ALI_ MI 6 historical flood information _&I_ MI 7 natural #loodplain functions ~ 320 MI: Attached is a copy of the publicity fop., the credited elements of this service this year. Community Certifications CC-213-1 Edition: 2017 Community Kittitas County State WA CID 530095 County Kittitas COMMUNITY BATING SYSTEM ANNUAL RECERTIFICATION IL 320 MI: Attached is a copy of one page of the log, a letter, or other record that we Xopt on this service this year. Q .1 320 MI: We are continuing to Deep our FIRM updated and maintain old copies of our FIRM. lit 330 OP: We continue to Conduct or provide all credited outreach projects. � 340 ODR: People looking to purchase flood prone property are being advised of the flood hazard through our credited hazard disclosure measures. 350 L1BiLPD: Our public library continues to maintain flood protection materials. trs 350 WEB: We continue to conduct an annual review and update of the information and links in our flood protection website. 410 MAP: We continue to use our additional regulatory flood data before a new development can proceed in our floodplain. 420 OSP: We continue to preserve our open space in the floodplain. 420 LZJOSI: We continue to enforce our ordinance(s) for low -density zoning and/or open space incentives. f Initial here if you have changed the allowable density of development in any of your zoning districts, rezoned parcels in the floodplain or changed your open space incentives. Attach a copy of the amended regulations, provide a summary of the change4 and marlr up the regulation indicating what's been changed r<Y's 430: We continue to enforce the floodplain management provisions of our zoning, subdivision and building code ordinances for which we are receiving credit. [_] Initial here if you have amended your floodplain regulations. Attach a copy of the amended regulations, provide a summary of the changes and mark up the regulations indicating what's been changed. 430 RA: We continue to enforce our procedures for administering our floodplain management regulations. If applicable, we also continue to employ CFMs and staff who took credited training courses. We currently have �� _ CFMs on staff. t 440 AMD. We continue to use and update our flood data maintenance system on an annual basis as needed. . � 440 BMM: We continue to maintain our system of Benchmarks. f i Initial here if any Benchmarks were found to be missing or inaccurate. Attach a copy of the correct elevation or a description of the missing Flenchmark(s). Community Certifications CC-213-2 Edition: 2017 Community Kittitas Coun� .y State WA CID 530095 County Kittitas COMMUNITY RATING SYSTEM ANNUAL RECERTIFICATION -I 440 FM: We continue to maintain our historical Flood Hazard Boundary Map, FIRMS and Flood Insurance Studies_ 450 SMR: We continue to enforce the stormwater management and low impact development provisions of our zoning, subdivision and building code ordinances for new developments in the watershed. [ Initial here if you have amended your stormwater management regulations that will impact your CRS program. attach a copy of the amended regulations, provide a summary of the changes and mark up the regulations indicating whails been changed. 450 ESCMQ: We continue to enforce the provisions of our zoning, subdivision and building codes as they pertain to erosion and sediment control and water quality. 502 RL: We currently have it's repetitive loss properties and send our notice to an properties in the repetitive loss areas. -AT 502 RL: Attached is a copy of this year's notice on property protection, flood insurance and financial assistance that we sent to our repetitive loss areas. it C 510 FMP: Attached is a .copy of our floodptain management olan's annual progress report for the action items contained in the plan. We have included a progress report template for you to use (in the email notification) if you don't have one of your own. ;'_ 510 FMP: We have provided copies of this/these progress report(s) to our governing board and local media. 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Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agenticompany, ana (s) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number: Evan and Lindsay Farris A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 18401 Salmon la Sac Road City State ZIP Code Ronald Washington 98940 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Kittitas County Tax Parcel Number 951655 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat.47°18'11.23" Long. -121°06'07.65" Horizontal Datum: ❑ NAD 1927 0 NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 7 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 1155.00 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0.00 sq in d) Engineered flood openings? ❑ Yes 21 No A9. For a building with an attached garage: a) Square footage of attached garage 0.00 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 0.00 sq in d) Engineered flood openings? ❑ Yes ❑x No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State Kittitas County 530095 Kittitas Washington B4. Map/Panel B5. Suffix B6. FIRM index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth) Revised Date 53037CO365 D 09-24-2021 09-24-2021 I A 2254.2 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139: ❑ FIS Profile ❑ FIRM ❑x Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 x] NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No 1660.0008 Expiration Date Novembe►.3 2022 IMPORTANT: In these spaces, copy She corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address jincluding Apt Unit. Suite, and/or Bldg Noy or P O Route and Box No Policy Number 18401 Salmon Is Sac Road City State ZIP Code Company NAIC Number Ronald Washington 98940 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1 Building elevations are based on: ❑ Construction Drawings* [] Building Under Construction" ® Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2 Eievations -Zones Al-A30. AE, AH, A (with BFE), VE, V1-V30, V (with EFE), AR, ARIA, AR1AE, ARIA1-A30, AR/AH, ARIAO Complete Items C2 afi below according to the building diagram specified in Item AT In Puerto Rico only, enter meters Benchmark Utilized. WSRN Vertical Datum: NAVD 88 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the 8FE. Check the measurement used a) Top of bottom floor (including basement, crawispace, or enclosure floor) 2289.7 ® feet ❑ meters b) Top of the next higher floor 2299.9 feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A © feet ❑ meters d) Attached garage (top of slab) 2289.7 ® feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 2297.8 lest ❑ meters jDescnbe type of equipment and locabon in Comments) - f) Lowest adjacent (finished) grade next to building (LAG) 2286.0 ® feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 2299.0 m feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 2286.0 0 feet ❑ meters structural support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This c artiflcation is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information f certify that the inframabort on this CerMcate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? ®Yes ❑ No Certiffer's Name License Number Samuel R Ward 52843 iyO -_ _ 7Rle Professional tend Surveyor Company Name APS Survey & Mapping 13221 SE 26th Street, Suite A HAL city Stain ZIP code L11tzD Bellevue Washington 98005 Signature pale Telephone End 13.2022 (425) 148 3200 i t t Copy all pages of lilts Elevation Certitats and all attachments for (1) c timunily Official, (2) Irtsuranf.•d aWlitrrpiiriianv. ani i1) boikttny o%ner j Comments (induding type of equipment and location, per C2(e), of applicable) The type of machinery servicing the building, on section C2a , rs a hvac unit located an the autsrdd ul the noitham buikiiny wail L".m I]l G FEMA Form 086-0.33 (12/19) Replaces all previous eanions - -V ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 18401 Salmon la Sac Road City State ZIP Code Company NAIC Number Ronald Washington 98940 SECTION E - BUILDING ELEVATfON INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items El-E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items El-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is — ❑ feet ❑ meters above or ❑ below the LAG. E2, For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is — ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F -- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: !November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 18401 Salmon la Sac Road City State ZIP Code Company NAIC Number Ronald Washington 98940 SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2 ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or oommunity-issued BFE) or Zone AO. G3. ❑ The following information (Items G4—G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Complianoe/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) E]feet ❑ meters Datum of the building: G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Community's design flood elevation: ❑ feet ❑ meters Datum _ Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (12/19) Replaces all previous editions. Farm Page 4 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 18401 Salmon la Sac Road City State ZIP Code Company NAIC Number Ronald Washington 98940 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and 'Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. ,r t i Photo One Photo One Caption Front View 10-13-2022 Clear Photo One r'- s .* LA �C - 9 f S { Photo?wo Photo Two Caption Rear View 10-13-2022 Clear Photo Two FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMB No.1660-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 18401 Salmon la Sac Road City State ZIP Code Company NAIC Number Ronald Washington 98940 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. s � : a k '4 l+ k k' F ok. Mr Rdo I tlree Photo Three Caption Right Side View 10-13-2022. Clear Photo Three ,4 7r. ,Y 4 i Pnoia Four Photo Four Caption Left Side View 10-13-2022 Clear Photo Four FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 6 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 Federal Emergency Management Agency Expiration Date: November 30, 2022 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1 9. Copy all pages of this Bevation Certificate and all altachrnents for (1) community official, (2) insurance agenticompany, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner`s Name Policy Number. GARY FAUSSET A2. Building Street Address (including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 390 HERON FARM LANE City State ZIP Code ELLENSBURG Washington 98926 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legit Description, etc.) TAX PCL. # 17-19-19053-0004; LOT i 1 D WRIGHT CLUSTER PLAT. A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitudell-ongi6ude: Lat. N46.9436" Long. W120.51349 Horizontal Datum: ❑ NAD 1927 © NAD 1983 AS. Attach at least 2 photographs of the building if the Certificate Is being used to obtain flood insurance. A7. Building Diagram Number 9 A8. For a building with a crewlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 2178.00 sq ft b) Number of permanent flood openings in the crawlspece or anclosure(s) within 1.0 foot above adjacent grade c) Total net area offlood openings in A8.b 2293.00 sq in d) Engineered flood openings? ❑ Yes ® No AS. For a building with an attached garage: a) Square footage of attached garage 740.00 sq ft b) Number of permanent hood openings in the ached garage within 1.0 foot above adjacent grade NIA c) Total net area of flood openings in A9.b NIA sq in d) Engineered flood openings? [] Yes ® No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Community Name & Community Number B2. County Name 83. State KITTITAS COUNTY, WA 530095 KITTITAS Washington B4. Map/Panel B5. Suffix B6. FIRM Index B7, FIRM Panel B8. Flood B9. Base Flood Elevation(s) Number Date Effeclivel Zone(s) (Zone AO, use Base Flood Depth) Revised Date 53037C1284 D 09-24-2021 09L24-2021 AE 1445.5' B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered In Item B9: ❑ PIS Profile ❑ FIRM ® Community Determined ❑ Other/Source: B11. Indicate elevation datum used for WE in Item B9_ ❑ NGVD 1929 Z NAVO 1980 ❑ Other/Source: 812. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yee ® No Designation Date: ❑ CBRS ❑ OPA FEMA Form OWO-33 (12119) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMPORTANT:In these spades, copy the corfesponding Inlbrmation from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 390 HERON FARM LANE City State ZIP Code Company NAIC Number ELLENSBURG Washington 98926 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings` ❑ Building Under Construction" © Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations -Zones A1A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARIA, ARJAE, ARIA1 A30, ARIAH, AR/AO, Complete Items C2.a-h below according to the building diagram specified in Item A7. in Puerto Rico only, enter meters. Benchmark Utifizsd: NGS MONUMENT SBO592 Vertical Datum: NAVD88 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 [g NAVD 1988 © Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (inducting basement, crawispace, or enclosure floor) 14433 ® feet ❑ meters b) Top of the next higher floor 14470 ® feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet ❑ meters d) Attached garage (top of slab) 1445.6 ® feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) 1447.0 ® feet ❑ meters f) Lowest adjacent (finished) grade next to building (LAG) 1444.1 ® feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 1444.5 ® feet ❑ meters h) LaNestgrade at lowest elevation of deck or stairs, including adjacent N/A C] feet C] meters structural SECTION D - SURVEYOR, ENt31NEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 ce►#fy that the information on this Certincate represents my best efforts to urterpret the date available. I understand that any false statement may be punishable by Titre or krWiftonment under 16 U.S Code, section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? Z Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number CHRISTOPHER C. CRUSE 38815 TitlepH PROFESSIONAL LAND SURVEYOR °y Company Name CRUSE & ASSOCIATES ryr Address P.Q. BOX 959 3138i5 SlONvI R City Sh" ZIP Code ELLENSBURG Washington 98926 Signature Date Telephone Fart. 02 20-2023 (509) 982-8242 Copy an of this Elevation'Certificaft and all attachments for (1) community official, (2) insurance agenticompany, and (3) building owner. Comments (inducting type of equipment and location, per C2(e), if applicable) C2a. CRAWL SPACE; C2b. FINISHED FLOOR; C2d. CONCRETE SLAB ON GRADE; C2e. HEAT PUMP USED EXPIRED CERTIFICATE PER FEMA BULLETIN W-22020. 69 & B10 - BASED ON KITTITAS COUNTY FLOOD PERMIT FD-21-00002. FEMA form Ut D-33 02119) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1880-0008 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt, Unit, Suite, and/or Bldg. No_) or P_O. Route and Box No. Policy Number. 390 HERON FARM LANE City State ZIP Code Company NAIC Number ELLENSBURG Washington 98928 SECTION E -BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1-E5. If the Certificate Is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items E1-E4, use natural grade, If available. Check the measurement used. In Puerto Rico only, enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the [owed adjacent grade (LAG). a) Top of bottom floor (including basement, erawispace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, creMspece, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1--2 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this Information In Section G. SECTION F -- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The properly owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-rued or conlmunityAssued SFE) or Zone AO must sign here. The statements in Sections A, B, and E are cofrect to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here If attachments. FEMA Form 086-0-33 (12/19) Replaces aii previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Hate: November 30, 2022 IMPORTANT: In these spaces, soapy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt, Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. Policy Number 390 HERON FARM LANE City State ZIP Code Company NAIC Number ELLENSBURG Washington 98926 SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A. B, C (or E), and G of this 0evation Certificate. Complete the applicable Item(s) and sign below. Check the measurement used in items G8--G10. In Puerto Rico only, enter meters. G1, ❑ The Information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architact who is authorized by l2w to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2 ❑ A community official completed Section E for a building located in Zone A (without a FEMAassued or comrrwnity-issued BFE) or Zone AO. G3. ❑ The following information (harms G4—G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Complianceiancy Issued G7. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement GB. Elevation of as -built lowest floor (inducting basement) of the building: ❑ feel ❑ meters Datum G8. BFE or (in Zone AO) depth of flooding at the building site: _ ❑ feet ❑ meters Datu m G10. Community's design flood elevation: _ ❑ feet ❑ meters Dim Local Official's Name Title Community Name Telephone Signature date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No. 186MOO8 ELEVATION CERTIFICATE See Instructions for Item AB. Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt, Unit, Suite, and/or Bldg- No.) or P.O. Route and Box No. Policy Number. 390 HERON FARM LANE City State ZIP Code Company NAIC Number ELLENSBURG Washington 98926 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item AS. Identify all photographs with date taken; "Front View{' and "Rear View' and, If required, "Right Side Vieaf' and "Left Side View:' When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section AS. If submitting more photographs than will fit an this page, use the Continuation Page. F rI- •�� Sol 0" Photo One Caption PHOTO TAKEN 02-10--2022; FRONT OF HOUSE FACING SOUTHWEST Cider Photo One imom two Photo Two Caption PHOTO TAKEN 02-10-2023; REAR OF HOUSE FACING NORTHEAST. Clear Photo Two FEMA Form 088-0-33 (12119) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMB No_ 166"008 ELEVATION CERTIFICATE Continuation Page Expiration Date. November 30, 2022 IMPORTANT: in these spaces, Dopy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address ('including Apt_, Unit, Suite, and/or Bldg, No.) or P.O. Route and Box No. Policy Number; 390 HERON FARM LANE City State ZIP Code Company NAIC Number I=LLtNSt9UIK(S Vvaslvngton 10892b If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front Niew" and "Rear YieW', and, if required, "Right Side Yew" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. Photo Three ptowThrft Photo Three Caption Clear Photo Thme Photo Four PrM ftw Photo Four Caption Clear Ph* Four FEMA Form 086-0-33 (12(19) Replace& all previous editions. Form Page 6 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY OMB No, 1660-0008 Federal Emergency Management Agency Expiration Date: November 30, 21122 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy as pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agentleompany, Land (3) building owner. SECTION A —PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number. ROBERT HAZEL A2. Building Street Address (including Apt., Unit, Suits, andlor Bidg_ No.) or P.O. Route and Company NAIL Number: Box No. 14710 MANASTASH RD. City State ZIP Code ELLENSBURG Washington 98926 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) TAX PCL. t117-17-18000-0015., LOT 5, BOOK 32 OF SURVEYS AT PAGES 61-82. A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. LatitudelLongitude: Lat. N 46.9629' Long. W 120.7551 ° Horizontal Datum: ❑ NAD 1927 NAD 1983 A6. Attach at least 2 photographs of the building 9 the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 9 A8. For a building with a crawlspaca or enciasure(s): a) Square footage of c►awlspace or enclosure(s) 844.00 sq f . b) Number of permanent flood openings in the crawtspace or enclosure(s) within 1.0 foot above adjacent grade c) Total net area of flood openings in AB.b sq in d) Engineered flood openings? El Yes No A&. For a building with an attached garage: a) Square footage of attached garage 764,00 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 4 r-) Total net area of flood openings in A9.b 1600.00 sq in d) Engineered flood openings? E] Yes ❑ No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B4, NFIP Community Name & Community Number 82, County Name B3. State KITTITAS COUNTY 630095 KITTITAS Washington 134. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood FUevation(s) Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth) Revised Date 53037C1234 D 09-24-2021 09-24-2021 AE 2460.0' 1310. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9_ ❑ FIS Profile 0 FIRM (] Community Determined ❑ OtherlSource: 811. Indicate elevation datum used for BFE in item Bg: ❑ NGVD 1929 ❑x. NAVD 1988 ❑ OtherlSource: 812_ Is the building located in a Coastal•Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes ❑x No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1560-0008 Expiration Date. November 30, 2022 WPORTANT: In !brae spaces, copy the corresponding Womation from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt, Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. Policy Number, 14710 MANASTASH RD. City State 7JP Code Company NAIC Number ELLENSBURG Washington 98926 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction` ❑x Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations -Zones Ai A30, AE, AH. A (with BFE), VE, V1 V30, V (with BFE), AR, ARIA, AR/AE. AR/A1-A30, AR/AH, AR/AO. Complete Items C2.2-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark UtiC¢ed: SB0592 Vertical Datum: NAVD SS Indicate elevation datum used for the elevations in items a) through h) below. [] NGVD 1929 0 NAVD 1988 ❑ Other/Source'. Datum used for building elevations must be the some as that used for the BFE. Chock the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 2456.8 x❑ feet ❑ meters b) Top of the next higher floor 2461.6 x❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feel ❑ meters d) Attached garage (top of slab) 2458.2 Pg feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 2462.t x feet meters (Describe type of equipment and location in Comments) Lowest adjacent (finished) grade next to building (LAG) 2457.6 Q beet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 24S7.8 ❑X feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support _2457.9 ❑x feet ❑ meters SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification Is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. ! oartify that the information on lfrls Cerfifrcafe represents my best efforts to met the date available. f understand that any false statement may be punishable by Fine or fmypilsonment under 18 U.S. Cade, Seabn 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? Yes ❑ No ❑ Check here if attachme Certifiet Name License Number CHRISTOPHER C. CRUSE 36815 NER ` Title PROFESSIONAL LAND SURVEYOR Company Name .0 Lri CRUSE AND ASSOCIATES ++a' Address P.O. BOX 959 =its City State ZIP Code f0 1SA�Q NAIL ELLENSBURG Washington 98926 Signatur> i Date Telephone F_xt 1 "1 2022 (509) M-8242 Copy slip es of this Elevation eertifcate and all attachments for (1) community official, (2) Insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), it applicable) Acid and Aft ENGINEERED SMART VENT MODELS 1540- i10 & 1540-511; C2a. EARTHEN CRAWL SPACE; C2b. FINISHED FLOOR; C2d. CONCRETE SLAB; C2e. TANKLESS HEATER LOCATED IN GARAGE. F£MA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-ODDB Expiration Hate: November 30,2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 14M MANASTASH RD. City State ZIP Code Company NAIC Number ELLENSBURG Washington 98926 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items El—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A. B,and C. For Items E1—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, aswlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the FLAG. E3. Attached garage (top of slab) is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or awner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA4ssued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments [] Check here if attachments. FEMA Form 086-0-33 (12119) Replaces all previous editions. Form age 3 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 14710 MANASTASH RD. City State ZIP Code Company NAIC Number ELLENSBURG Washington 98926 SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable items) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. G1, ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2 ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) or Zone AO. G3_ ® The following information (Items G4—G10) is provided for community floodplain management purposes. G4. Permit Number G5_ Date Permit Issued G6, Date Certificate of Compliance/Occupancy Issued FD-21-00034 11-10-2021 12 22-2022 G7. This permit has been issued for: ® New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) 2456.8 feet meters of the building: ® ❑ Datum NAVD 88 G9. BFE or (in Zone AO) depth of flooding at the building site: 2460.0 ® feet ❑ meters Datum NAVD 88 G10. Community's design flood elevation: 2461.0 ® feet ❑ meters Datum NAVD 88 Local Official's Name Tile SAMANTHA COX WATER RESOURCES SPECIALIST Community Name Telephone KITTITAS COUNTY (509) 962-7523 Signature Date 12.22-2a22 Comments fiincluding type of equipment and location, per C2(e), if applicable) G8 is crawlspaee floor, top of finished floor is 2461.6 NAVD88 Certificate for Smart Vents attached ® Check here if attachments. FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Bate. November30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 14710 MANASTASH RD. City state ZIP Code Company NAIC Number ELLENSBURG Washington 98928 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front vew" and "Rear View ; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. •r r f i x� Photo One Caption PHOTO TAKEN 8-24-20V NORTH SIDE OF ROUSE, FACING SOUTH. Gear Photo One Prwm TWO Photo Two Caption PHOTO TAKEN 8-24-2022. WEST SIDE OF HOUSE AND GARAGE, FACING EAST. Clear Photo Two FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMB No. 16 0-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 14710 MANASTASH RD. Policy Number: City State ZIP Code ELLENSBURG Washington 98926 Company NAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View' and "Left Side Mew." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section AB. Rwlo Yhm _ Photo Three Caption Clear Photo Three PhOW Four Photo Four Caption Clear Phow Four FEMA Form 086-M3 (12119) Replaces all previous editions. Form Page 6 of 6 IMES Evaluation Report ESR-2074 Reissued February 2021 This report is subject to renewal February 2023. www.icc-es.orq 1 (800) 423-6687 1 (562) 699-0643 A Subsidiary of the Intemational Code Council6 DIVISION: 08 00 00—OPENINGS Section: 08 95 43—Vents/Foundation Flood Vents REPORT HOLDER: SMART VENT PRODUCTS, INC. EVALUATION SUBJECT: SMART VIEI+ rAUTOMATIC FOUNDATION FLOOD VENTS: MODELS #1S40-520; #1640-521; 01540-510; 91540- 511; #1540-670, #1540.574; #1640-524; #1540-614 FLOOD VENT SEALING KIT 91540-626 1.0 EVALUATION SCOPE Compliance with the following codes: ■ 2018, 2015, 2012, 2009 and 2006 International Building Code* (113C) ■ 2018, 2015, 2012, 2009 and 2006 International Residential Code* (IRC) V 2018 lntemational Energy Conservation Code* (IECC) IN 2013 Abu Dhabi International Building Code (ADIBC)t tThe ADISC i9 based on the 2009 IBC. 2009 ISC code sections referenced in this reportere the same sections in the ADISC. Properties evaluated: ■ Physical operation Ir Water flow 2.0 USES The Smart Vents units are engineered mechanically operated flood vents (FVs) employed to equalize hydrostatic pressure on wails of enclosures subject to rising or falling flood waters. Certain models also allow natural ventilation. 3.0 DESCRIPTION 3.1 General: When subjected to rising water, the Smart Vent°' FVs internal floats are activated, then pivot open to allow flow in either direction to equalize water level and hydrostatic pressure from one side of the foundation to the other. The FV pivoting door is normally held in the closed position by a buoyant release device- When subjected to rising water, the buoyant release device causes the unit to unlatch, allowing the door to rotate out of the way and allow flow. The water level stabilizes, equalizing the lateral forces. Each unit is fabricated from stainless steel. Smart Vent* Automatic Foundation Flood Vents are available in various models and sizes as described in Table 1. The SmartVENr Stacking Model #1540-511 and FloodVENr Stacking Model #1540-521 units each contain two vertically arranged openings per unit. 3.2 Engineered Opening: The FVs comply with the design principle noted in Section 2.7.2.2 and Section 2.7.3 of ASCE/SEI 24-14 [Section 2.6.2.2 of ASCEISEI 24-05 (2012, 2009, 2006 IBC and IRC)] for a maximum rate of rise and fall of 5.0 feet per hour (0.423 mmis). In order to comply with the engineered opening requirement of ASCEISEI 24, Smart Vent FVs must be installed in accordance with Section 4.0. 3.3 Ventilation: The SmartVENr Model #1540-510 and SmartVENr Overhead Door Model #1540-514 bosh have screen covers with 1/4-inch-by-1144nch (6.35 by 6.36 mm) openings, yielding 51 square inches (32 903 rnm2) of net free area to supply natural ventilation. The SmartVENT* Stacking Model #1540-511 consists of two Model #1540-510 units in one assembly, and provides 102 square inches (65 806 mm2) of net free area to supply natural ventilation. Other FVs recognized in this report do not offer natural ventilation. 3.4 Flood Vent Sealing Kit: The Flood Vent Sealing Kit Model #1540-526 is used with SmartVENT* Model 91540-520, It is a Homasote 440 Sound Barriers (ESR-1374) insert with 21 — 2-inch-by-2- inch (51 mm x 51 mm) squares cut in it. See Figure 4. 4.0 DESIGN AND INSTALLATION 4.1 SmartVENr and FloodVENr: SmartVENT* and FloodVENT* are designed to be installed into walls or overhead doors of existing or new construction from the exterior side. Installation of the vents must be in accordance with the manufacturer's instructions, the applicable code and this report. installation clips allow mounting in masonry and concrete walls of any thickness. In order to comply with the engineered opening design principle noted in Section 2.7.2.2 and 2.7.3 of ASCE/SEI 24-14 [Section 2.8.2.2 of ASCE/SEI 24.05 (2012, 2009, 20D6 IBC and IRC)], the Smart Vent* FVs must be Installed as follows: C With a minimum of two openings on different sides of each enclosed area- 0 With a minimum of one FV for every 200 square 1C Y'-r:1 Llvivatxw Neprrr+ are tot to he rarua xed fn representing aesthern s ur amry• twher anrrhutea trn sper+ficalh mHersoed. nor urc thry Nr he amsrrnrd us mr emlur5errent of &r aehjecr gfthe report ro' a ret-(mmenduffim fix th uu•. There t% nu warraaA• Ar• Ir C l rehunuue 4rvur, 11C'..xpress rn• nrplrrd. rrr awry.(1nthng fir other mxgr in rhm r, pw, or us to ant°pnducr ca ered by die report. Copyright 0 2021 ICC Evaluation Service, LLC. All rights reserved Page Iof5 ESR-2074 I Most Widely Accepted and Trusted Page 2 of 5 feet (18.6 M) of enclosed area, except that the SmartVENTf Stacking Model #1540-511 and FloodVENTe Stacking Model #1540-521 must be installed with a minimum of one FV for every 400 square feet (37.2 m2) of enclosed area. Below the base flood elevation. C With the bottom of the FV located a maximum of 12 inches (305.4 mm) above the higher of the final grade or floor and finished exterior grade immediately under each opening. 4.2 Flood Vent Sealing Kit The Flood Vent Sealing Kit Model 1540-526 is used in conjunction with FloodVENT® Model #1640-520. When installed and tested in accordance with ASTM F-283, the FV and Flood Vent Sealing Kit assembly have an air leakage rate of less than 0.2 cubic feet per minute per lineal foot (18.66 Ilmin per lineal meter) at a pressure differential of 1 pound per square foot (50 Pa) based on 12.58 lineal feet (3,8 lineal meters) contained by the Flood Vent Sealing Kit. 6.2 The Smart Vene FVs must not be used in the place of "breakaway walls" in coastal high hazard areas, but are permitted for use in conjunction with breakaway walls in other areas. 6.0 EVIDENCE SUBMITTED 6.1 Data in accordance with the ICC-ES Acceptance Criteria for Mechanically Operated Flood Vents (AC364), dated August 2015 (editorially revised October 2017). 6.2 Test report on air infiltration in accordance with ASTM E283. 7.0 IDENTIFICATION 7.1 The Smart VENT models and the Flood Vent Sealing Kit recognized in this report must be identified by a label bearing the manufacturer's name (Smartvent Products, Inc.), the model number, and the evaluation report number (ESR-2074). 7.2 The report holder's contact information is the following: 6.0 CONDITIONS OF USE SMART VENT PRODUCTS, INC. e 430 ANDBRO DRIVE, KNIT 1 The Small Vent FVs described in this report comply with, PITMAN, NEW JERSEY 0807i or are suitable alternatives to what is specified in, those PITMAN, N, NEW codes listed in Section 1.0 of this report, subject to the www 4414 yr B corn following flonditions: info{liasmarfirentcom 5.1 The Smart VerO FVs.must be installed in accordance with this report, the applicable code and the manufacturer's installation instructions. In the event of a conflict, the instructions in this report govem. TABLE 1—MODEL. SIZES MODEL. NAME MODEL NUMBER MODEL SIZE (in.) COVERAGE (sq. ft.) FloodVE 1540-620 15 !A' X 714" 20D Smar1VENT 1540-510 15314" X 73/4" 20D FloodVENTO Overhead Door 1540-524 1531i' X 7314' 200 SmartVENT® Overhead Door 1540-514 153/4" X 7314" 200 Wood Wall FloodVENTO 1540-570 14" X 83/4„ 200 Wood Wall FloodVE Overhead Door 1540-574 14" X 8314" 200 SmadVENT® Stacker 1640-511 16" X 16" 400 FloodVento Stacker 1640-621 Ion X iv, 400 For SI: 1 inch = 25A MM; 1 square foot = m' f FIGURE 1-4MART VENT: MODEL 1540-610 ESR-2074 E Most Widely Accepted and Trusted page 3 of 5 FIGURE 2--SMART VENT MODEL 1540.620 +— FIGURE 3—SMART VENT: SHOWN WITH FLOOD DOOR PIVOTED OPEN ! INTERIOR ! EXTERIOR FIGURE 4—FLOOD VENT SEALING KIT IMES Evaluation [deport ESR-2074 CBC and CRC Supplement Reissued February 2021 This report is subject to renewal February 2023. www,icc-es.org 1 (800) 423-6587 1 (562) 699.0643 A Subsidiary of the International Code CouncilO DIVISION: 08 00 00—OPENINGS Section: 08 95 43—Vents/Foundation Flood Vents REPORT HOLDER: SMART VENT PRODUCTS, INC. EVALUATION SUBJECT: SMART VENT* AUTOMATIC FOUNDATION FLOOD VENTS: MODELS #1540-620; #1540-621; #1540-510; #1640-511; #1540- 570; #1540474; #1540-524; #1540-514 FLOOD VENT SEALING KIT #1640.526 1.0 REPORT PURPOSE AND SCOPE Purpose: The purpose of this evaluation report supplement is to indicate that Smart Vent* Automatic Foundation Flood Vents, described in ICC-ES evaluation report ESR-2074, have also been evaluated for compliance with codes noted below. Applicable code edition: iw 2016 California Building Code (CBC) in 2016 California Residential Code (CRC) 2.0 CONCLUSIONS 2.1 CBC: The Smart Vent* Automatic Foundation Flood Vents, described in Sections 2.D through 7.0 of the evaluation report ESR- 2074, comply with 2016 CBC Chapter 12, provided the design and installation are In accordance with the 2015 International Building Code* (IBC) provisions noted in the evaluation report and the additional requirements of CBC Chapters 12, 16 and 16A, as applicable. 2.2 CRC: The Smart Vent* Automatic Foundation Flood Vents, described in Sections 2.0 through 7.0 of the evaluation report ESR- 2074, comply with the 2016 CRC, provided the design and installatlon are In accordance with the 2015 Intemational Residential Code* (IRC) provisions noted in the evaluation report. This supplement expires concurrently with the evaluation report, reissued February 2021. 1CY'-F.S livalrmubq Rrpurn am non ro he ernxsrneed ac npn,Feu+ing urxrhelir.+ or anTo4 er arrrrbwrs rk,r.rJxgiiealfl a,llnsgd iror are rlxr N) he Caga9rned us an erkh-rsen+enr of Me re/wr1 or a ncrkllarerklarlan,Aer (ra use. !here n rer nurranp, by 1r Y • Av4oull-) Srnxx•. LL(', esprexa or +nrpli[v!, as r +o j# firxhnx or hiller mortar to do.5 repon, or av to anv praduer covered by dw reparr. Copyright V 2021 ICC Evaluation Servioe, LLC. All rights reserved. page 4 Or 6 IMES Evaluation Report ESR-2074 FBC Supplement Reissued February 2021 This reporf is subject to renewal February 2023. www.icc-es.org 1 (800) 423-6587 j (562) 699-0643 A Subsidiary of the International Code Council DIVISION: 08 00 DO —OPENINGS Section: 08 95 43—VentslFoundation Flood Vents REPORT HOLDER: SMART VENT PRODUCTS, INC. EVALUATION SUBJECT: SMART VENT AUTOMATIC FOUNDATION FLOOD VENTS: MODELS #1540-520; 91540-M; #1640-510; #1640-611; #1540-570; #1540-574; #1540-624; #1540-614 FLOOD VENT SEALING KIT #1540.526 1.0 REPORT PURPOSE AND SCOPE Purpose: The purpose of this evaluation report supplement is to indicate that Smart Vence Automatic Foundation Flood Veins, described in ICC-ES evaluation report ESR-2074, have also been evaluated for compliance with the codes noted below. Applicable code editions: * 2017 Florida Building Code —Building * 2017 Florida Building Code —Residential 2.0 CONCLUSIONS The Smart Vent* Automatic Foundation Flood Vents, described in Sections 2.0 through 7.0 of the evaluation report ESR-2474, comply with the Florida Building Code —Building and the FRC, provided the design and installation are in accordance with the 2015 international Building Code* provisions noted in the evaluation report. Use of the Smart Vent® Automatic Foundation Flood Vents has also been found to be in compliance with the High -Velocity Hurricane Zone provisions of the Florida Building Code --Building and the Florida Building Code —Residential. For products falling under Florida Rule 9N-3, verification that the report holder's quality assurance program is audited by a quality assurance entity approved by the Florida Building Commission for the type of inspections being conducted is the responsibility of an approved validation entity (or the code official when the report holder does not possess an approval by the Commission). This supplement expires concurrently with the evaluation report, reissued February 2021. if •i -E-1; b—atualwor Heparlf tin' !we Ni ln' avrnT rwd at "preseMHif{ aeslisclies or any o0wr Garibir % nar an, Hui, Ni he cemo ed W an enrhrrresrinr al rin• +nhJev1 ! f Ow relrnrl or u renoxrrreadwifor for lis nae. Tirere is rw uvrrwin, h} H'(" FralrrarrrNr Sen n•c. Td.C', expm.L* nr mooed a.. !n orn'rlrrdnrl,' or adwr Nrollel' rn I&S reprirl. Or Os 10 anrPrOflutf t ered h1' dw re prlrr. Copyright 0 2021 ICC Evaluation service, LLC. All rights reseed. Pape 6 of$ U.S. DEPARTMENT OF HOMELAND SECURITY OMB Na. 1660-0008 Federal Emergency Management Agency Expiration Date: November 30, 2022 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the Instructions on pages 1-9. Coov all Rages of this Elevation Certificate and all attachments for (1) community official, (2) Insurance agentloomperry, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al Building Owner's Name Policy Numbers SSHI LLC. A2. Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIL Number; Box No. 2911 Roan Drive Cfly State ZIP Code Ellensburg Washington 98926 A3. Property Description {Lot and Block Numbers, 'Tax Par(*l Number, Legal Description, etc.) Division a Lot 2, 961887 A4, Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential AS. t_afitudelLongitude: Lat. N47°01129,68532- Wng, W120`303.05814" Horizontal Datum: ❑ NAD 1927 Q NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is baing used to obtain Hood insurance. A7. Building Diagram Number 18 A8. For a building with a cravAspacs or enclosure(s): a) Square footage of crawlspaoe or enclosures) N/A sq ft b) Number of permanent Hood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade WA o) Total net area of flood openings in A6,b NIA sq In d) Engineered flood openings? ❑ Yes Q No M. For a building with an attached garage: a) Square footage of attached garage 604.00 sq ft b) Number of permanent flood openings In the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 000 eq In d) Engineered flood openings? ❑ Yes ❑x No SECTION S—FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name 83. State KITTITAS COUNTY, 630095 FMITAS Washington B4. Map(Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Patel C-ffectivW 88. Flood Zone(s) 139. Base Flood Elevation(s) (zone AD, use Base Flood Depth) Revised Date 5303701064 D W24-2021 09-24-2021 Air 1898.1 ft B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered In Item B9: [a FIS Profile [] FIRM ❑ Community Determined ❑ OtherlSource: 811. Indicate elevation datum used for BFE In Item B9: ❑ N©VD 1929 Q NAVD 1988 ❑ OtherlSource: B12, is the building located In a Coastal Bander Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No Designation Date: ❑ CBRS ❑ OPA FEuIA Form 086-0-33 (12119) Replaces all previous editlons. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. I M-0008 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information From Seatlon A. FOR INSURANCE COMPANY USE Ti Idi ng Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. P0116Y Number. 2011 Roan Drive City State ZIP Code Company NAIC Number Ellensburg Washington 98926 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Constmotion' ❑x Finished Construction *A new Elevation Certificate will be required when construction of the building Is complete. C2. Elevations - Zones Aim, AE, AH, A (with BFE), VE, VI--V30, V (with BFE), AR, ARIA, AR/AE, ARIA1-430, ARIAH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meter& Benchmark Utilized: Center of 8 27, T 18 N, R'18 E Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations In Items a) through h) below. ❑ NGVD 1929 Fj] NAVD 1988 ❑ OthedSource: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawlapace, or enclosure floor) 1601.3 M feet ❑ meters b) Top of The next higher floor NIA ❑ feet ❑ meters o) Bottom of the lowest horizontal structural member (V Zones only) NIA ❑ feet ❑ meters d) Attached garage (top of slab) 1601.3 x❑ feet ❑ meters e) Lowest elevation of machinery or equipment earvking the building 1601.5 feet ❑meters (Describe type of equipment and location In Comments) f) Lowest adjacent (finished) grade next to building (LAG) 1599.8 x❑ feet ❑ meters g) Hlghest adjacent (finished) grade next to building (HAG) 1600,E feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stain's, Including NIA ❑feet ❑meters structural support - SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification Is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation h0ormation. I aediry that the Information on this Cerffficate ►represents my best eftorfs to Inte�rot the data available. I understand that any false staterhent may be pwd4mble by fine or Imprisonment under 18 U.S. Code, Ssctfon IW I. Were latitude and longitude in Section A provided by a licensed land sunreyor? 0 Yes ❑ ND ❑ Check here I attachments. Certifiers Name License Number Rick Skinner 43819 I'is� QS�M!�?►I S , j NWAsji�'�1� Title Professional Land Surveyor � pi �! Company Name Western Paoiflc Engineering & Survey, Inc. v, ZE x ! A3G19 Q { Address 1224 S. Pioneer Way gL i,AN Cli state ZIP Code Y Moses Lak Washington 98837 1�t i t Signatu Date Telephone t=xt I&VX A I i_..._...... [/ 1' (609) 76&1023 Copy all palges of I& Elevation Certificate and ail attachments fo (1) coinmurfity official, (2) Insurance agenticompany, and (3) building owner. Comments (including type of equipment and location, per C2(e), If applicable) The elevation of the heat pump located outside of home was measured by using a GPS and then adding the height of the legs for the heat pump. FEMA Form 0864-33 (12119) Replaces all previous editions, corm Page 2 of 5 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date. November 30, 2022 IMPORTANT., In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Sireet Address (including Apt., Unit, Sufle, andfor Bldg. No.) or P.O. Route and Box No. Poky Number. 2011 Roan Drive City State ZIP Code Company NAIL Number Ellensburg Washington 98926 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without SIFE), complete Items El —Ea. If the Cerliiioate is intended to support a LOMA or LOMR-F request, complete Sections A, Band C. For Items E1-134, use natural grade, If available. Check the measurement used. In Puerto Rdoo only, enter meters. E1. Provide elevation Information for the following and check the appropriate boxes to show whether the elevation Is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, amwlspece, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawispace, or enclosure) Is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 82 with permanent flood openings provided In Section A Items 8 andfor 9 (see pages 1 2 of InsWctlonsy the next higher floor (elevation C2b in the diagrams) of the building is ❑ feet ❑ meter: ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) Is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4, Top of platform of machinery andlor equipmant servicing the building Is _ ❑ feet ❑ meters ❑ above or d below the HAG. ES. Zone AO only. If no flood depth number is available, Is the top of the bottom floor elevated In accordance with the communtVa floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information In Section G, SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-Issued or oommunrlyissued BM or Zone AO must slgn here. The statements In Sections A. B, and E are correct to the best of my knowledge. Property Owner or Owners Authorized Representative's Name Scott Henson Address Cily State ZIP Code 1224 S Pioneer Way Moses Lake Washington 98837 Signature,, Date Telephone (509) 855.6112 Commerce ❑ Check hers N attachments. FEMA Form 086-0-33 (12f1g) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No.1660-0008 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Seedon A. FOR INSURANCE COMPANY USE Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Polioy Number: 2911 Roan Drive City State ZIP Code Company NAIC Number Ellensburg Washington 96926 SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who Is authorized by law or ordinance to administer the community's tloodplain management ordinance can complete Sections A, B, C (or E), and O of this Elevation Certificate. Complete the applicable Item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. 01. ❑ The infommatiort in Section C was taken from other documentation that has been signed and seated by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation Information. (Indicate the source and date of the elevation data in the Comments area below.) G2, ❑ A community official completed Section E for a building located in Zone A (without a FEMA4ssued or community -Issued BFE) or Zone AO. (33. ❑ The following Information (items 04—G10) Is provided for community floodplain management purposes. 04. Permit Number G5. Date Permit issued G6. hate Certificate of Compliance/Occupancy Issued G7. This permit has been Issued for: ❑x New Construction ❑ Substanflal Improvement G6• Elevation of as -built lowest floor (Including basement) ❑ feet ❑ meters Datum of the building: G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum 010. Community's design flood elevation: ❑ feet ❑ meters Datum Local official's Name 710e Community Name Telephone Signature bate Comments (Including type of equipment and location, per C2(e), If applicable) ❑ Check here if attachments. FEMA Farm 086-0-33 02/19) Replaces all previous editions. Farm Page 4 of 6 BUILDING PHOTOGRAPHS OMB No.1680-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Cate: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Sectloh A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Poilay Number: 2911 Roan Drive Lily State ZIP Code Company NAIC Number Ellensburg Washington 98925 tf using the Elevation Ceriilfcefe to obtain NFIP flood Insurance, affix at least 2 building photographs below according to the Instruotkme for Item A8. Identify all photographs with date taken; "Front View" and "Rear VleW; and, If required, "Right Side ViewP and "Left Side View" When applicable, photographs must show the foundation with representative wtempies of the flood openings or vents, as Indicated In Section AS. If submitting more photographs than wit/ fit on this page, use the Continuation Page. :a: , :••tic h0[G1TMf04..+.... Photo Two Caption Side Clearptrgto,7iva. FEMA Form 088.0-33 (12119) Replaces all previous editions. Form Page 6 of 6 Photo Four Caption Side Ow Photo FOW FEMA Form 086-0-33 (1211 9) Replaces all previous edflons. Form Page 6 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY OMB No.1660-0008 Federal Emergency Management Agency Expiration Date: November 30, 2022 National Flood Insurance Program ELEVATION CERTIFICATE Important Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for (1) commuNty official, (2) Insurance agent/company, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Building Owner's Name Policy Number: SSHI LLC. A2. Bulkling Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 2916 Roan Drive city state ZIP code Ellensburg Washington 98926 A3. Property Description (Lot and Blodc Numbers, Tax Parcel Number, Legal Description, do.) Division 6 Lot 3,961888 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential AS. Latitudell-ongitude: Lat. N47001'30.46667" Long.W120°303.83831" Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983 AS. Attach at least 2 photographs of the building If the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1 BB AS. For a building wflh a orawispaoe or enclosure(s): a) Square footage of crawlepace or enclosure(s) NIA aq ft b) Number of permanent flood openings in the crawlepac:e or enclosure(s) within 1.0 foot above adiacent grade WA c) Total net area of flood openings In AB.b NIA sq in d) Engineered flood openings? ❑ Yes M No A9. For a building with an attached garage: a) Square footage of attached garage 520.00 sq R b) Number of permanent flood openings In the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings In A9.b 0.00 sq in d) Engineered flood openings? ❑ Yes ❑x No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name 83. State KITTITAS COUNTY, 530095 KITTTAS Washington B4. Mep/Panel 86. Suffix 06. FIRM Index B7. FIRM Patel 68. Flood SO. Base Flood Elevation(s) Number Date Eifecti W zone(s) (Zone AO, use Base Flood Depth) Revised Date 53037CIO64 D 09-24-2021 09 24-2021 AE 1698.1 ft B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered In Item B9: a] Fla Profile ❑ FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE In item 89. ❑ NGVD 1929 Ej NAVD 1988 ci Other/Source: B12. is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No Designation Date: ❑ CBRS ❑ OPA FEMA Form Ot36 "3 (12119) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No.1660-OD08 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, eopy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, andfor Bldg. No.) or P.O. Route and Box No. Policy Number: 2915 Roan Drive City State ZIP Code Company NAG Number Ellensburg Washington 98926 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Ci . Building elevations are based on: ❑ Construction Drawings"` ❑ Building Under Construction* Z Finished Construction 'A new Elevation Certificate will be required when construction of the building Is complete. C2. Elevations - Zones Ai-A30, AE, AH, A (with BFE), VE, V1 V30, V (with BFE), AR, ARIA, AWAE, AR►AI-A30, AWAH, AR1AO. Complete items C2.a-h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters. Benchmark Utilized: Center of 8 27, T 18 N, R 18 E Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations In Items a) through h) below. ❑ NGVD 1929 ❑x NAVD i988 ❑ OtherlSouroe: Datum used for building elevations must be the same as that used for the OFE. Check the measurement used. a) Top of bottom floor (including basement, crawispace, or enclosure floor) 1601.E rr❑ feet ❑ motors b) Top of the next higher floor NIA ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) NIA ❑ feet ❑ meters d) Attached garage (top of slab) 1601.6 feet j] meters a) Lowest elevation of machinery or equipment servicing the building 1601.2 K❑ feet ❑ meters (Describe type of equipment and location In Comments) f) Lowest adjacent (finished) grade next to building (LAG) 1600.0 0 feet ❑meters g) Highest adjacent (flnlehad) grade next to building (HAG) 1600.9 Q feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, Including _ NZA ❑ feet ❑ meters structural support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification Is to be signed and sealed by a land surveyor. engineer, or architect authorized by law to certify elevation Information. l certify Mat the Information on this Certificate represents my bee! oft* to interpret the date available. l underdand that any false abatement may be punishable by the or Imp►isonment under I8 U.S. Code, SocWn 1001. Were latitude and longitude In Section A provided by a licensed land surveyor? M Yes ❑ No ❑ Check here If attachments. Certifw!s Name License Number Rick Skinner 43619 . pFIVAS l wad' Title Professional Land Surveyor G+�� O Company Name Western Pacific Engineering & Surrey, Inc. ( M f Address 1224 S. Pioneer Way 43618' ! ~ AL cityState ZIP Code M Lake Washington 98837Telephone Signatures _ _ �_ .._.. Data (509) 768.1023 Ext. Copy all pa es of thils Elevation Certificate and all attachments fdr (1) mmvrn official, (2) insurance agenticompany, and (3) building owner. Comments (including type of equipment and location, per C2(e), If applicable) The elevation of the heat pump located outside of home was measured by using a GPS and then adding the height ofthe legs for the heat pump. FEMA Form 086-0-33 (12119) Replaces al previous editions. rums rayo A an ELEVATION CERTIFICATE OMB No.1660-0008 Expiration Date: November 30, 2022 IMPORTANT: In there spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Polley Number. 2915 Roan Drive City State ZIP Code Company NAIC Number Ellensburg Washington 98926 SECTION E -- BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE} complete Items E1--E6. If the Certificate Is intended to support a LOMA or LOMR-F request, complete Sections A, Band C. For Items E'I--£4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, orawlspece, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams " with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1 2 of instructions), the next higher floor (elevation C2.b in the diagrams) of the building Is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or []below the HAG. E4. Top of platform of machinery and/or equipinent servicing the building is ❑ feat ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no ttood depth number Is available, Is the top of the bottom floor elevated in accordance with the communWe floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The lord official must certify this Information in Section G. SECTION F -- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, 8, and E for Zone A (without a FEMA-Issued or community -issued BFE) or Zone AO must sign here. The statements In Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Scott Benson Address City state ZIP Code 1224 8 Pioneer Way Moses Lake Washington 98837 Signature Date Telephone (509) 86"112 Comments ❑ Check here if attachments. FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 3 Of 43 ELEVATION CERTIFICATE OMB No.1660-0008 Expiration Data: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O, Route and Box No. Policy Number: 2915 Roan Drive City state ZIP Code Company NAIC Number Ellensburg Washington 98926 SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who Is authorized by law or ordinance to administer the community's fioodplaln management ordinance can complete Sections A. B. C (or E), and G of this Elevation Certificate. Complete the applicable Item(s) and sign below. Check the measurement used in Items G8-010. In Puerto Rico only, enter meters. G1. ❑ The informatlon in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who Is authorized by law to cwfify elevation Information. (Indicate the source and date of the elevation data In the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA4asued or community -Issued WE) or Zone AO. Gg, ❑ The following information (Items G4—GI0) Is provided for community floodplain management purposes. 04. Permit Number 05, Date Permit Issued G6. Date Certfcate of Complianoe/Oocupancy Issued G7. This permit has been Issued for: New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) 0feet ❑meters Datum of the building; G9. SFE or (in Zone AO) depth of flooding at the building site: ❑ feat ❑ meters Dim G10. Community's design hood elevation: feet 0 meters Datum Local Officials Name Title Community Name Telephone signature Date Comments (Including type of equipment and location, per C2(e), p applicable) ❑ Check here if attachments. FEMA Form 086-0 33 (12119) Replaces all previous editions. rorm rage +r of v BUILDING PHOTOGRAPHS OMB Na.16so�oas ELEVATION CERTIFICATE See Instructlons for item A6. Expiration Date: November 30, 2D22 IMPORTANT, In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Sheet Address (Including Apt., Unit, Suits, and/or Bldg. No:) or P.O. Route and Box No. Policy Number: 2915 Roan Drive City State ZIP Code Company NAIC Number Ellensburg Washington 98926 If using the Elevation Certificate to obtain NFIP flood Insurance, affix at least 2 building photographs below according to the Instructions for Item A6. Identify all photographs vrlth date taken; "Front View" and "Bear View"; and, if required, `Right Side View' and "Loft Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated In Section AS. If submitting more photographs than will fit on this page, use the Continuation Page. PM 'LJL: I S, PADiO o00 Photo One Option Front 'u"i..Photo.biie : ..J - S . - "M5 C ass' t t+•' j 1. tt\:i it Y {i is 9' Photo Two Caption Side Olw Photo Two . FEMA Form 0884)-33 (12/19) Replaces all previous editions. Form Page 0 of 5 BUILDING PHOTOGRAPHS OMS No.1BB0-0008 ELEVATION CERTIFICATE Contlnuatlon Page Expiration oats: November 30, 20Z IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Rotate and Box No. Policy Number; 2915 Roan Drive City State ZIP Code Company NAIC Number Ellensburg Washington 98926 if submitting more photographs than wIR fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show The foundation with representative examples of the flood openings or vents, as indicated In Section A8. PholD Four Photo Four Caption Side .gear Photo Four, FEMA Form 088-0-33 (12f19) Replaces all previous editions. rorm rage a or o U.S. DEPARTMENT OF HOMELAND SECURITY OMB No.1660-0008 Federal Emergency Management Agency Expiration Data: November 30, 2022 National Flood Insurance Program ELEVATION CERTIFICATE Important: Fallow the instructions on pages 1 9, Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) Insurance agerWoompany, and (3) building owner. SECTION A- PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number. SSHt LLC. A2. Building Street Address (Including Apt., UnN. Suite, and/or Bldg. No.) or P.O. Route and Company NAIL Number: Box No. 2919 Roan Drive City State ZIP Code Ellensburg Washington 98928 A3, Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Division 6 Lot 4, 961889 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat. N47.01W.W960" Long,W120°34W.6738W Horizontal datum: ❑ NAD 1927 ❑x NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number I A8. For a building wlfh a omwlspace or enclosure(s): a) Square footage of crawlspaoe or enclosure(s) N/A sq It b) Number of permanent flood openings In the crawlspaco or enclosures) within 1.0 foot above adjacent grade NIA c) Total not area of flood openings In AB,b NIA sq In d) Engineered fiaad openings? ❑ Yes ❑x No A9. For a building with an attached garage: a) Square footage of attached garage 520.00 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 0.00 aq In d) Engineered flood openings? ❑ Yes ❑x No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name 83. State IQTTITAS COUNTY; 630096 KITTITAS Washington 84. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9, Base Flood Elevation(s) Number Date Effective/ Zone(s) (Zone AO, use Base Fl6od Depth) Revised Date 63037CIO64 D 09 24-2021 09-24.2021 AE 1697.9 fi B10, Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered In item B9: ❑x FIS Profile ❑ FIRM ❑ Community Determined [3 Other/Source: 1311. Indicate elevation datum used for BFE In Item 139: ❑ Nr3VD 1929 x] NAVD 1988 ❑ Other/Souroe: B12. Is the building looted in a Coastal Barrier Resources System (CBRS) area of Otherwise Protected Area (OPA)? ❑ Yes 0 No Designation Date: ❑ CBRS ❑ OPA FEMA Form 088-0-33 (12H9) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No.1660-0008 Expiration Date: November 30, 2022 IMPORTANT: in these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 2919 Roan Drive City State ZIP Code Company MA -IC Number Ellensburg Washington 98926 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) CS. Building elevations are based on: ❑ Construction Drawings" ❑ Building Under Construction" M Finished Construction "A new Elevation Certificate will be required when construction of the bcrilding Is compete. C2. Elevations - Zones Ai-A30, AE, AH, A (with OFE), VE, VI-V30, V (with SFE), AR, ARIA, ARIAS, ARIA1-MO, ARlAH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: Center of S 27, T 18 N, R 18 E Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations In items a) through h) below. ❑ NGVD 1929 ❑x NAVO 1088 ❑ Other/Source: Datum used for buiding elevations must be the same as that used for titre BFE. Check the measurement used. a) Top of bottom floor (Including basement, crawlspec% or enclosure floor) 1600.6 0 feet ❑ meters b) Top of the next higher floor NIA ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) NIA ❑ feet ❑ meters d) Attached garage (top of stab) 1600.6 d feet ❑ meters ej Lowest fuildon servicing the ��ing (Describe type of equipment machinery or Co vnents) 1600.2 feet Q meters f) Lowest adjacent (finished) grade next to building (LAO) 1599.6 []x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 1600.0 feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A ❑ feet ❑ meters structural support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification Is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify, elevation information. r certify that the Information on this Certfficate represents my best efforts to Werrppret the data aveNable. { understand that any fares siatemenf maybe purdshable by Sao orlmprisonment under 18 U. S. Code: , oWn 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes ❑ No ❑ Check here fi attachments. Ceditlees Name License Number Ride Skinner 43619 �tM!AIW 'nos Professional Land Surveyor Ckr��r - 0. Company Name Western Pacific Engineering 8 Survey, Inc. "b Zia: 43619 Address 1224 S. Pioneer Way • , ... 1?.�rr'� AL i.AN� City State ZIP Code Moses Lake Washington 98837 1 Sigrmture ; Date Telephone Ext. ,. �_ ..._............. .._.....� .. ZZ41,2 (609) 76&1023 Copy all p46es of this Elevation Certificate and all attachments for ( oo un official, (2) Insurance agent/cornpany, and (3) building owner. Comments (including type of equipment and location, per C2(s), # applicable) The elevation of the heat pump located outside of tome was measured by using a GPS and then adding the height of the legs for the heat pump. FEMA Form 066-0-33 (12119) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No, 1880-0008 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or R.O. Route and Box No. Policy Number. 2019 Roan Drive City state ZIP Code Company NAIC Number Ellensburg Washington 98926 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1—E5, N the Certificate Is Intended to support a LOMA or LOMR-F request, complete Sections A, B,and G. For items E1—E4, use natural grade, if available. Check the measurernent used. In Puerto Rico only, enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent Wade (LAG). a) 'Top of bottom floor (including basement, crawispace, or enclosure) is ❑ feet ❑ nrs ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 84 with parmanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions), the next higher floor (elevation C2.b In the diagrams) of the building is _-- . ❑ feet ©meters, ❑ above or ❑ below the HAG. E3. Attached garage (top of aiab) Is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑ meters ❑ above or ❑belowthe HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodpkain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this triformat#on in Section G. SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The prop owner or owner's authorized representative who completes Sections A. B, and E for Zone A (without a FEMA-lssuad or oommuMty ssued BFE) or Zone AO must sign here. The statements In Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Scott Henson Address City state ZIP Code 1224 S Pioneer Way Moan lake Washington 98837 Signature Date Telephone . --). f, (509) 855-5112 Comments ❑ Check here I attachments. FEMA Form 0813.MB (12/19) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No. 166M008 Expiration Dale: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (Including Apt., Unit, Sulte, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 2919 Roan Drive City State ZIP Coda Company NAIL Number Ellensburg Washington 98926 SECTION 0 — COMMUNITY INFORMATION (OPTIONAL.) The local official who Is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,13, C (or E), and G of this Elevation CwWlcate. Complete the applicable item(s) and sign below. Check the measurement used in Items G"I0. In Puerto Rico only, enter meters. G1. ❑ The Information In Section C was taken from other documentation that has been signed and seated by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation Information. (Indicate the source and date of the elevation data in the Comments area below.) (32. ❑ A community official completed Section E for a building located in Zone A (without a FEMA-Issue/ or community -Issued SFE) or Zone AO. G3. ❑ The following information (Items Gil—G10) Is provided for community hoodplain management purposes. G4. Permit Number 05. Date Permit Issued 06. Date Certificate of Compliance/Occupancy Issued 07. This permit has been issued for: 0 New Construction ❑ Substantial Improvement G8. Elevation of as -built kmmst floor (Including basement) of the building: ❑ feet ❑ meters Datum G9. OFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum 010. Community's design flood elevation: ❑ feet ❑ meters Datum Local Ofidel's Name Title Community Name Telephone Signature Date Commerb (Including type of equipment and location, per C2(e), If applicable) ❑ Check here if attachments. FEMA Form 08"-33 (12119) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No.1660-0008 ELEVATION CERTIFICATE See Instructions for Item AS. Expiratton Date: November 30. 2022 IMPORTANT. In these spam, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite. and/or Bidg. No.) or P.O. Route and Box No. Policy Number: 2919 Roan Drive City State ZIP Code Company NAIC Number Ellensburg Washington 98M If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the Instructions for Item A6. Identity all photographs with date taken; "Front View" and "Rear Vtew'; and, If required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as Indicated In Sentlon AS. If submitting more photographs than will 2 on this page, use the Continuation Page. vY1 7 •, :. i ti^ a :s• Phado One Photo One Caption Front Clear:l?ttgto. oes .: ¢ �e b:'�•s� _ �: '�. *�{�,�'-T a=P a,:.E., l'aA• .-bur... ". _. .�`•M1 .yam_` rl�til:..- - ; '"�a g`�s��i � � r•� 1 - - , �.o-•�.._ ?vim i .,,�,?� ;• -4� ;i _- - _ _ � _ `�� - �� jam,' � - _ 1 S -.T-'�L•t Photo T" Photo T Caption Side GlearAhato.11ato FEMA Font 088-0-33 (12M9) Replaces all previous editions. Form Page 5 of 8 BUILDING PHOTOGRAPHS OMB No.1680-0008 V.b.W.-ra-L r vl' v9.R" vr% a ff-- wnunuauan rage txplrauon Me: NovemDer au, 2U2Z IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (Including Apt., Unit, Suite, andfor Bldg. No.) or PA Route and Box No. Policy Number: 2919 Roan Drive City State ZIP Code Company NAIC Number Ellensburg Washington 98926 If submitting more photographs than will fit on the preceding page, affix the addMonal photographs below. Identify all photographs with: date taken; "Front View" and "Rear View", and, if required, 'Right Side View" and '7.eft Side View." When applioabie, photographs must show the foundation with representative examples of the flood openings or vents, as indicated In Section A8. 1• PEsoW Th1*6 Photo Three Caption Back Glaer Photo.Threa FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 6 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 Federal Emergency Management Agency Expiration Date: November 30, 2022 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for (1) community offlciall, (2) Insurance agenUcompany, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number: SSHI I.I.C. A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIL Number: Box No. 3012 Dapple Gray Way City State ZIP Code Ellensburg Washington 98926 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Dawiplion, etc.) Division 6 Lot 5, 961890 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential AS. LatitudelLongituds: Let. N47°01'33.23464" Long. W120"34'34.5883" Horizontal Datum: ❑ NAD 1927 x❑ 14AD 1983 AB. Attach at least 2 photographs of the building If the Carliflcate Is being used to obtain flood Insurance. A7. Building Diagram Number 1 B A8. For a building with a crawlspaoe or enclosure(s): a) Square footage of crawispece or endosure(s) WA sq ft b) Number of permanent flood openings In the crawlspace or enclosure(s) within 1.0 loot above adjacent grade c) Total net area of flood openings In A8.b NIA sq in d) Engineered flood openings' ❑ Yes [j] No A9. For a building with an attached garage: a) Square footage of attached garage 620.0D aq It b) Number of permanent flood openings in the attached garage within 1.0 toot above adjacent grade 0 c) Total net area of flood openings in A9.b 0.00 sq in d) Engineered flood openings? ❑ Yes ❑x No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number 82. County Name B3. State KITTITAS COUNTY; 630OD95 KITTITAS Washington 134. Map/Panel B5. Suffix 86. FIRM Index B7. FIRM Panel 88. Flood B9. Base Flood Elevation(s) Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth) Revised Date 53037CID64 D 09-242021 09-24 2021 AE 1597.0 it 1310. indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 89, ❑x FIS Profile ❑ FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in item 89: ❑ NGV01029 x❑ NAVD 1988 ❑ Other/Source: B12. Is the building located In a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)7 ❑ Yes Q No Designation Date: CBRS ❑ OPA FEMA Form D86-0-33 (12/19) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 EXDiration Dale: November 30. 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Rouie and Box No. Policy Number: 3012 Dapple Gray Way City State ZIP Code Company NA1C Number Ellensburg Washington 98928 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction" x❑ Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations — Zones Al—A30, AE, AH, A (with BFE), VE, V1 V30, V (with BFE), AR, ARIA, ARIAE, AR/A1—A30, ARIAH, AR/AO. Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: Center of S 27. T 18 N, R 18 E Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. [] NGVD 1929 R] NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the some as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure Floor) 1599.1 [E feet ❑ meters b) Top of the next higher floor N/A ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet [] meters d) Attached garage (top of slab) 1599.1 Q feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 1549 2 >t feet meters (Describe type of equipment and location in Comments) ❑ ❑ f) Lowest adjacent (finished) grade next to building (LAG) 1597.8 Q feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) _ 1598.1 ❑rr feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support hfiA ❑ Feet ❑ meters SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification Is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the inrormation on this Certificale represents my best efforts to inteMref the data avaftable. I understand that any false statement may be punishable by fine or Imprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? i�x.. Yes ❑ Noi4 Certifier's Name License Number Rick Skinner 43619 3' p. WAS[ TitleO� Professional Land Surveyor �' % Company Name Western Pacific Engineering & Survey, Inc. 36 9 ' 4Q Address 1224 S. Pioneer Way t P+ City State ZIP Code Moses Lake Washington 98837 Signature Date Telephone Ext. 412OLZ-3 (509) 706-1023 Copy all pades of this Elevation Certificate and all attachments o (1) community official, (2) insurance agendoompany, and (3) building owner. Comments (including type of equipment and location, per C2(e). If applicable) The elevation of the heat pump located outside of home was measured by using a GPS and then adding the height of the legs for the heat pump. FEMA Form 08"-33 (12119) Replaces all previous editions. Form Page 2 of ti ELEVATION CERTIFICATE OMB No. 1660-0008 Expiraiian Date: November 30. 2022 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. Policy Number. 3012 Dapple Gray Way City Slate ZIP Code Company NAIL Number Ellensburg Washington 98926 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1—E5. If the Certificate is Intended to support a LOMA or LOMR-F request, complete Sections A, Bend C. For Items E1—E4, use natural grade, if available, Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawispace, or enclosure) Is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent Rood openings provided in Section A Items 8 andlor 9 (see pages 1-2 of Instructions), the next higher floor (elevation C2.b in the diagrams) of The building is _ _ []feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery andlor equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E6. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated In accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ unknown. The local official must certify this information in Section G. SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community -issued BFE) or Zone AO must sign here. The statements In Sections A, B. and E are correct to the best of my knowledge. Property Owner or Owner`s Authorized Representative's Name Scott Henson Address City State ZIP Code 1224 S Pioneer Way Moses Lake Washington 98837 Signature Date Telephone r . r (509) 855-5112 Comments ❑ Check here if attachments. FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No.1000-0008 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suile, andfor Bldg. No.) or P.O. Route and Box No. Policy Number: 3012 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98920 SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized, by law or ordinance to administer the community's floodplain management ordinance oan complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable Item(s) and sign below. Check the measurement used In Items G8--G10. In Puerto Rico only, enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor; engineer, or architect who Is authorized by law to certify elevation information. (indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA-lesued or community -issued BFE) or Zone AO. G3. ❑ The following information (Rome G4-1310) Is provided for community floodplaln management purposes. G4. Permit Number 05. Date Permit Issued G8, Date Certificate of Cornpilanoo/Occupancy Issued G7. This permit has been Issued for. ❑u New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: _ _ - - ©feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Communily's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e). if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Exo1ration Date: November 30. 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 3012 Dapple Gray Way City State ZIP Code Company NAIL Number Ellensburg Washington 98926 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View'; and, if required, "Right Side View and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood opanings or vents, as Indicated in Section AS. If submitting more photographs than will fit on this page, use the Continuation Page. an Photo One Photo One Caption Front Clear Photo One wt * Maio Two Photo Two Caption Side Clear Photo Two FEMA Form 066-D-33 (12119) Replaces all previous editions. Form Page 6 of 6 BUILDING PHOTOGRAPHS OMB No.1660.0008 ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 3012 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, 1f required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. Mr Nhdo Tt,raa Photo Three Caption Rear Clear Phato Three 'Lill, i . r Mto FWr Photo Four Caption Side Clear Phato Four FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 6 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY OMB No.1660-00p8 Federal Emergency Management Agency Expiratlon Date, November 30, 2022 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instmolions on pages 1-2. Copy all pages of this Elevatlon Certificate and all attachments for (1) community of vial, (2) insurance agenticomparry, and (3) budding owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number: SSHI LLC. A2. Building Street Address Oncluding Apt., Urdt, Suite, andlor Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 3010 Dapple Gray Way City State 21P Code Ellensburg Washington 98926 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Division 8 Lot 8, 961891 A4, Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. LatitudelLongitude: Lat. N47901`62.69399" Long. W12D"3418,80056" Hodwntal Datum: ❑ NAD 1927 0 NAD 1983 A6. Attach at least 2 photographs of the building N the Certificate is being used to obtain flood insurance. A7. Su6ding Diagram Number 1 B AS. For a building with a csawlspace or enclosure(s): a) Square footage of crawispace or enclosure(s) NIA sq ft b) Number of permanent flood openings in the emwlspace or enclosure(s) within 1.0 foot above adjacent grade NA c) Total net area of flood openings In A8.b NIA sq In d) Engineered flood openings? ❑ Yes 0 No A9. For a building with an attached garage: a) Square footage of attached garage 52000 sq ft b) Number of permanent flood openings in the attached garage within 10 foot above adjacent grade 0 c) Total net area of flood openings In A9.b 000 sq in d) Engineered flood openings? ❑ Yea M No SECTION 8 — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name d, Community Number B2. County Name B3. State KITTITAS COUNTY, 630095 KITTITAS Washington S4. MaWanal B5. Suffix S6. FIRM Index 137. FIRM Panel BS. Flood B9. Base Flood Elevalion(s) Number Date Effeclivvel Zone(s) (Zone AO, use Base Flood Depth) Revised Date 63037CIO04 D 09-24 2021 09-24-2021 AE 1595.5 It 1310. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered In Item S9: Q FIS Profile ❑ FIRM ❑ Community Determined ❑ OtherlSource: B11. Indicate elevation datum used for BFE In Item sag: ❑ NGVD 1929 0 NAVD 1988 ❑ OtherlSouroe: 812. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes Q No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33 (12119) Replaces all previous edfllons. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No.1660-0008 Expiration Date: November 30, 2022 IMPORTANT. In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt, Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. Policy Number; 3010 Dapple Gray Way City State ZIP Code Company NAIC Number Blensburg Washington 98926 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Bultding elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* 0 Finished Construction *A new Elevation Certificate will be required when construction of the building Is complete. C2. Elevations — Zones Al—A30, AE, AH, A (with BFF), VE, Vi V30, V (with BFE), AR, ARIA, AR/AE, ARIA1—A30, ARIAH, ARIAO. Complete Items C2.a—h below according to the building diagram specified In Item AT In Puerto Rico only, enter motors. Benchmark Utilized: Center of S 27, T 18 N, R 18 E Vertical Datum: NAVD 1985 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ❑x NAVD 1988 ❑ OtherlScurce: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used, a) Top of bottom floor (Including basement, crawlspac:e, or enclosure floor) 1598.3 r❑ feet ❑ meters b) Top of the next higher floor NIA ❑ Feet ❑ meters c) Bottom of the lowest horizontal structural member (V zones only) N/A ❑ feet ❑ meters d) Attached garage (top of slab) 1598.3 0 feet ❑ meters e) Lowest elevation of machinery or equt ment servicing the building 1598,2 x❑ feet ❑ meters (Describe type of equipment and location In Comments) f) Lowest adjacent (finished) grade next to building (LAG) 1596.8 0 feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 1597.1 0 feet ❑ meters h) Lowest adjacent grade at lowest elevation of dock or stairs, Including N/A ❑feet El meters structural support SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification Is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation Information. I certify that the. Information on this Certificate represents my beat efforts fo Interpret the data available. I understand that any false statement maybe punishable by fine orlmprisonment under 18 U.S. Code, Secllon 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes ❑ No ❑ Check here if attachments. NNIONNOWN-1411dw oil Certifier's Name License Number 43619 — Rick Skinner „ . S P � <p ,j O� WAS This Professional Land Surveyor ;� O Company Name Western Pacific Engineering & Survey, Inc. +CA `. z; nc Address 1224 S. Pioneer Way � ,rS'1'4`�.�•�� City state ZIP Code Moses Lake Washington 98837 Signal /, „ '; Date Telephone Ext. i (509) 766-1023 Copylall pages of this Elevatlo -Certificate and all attechme fo () community official, (2) Insurance agent/company, and (3) building owner. Comments (Including type of equipment and location, per C2(e), if applicable) The elevation of the heat pump located outside of home was measured by using a GPS and then adding the height of the lags for the heat pump. FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page z of 6 ELEVATION CERTIFICATE OMS No.1660-0008 Expiration hate: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 3010 Dapple Gray Way City State ZIP Code Company NAIL Number Ellensburg Washington 98926 SECTM E — BUILDING ELEVATION INFORMATION SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT SFE) For Zones AO and A (without BFE), complete items E1--ES. If the Certificate is Intended to support a LOMA or LOMR-F retluest, compute Sections A, 13,and C. For Hems E'I—E4, use natural grade, If available. Check the measurement used. In Pinto Rion only, enter meters. E1. Provide elevation Information for the following and check the appropriate boxes to show whether the elevation Is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (inclining basement, crawispace, or enclosure) Is — [] feet ❑ meters ❑ above or Gj betow the HAG. b) Top of bottom floor (induding basement, crawlspace, or enclosure) to — ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Bullding Diagrams 84 with permanent hood openings provided In Section A Items 8 and/or 9 (see pages 1-2 of instructions), Ow next higher floor (elevation C2.b in the diagrams) of the building Is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery andlor egdpme t servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: if no flood depth number is available, Is the top of the bottom floor elevated in accordance with the comminily% floodplain management ordinanoe7 ❑ Yes ❑ No E] Unknown. The local officlal must codify this information in Section G. SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A B, and E for Zone A (without a FEMA-issued or community dssued BFE) or Zone AO must sign here. The statements in Sections A, 6, and E are owed to the best of my knowledge. Property Owner or Owner`s Authorized RepresentaflvWs Name Scott Henson Address Ciiy State ZIP Code 1224 S Pioneer Way Moses Lake Washington 98837 Signature Date Telephone (509) 85"112 Comments C] Check here If attachments. FEMA Form 086-0-33 (12119) Replaces all previous edltiotna Form Page 3 of 6 ELEVATION CERTIFICATE OMS No.1660.0008 Explrallon Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding Intornutton from Sectlon A. FOR INSURANCE COMPANY USE BWlding Street Address (including Apt., Unit, Suite, andtor Bldg. No.) or P.O. Route and Box No. Policy Number: 3010 Dapple Gray Way CRY State ZIP Code CompwW NAIL Number Ellensburg Washington 98926 SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who Is authorized by law or ordinance to administer the community`s floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable items) and sign below. Check the measurement used In Items 08-G10. In Puerto Rico only, enter motors. a1. ❑ The information In Section C was taken from other documentation that has been signed and seated by a licensed surveyor, engineer, or architect who Is authorized by law to certify, elevation information. (indicate the source and date of the elevation data In the Comments area below.) Q2. © A community official completed Section E for a building located In Zone A (without a FEMA-Issued or community-lssued BFE) or Zone AO. G3. ❑ The following information (Items G4-G1O) Is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued 06. Date Certificate of ComplianoelOccupancy Issued G7. This permit has been Issued for. ❑x New Construction ❑ Substantial Improvement G& Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ metma Datum G10. Community's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name Tltie Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e). if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No.16W-0008 ELEVATION CERTIFICATE see Instructions for Item A6. Expiration Date: November 30, 2022 IMPORTAAiT. In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt.. Unit, Suite. and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 3010 Dapple Gray Way City state ZIP Code Company NAIL Number Blensburg Washington 98928 If using the Elevation Certificate to obtain NFIP flood Insurance, affix at least 2 building photographs below according to the Instructions for Kern A6. Identify all photographs with date takerr, Tront View" and "Rear Vlaw' ; and, If required, "Right Side MeW and "Lett Side View." When applicable, photographs must show the foundation with representative wmnVies of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will It on this page, use the Continuation Page. A. �x n - 1 ritit r _ ` s :j s Photo On Photo One Caption Front ;Clear Pjigto one.: .-.:. .- ................ .. PhotoT" Photo Two Caption Side :•®�r Two.: FEMA Form 086-0-33 (12149) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS 01VIa NO. lao"008 ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2022 IMPORTANT, In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P,O, Route and Box No. Policy Number. 3010 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 08920 If submitting more photographs than will lit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and `Rear View": and, if required, 'Right Side View" and "Left Side View," When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as Indicated in Section A8. `:t 4 ...s'i• •- ...:.•.4 ..: Photo Three Photo Three Caption Rear Clear•.phgYo Three. '�.Y'ii ''-^e .5�f. °i �„':.yr�. �+�y3t �!rt,•P:?�s� �{:y�v �'Y,.a?, .A EL k. 1 -r y d.F+ d - .•1 S - "4 � - Y � x � 40b%ur Photo Four Caption Side :'Clear,Pflplo.Fptr - FEMA Form 086-"3 (12/19) Replaces all previous editions. Form Page 6 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY OMB No.1660-0008 Federal Emergency Management Agency > xpiratlon Date: November 30, 2022 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1--9. Copy all gages of this 0evatien Certificate and all attachments for (1) community official, (2) Insurance agentloompany, and (3) building owner. SECTION A— PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name policy Number SSHI LLG. A2. Building Street Address (including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Company NAIL Number: Box No. 3DD8 Dapple Gray Way City State ZIP Code Ellensburg Washington 90920 A3, Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Desalpflon, etc.) Division B Lot 7, 901892 A4. Building Use (e.g., Residential, Non- Residential, Addition, Accessory, eto.) Residential AS. Latltudell-ongitude: Let N47°01'31.64862" Long, W120434'40.20136" Horizontal Datum: ❑ MAD 19ZT x❑ NAD 1983 A6. Attach at feast 2 photographs of the building If the Certificate Is being used to obtain flood Insurance. AT Building Diagram Number 1 B A6. For a building with a crawlspace or enclosurs(s): a) Square footage of crawlspace or enclosure(s) NIA sq ft b) Number of permanent flood openinge in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A c) Total net area of flood openings In A8.b NIA sq In d) Engineered flood openings? ❑ Yes [fl No A9. For a building with an attached garage: a) Square footage of attached garage 520.00 sq It b) Number of permanent flood openings In the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 0.00 sq in d) Engineered flood openings? [:]Yes ❑X No $EC'17ON B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number 13Z Counly Name 133. State KITTITAS COUNTY; 530095 KITTITAS Washington B4. Map/Panel B5. Suffix 86. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevatios) Number Date Effechw zone(s) (Zone AO, use Base Flood Depth) Revised Date 5303701064 D 09-24-2021 119-24-2021 AE 1594.2 ft B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item Be: ❑x FIS Profile ❑ FIRM ❑ Community Determined ❑ Other/Source: Bl l . Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ❑x NAVD 1988 ❑ OtherlSource: B12. Is the building located In a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)7 ❑ Yea ❑Q No Designation Date: ❑ CBRS OPA FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page of 6 ELEVATION CERTIFICATE OMB No. 1OW-0003 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Budding Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Sox No. Policy Number. 3008 Dapple Cray Way City State ZiP Code Company NAIL Number Ellensburg Washington 98926 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) 01. Building elevations are based on: ❑ Construction Drawiings* []Building Under Construction* ❑x Finished Construction *A now Elevation Certificate will be required when oonstructlon of the building Is complete. C2. Elevatlons --Zones Al-A30, AE, AH, A (with SFE), VE, Vf-V30, V (with BFE), AR, AR/A, AR/AE, AWA1 A30, AR/AH, ARIAO. Complete Items C2.a-h below ac oording to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: Center of S 27, T 18 N, R 18 E Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in Items a) through h) below. ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the some as that used for the BPE. Check the measurement used. a) Top of bottom floor (including basement, crawlspaoe, or enclosure floor) , 1595.2 ❑rr feet ❑ meters b) Top of the next higher floor WA ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) WA ❑ feet ❑ meters d) Attached garage (top of slab) 1595.2 rr❑ feet ❑ meters e) Lowest elevation of machinery or equippment servicing the building x feet meters (Describe type of equipment and loca#lo1595.2 n In Comments) d ❑ 9 Lowest adjacent (finished) grade next to building (LAG) _ 1594.3 at❑ feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 1594.7 0 feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including NIA ❑ feet ❑ meters structural support SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICA11ON This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by IAw to certify elevation informatlon, l certify that the Information on th/s Certificate represents my beef efforts to lnferrMpret the data available. l understand that any false statement may be purr/&*able by fine or imprisonment under 18 U.S. Code, SecBon 1001. Were latitude and longitude in Seclon A provided by a licensed land surveyor? ffl Yes ❑ No ❑ Check hare If attachments. C114�Lt Certifier's Name License Number Rick Skinner 43619 ZsM!VV \VAS��T' Tithe Land Professional Surveyor M Company Name I xj� Western Pacific Engineering & Survey, Inc. oG t f Address ti113� 1224 S. Pioneer Way � �l City state ZIP Code Moses Lake Washington 98837 l.r. Y. Mr,i.11lJai�}i Sig Date Telephone EA. (509)765-1023 CoN all pages of this Elevation Certificate end all attachmen& for ) community official, (2) insurance agenticompany, and (3) building owner. Comments (including type of equipment and location. per 02(s), If applicable) Heat pump was on exterior of bullding and on a concrete pad that was measured with gps. The bottom of the heat pump Is resting on legs that raise at a measured height of 8" above the concrete pad. The elevaton for the equipment Is to the bottom of the heat pump. FEMA Form 080-0-33 (12119) Replaces all previous editors. Form Page 2 of B ELEVATION CERTIFICATE OMB No. 1860-0008 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.D. Route and Box No. Policy Number. 3008 Dapple Gray Way City State ZIP Code Company NAIL Number Ellensburg Washington 98926 SECTION E -- BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (1MTHOUT BPE) For Zones AO and A (without BFE), complete Items El —ES. If the Certificate is Intended to support a LOMA or LOMR-F request, complete Sections A, Band C. For Items E1- E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter motors. El. Provide elevation Information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawiepace, or enclosure) Is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (Including basement, crowlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Bull ding Diagrams tip with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1 2 of Instructions), the next higher floor (elevation C2.b In the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. F3. Attached garage (top of slab) is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the bullding Is ❑feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available. Is the top of the bottom floor elevated in accordance with the community"s flood plain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this infnrmatlon in Sactlon G. SECTION F -- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) GERTIFICA11ON The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-Issued or communrtyassued BFE) or Zone AO must sign here. The statements In Sections A, B, and E are correct to the best of my knowledge, Property Owner or Owner's Authorized Representative's Name Scott Henson Address City state ZIP Code 1224 S Pioneer Way Moses Lake Washington 98837 Signature Data Telephone (609) 855-0112 Comments ❑ Check here if attachments, FEMA form 080-0-33 (12/19) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Data: November 30. 2022 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt, Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. Policy Number. 3008 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washingtran 98926 SECTION G —COMMUNITY INFORMATION (OPTIONAL) The local official who Is authorized by law or ordinanos to administer the community's floodplaln management ordinance can complete Sections A, 8, C (or E), and a of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G6—G10. in Puerto Rico only, enter meters. G1. ❑ The information In Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data In the Comments area below.) G2 ❑ A community oicial completed Section E for a building located In Zone A (without a FEMA-Issued or community -issued BFE) or Zone AO. G3. ❑ The following information (Items 134-G10) is provided for community iloodplain management purposes. G4. Permit Number G5. Dane Permit Issued 06, Data Certificate of Compliance/Occupancy Issued 07. This permit has been Issued for: x❑ New Constriction ❑ Substantlal Improvement 08. Elevation of as -built lowest floor (including basement) of the building: []feet ❑ meters Daturn 139. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Community's design flood elevaton: ____ ❑ feet ❑ meters datum Local Official's Name Title Community Name Telephone Signature Data Comments (Including type of equipment and location, per C2(e), If applicable) ❑ Check here if attachments, FEMA Form 086-0�33 (12119) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instmotions for Item A6. Expiration Bate. November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Secltan A. FOR INSURANCE COMPANY USE Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 3008 Dapplo Gray Way City State ZIP Code Company NA1C Number Ellensburg Washington 98926 If using the Elevation Certificate to obtain NFIP flood Insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear MaW; and, If required, "Right Side View" and "Left Side Vlew." When applicable, photographs must show the Foundation with representative examples of the food openings or venis, as Indicated in Seofon AS. It submitting mots photographs than will fit on this page, use the Continuation Page. et Pk oto Cana Caption Front of House Clear Phalo one Photo Two Caption Side of House Clear Immoto Two FEMA Form 066.0-33 (12119) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OM13 No,16W-0008 ELEVATION CERTIFICATE Conunuaflon Page Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.D. Route and Box No. Polley Number. 3008 Dapple Gray Way City State ZIP Code Company NAIL Number Ellensburg Washington 98926 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: dais taken; 'Front View" and 'Rear View"; and, if required, 'Right Side View" and "Left Side View.' When applicable, photographs must show the foundation with representaflve examples of the flood openings or vents, as indicated in Section A8. zf Grp.•'. - ♦•Y '. �..Y� . Pico, 71ga photo Throe Captloii Bad of Houso Clear Pho a 1hm - {,,�_���r'$.3aZ: �-rn�Er'��'L���;"'Ya::4.x;.3e. ��:,"� 1:: ,-,•:., t�t . '. ;'•wa SOr. � '.''".'C�: °��'It.:...''`..rr-•"-y-� �.r..�r._ s��Iv.i:nS�.t±.5[ze: Pho: Four Caption Side of Douse Clear Mato l our rEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 6 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY OMB No.1660-0008 Federal Emergency Management Agency Expiration Date: November 30, 2022 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) Insurance agent/company, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number: SSHI LLC. A2. Building Street Address (including Apl., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 3006 Dapple Gray Way City State ZIP Code Ellensburg Washington 98926 A3. Property Description (Lot and Black Numbers, Tax Parcel Number, Legal Description, etc.) Division 6 Lot 8, 961893 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Lafitude/Longilude: LaL N47°01'30.81169" Long, W120'3441.0441 V Horizontal Datum: ❑ NAD 1927 x[,- NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain Hood Insurance. A7. Building Diagram Number 'I B A8. For a building with a crawlspace or endosure(s): a) Square footage of crawlspace or enclosure(s) N/A sq It b) Number of permanent flood openings in the crawispece or anclosure(s) within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b NIA sq in d) Engineered flood openings? ❑ Yes Q No A9. For a building with an attached garage: a) Square footage of attached garage 604.00 sq fl b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b sq in d) Engineered flood openings? ❑ Yes ❑x No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bl. NFIP Community Name S Community Number B2. County Name B3. State KITTITAS COUNTY; 530095 KITTITAS Washington B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) Number Date Fffectw Zone(s) (Zone AO, use Base Flood Depth) Revised Bate 53037C1064 D 09-24-2021 09-24-2021 AE 1592.9 fl 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 89: ❑x FIS Profile ❑ FIRM [] Community Determined ❑ Other/Source: 811. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 al NAVO 1988 ❑ OtherlSource: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes 0 No Designation Dale: 0 CBRS [] OPA FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMPORTANTs In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 3006 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 SECTION C -- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction` 0 Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations — Zones Al—A30, AE, AH, A (with BFE), VE, Vi—V30, V (with BFE), AR, AR/A, AR/AE, AR/A1— ill, ARIAH, AR1AO. Complete Items C2.a—h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters. Benchmark Utilized: Center of S 27. T 18 N, R 18 E Vertical Datum: NAVO 1988 Indicate elevation datum used for the elevations In Items a) through h) below. ❑ NGVD 1929 ❑x NAVD 1988 ❑ OtherlSource: Datum used for building elevations must he the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 1594.8 ❑x feet ❑ meters b) Top of the next higher floor N/A ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet ❑ meters d) Attached garage (top of slab) 1594.8 ❑x feet ❑ meters servicing the building x e) Lowest elevation of machinery or equip1594E feet meters (Describe type of equipment and location In Comments) ❑ ❑ f) Lowest adjacent (finished) grade next to building (LAG) 1593A ❑x feel ❑ meters g) Highest adjacent {finished) grade next to building (HAG) 1593.9 (] feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A ❑ feet ❑ meters SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification Is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation Information. I certify that the Information on this Certificate represents my best efforts to Interpret the date available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Ware latitude and longitude In Section A provided by a licensed land surveyor? ElYes ❑ No ❑ Check here if attachments. Certiflees Name License Number Rick Skinner 43619 S f 4IIA51y� Title Professional Land Surveyor rt O; Company Name Western Pacific Engineering & Survey, Inc. Z aC +� 61 I Address 1224 S. Pioneer Way City Slate ZIP Code Moses Lak 7Washington 98837r � Signature ate Telephone Ext. (509) 766-1023 Copy all Nges of this Elevation Certificate and all attachm is for (1) community official, (2) insurance agent/company..and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) The elevation of the heal pump located outside of home was measured by using a GPS and then adding the height of the legs for the heat pump. FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 3006 Dapple Gray Way City State ZIP Code Company NAIL Number Ellensburg Washington 98926 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items El—E5. If the Certificate is Intended to support a LOMA or LOMR-F request, complete Sections A, $,end C. For Items E1—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters [❑ above or ❑ below the HAG. b) Top of bottom floor (Including basement, crawispace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 64 with permanent flood openings provided in Section A Items 8 and/or9 (see pages 1 2 of Instructions), the next higher floor (elevation C2.b In the diagrams) of the building Is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of stab) is _ ❑ feet ❑ meters ❑ above or E] below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is []feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B. and E for Zone A (without a FEMA-issued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Scolt Henson Address City State ZIP Code 1224 S Pioneer Way Moses Lake Washington 98837 Signature Date Telephone %d,3 (509) 855-5112 Comments ❑ Check here if attachments. FE=MA Form 086-"3 (12/19) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30.2022 IMPORTANT: in these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No, Policy Number: 3005 Dapple Gray Way City State ZIP Code Company NAIL Number Ellensburg Washington 98926 SECTION G -COMMUNITY INFORMATION (OPTIONAL.) The local official who is authorized by law or ordinance to administer the community's floodptain management ordinance can complete Sections A, B, C (or E), and G of this Elevalion Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8-G10. In Puerto Rico only, enter meters. G1, ❑ The Information In Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2 ❑ A community official completed Seclfon E for a building located in Zone A (without a FEMA-issued or community4ssued BFE) or Zone AO. G3. ❑ The following information (Items G4-G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for: New Construction ❑ Substantial Improvement G8. Elevation of es -built lowest floor (including basement) of the building: El feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Community's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, par C2(e), If applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See instructions for Item A6. Expiration Date: November 30, 2022 IMPORTANT. in these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt„ Unit, Suite, andfor Bldg. No,) or P.O. Route and Box No. Policy Number. 3006 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 If using the Elevation Certificate to obtain NF1P flood insurance, affix at least 2 building photographs below according to the Instructions for Item A6. identify all photographs with date taken; "Front View" and "hear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated In Section AS. If submitting more photographs than will fit on this page, use the Continuation Page. 1 i 1 Photo One Caption Front Clear Photo One y Pa. Photo Two Caption Side Clear Photo Two FEMA Form 086-"3 (12119) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30. 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 3006 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 If submitting more photographs then.will fit on the preceding page, affix the additbnal photographs below. Identify all photographs with: date taken; "Front View' and "Rear View'; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the `lood openings or vents, as indicated in Section A8. PMto7hmo Photo Three Caption Rear Clear Photo Three 6 Plain Four Photo Four Caption Side Clear Photo Four FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 6 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY OMB No.1660.0008 Federal Emergency Management Agency Expiration Date: November 30, 2022 Natlonal Flood insurance Program ELEVATION CERTIFICATE InVortant Fallow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for (1) community official. (2) insurance agenticompany, and (3) building owner, SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number: SSHI LLC. A2. � Streat Address (including Apt., Unit, Sulte, and/or Bldg. No.) or P.O. Route and Company NAiC Number: 3004 Dapple Gray Way City State ZIP Code Ellensburg Washington 98926 A3, Properly Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Division 6 Lot 9, 961894 A4. Building Use (eg., Residential, Non -Residential, Addition, Accessory, etc,) Residential A5. Letituude&ongitude: Let. N47.01'30.01245" Long. W120.301.85858" Horizontal Datum: ❑ NAD 1927 NACU 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1 B A8. For a building with a crawlepace or enclosure(s): a) Square footage of crawlapaae or endome(s) NIA aq ft b) Number of permanent flood openings in the cmwrispace or enclosure(s) within 1.0 foot above adjacent grade NIA c) Total net area or flood openings In A8.b NIA sq in d) Engineered flood openings? ❑ Yes 0 No A9. For a building with an attached garage: a) Square footage of attached garage 520.00 sq R b) Number of permanent flood openings In the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings In A9-b 0.00 sq in d) Engineered flood openings? ❑ Yes ❑x No SECTION B -- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name 83. State IQTTITAS COUNTY; 53W95 KITTITAS Washington B4. Map/Panel 85. Suffix BB. FIRM Index S7. FIRM Panel 88. Flood BO. Base Flood Elevation(s) Number Date Effective! Zone(s) (Zone AO, use Base Flood Depth) Revised Date 63037C1084 D 09-24--2021 09-24-2021 AE 1692.4 ft 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Itern B9: ❑x FIS Profile ❑ FIRM ❑ Community Datermtned ❑ OthertSource: 1311. Indicate elevation datum used for OFE in Item 139: ❑ NWD 1929 0 NAVD 1088 ❑ Other[Source: 812. Is the building looted In a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes x❑ No Designation Date; ❑ CBRS ❑ OPA FEMA Form 066-0-33 (12119) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No.1060-DO08 Expiration Date: November 30, 2022 IMPORTANT; in time spaces, copy the corresponding Information from Section A. IFOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Sulte, and/or Bldg- No.) or P.O. Route and Box No. Policy Number: 3004 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 9W28 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drewings* ❑ Building Under Construction* DK Finished Construction *A new Elevation Certificate will be required when construction of the building Is complete. C2. Elevations -- Zones Ai-A30, AE, AH, A (with BFE), VE, V1 V30, V (with SFE), AR, AMA, ARIAS, AR/A1-A30, ARIAH, ARfAO. Complete Items C2.a-h below according to the building diagram specified In Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: Center of S 27, T 18 N, R 18 E Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations In items a) through h) below. ❑ NGVO 1929 Q NAVD 1988 ❑ Other/Sourna: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Tap of boliom floor (Including basement, crawlspace, or enclosure floor) 1593.7 ❑x feet ❑ meters b) Tap of the neud higher floor NIA [] feet ❑ meters o) Bohm of the lowest horizontal structural member (V Zones only) NIA ❑ feet ❑ meters d) Attached garage (top of slab) 1593.7 feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 1593.8 ❑x feet El Meters (Describe type of equipment and local on In Comments) f) Lowest adjak> d (flnlshed) grade next to building (LAG) 1592.8 ❑x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 1593.0 feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support NIA ❑feet ❑ ureters SECTION D SURVEYOR, ENGINEEK OR ARCHITECT CERTIFICATION This certification Is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I cer* that the fnformalion on this Cerfiticafe r6presonf°s my best efforts to Interpret the data available. I understand that any false may be by fibre or kr*visonment under 18 U.S. Code, Section 1001. statement punls/Wga Waft latitude and longitude In Section A provided by a licensed land surveyor? d Yes ❑ No ❑ Check here if attachments. Certi@er`s Name License Number Rick Skinner 43819 1 IFI ��►' zj a Title Professional Land Surveyor Cornp ain Pacific WEngineering S Survey, Inc. Address 1224 S. Pioneer Way 43819 1pp� y;1�.11010, (v �.,,° ►'A;~ �j jl¢ r state ZIP Code City y Moses Lake Washington 98837 't } Signature ? i +4!` �;-� „� Date Telephone �... (509) 765-1023 Ext. Copy all pa es of this Elevation Certificate and all atlachmen for ('1yoommUnity official, (2) insurance agentfcompany, and (3) building owner. Comments (inducting type of equipment and location, per C2(e), If applicable) The elevation of lire heat pump located outside of home was measured by using a GPS and then adding the height of the legs for the heat pump. FEMA Form 08"-33 (12119) Romme all previous editions. Form rage z or e ELEVATION CERTIFICATE OMS No. 1660-0008 Expiratlon Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding Information from Secfion A. FOR INSURANCE COMPANY USE Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 3004 Dapple Gray Way City state ZIP Code Company NAIC Number Ellensburg Washington ome SECTION E -- BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT SFE) For Zones AO and A (without BFE), complete Items Ei--ES. If the Certiflcate Is Intended to support a LOMA or LOMR-F request, complete Sections A, %and C. For Items EI—E4, use natural grade, If evallable. Check the measurement used. In Puerto Rl o only, enter meters. E1. Provide elevation Information for the following and check the appropriate boxes to show whe0rer the elevation Is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (Including basement, crawlspace, or enclosure) Is El feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (Including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 8-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions), the next higher floor (elevation 02.b in the diagrams) of the building is ❑ feel ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) Is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servWIng the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. ES. Zone AO only: If no food depth number is avallable, is the top of the bottom floor elevated In accordance with the oommunity's floodpiain management ordinance? [] Yes ❑ No [3 Unknown. The local official must certify this Information in section G. SECTION f — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The properrttyy owner or owner's authorized representative who completes Sections A B, and E for Zone A (without a FEMA-Issued or community -Issued BFE) or Zone AO awst sign hare. The statements in Sections A, h, and E are correct to the best of my knowledge. Property Owner or Owners Authorized RepresentagWe Name Scott Henson Address City State ZIP Code 1224 S Pioneer Way Moses Lake Washington 98837 Signature Date Telephone (509) 8564112 Comments ❑ Check here if attachments. FEMA Form OWO-33 (12118) Repiaoee all previous editions. Form Page 3 of 8 ELEVATION CERTIFICATE OMB No.1660-0005 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding informatlon from Section A. FOR INSURANCE COMPANY USE Buliding Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 3004 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 SECTION G - COMMUNITY INFORMATION (OPTIONAL.) The local official who Is authorized by law or ordinance to administer the oommunitys floodploin management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable Item(s) and sign below, Check the measurement used in Items 08-G10. In Puerto Rico only, enter meters. G1. [] The Information in Section C was taken from other documentation that has been sued and sealed by a licensed surveyor, engineer, or architect who Is authorized by law to certify elevation Information. (Indicate the source and data of the elevation dale in the Comments area below.) O2. ❑ A community official completed Section E for a bulldlog located in Zone A (without a FEMA-issued or community -Issued BFE) or Zone AO. G3. ❑ The following information (items G4-G10) Is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued 06. Date Certificate of Compliance/Occupancy Issued 07. This permit has been Issued for. Q New Construction ❑ Substantial Improvement G8. Elevation of as -bull lowest floor (Including basement) of the building: ❑ feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: .. -_ _ ❑ feet ❑ meters Datum G10. Community's design flood elevation: ❑ feet ❑ meters Datum Local Offiow's Name Tide Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here If attachments. FEMA Form 006-0-33 (12119) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB NM 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6, Expiration Date; November 30. 2022 IMPORTANT: In theso spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (Including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Routs and Box No. Policy Number: 3004 Dapple Gray Way City State ZIP Code Company NAIL Number Ellensburg Washington 98928 If using the Elevation Ceriifiaats to obtain NFIP flood Insuranoe, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" anti "Rear View"; and, If required, "Right Side View" and °t.efl Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section AS. If submitting more photographs then will fit on this page, use the Continuation Page, is ::1+~ � "11 Y Pholo One Photo one Caption Front 0ear:Photq brie ti:y is e+3.. s ,y+• ry s :, ••- :. thy.-.,:-...:..... :....... - . .:..:......... ......: .:....... ........ A.� :..........:. . PhotoTW0 bpoto Two Caption Side -; iI r t Wi—o Two.:: FEMA Form OBM-33 (12119) Repiac ss all previous editions. Form Page 6 of 6 BUILDING PHOTOGRAPHS OMS No. 1600-0008 ELEVATION CERTIFICATE Contlnuation Page Expiration Date: November 30, 2022 IMPORTANT: In theses spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (Including Apt., Unit, Sute, andlor Bldg. No.) or P.O. Route and Box No. Poky Number. 3004 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear VI®W"; and, if required, "Right Side VleW and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as Indicated In Section AS. ":ii:;:;i?`.'�•,' `.iyT.::�i:f.'i}�i:;:::i:: .`:;'' j:i[y;i�..',.;t-':. �:+.5;:;i::}:i5{:".•.:::f:i}.:::.-:::'.:....:..': )::;`_`.,';. '•:5't: :•:1 ik -:1 a5� -- V - { k - ■+ S �•�i ..\ _ :l Photo Three Caption Rear iieer:Ri ThrO' v�••:Mai j+t.' ii S::. i. .T.':'::'i:•::::+. j�4�'nti •'Y'4, i:.. ..'.': t .f�v ::''':::•:':.:::.i .•fir":' ::-Yk:.: .v Photo Foot Phoia Four CapIon Side Ct r:PhototFour FEMA Form 08"-33 (12119) Realaces all previous editions. Form Page 6 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY I OMB No.1660-0008 Federal Emergency Management Agency E National Flood Insurance Program xpirailon Date: November 3p, 2p2x ELEVATION CERTIFICATE Important: Follow the Instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agenticompany, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Ai. Building Owner's Name Policy Number. SSFII I.I.C. A2. Bulking Street Address (Including Apt., Unit, Sulfe, and/or Bldg. No.) or P.O. Route and Company 1VAIC Number: Box No. 30D2 Dapple Gray Way City State ZIP Code Ellensburg Washington 98926 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Division 6 Lot 10.981895 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude, Let. N47°01'29.43926" Long, W120034'42.53203" Horizontal Datum: ❑ NAD 1927 NAD 1983 AS. Attach at least 2 photographs of the building it the Cedi icate Is being used to obtain flood insurance. A7. Building Diagram Number 1 B A$. For a building with a crawlspace or enc losure(s): a) Square footage of crawispace or enclosure(s) NIA sq ft b) Number of permanent flood openings in the crawlspace or enclosura(s) within 1.0 foot above adJacent grade NIA c) Total net area of flood openings in AB.b NIA sq in d) Engineered flood openings? ❑ Yes 0 No A9. For a building with an attached garage: a) Square footage of attached garage 520.00 sq ft b) Number of permanent Rood openings In the attached garage within 1.0 foot above adjacent grade 0 c) Total not area of flood openings In A91 0.00 sq In d) Engineered flood openings? ❑ Yes 0 No SECTION 13 — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State KITTITAS COUNTY; 630095 KITTITAS Washington B4. MaplPanat 135. suffix 136. FIRM Index B7. FIRM Panel B8, Flood B9. Base Flood Elavation(s) Number Date Effective) Zones) (Zone AO, use Base Flood Depth) Revised Date 53037CIO64 D 09-24 2021 09-24-2021 AE 1591.2 R B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 89: ❑x FIS Profile ❑ FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item 89: ❑ NGV01929 d NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? © Yes R] No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33 (12119) Replaces all previous eftons. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No.1660-0008 Expiration Date: November 30.2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.Q. Route and Box No. Policy Number: 3002 Dapple Grey Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings` ❑ Building Under Construction• ❑x Finished Construction `A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones AI-A30, AE, AH, A (with BFE), VE, V7 V30, V (with BFE), AR, ARIA, ARIAE, ARIA1-A30, AR/AH, ARIAO. Complete Items C2.a-h below according to the building diagram specified In item A7. In Puerto Rico only, enter meters. Benchmark Utilized: Center of S 27, T 18 N, R IS E Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations In items a) through h) below. ❑ NGVD 1929 Q NAVD 1988 ❑ OlherlSouroe: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (Including basement, crawlspaoe, or enclosure floor) 1592.3 0 feet ❑ meters b) Top of the next higher floor N/A ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) NIA ❑ feet ❑ meters d) Attached garage (top of slab) 1592.3 feat ❑ meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location In Comments) 1592.3 FE] feet ❑ meters f) Lowest adjacent (finished) grade next to building (LAG) 1591.6 x❑ feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 1591.8 ❑x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, Including structural support NIA ❑ feet ❑meters SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification Is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation Information. I certify that the Infamratlon on this Certificate reprosents my best efforts to MteMrst the data available. I understand that any false statement maybe punishable by fine or Imprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude In Section A provided by a licensed land surveyor? 21 Yes ❑ No ❑ Check here 9 attachments. Ced fler's Name License Number Rick Skinner 43619 P c; d1 *AJV WAS Title Professional Land Surveyor H 1i a Company Name Western Pacific Engineering & Survey, Inc. 3619,q Address 1224 S. Pioneer Way City state ZIP Code Moses Lake Washington 98537 Signature Date Telephone Ext. (609) 765-1023 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) Insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) The top of the slab for the hest pump was measure by GPS. The heat pump was resting on lags so the height difference between the bottom of heat pump and the top of slab was measured and accounted for in the elevation. FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMPORTANT, In these spaces, copy the corresponding Informatlon from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Polley Number. 3002 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items El —ES. if the Certificate Is intended to support a LOMA or LOMR-F request, complete Sections A, Band C. For Items E1—E4, use natural grade, 0 available. Check the measurement used, In Puerto Rioo only, enter meters. E1. Provide elevation Information for the following and check the appropriate boxes to show whether the elevation Is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, cxawlspece, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspeca, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6--9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet Q meters ❑ above or ❑ below the HAG. E4. 'Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. ES. Zone AO only., If no flood depth number is available, Is the top of the bottom floor elevated In accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this Information in Section G. SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The properly owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-Issued or community -Issued BFE) or Zone AO must sign here. The statements In Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Scott Henson Address City State ZIP Code 1224 S Pioneer Way Moses Lake Washington 98837 Signature Date Telephone (509) 855-5112 Comments ❑ Check here if attachments. FEMA Form 086-0-33 (12(19) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No.1660-0008 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (Including Apt., Unit, Suite, andfor Bldg. No.) or P.O. Route and Box No. Policy Number: 3002 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 SECTION 0 — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplaln management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below_ Check the measurement used in Items G8—G10. In Puerto Rloo only, enter meters, G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who Is authorized by taw to certify elevation Information, (Indicate the source and date of the elevation data In the Comments area below.) G2, ❑ A community official completed Section E for a building located in Zone A (without a FEMA-Issued or communlly-Issued SFE) or Zone AO. 03. ❑ The following Information (Items G4—G10) Is provided for community floodplain management purposes. 04. Permit Number G5, Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued 07. This permit has been Issued for; ❑x New Construction ❑ Substantial Improvement GB. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum 09. BFE or (in Zone AO) depth of flooding at the building site: El feet ❑ meters Datum G10_ Community's design flood elevation: ❑ feet ❑ meters Datum Local Offldal's Name Title Community Name Telephone Signature Date Comments (Including type of equipment and location, per C2(e), if applicable) ❑ Check mere If attachments. FEMA Form 086-M3 (12119) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No.1660-0008 ELEVATION CERTIFICATE See Instructions far Item A$. Exniratlon bate: November 30.2022 IMPORTANT; In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, andfor Bldg. No.) or P.O. Route and Box No. Policy Number: 3002 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the Instructions for (Gem Ali. Identity all photographs with date taken; "Front VieW and "Rear Vier; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. .ra :d r.NV MII" Photo One Caption Back View of House Clear Photo One Photo Two Caption Side View of House Clear Photo Two FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMB No.1660-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, andfor Bldg. No.) or P.O. Route and Box No. Policy Number: 3002 Dapple Dray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 If submlWng more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken. "Front Vlaw" and "Rear Mew . and, If required, 'Right Side VieW° and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as Indicated in Section AB. 71 Photo �hrae Photo Three Caption Front View of House mar Pip Three rr rrroiu roar Photo Four Caption Side View of House Clear Photo Four FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 6 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program 94��� ELEVATION CERTIFICATE important: Follow the instructions on pages 1-9. Copy all Pages of thts Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. 3ECTION'A -PROPERTY INFORMATION Al. Building Owne►'s Name FOR INSURANCE COMPANY USE Kurt Lustig/ Tara Allen Policy Number; A2. Bullding Street Address (including Apt.. Unit, Suite, and/or Bldg. No.) or P,b. Route and Box No, 83O Pebble Beach Drive Company NAIL Number: CRY Cie I=lum State ZIP Code Washington i�:1 98922 A3. Property Descriptlon (Lot and Blanc Numbers, Tax Parce! Number, L el Lot 1, Sun Country Estates 3rd Addition Tax #SB3234 arption, etc:) A4. Building Use (e.g., Residential, Non -Residential, Addition. Accessory, etc,) residential A5. Latitudefi=gitude: Lat. 47-11-05.054 N Long_ i21-03-01.80 W Horizontal Datum: NAD 1983 ho NAD 1927 Photographs of the building if the Certificate is being used to obtain flood insurance. A8. Attach at least 2 A7. Building Diagram Number 113 m AB. For a building with a crawlspace or enclosure(s): a) Square footage of Crawispace or enclosure(s) nla sq fY b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade nla c) Total net area of flood openings in AB.b -� nls sq in d) Engineered flood openings? ❑ Yes ElNo A9. For a building with an attxhed garage: a) Square footage of attached garage 330 sq ft b) Number of permanent flood openings in the attached a g rage within f .0 foot above adjacent grade 2 C) Total net area of flood openings in AB.b 400 sq in d) Engineered flood openings? ® Yes ❑ No SECTION 8-FLOOD INSURANCE RATE MAP (FIRM) INFO ItMA I$OH 81. NFIP Community Name 8 Community Number 132. County Name Kittitas County 530095 83. State Kittitas Washington B4. M'p/Panel B5. Sulfix B6. FIRM Index B7. FIRM Panel 68_ Flood Number Date Effective/ 139. Base Flood Elevations) Revised Date zone($) (Zone AO, use Base cod Depth) 53037CO666 D 09-24-2021 Og-24-2021 A hnm o. 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B$: ® FIS Profile ❑ FIRM (] Community Determined ❑ Qlher/Source: 1311. Indicate elevation datum used For BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 OtherlSource: 512. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise P Designation Date: rotected Area t?PA ( )• yes 0 No El cans EloPA FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 1 of 6 ELEVAi10N CEFMFICATE CM No.16woom MPORrANT h tilrae spaces, cpF!► aria oorres FVMO n Date: November 3Q, 2022 Building Steal Addne� ardludl Innortrmtlarl irom section A. fiOR IfJSURAl+ICE COi41PAN1Y USE C c9 APt , Unit Suite, sndfor Bldg. Pb,} at P.O. Route snd igox tJo Pcicv �k. 890 Pebble ftch t7+ive Cie arttl Suds, Lir- W 89022 t Pent hharlbsr SECTII3N C - BUIL M"O ELEVAi N INFDRMAMN (SURVEY Ci. B�Iding eievaHona arse based err: i (fVEY REtat.IlREDj C2 *AA new El IMA C sr a bate yirHl be ❑ canet Ucdon Draws g,• ❑ Bi4� Under con ory• 0 Finished n no lone - Zones Ai-A3tt MWmd WMn MabucH of the bu leg Is , le Items Zones bet, Aacm . A {wet WE)- VE, Vt-V30, V (wttd BFEJ AR, ARIA. AR1AE, AFVAi MinD b tM bwWmg dlagmm specified In Stem A?. A Puerto Rico "�' ARIAH, ARM). Behftnark �iaed: FEW RM 53 Vodka[ Datum: NGVD 29 armverted is �Y. artier mdere, krdkmte elevation datum used for to elevations in a th NOD a8 DatumNGVO1tt2e ® I roughh}Isekrw ed tar bui hl11Vt) lees ❑ 4HreN8a»rtie: 7djV elevaflarws must be the same as that used far tha OFE. a) Top of N tcm tiaor (kcluding ba"MOM, aaarlsPua, or ancl=v;a floor) 20� the M"eIxr ne�tGed. b) Tap Ot fire need htgtmr Hoar © feet (] Man © e) Bourn offhe lowest tonial atnrcwrd member NZerrea only) NIA teat p metersIV/A p fed p Moon Attached genrgs (top or slab) 2a07.9 0 taet ❑ $) Lowest elevalton � �Y ��cr� meat aervising the txelkling (ire bpsegcdptrrerfE Irleftm and locslf- prr le t:ammenntal 2Df)4.0 rawest s4adent MMMed) grade next to building (LAG) - ® ❑meters g} i halft adjacent (finished toS.D ®feet ❑ , grade treat bn lwiuGng (IiAG) 2007A p seat ❑meters h) L-44btu*ual t UnWe at lowcsat elevation otdm* or stalls. lnduding WA p teat ❑ metals 3EGTIpI♦1b-;3LlRVEYOR,ENGINeMORARCHirl,I fGEiiTtFIC1lTION This cerOcailan is to be Signed and sealed by a land Surveyor. arm9heer, t off* Stet k�l6rrrsatlarr on 1tYa L1erHAraebe re senfa t►diE elravts,ao OrwOhlMdeudrartzad by law to am* slevMon Int molioo. atalsri&& may ba pM*ftaW& by lire or impli �srd urn 70 t! cam, �i�1 tvaiftEra 1 � y�,".QM Were latlluds and IOMkWe In $BdJon A provided by a Harraced land a wmw? ® Yes ❑ No p Check lstrrwa FI attaclsererrte. GerlituaNa us...� &endon Winters, PLS Tide PnMMent company Name Chadwick a Wk t m Land Surveft Addrs= 1422 NW a5th 8L CRY seam 12-12 MM and �I aenle for (1) Horn u Commerria (inclding type of 6"Pmerd and 1100 ian, par G2(e), P a C2(a) Heat PMV Iocadeed abV own raft of tHacired gwne;;� PS) 297-Me Etevaflon Datum . Pr Ct me r efaiive to NAVD seas darlvad by fired 4leld ties to FEMA RNHss. ad)ustsd by maNrerrsetieal NCyVO 1928/ NAVD M conversion, and Milled by disci G9PS dmWgkn utiHft t DCA 9Ps rea kw. FEMA Form 00-0-M (17118) Repteoes an previous el"Ons. Fenn Page 2 of 8 ELEVATION CM-nFICATE m- opoRrIawr. >n f ..-- "'Nh► the a 830 Pebble %ach D6e Mom tnfamuftn rmm mu-mon A and►ar Bidg. Naj ar P.O. Rouls and Box Cf. ERen am ---ZI-P-a - weefrrom BMW =eb�'o�ntl�� fdpvr� 30, 2022 Number, tojumm ELlEYN17DN INF0RAAA�R Y NOT FM ZDNE AO ANO aDNE A �gUIRI�) awroft FarZones ao rnd a (wilhotrt BPE), lb"W Et-B. ff Me CerM d.le Inusnded : ester 8rotlormA, 13.8nd C. For E3�1. Use r grade, if avav kb. t0 Por!a LOMAor LOMP F squeak E7_ PnsNde Check ttre . Puaicv only, abobxn 11op �H. Oda +t a j boxes to qww whether the ade�t Used. IT vagpn is above ar bobw mar (+kam) is k bj TOP of bof m dear (IndU ft 6a mwt ❑ fWM ❑ meEens ❑ abor a or 0.below the HAG, aw&%Pws� twerckwrej is Q feet ❑mks E2. For Build ? above Or Q below 0. LAG. the 71md �(� an C2 6� PomsmM *30d ° Provided in 5ec6on A i B endlor 6 (are Pe9es 1-2 or ). fey of the b�udtr>g is ❑rest ❑ MEN"ES. Atlrched garb (lop of deb) is❑ ob&m or Q bebw the HAM E4. STOP of:Ptaffom of msWmry imdforegUipwo t items ❑ ° ❑ ebwm ar ❑ helawfire HAG. servicing the buitding is ES. Zane Ao 0*. if no food depth nmhbrr is rvalle6la, is the lop of be fxrlLon, feet © above ar [] bwow the KaQ. °odPtain hm"29 msnt ordinrnoRy Q Yea Q , ie ©Unf In b The fo � fh acoardenca with the oammunws etliOW must certify this WMTWM En Smamr C3. S11 1 lOff f'-PROPERTY DtA1 IM (OR O"En �l�@fTA7fVE) CERTLFICAToN The eAantnunOr diva who omViMes so P+aPer� Owner ar Own a AO n>u sign h The otem �4 A g, MW E er �( the boo W af�lm adge- iu+morfzad liver ..,e„ a.__ MMA Form 088-0-33 (17jiB) d OF e& hero tramachmmA, RePfernea an prrvlous solo". Faun Page 3 of 8 ELEVATION CERTIFICATE OMB No. 1660-00oB Expiration Hate: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 630 Pebble Beach Drive City State ZIP Code Company NAIC Number Cie Elum Washington 98922 SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A. B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2 ❑ A community official completed Section E for a building located in Zone A (without a FWA-issued or community -issued BFE) or Zone AO. G3. ® The following information (Items G4—G10) is provided for community floodplain management purposes. G4. Permit Number G5_ Date Permit Issued G6_ Date Certificate of CompliancelOocupancy Issued FD-2140047 02-01-2022 , 12-16-2022 G7. This permit has been issued for: ® New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building. 2008.9 feet ❑ meters Datum NAVD 88 Gg. BFE or (in Zone AO) depth of flooding at the building site: 2007.8 ® feet ❑ meters Datum NAVD 88 G% Community's design flood elevation: 2008.8 ® feet ❑ meters Datum NAVD 88 Local Official's Name Title Samantha Cox Water Resources Specialist Community Name Telephone Kittitas County (509) 962-7523 12-16-2022 Commel"cluding type of equipment and location, per C2(e), if applicable) 2 Smart Vents, model number 1540-520, installed in the garage. Certification for vents attached. 0 Check here if attachments. FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item AS. Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P,O. Route and Box No, Policy Number: 830 Pebble Bead Drive City State ZIP Code Company NAIC Number Cie Elum Washington 98922 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. identify aN photographs with date taken; "Front View" and "Rear View"; and, if required, "bight Side Yew" and "Left Side View." When appitcable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page, -`a Phwo one Photo One Caption Rear view (east side) taken 12/16/2022 Clew Photo One Phft TvM Photo Two Caption Front View ( west side) taken 12/16/2022 Clear Photo Two FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMS No. 1660-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, andior Bldg. No,) or P.O. Route and Box No. Policy Number: 830 Pebble Beach Drive City State ZIP Code Company NAIC Number Cie Elum Washington 98922 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section AS. Photo Three Photo Three Caption Clear Photo three Photo Four Photo Four Caption Clear Photo Four FEMA Form 085-0-33 (12119) Replaces all previous editions. Form Page 6 of 6 [CC -ES Evaluation Report ESR-2074 Reissued February 2021 This Mort is subject to renewal February 2o23, WWW-icc;es.Qrn 1 (800) 423-6687 1 (562) 69940543 A Subsidiary of the international Code Council® DIVISION: 08 00 00—OPENINGS Section: 08 95 43—VentsiFoundation Flood Vents REPORT HOLDER: SMART VENT PRODUCTS, INC. EVALUATION SUBJECT: SMART VENT`* AUTOMATIC FOUNDATION FLOOD VENTS: MODELS 01640420; #1540-521; #1540410; #1640- 511; #1640-670, #1540474; #1540-624; 0154"14 FLOOD VENT SEALING KIT #1640.826 1.0 EVALUATION SCOPE Compliance with the following codes: ■ 2018, 2015, 2012. 2009 and 2006 International Building Code19 (IBC) 0 2018, 2015, 2012, 2009 and 2006 International Residential Code`* (IRC) ■ 2018 International Energy Conservation Code® (IECC) ■ 2013 Abu Dhabi International Buitding Code (ADiBC)t TThe ADISC 16 based on the 2009 IBC. 2009 IBC code sealo3ns reremmed in rhea ropon are the some sections in the A010C. Properties evaluated: ■ Physical operation * Waterflow 2.0 USES The Smart VerP units are engineered mechanically operated flood vents (FVs) employed to equalize hydrostatic pressure on walls of enclosures subject to rising or falling flood waters. Certain models also allow natural ventilation. 3.0 DESCRIPTION 3.1 General: When subjected to rising water, the Smart Vent`* FVs internal floats are activated, then pivot open to allow flow in either direction to equalize water level and hydrostatic pressure from one side of the foundation to the other. The FV pivoting door is normally held in the closed position by a buoyant release device. When subjected to rising water, the buoyant release device causes the unit to unlatch, allowing the door to rotate out of the way and allow flow. The water level stabilizes, equalizing the lateral forces. Each unit is fabricated from stainless steel. Smart Vent`* Automatic Foundation Flood Vents are available in various models and sizes as described in Table 1. The SmartVENr Stacl ing Model #1540-511 and FloodVENTO Stacking Model #1540-521 units each contain two vertically arranged openings per unit. 3.2 Engineered Opening: The FVs comply with the design principle noted in Section 2.7.2.2 and Section 2,7.3 of ASCEISEI 24-14 [Section 2.6.2.2 of ASCEISEI 24-05 (2012, 2009, 2006 IBC and IRC)] for a maximum rate of rise and fail of 5.0 feet per hour (0.423 mmis). in order to comply wish the engineered opening requirement of ASCE1SEf 24, Smart Vent FVs must be installed in acoordanoe with Section 4.0. 3.3 Ventilation: The SmarfVENr Model 01540-510 and SmartVENr Overhead Door Model #1540-514 both have screen covers with 114-inch-by-114-inch (6.35 by 6.35 mm) openings, yielding 51 square inches (32 903 mm2) of net free area to supply natural ventllation. The SmartVENr Stacking Model #1540-511 consists of two Model #1540-510 units in one assembly, and provides 102 square inches (65 806 mrn2) of net free area to supply natural ventilation. Other FVs recognized in this report do not offer natural ventilation, 3.4 Flood Vent Sealing Kit: The Flood Vent Sealing Kit Model 01540-526 is used with SmartVENr Model #1540-520. It is a Homasote 440 Sound Barriers (ESR-1374) insert with 21 — 24nch-by-2- inch (51 mm x 51 mm) squares cut in it. See Figure 4. 4.0 DESIGN AND INSTALLATION 4.1 SrnartVEN1'`*and FtoodVENT`*: SmartVENT`* and FloodVENT`* are designed to be installed into wails or overhead doors of existing or new construction from the exterior side. Installation of the vents must be in accordance with the manufacturer's instructions, the applicable code and this report. Installation clips allow mounting in masonry and concrete walls of any thickness. in order to comply with the engineered opening design principle noted in Section 2.7.2.2 and 27.3 of ASCEISEI 24-14 [Section 2.6.2,2 of ASCE/SEI 24-05 (2012. 2009, 2006 IBC and IRC)], the Smart Vent`* FVs must be installed as follows: ■ With a minimum of two openings on different sides of each enclosed area. ■ With a minimum of one FV for every 200 square 1 C-L•S Ism/urunxi flip Arn an- mre to be r wKFmLV f4. MInV ielreollg rn:ulurerI ev um• rAer mrrrhh*1 nrN anc� fjFtr>lh• ad:IrrRer�! mw urc !Ix r rn he• r�+q,.rnrcd ne mi rrurernemtur ey Hee auhjrc! n11Ge relwj or a rrrrxnernls$etnrr fnr u. r se. 7'lh•n-!,� nn exrrnoNr hr kY' Ieevlrrprewr J'rn're+e. 1.1,(', rXprrse er rnrfdreeL ns h+ ane lierdtag ar whrr n rrpr it, thrz reprw. w at !n all. pwrhrr! ev tY'xsr by A. rerrrrl 0 _ Copyright 0 2021 iCC Evaluation Service, LLC. A9 rights reserved. Page 1 of 6 ESR-2074 I Most Widely Accept, . and Trusted Page 2 of 5 feet (18.6 m) of enclosed area, except that the 5.2 The Smart Vent FVs must not be used in the place SmartVENT* Stacking Model #1540-511 and of 'breakaway walls" in coastal high hazard areas, but FloodVENT* Stacking Model #1540-521 must be are permitted for use in conjunction with breakaway installed with a minimum of one FV for every walls in other areas. 400 square feet (37.2 m2) of enclosed area. 6.0 EVIDENCE SUBMITTED Below the base flood elevation. 6.1 Data in accordance with the ]CC -ES Acceptance = With the bottom of the FV located a maximum of Criteria for Mechanically Operated Flood Vents 12 inches (305.4 mm) above the higher of the final (AC364), dated August 2015 (editorially revised grade or floor and finished exterior grade immediately October 2017). under each opening. 6.2 Test report on air infiltration in accordance with ASTM 4.2 Flood Vent Sealing Kit E283. The Flood Vent Sealing Kit Model 1540-526 is used in conjunction with FloodVENTe Model 01540-520. When installed and tested in accordance with ASTM E283, the FV and Flood Vent Seating Kit assembly have an air leakage rate of less than 0.2 cubic feet per minute per lineal foot (18.56 Vmin per lineal meter) at a pressure differential of 1 pound per square foot (50 Pa) based on 12.58 lineal feet (3.6 lineal meters) contained by the Flood Vent Sealing Kit. 7.0 IDENTIFICATION 7.1 The Smart VENT* models and the Flood Vent Sealing Kit recognized in this report must be identified by a label bearing the manufacturers name (Smartvent Products, Inc.), the model number, and the evaluation report number (ESR-2074). 7.2 The report holders contact information is the following: &0 CONDITIONS OF USE SMART VENT PRODUCTS, INC, The Smart Vent* FVs described in this report comply with, 430 ANDBRO DRIVE, UNIT 1 or are suitable alternatives to what is specified in, those PITMAN, NEW JERSEY 08071 codes listed in Section 1.0 of this report, subject to the (077) 441-8368 following conditions: www.$m4 tverrt,som 5.1 The Smart Vente FVs must be installed in accordance infoftsma:tvent.com with this report, the applicable code and the manufacturers Installation instructions. In the event of a conflict, the instructions in this report govern. TABLE 1--MODEL SIZES MODEL NAME MODEL HUM13ER MODEL SIZE (in.) COVERAGE (sq. ft.) FloodVEN SmartVENT* 1540-520 1540-510 15 /4" X 7 /4' 15'/,- X 73/4" 200 200 FioodVENTO Overhead Door SmartVENT* Overhead Door 1540-524 1540-514 153/4" X 73/4" 153/4' X 73... 200 200 Wood Wall FloodVENT® 1540-570 14" X 83l4" 200 Wood Wall FloodVEN Overhead floor 1540-574 14" X 83!4" 200 SmartVENT* Stacker 1540-511 16" X 16" 400 FloodVent Stacker Fnr SI? 7 bw+k = 7K d mm• 7 f m — —2 1540-521 16" X 16" 400 FIGURE I ---SMART VENT.- MODEL 1640.510 INTERIOR FIGURE 4—FLOOD VENT SEALING KIT ESR-2074 1 Most Widely Accept,- ,nd Trusted Page 3 of 5 FIGURE 2—SMART VENT MODEL 1540-520 FIGURE 3--SMART VENT: SHOWN WITH FLOOD DOOR PIV07ED OPEN I i EXTERIOR IMES Evaluation Report ESR-2074 CBC and CRC Supplement Reissued February 2021 This report is subject to renewal February 2023, www.icC-es.arg j (800) 4234687 1 1562j 698-0543 A Subsidiary of the International Code Councils DIVISION: 06 00 00—OPENINGS Section: 08 95 43--Vents/Foundation Flood Vents REPORT HOLDER: SMART VENT PRODUCTS, INC. EVALUATION SUBJECT: SMART VENT AUTOMATIC FOUNDATION FLOOD VENTS: MODELS 111540-1W); #16"21; #1540-610; 01540.511; #1540- 570; 01640.674; #1540-524; 01640.514 FLOOD VENT SEALING KIT #1540-626 1.0 REPORT PURPOSE AND SCOPE Purpose: The purpose of this evaluation report supplement is to indicate that Smart Vente Automatic Foundation Flood Vents, described in ICC-ES evaluation report ESR-2074, have also been evaluated for compliance with codes noted below. Applicable code edition: to 2016 California Building Code (CBC) ■ 2016 California Residential Code (CRC) 2.0 CONCLUSIONS 2.1 CBC: The Smart Vent® Automatic Foundation Flood Vents, described in Sections 2.0 through 7.0 of the evaluation report ESR- 2074, comply with 2016 CBC Chapter 12, provided the design and installation are in accordance with the 2015 fnternalional Buftng Codee (113C) provisions noted in the evaluation report and the additional requirements of CBC Chapters 12, 16 and 16A, as applicable. 2.2 CRC: The Smart Vente Automatic Foundation Flood Vents, described in Sections 2.0 through 7.0 of the evaluation report ESR- 2074, comply with the 2016 CRC, provided the design and installation are in accordance with the 2015 International Residential Coffee (IRC) provisions noted in the evaluation report. This supplement expires concurrently with the evaluation report, reissued February 2021 R7 1:;C h It alikiremi &)WWA un• Wa to he cvarsrrwdos relw-w rrlrrll• m-si eirr.l rw arr_I° W/x'r rr!!rlhi/1Cs 1f[lf �h'c jFr trllr treJSln rsrd, xur rw rile)• Nr he [,xrslr1ftq ns ml emhln.•mrnl aflh¢ alrhlrrl nJ rllr rrr+orr rlr n n•e'alxmnminli<nl rnr lla rtss•. T Jk•rr 1c ur/ pglrrunq• A�• fl •f ' I: r»lurui+W Yrnxr, 1.1 f', cgrrra r nr lmpinrl, ns r M rmv f mhJY d r'killer waller in rhiv retwi. oray 1n ourlwmha•e e+mrn%l Ar r1k )Tpwl. Copyright 0 2021 ]CC Evaluaffan Service, LLC. All rtgMs reserve0 Page 4 of 6 ICC-ES Evaluation Report ESR-2074 FBC Supplement Reissued February 2021 This report Is subject to renewal February 2023. www.icC, a .ova 1 (800) 423-6587 1 (562) 699-0543 A Subsidiary of the International Code Council' DIVISION: 08 00 00—OPENINGS Section, 08 96 43—Vents/Foundation Flood Vents REPORT HOLDER: SMART VENT PRODUCTS, INC. EVALUATION SUBJECT: SMART VENT AUTOMATIC FOUNDATION FLOOD VEM: MODELS #1640-62D; #1640-621; #1540.610; #1S40-611; #15404670; #I SO-674; 91540-624; #1640.514 FLOOD VENT SEALING KIT 0540-628 1.0 REPORT PURPOSE AND SCOPE Purpose: The purpose of this evaluation report supplement is to indicate that Smart Venle Automatic Foundation Flood Vents, described in ICC-ES evaluation report ESR-2074, have also been evaluated for compliance with the codes noted below. Applicable code editions_ * 2017 Florida Building Code —Building at 2017 Florida Building Code --Residential 2.0 CONCLUSIONS The Smart VeneAulomalic Foundation Flood Vents, described in Sections 2.0 through 7.0 of the evaluation report ESR-2074, comply with the Florida Building Code —Building and the FRC, provided the design and installation are in accordance with the 2015 International Building Cod#* provisions noted in the evaluation report. Use of the Smart Vene Automatic Foundation Flood Vents has also been found to be in compliance with the High -Velocity Hurricane Zone provisions of the Florida Building Code —Building and the Florida Building Code —Residential. For products falling under Florida Rule 9N-3, verification that the report holders quality assurance program is audited by a quality assurance entity approved by the Florida Building Commission for the type of inspections being conducted is the responsibility of an approved validation entity (or the code official when the report holder does not possess an approval by the Commission). This supplement expires concurrently with the evaluation report, reissued February 2021. 1(Y -1;\ Fe+nh errrrHr Rejurrl.� are e7W ru he rmaiflgduT relvwswain ue.Trheno &r um• nnccralrrrhuh% nevi Srl'['%Jfl'Q%r1• [p�,f/['F�ie'ii. mir we ther M AeiYfyy[1 wit tar ml rmkaeenreru ,y'rhr seeh/ecr ref Ilx= n pear rare +rrr+nlurrrr,hrrirxr Ira irT rae. 1'hrvr ra rerr u�rrrerrrty hi' h'1' l:rulwenwr =kn'ere. 1.14 : ripn�rt dr omptred m dft kr e»ryJindia�; raWhOr NrrNrrr nr then rejWW1, ,H'pT !n arty' pr(4h*'f rr+rererf h,• Me repnrl. Copyrighl 0 2021 ICC Evaluation Service, LLC. All rights reserved. Page 5 of 5 U.S. DEPARTMENT OF HOMELAND SECURITY odes cord No. iesa•am Federal Emergency Management Agency EeWfailonoKe.O 012026 National Flood Insurance Program ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 :opy all pages of this Elevation Certificate and all attachments for (1 community orfldal, (2) lnsuranoe agenveomparry, and (3) building owner, SI=Cr10N A - PAOPEWTY INF69 ATION ; FOR INSURANCE COMPANY USE Al. Building Owner's Name: SSHI 11C Policy Number. A2. Bulkling Street Address (Including Apt„ Unit, Suite, and/or Bldg. No.) or P.O. Route and Box Company NAIL Number: -' No..,3007 Roan Dr. City: Ellensburg State: WA ZIP Code: 98926 A3. Properly Desolption (e.g.. Lot and Block Numbers or Legal Description) and/or Tax Parcel Number: Division 7 Lot 1. 962117 A4. Building Use (e.g., Residential, Non-Residenflal, Addition, Accessory, etc.): Residential AS, LalitudelLongitude: Lot. N47°01'34.91581 long. W120°3437.029 Horizontal Datum: ❑ NAD 1927 dNAD 1983 ❑ WGS 84 A6. Allach at least two and when possible four clear photographs (one for each side) of the building (see Form pages 7 and 8). A7. Building Diagram Number: 18 A8. For a building with a cxawispace or enclosure(s)r f a) Square footage of arawispace or endosure(s): f ),A aq. ft. b) Is there at least one permanent flood opening on two different sides of each enclosed area? ❑ Yes ❑ No f) WA c) Enter number of permanent flood oponsn s in the crawispnce or andosure(s) within 1.0 foot above adjacent grade: Non -engineered flood openings: � Engineered Ilood openings: d) Total not open area of non -engineered (food openings in A8.a: &A sq. in. a) Total rated area of engineered flood openings In A8.c (attach documented -see inslruclions): Al /f sq. fl. 0 Sum of ABA and A6.e rated area (lf applicable - see lnstrudbns):_ A/ /4 sq, ft, A9. For a bdIding with an attached garage: a) Square footage of attached garage: 604.00 sq. ft. b) Is there at least one permanent flood opening on two different sides of the attached garage? ❑ Yes [fl No ❑ NIA c) Enter number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade: Non -engineered flood openings: -Al f j� engineered Rood openings: _,N 1A d) Total net open area of non -engineered flood openings In AR.c. _ 11 sq, In. e) Total rated area of engineered flood openings In A9.e (attach documentation - see Instructions): 61/ ,,,, sq. H. f) Sum of A9.d and A9.e rated area (if applicable --see Instructions): NIA sq. fl, it$tfiiNL'E'iiATIf'�irjAPt=RlWj IlfORMATIOtIf 81.a. NFIP Community Name. KITTITAS COUNTY Bl.b. NFIP Community Ident ilkmilon Number: 530095 B2. County Name: KITTITAS 89. State: WA B4. Map/Panel No.: 53037Ci O64 65, Suffix: D B6. FIRM Index Date: 09/2412021 B7. FIRM Panel EffedivalRevised bale: 09/24/2021 B8. Flood Zone(a). AE 89. Base Flood Elevallon(s) (BFE) (Zone AO, use Base Flood Depth): 1696.9 810, Indicate the source of the BFE data or Base Flood Depth entered In Item 139: p PIS ❑ FIRM ❑ Community Determined ❑ Other: 1311, Indicate elevation datum used for BFE In item 139: ❑ NGVV 1929 Q NAVD 1988 U OtherlSource: B12, Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes d No Designation Data: ❑ CBRS ❑ OPA B13. Is the building located seaward of the Limit of Moderate Wave Action (LIMWA)? n Yes n No FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10122) Page 2 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.19 Building Street Address (including Apt., Unit, Suite, andlor Bldg, No.) or P.O. Route and Box No.: FOR INSURANCE CQMPAtdY USB 3007 Roan Dr. - - �City: Ellensburg Stale: WA ZIP Code: 9892ti Policy Number: Company NAIC Number: a.'t�vir•ti: �PviLiNIP1�7 CL'CVA'rrtrn[ rNit'CiKfY1AIICi t ( )UKV.EY'REQUIRED) C1. Building elevations are based ow ["] Construction Drawings' ❑ Bullding Under Construction' [fl Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations —Zones AI-A30, AE, AH, AO, A (with BFE), vE, V1--V3o, v (with eFE), AR, ARIA, ARIAE, ARlA1—A30, ARIAH, ARIAO, A99. Complete Items C2.a—h below according to the Building Diagram specified In Item A7. In Puerto Rioo only. enter meters. Benchmark Utilized: Center of S 27, T 18 N, R 18 E _ Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations In Items a) through h) below. [j NGVD 1929 M NAVO 1986 [] other: Datum used for building elevations musi be the some as that used for the BFE. Conversion factor used? j; J Yes JE No if Yes, describe the source of the conversion factor in the Section D Comments area. a) Top of bottom floor (including basement, crawlspare, or enclosure floor): 1600.30 Check the measurement used: ❑r` feet ❑ meters b) Top of the next higher noor (see Instructions): _ 'IA ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (see Instructions). Al IA- . ❑ feet ❑ meters d) Attached garage (lop of slab). 1,600.30 'x❑ feet ❑ meters e) Lowest elevation of Machinery and Equipment (MITE) servicing the building (describe type of M&E and location in Section D Comments area): 1,600.10 [x] feet ❑ meters f} Lowest Adjacent Grade (LAG) next to building: r] Natural Finished 1,698.80 ❑x feat ❑ meters g) Highest Adjacent Grade (HAG) next to bullding: ❑ Natural Q Finished 1,600.00 ❑ feat ❑ motors h) Finished LAG at lowest elevation of attached dock or stairs, Including struelurai support A,,A r _ ❑ feet [ meters SFC '10N i3 — SW(VEY4i3;..lEi GINEER,.OR•�ARCH TiECT GLI I iPiATiQN This certification Is to be signed and sealed by a land surveyor, engineer, or architect authorized by state law to certify elevation information. I oerfffy that the Infommflon on this Certificale represents my best eflorie to Inferpret fho data avaAeble. I underelaurd that any false statement may be punishable by One orlmpdsonmen( under 18 U.S. Code, Section 1001, Were latitude and longitude In Section A provided by a licensed land surveyor? IF) Yes ❑ No ❑ Check here If attachments and describe in the Comments area. Certifler's Name: Rick Skinner License Number, 43619 Tine: Professional Land Surveyor p ''...... 3' Company Name: Wostern Pacific Engineering 8, Survey, Inc.c.���, t+a Address: 1224 S. Pioneer Way City. Moses LaJW State: WA ZIP Code: 98837 r g 43619 Signature: 4 3 ,1...'X ,, 9 Date: ,,....... V Telephone: (509) 765-1023 EA.: Email. rskinner@wpelnc.netNIMANVU Copy all pages of this Elevation Corlincate and all attachments for (1) community official, (2) Insurance agenNcomparly, an u ng owner. Comments (inckrdtng source of conversion factor in C2; type of equipment and location per C2.e; and description of any attachments): Heat Pump pad was measured at the top with the bottom of the heat pump raised an eddilionat eight Inches with legs FEMA Form FF-206-FY 22-152 (formerly 066-0-33) (10122) Page 3 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or KO. Route and Box No.: FOR INSURANCE COMPANY USE 3007 Roan Dr. — City: Ellensburg State: WA zip Code: 98926 Policy Number: Company NAIC Number: 8ECr14N:E—SIiILpING Ml1RMENTINFORIVIA7?IOIV.>jSUR1Pi_Ypi REGtIJiRED) FOR'Z.ONEAO, i;ONEAPjAb,AND ZQNE-A.(WITHOUT 121117E1 For Zones AO. AR/AO, and A (without BFE), complete Items Ef—E5. For Items E1—E4, use natural grade, If available. If the Certificate Is Intended to support a Letter of Map Change request, Complete Sections A, 8, and C. Check the measurement used. In Puerto Rico only, ardor meters. Building measurements are bssed on: ❑ Construction Drawings* ❑ Building Under Construction' ❑ Finlsfned Construction 'A new Elevation Certificate wilt be required when construction of the building Is complete. E1. Provide measurements (C,2.a In applicable Bullding Diagram) for the following and check the appropriate boxes to show whether the measurement is above or below the natural HAG and the LAG. a) Top of bottom floor (lntWding basement, crawlspace, or enclosure) Is: ❑ feat ❑ meters j] above or ❑ below the HAG. b) Top of bottom floor (Including basement, crawispaee. or enclosure) Is: ❑ feet ❑ meters ❑ above or ❑ below the LAG, E2, For Building Diagrams " with permanent flood openings provided in Section A Items S and/or a (see pages 1-2 of Instructions), the next higher floor (C2.b In appiloable Building Diagram) of the building Is: ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) Is: ❑ feel j ] meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building Is: _ _ ❑ feel ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number Is available, is the top of the bottom floor elevated In accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown: The local oiffclat must certify this information in Section G. $EG 160 F t koplit k'TY OWNS' R- �{Oil ( WNER'S AUTH6MZED REPIkEtt TAT-1 E) cERTIF)CAf`i6N The property owner or owner's authorized representative who completes Sections A, 8, and E for Zone A (without SFE) or Zone AO must sign here. The statements In SectlartsA, B, and Eare correct to the best ormyknuw/edge ❑ Check here if attachments and describe In the Comments afea. Property Owner or Owner's Authorized Represenfattve Name; Scrott Henson Address: 1224 S. Pioneer Way City: Moses Lake Stela• WA ZIP Code: 98837 Signature: Dale: J C) d- Telephone: (509) 755-1023 Ext,: F-malt: shenson®wpeine.net Comments: FEMA Form FF-206-FY-22.152 (formerly 086-0-33) (1W2) Page 4 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9AS Building Street Address (including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No.: 3007 Roan Dr. City: Ellensburg State: WA ZIP Code: 98926 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number: SECTION G W COMMUNITY INFORMATION (RECOMMENDED FOR COMMUNITY OFFICIAL COMPLETION) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Section A, B. C. E, G. or H of this Elevation Certificate. Complete the applicable item(s) and sign below when: G1. ❑ The information in Section C was taken from other documentation that has been signed and seated by a licensed surveyor, engineer, or architect who is authorized by state law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2.a. ❑ A local official completed Section E for a building located in Zone A (without a BI=E), Zone AO, or Zone ARIAO, or when item E5 is completed for a building located in Zone AO. G2.b. X❑ A local official completed Section H for insurance purposes. G3. ❑ In the Comments area of Section G. the local official describes specific corrections to the information in Sections A, B, E and H. G4. D The following information (Items G5-1371) is provided for community iloodplain management purposes. G5. Permit Number: FD-22-00006 G6. Date Permit Issued: 03/02/2022 G7. Date Certificate of Compliance/Occupancy Issued: G8. This permit has been issued for: 9 New Construction ❑ Substantial Improvement G9.a. Elevation of as -built lowest floor (including basement) of the building: G9.3. Elevation of bottom of as -built lowest horizontal structural member: G10.a. BFE (or depth in Zone AO) of flooding at the building site: G10.b. Community's minimum elevation (or depth in Zone AO) requirement for the lowest floor or lowest horizontal structural member: 1,600.30 ❑x feet ❑ meters Datum: NAVD 1988 ❑ feet ❑ meters Datum: 1,596.90 feet ❑ meters Datum: NAVD 1988 1,597.90 ❑x feet ❑ meters Datum: NAVD 1988 G11. Variance issued? O Yes x❑ No If yes, attach documentation and describe in the Comments area. The local official who provides information in Section G must sign here. 1 have completed the information in Section G and certify that it is correct to the best of my knowledge. if applicable, I have also provided specific corrections in the Comments area of this section. Local Official's Name: Samantha Cox, CFM Title: Water Resources Specialist NFIP Community Name: Kittitas County Telephone: (509) 962-7523 Ext.: Email: publimorks&o.kittites.wa.us Address: 411 N. Ruby St., Suite 1 City: Ellensburg State: WA ZIP Code. 98926 Signature: _ . _,� ___ Date: 08/21/2023 Comments (including type of equipment and location, per C2.e; description of any attachments. and corrections to specific information in Sections A, B, D, E, or H): FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 5 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit. Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 3007 Roan Dr. City: Ellensburg State: WA ZIP Code: 98926 Policy Number: Company NAIC Number: SECTION H — BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES (SURVEY NOT REQUIRED) (FOR INSURANCE PURPOSES ONLY) The property owner, owner's authorized representative, or local floodplain management official may complete Section H for all flood zones to determine the building's first floor height for insurance purposes. Sections A, B, and I must also be completed. Enter heights to the nearest tenth of a foot (nearest tenth of a meter in Puerto Rico). Reference the Foundation Type Diagrams (at the end of Section H Instructions) and the appropriate Building Diagrams (at the end of Section I Instructions) to complete this section. 1-11. Provide the height of the top of the floor (as indicated in Foundation Type Diagrams) above the Lowest Adjacent Grade (LAG): a) For Building Diagrams 1A,1B, 3, and 5-0. Top of bottom 1.50 x❑ feet ❑ meters x❑ above the LAG floor (include above -grade floors only for buildings with subgrade crawlspaces or enclosure floors) is: b) For Building Diagrams 2A,.2B, 4, and 6-9. Top of next ❑ feet meters above the LAG higher floor (i.e., the floor above basement, crawispace, or enclosure floor) Is: H2. Is all Machinery and Equipment servicing the building (as listed in Item H2 instructions) elevated to or above the floor indicated by the H2 arrow (shown in the Foundation Type Diagrams at end of Section H instructions) for the appropriate Building Diagram? ❑ Yes 0 No SECTION I — PROPERTY OWNER (OR OWNER`S AUTHORIZED REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and H must sign here. The statements in Sections A, B, and H are correct to the best of my knowledge. Note: If the local floodplain management official completed Section H, they should indicate in Item G2.b and sign Section G_ ❑ Check here if attachments are provided (including required photos) and describe each attachment in the Comments area. Property Owner or Owner's Authorized Representative Name: Address: City: Signature: Telephone: Ext.: Email: Comments: — Date: State. ZIP Code: FEMA Form FF..206-FY-22-152 (formerly 086-0-33) (10122) Page 6 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.19 BUILDING PHOTOGRAPHS See Instructions for Item A6. Building Street Address (including Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 3007 Roan Dr. City: Ellensburg State: WA ZIP Code: 98928 Policy Number: Company NAIC Number. instructions: Insert below at least two and when possible four photographs stowing each side of the building (for exampte, may only be able to take front and back pictures of townhouses/rowhouses). Identify all photographs with the date taken and "Front View,"'Rear View," "Right Side View; or "Left Side View," Photographs must show the foundation. When flood openings are present, include at least one close-up photograph of representative flood openings or vents, as Indicated In Sections AS and AS. r.� tPhoto One Photo One Caption: Front View Photo TWO Photo Two Caption: Side View Clear Photo one pear Photo Two FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10122) Page 7 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 949 BUILDING PHOTOGRAPHS Continuation Page Building Street Address (Including Apt., Unit, Suite, ardor Bldg. No.) or P.O. Route and Box No.; FOR INSURANCE COMPANY USE 3007 Roan Dr. City: Ellensburg Policy Number: Stale; WA 21P Code; 98828 Company NAIC Number. Insert the third and fourth photographs below. Identify all photographs with the date taken and "Front View," "Rear View," "Right Side View," or "Left Side View." When flood openings are present, include at least one close-up photograph of representative flood openings or vents, as tndloated in Sectfons AS and A9. Photo Four Photo Four Caption: Side View FEM1A Form FF-206-FY-22-152 (formerty 086-0-33) (10M) Gear Photo Tlxee Clear Photo Four Page 8 of 19 U.S. DEPARTMENT OF HOMELAND SECURITY OMB Calyd No. 1880-0008 Federal Emergency Management Agency B4*akn Date. DW3VA28 National Flood Insurance Program ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 949 Copy all panes of this Elevation Certificate and all attachments for (1) communitv official. (2) Insurance aaenticomoanv. and fat buiidlnc owner. S1Eivi'ION i{� RI iPERT'i( NFORMA'E'!ON FOR INSURANCE COMPANY USE Al. Building Owner's Name: SSHI LLC Policy Number. A2. Building Street Address (including Apt., Unit, Sub, and/or Bldg. No.) or P.O. Route and Box Company NAIC Number: No.: 3009 Dapple Gray Way City: Ellensburg State: WA ZIP Code: 98926 A3. Property Description (e.g., Lot and Block Numbers or Legal Description) and/or Tax Parcel Number Division 7 Lot 2, 962118 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.): Residential A5. LeGtude1Lon9Wde; Let. N47°01'34.12" Long. W120°34'39.97" Horizontal Datum: [] NAD 1927 0 NAD 1983 ❑ WGS 84 A6. Attach at least two and when possible four clear photographs (one for each side) of the building (see Form pages 7 and 8). A7. Building Diagram Number. 113 A8, For a building wilh a crawispece or enclosure(s): a) Square footage of crawispace or endoeure(s): A1114' sq. 0. b) Is there at least one permanent flood opening on two different sides of each enclosed area? ❑ Yes ❑ No E] N/A c) Enter number of permanent flood openings In the orawlspace or enclosure(s) within 1.0 foot above adjacent grade: Non -engineered flood openings; -_&,, ,4- Engineered flood openings: OM d) Total net open area of non -engineered Hood openings In A8.c: �( f 1A. sq. in. 1 s) Total rated area of engineered flood openings in AS.c (attach documentation -- see Instruc tiions): I � 114 sq. ft. f) Sum of A8.d and A8.e rated area (if applioable -- see Instructions): sq, 4. A9. For a building with an attached garage; a) Square footage of attached garage: 603.00 sq. (L b) Is there at least one permanent flood opening an two different sides of the attached garage? ❑ Yes Q No ❑ N/A c) 2nter number of permanent flood openings In the attached garage within 1.0 foot above adjacent grade; Non -engineered flood openings. Engineered flood openings: 4 d) Total net open area of non -engineered flood openings In All= 2 Z_ sq. In. e) Total rated area of engineered Good openings in A9,c (attach documentation — see Instructions); �AIIA sq. ft. f) Sum of A9.d and A9.e rated area (if applicable — see Instructions): sq. fl. QN-=:FLQf3Ulll![iAIC 'IiA':MA (FIR{lilj:lhlFOt►11� . B1.a, NFIP Community Name: KITTITAS COUNTY B1.b. NFIP Community Identification Number; 530095 B2. County Name:KITTITAS B3. State: WA 134. Map/Panel No.: 53037C1064, B5. Suffix:D B6, FIRM Index Date: 09/2412021 B7. FIRM Panel Effective/Revised Date: 09/24/2021 88. Flood Zones): AE 89. Base Flood Elevatlon(s) (BFE) (Zone AO, use Base Mood Depth): 1695.6 B10. Indicate the source of the BFE data or Base Flood Depth entered In Item 89: []x FIS ❑ FIRM [] Community Determined ❑ Other. 511. Indicate elevation datum used for BFE in item B9: ❑ NGVD 1929 Q NAVO 1988 [] Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑ri No Designation Data: ❑ CBRS ❑ OPA 813, Is the building located seaward of the Limit of Moderate Wave Action (LIMWA)? Yes x No FEMA Form FF-206-FY 22-162 (formwly 086-0-33) (10122) Page 2 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit. Suite, and/or Bldg. No.) or P,O, Route and Box No.: FOR INSURANCE COMPANY USE 3009 Dapple Gray Way Policy Number: City: Ellensburg State: WA ZIP Code: 98926 --S---W Company NAIC Number. slo ::.—°@%iLoi�Grjilnivi►iv (suRvrtii4)'. 01. Building elevations are based on: ❑ Construction Drawings" ❑ Building Under Construction' ❑x Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. 02. Elevations - Zones Al-A30, AE, AH, AO, A (with BFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, ARIAt- A30, AWAH, AWAQ, A99. Complete Items C2.a-h below according to the Building Diagram specified in Item A7. In Puerto Rico only, enter meters, Benchmark Utilized: Center of S 27, T 18 id, R 18 E Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 D NAVD 1988 ❑ Other: Datum used for building elevations must be the same as that used for the BFE. Conversion factor used? If Yes, describe the source of the conversion factor in the Section D Comments area. a) Top of bottom floor (including basement, crawlspace, or enclosure floor): b) Top of the next higher floor (see Instructions): c) Bottom of the lowest horizontal structural member (see Instructions): d) Attached garage (top of slab): 1,597.60 Air 1,597.60 [] Yes 0 No Check the measurement used: ] feel ❑ meters ❑ feet ❑ molars ❑ feet [j meters ❑x feet ❑ meters e) Lowest eloVatlon of Machinery and Equipment (M&E) servicing the building (describe type of M&E and location in Section D Comments area): 1,697.80 ❑rr feet ❑ meters f) Lowest Adjacent grade (LAG) next to building: ❑ Natural [ Ftnlshad 1,696.10 ❑x feet ❑ meters g) Highest Adjacent Grade (HAG) next to building: [] Natural Finished 1.597.40 feet ❑ meters h) Finished LAG at lowest elevation of attached deck or stairs, including structural ,� J j ❑ ❑ support: /�'! feet meters This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by state law to codify elevation Information, i cerfify that the Information on this C&Nficate represents my best efforts to interpret the data available. / understand that any false statement may be punishable by fine or imprisonment under 18 U.S Code, Section 1001, Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes ❑ No ❑ Check here If attachments and describe In the Comments area. Certifiers Name: Rick Skinner License Number 43619 Title: Professional Land Surveyor 4r'O� �WAS�jl,� C� Company Name: Western Pacific Engineering & Survey, Inc. 0 Address: 1224S. Pioneer Way ,otv�i z aC City: Moses i7a4GAState: WA ZIP Code: 98837 19 Signature: 1 ,6 _,�*"'••...... .. Date: 785-1t32$ Ext.: Email: rskinner einc.net HAM - Copy ( ) @wp i Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) Insurance agentloompany, and (3) building owner. Comments (including source of conversion factor In C2: type of equipment and location per C2.e; and description of any attachments): Heat Pump pad was measured at the top with the bottom of the heat pump raised an additional eight Inches with legs FEMA. Form FF-206-FY-22-162 (formerly 086-0-33) (10/22) Page 3 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST POLLOW THE 94STRUCTIONS ON PAGES 949 Building Street Address (including Apt., Unh, Suite, and/or Bldg. No.) or P.O. Route and Box No,: FOR INSURANCE COMPANY USE 3009 D222t2Laj Way policy Number: City: Ellensburg State: WA ZIP Code: 98926 Company NA1C Number. ST404=BIItIN'1iEUlEiIiEN'IiVFQitNfi4T13N:$A1f NQT`RI~QU1RE1} FOt2QI�E AQ,=ZONEARIAp, AND?ONE:A.(1NiF10t}TSF For ,Zones A0, AWAO, and A (withouttBFE), complete Items E1—E5. For Items E1—E4, use natural grade, If available. If the Certificate Is Intended to support a Letter of Map Change request, complete Sections A, B, and C. Check the measurement used. In Puerto Rico only, enter meters. Building measurements are based on: ❑ Construction Drawings*[] Building Under Construction' [x' Finished Construction 'A new Elevation Certificate will be required when construction of the building Is complete. E1. Provide measurements (C.2.a in applicable Building Diagram) for the following and check the appropriate boxes to show whether the measurement is above or below the natural HAG and the LAG. a) Top of bottom floor (including basement, crawlspace, or enclosure) is: ❑ feet 0 meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is: _ ❑ feet meters ❑ above or ❑ below the LAG. E2. For Building Diagrams " with permanent flood openings provided In Section A Items 8 and/or 9 (see pages 1 2 of instructions), the neat higher floor (C2.b In applicable Building Diagram) of the building Is: ❑ feet ❑ meters ❑ above or ❑ below the HAG, E3. Attached garage (fop of slab) Is: _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is: ❑ feet ❑ meters ❑ above or ❑ below the HAG. ES, Zone AO only: If no flood depth number is evallable, is the top of the bottom floor elevated In accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown The local official must certify this information in Section G. S 1'ILIF-PFl4ER'1't�WIER},4Z13NlER4SsAi)HORIZEDIPRE1T "1I)•CRT1FiC�1`fyDN The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without BFE) or Zone AO must sign here. The statements In Sections A, B, and E are correct to the bast of my knowledge ❑ Check here if attachments and describe in the Comments area. Property Owner or Owner's Authorized Representative Name: Scott Henson Address: 1224 S. Pioneer Way City: Moses Lake Slate: WA ZIP Code; 98837 Signature: .�`,•.� Dater Telephone: (509) 765-1023 Ext.: Email:shensonewpeinc.net Comments: FEMA Form FF-206-FY-22-162 (formerly 086-0-33) (10122) Page 4 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite. and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 3009 Dapple Gray Way Policy number: _ City: Ellensburg -- State: WA ZIP Code: 98926 Company NAIL Number:-- — SECTION O — COMMUNITY INFORMATION (RECOMMENDED FOR COMMUNITY OFFICIAL, COMPLETION) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Section A, 8, C, E, G. or H of this Elevation Certificate. Complete the applicable hem(s) and sign below when: G 1 • ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by state law to certify elevation information. (indicate the source and date of the elevation data In the Comments area below.) G2.a. L A local official completed Section E for a building located in Zone A (without a BFE), Zone AO, or Zone AR/AO, or when Item E5 is completed for a building located in Zone AO. G2.b. A local official completed Section H for insurance purposes. G3. ❑ In the Comments area of Section G, the local official describes specific corrections to the information in Sections A, B, E and H. G4. 0 The following information (Items G5-13 11) is provided for community floodplain management purposes. G5• Permit Number: FD-22-00007 G6. Date Permit Issued: 03/02/2022 G7- Date Certificate of Compliance/Occupancy Issued: G8. This .permit has been issued for: 9 New Construction ❑ Substantial Improvement G9.a. Elevation of as -built lowest floor (including basement) of the building: 1,697.60 ❑x feet ❑ meters Datum: NAVD 1988 G9,b• Elevation of bottom of as -built lowest horizontal structural member: G10.a. BFE (or depth in Zone AO) of flooding at the building site: �j ❑ feet ❑ meters Datum: 1.595.50 ❑x feet ❑ meters Datum: NAVD 1988 G1O.b. Community's minimum elevation (or depth in Zone AO) requirement for the lowest floor or lowest horizontal structural member. 1,596.50 0 feet ❑ meters Datum: NAVD 1988 G 11. Variance issued? ❑ Yes , No If yes, attach documentation and describe In the Comments area. The local official who provides information In Section G must sign here. I have completed the information in Section G and certify that it is correct to the best of my knowledge. If applicable, I have also provided spec corrections in the Corments area of this section. Locai Official's Name; Samantha Cox NFIP Community Name.. Kittitas Count Title: Water Resources Specialist Telephone: (509) 962-7523 Ext.: Email: publieworks&o.kittitas.wa.us Address: 411 N. Ruby Street, Suite 1 City: Ellensburg state: WA ZIP Code: 98926 Signature: �� _ Date:09128/2023 Comments (Including -Type of equipment's nd location, per C2.e; description of any attachments; and corrections to specific information in Sections A, B, D, E, or H): FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 5 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 8-19 Building Street Address (including Apt., Unit, Suite, ariftr Bldg. No.) or P.O. Route and Box No.; FOR INSURANCE COMPANY USE 3009 Dapple Gray Way Policy Number: City: Ellensburg State: WA ZIP Code: 98926 Company NAIC Number: SECTION H - BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES (SURVEY NOT REQUIRED) (FOR INSURANCE PURPOSES ONLY) The property owner, owner's authorized representative, or local floodplain management official may complete Section H for all flood zones to determine the building's first floor height for insurance purposes. Sections A, 8, and I must also be completed. Enter heights to the nearest tenth of a foot (nearest tenth of a meter in Puerto Moo). Reference the Foundation Type Diagrams (at the and of Section H Instructions) and the appropriate Building Diagrams (at the end of Section I Instructions) to complete this section. H1, Provide the height of the top of the floor (as indicated in Foundation Type Diagrams) above the Lowest Adjacent Grade (LAG): a) For Building Diagrams 1A, 113, 3, and ". Top of bottom 1.50 Q feet ❑ meters ❑x above the LAG floor {include above -grade floors only for buildings with subgrade crawlspaces or enclosure floors) is: b) For Building Diagrams 2A, 2B, 4, and ". Top of next _ © feet ❑ meters ❑ above the LAG higher floor (i.e., the floor above basement, crawlspace, or enclosure floor) Is: H2. Is all Machinery and Equipment servicing the building (as listed in Item H2 instructions) elevated to or above the floor indicated by the H2 arrow (shown in the Foundation Type Diagrams at end of Section H instructions) for the appropriate Building Diagram? ❑ Yes ❑x No SECTION I - PROPERTY OWNER (OR OWNER'S AUTHORIZED REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, 8, and H must sign here. The statements in Sections A, B, and H are correct to the best of my knowledge. Note: if the local floodplafn management official completed Section H, they should indicate in Item G2.b and sign Section G. ❑ Check here if attachments are provided (including required photos) and describe each attachment in the Comments area, Property Owner or Owner's Authorized Representative Name: Address: City: State: ZIP Code: Signature: Date: Telephone: Ext,: Email: Comments: FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 6 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 BUILDING PHOTOGRAPHS See Instructions for item A6. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Routs and Box No.: FOR INSURANCE COMPANY USE 3009 Dapple Gray Way Policy Number: City: Ellenslsutig State: WA ZIP Code: 96926 Company NA1G Number Instructions: Insert below at least two and when possible four photographs showing each side of the building (for example, may only be able to take front and back pictures of townhousestmwhouses). Identify all photographs with the date taken and "Front View," "Hear View," "Right Side View," or "Left Side Vlew." Photographs must show the foundation. When flood openings are present, include at least one dose -up photograph of representative flood openings or vents, as Indicated In Seotions AB and A9. Photo One Caption, Front View Photo Two Photo Two Caption: Side View 64'r.P,fiio 1n!o... I=EMA Form FF-206-FY 22-162 (formerly 086-0.33) (10122) Page 7 of 19 ELEVATION CERTIFICATE IMPORTANT., MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 BUILDING PHOTOGRAPHS Continuation Page Building Street Address (including Apt., Unit, suite, and/or Bldg. No.) or P.O. Route and Box No.: 3009 Dapple_q a" Way City: Ellensburg State: WA ZIP Code: 98926 FOR INSURANCE COMPANY USE Policy Number. Company NAIL Number: Insert the third and fourth photographs below. Identity all photographs with the date taken and "Front View; "'Rear View:' "Right Side View," or "Left Side View." When flood openings are present, Include at least one dose -up photograph of representative flood openings or vents, as Indicated In Sections AS and A9, In Z 'lzz Photo Three P It Thm-3 Caption: Back View Photo Four Photo Four Caption: Side View I FEMA Form rF-200-FY22-152 (formerly 086-0-33) (10122) Page 8 of 19 U.S. DEPARTMENT OF HOMELAND SEGURITY OMB No, 11660-0008 Federal Emergency Management Agency Expiration Date: November 30, 2022 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1--9. Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) Insurance agent/company, and (3) building owner. SECTION A-- PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owners Name Policy Number: S$HI LLC A2, Building Street Address (including Apt., Unit, Sub, and/or Bldg. No.) or P.O. Route and Company NAIL Number: Box No. 3005 Dapple Gray Way city state ZIP Code Ellensburg Washington 98926 A3. Properly Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Divislon 7 Lot 4, 962120 A4. Building Use (e.g.. Residential, Non -Residential, Addition, Accessory, etc.) Residential A5, Latdude/Longilude: Let: N47001'32A2590" Long, W12W3441.74535" Horizontal Datum: [] NAD 1927 0 NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood Insurance. A7. Building Diagram Number 7 B A8. For a building with a crawlspacs or enclosure(s): a) square footage of crawispace or enclosure(s) N/A sq ft b) Number of permanent food openings In the crawlspace or endosure(s) wkhdn 1.0 foal above adjacent grade NIA c) Total net area of flood openings in A8.b NIA aq in d) Engineered flood openings? ❑ Yes [D No A9. For a building with an attached garage: a) Square footage of attached garage 604.00 aq ft b) Number of permanent flood openings In the attached garage within 1.0 foot above adjacent grade n c) Total net area of flood openings In A9.b 0.00 aq in d) Engineered flood openings? ❑ Yes FE] No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1, NFIP Community Name & Community Number BZ County Name B3. State KITTITAS COUNTY; 63OD96 KITTITAS Washington 84. Map/Panel 85. Suffix BB. FIRM Index B7, FIRM Panel 88. Flood 89. Base Flood Elevatton(s) Number Date Effactivel Zone(s) (Zone AO, use Base Flood Depth) Revised Date 53037C7064 O W 242021 09-24 2021 AE 1593.3 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139: x❑ FIS Profile ❑ FiRM ❑ Community Detarmined ❑ Other/Source: B11. Indicate elevation datum used for BFE In Item 89: ❑ NGVD 1929 EINAVD 1988 ❑ Other/Source: B12. Is the building located Ina Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33 (112119) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No, Policy Number: 3005 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 SECTION C -- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction" ❑x Finished Construction •A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations — Zones Al-,A30, AE, AH, A (with BFE), VIE, VI—V30, V (with BFE), AR, ARIA, ARIAE, ARIA1 A30, ARIAH, AR1A0. Complete Items C2.a—h below according to the building diagram specified In Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: Center of S 27, T 18 N. R 18 E Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations In Items a) through h) below. ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawispaoe, or enclosure floor) 1595.0 0 feet ❑ meters b) Top of the next higher floor NIA ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet ❑ meters d) Attached garage (top of stab) 1595.0 x❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location In Comments) 1595,1 ❑ feet ❑ meters f) Lowest adjacent (finished) grade next to building (LAG) 1593.8 ❑x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 1594A ❑x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support tVfA ❑ teat ❑ meters SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be sighed and sealed by a land surveyor, engineer, or architect aulhorizad by law to certify elevation Information. I certify that the information on this Certificate represents ray best efforts to interpret the date avaNable. I understand that any false statement may be punishable by line or Imprisonment under 98 U.& Code, Section 1001. Were latitude and longitude In Section A provided by a licensed land surveyor? ffl Yes ❑ No ❑ Check here If attachments. Certifler's Name License Number Rick Skinner 43649 ff WASj 1J,-,l Title Professional Land Surveyor p? Company Name Western Pacific Engineering & Survey, Ina d , Address 1224 S. Pioneer Way �~IAi�i4 city State ZIP Code Moses Lake Washington 98837 Signature Date Telephone Ext. (509) 765-1023 Copy all peg a Ih Elevation Certificate and all attachments fa (1) ca unity official, (2) insurance agenticompany, and (3) building owner. Comments (Including type of equipment and location, per C2(e), If applicable) Heat pump pad was shot with GPS and the elevation was calculated with an additional 7 inches were added to the elevation due to the heat pump being risen with legs. FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30.2022 IMPORTANT- In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including ApL, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 3005 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOP. ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1—E5. If the Certificate is intended to support a LAMA or LOMR-F request, complete Sections A, B,and C. For Items E1—E4, use natural grade, If available. Check the measurement used. In Puerto Rico only, enter meters, E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom Floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or © below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided In Section A Items 8 and/or 9 (see pages 1--2 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building Is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, Is the top of the bottom floor elevated In accordance with the community's floodplaln management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this Information in Section G. SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The propert owner or owner's authorized representative who completes Sections A.B. and. E for Zone A (without a FEMA-issued or community -re BFE) or Zone AO must sign here. The statements in Sections A, B. and E are correct 10 the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Scott Henson Address City State ZIP Code 1224 S. Pioneer Way Moses Lake Washington 98837 Signature Date Telephone (609) 765-1023 Comments ❑ Check here if attachments. FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No. I1360-OODB Exoiration Dale: Novemhar 30. 2022 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. policy Number: 3005 Dapple Gray Way City State ZIP Code Company NAIL Number Ellensburg Washington 98926 SECTION G — COMMUNITY INFORMATION (OPTIONAL.) The local official who is authorized by law or ordinance to administer the communiWs fioadpiain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8 -G10. In Puerto Rico only, enter meters. Gf. ❑ The information in Section C was taken from other documentation that has been signed and seated by a licensed surveyor, engineer. or architect who is authorized by law to certify elevation information. (Indicate the source and [fate of the elevation data In the Comments area below.) Og ❑ A community official completed Section E for a building located In Zone A (without a FEMA-lssued or owmmunily-lssued 8FE) or Zone AO. G3, ❑ The following information (items 04-G10) is provided for community floodplafn management purposes. G4. Permit Number G5. Date Permit Issued GO. Date Certificate of CompliencelOccupancy Issued G7. This permit has been issued for. ❑ New Construction ❑ Substantial improvement G8. Elevation of as -built lowest floor (including basement) of the building: _ ❑ feet ❑ meters Datum G8. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Community's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name Tills Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0 33 (12/19) Replaces all previous editions. Form Page 4 of 6 I BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 3005 Dapple Gray Way --Y crate cir Uoae Company NAIC Number Ellensburg Washington 98926 1 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated In Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. Phuta One Caplian Frurt View Photo Two Caption Side W FEMA Form 086-0-33 (12119) Replaces all previous editions. Clear Photo one Clear Photo Two Form Page 6 of 6 BUILDING PHOTOGRAPHS OMB No. 1600-0008 ELEVATION CERTIFICATE Continuation Page Exotration Date: NovArnhar 30. 2n22 IMPORTANT: In these spaces, ropy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apl., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No, Policy Number: 3005 Dapple Gray Way City Slate ZIP Code Company NAIC Number Ellensburg Washington 98926 If submitting more photographs than will fit on the preceding page, affix the additional photographs below, Identify all photographs with: dale taken; "Front View" and "Rear View", and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents. as indicated In Section A8. J _.� ...- .. +�,•�r'-.-— - ��_{ref .�s-. z';.�.,_ w 1 •ti�`kl1"3'v„ ' �... r _ Y: - - r --; J ' ._ .ate •� t }, , r 4 gyp Photo TWO* Photo Three Caption Rear View Clear Photo Theta FWD FMN Photo Four Caption Side View Clear Photo Four FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 6 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY OMB Oor*rot No. 16M.00M Federal Emergency Management Agency Exp'rakn oarer0arso0M National Flood Insurance Program ELEVATION CERTIFICATE . IMPORTANT. MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 ropy au pages or tnts elevation UertlWate aW all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. $ECT C ;A R OPIsl 7 1` 1 Q _y ON FOR INSURANCE COMPANY USE Al. Building Owner's Name: SSHI LLC Policy Number. A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No,) or P.O. Route and Box Company NAIL Number: . No.:3003 Dapple Gray Way city. Ellensburg State; WA ZIP Code: 98926 A3. Prop" Description (e.g., Lot and Block Numbers or Legal Description) and/or Tax Parcel Number; Division 7 Lot &, 962121 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.); ResidenQai A6. Latilude/Longitude: Lat. N47"Di'31.t39" Long. W120°34'42.64" Horizontal Datum: El NAD 1927 x❑ NAD 1983 ❑ WGS 84 A6. Attach at least two and when possible four clear photographs (one for each side) of the building (see Form pages 7 and 8). A7. Building Diagram Number: A8. For a building with a crawispace or endosure(s): a) Square footage of crawispace or endosure(s): /i /A. sq. ft. b) Is there at least one permanent flood opening on two different sides of each enclosed area? [] Yes ❑ No ❑x NIA o) Enter number of permanent flood openings in the crawispace or enclosure(s) within 1.0 foot above adjacent grade: Non -engineered flood openings., 0//r Engineered flood openings: /1//,* d) Total not open area of non -engineered flood openings In A8.o:NI&� sq. in. e) Total rated area of engineered flood openings in A8.c (attach documentation - see Instructions): N/ sq. ft. Q Sum of A8.d and A8.e Fated area (if applicable - see Instructions): N /* sq. ft. A9. For a building with an attached garage: a) Square fbotage of attached garage: 603.00 sq. e. b) Is there at least one permanent flood opening on two different sides of the attached garage? (] Yes x!] No ❑ NIA c) Enter number of permanent flood openings in the attached garage within 1.0 fool above adjacent grade: Non -engineered flood openings; /V�� Engineered flood openings: NZA: d) Total net open area of non -engineered flood openings in A9.c: ,ylA- sq. In. e) Total rated area of engineered flood openings in A9.c (attach documentation - see Instrud ons); /liljf - sq. ft. f) Sum of A9.d and A9.e rated area (ff applicable - see Instructions): _ sq. ft. 1AP INFOR .T.I0r =; B1.a. NFIP Community Name: KIT11TAS COUNTY B1.b. NFIP Community Identification Number: 630095 B2. County Name:KITTITAS 136. FIRM -index Date: 09/24/2021 B3. State: WA 84. Map/Panel No.; 63037C1064 85. Suffix: D H7. FIRM Panel EffectivelRevised Data; 09/2412021 88. Flood Zone(s): AE B9. Base Flood Elevation(s) (BFE) (Zone AO, use Base Flood Clepthy 1691.0 810, Indicate the source of the BFE data or Base Flood Depth entered in Item Be: Fig [] FIRM ❑ Community Determined ❑ Other. B11. Indicate elevation datum used for SFE in Item 139: ❑ NGVD 1929 M NAVD 1988 ❑ Other/Source: B12. Is the building located In a Coastal Banter Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes Qf No Designation Date: ❑ CBRS ❑ OPA B13. Is the building located seaward of the Limit of Moderate Wave Action (LiMWA)? ❑ Yes 0 No FEMA Form FF-206-FY-22-162 (formally 086-0-33) (I D/22) Page 2 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 949 Building Street Address (including Apt., Unit, Suite, andkr Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 3003 Dapple Gray Way Policy Number. City: Ellensburg Slate: WA ZIP Code: 98926 Company NAIL Number: _ WC iIQI-�C11LDIid� TtLE�/A'1lORMA7i[(SUR'tIi~Y:RlIiD C1. Building elevations are based on: ❑ Construction Drawings` ❑ Building Under Construction' Finished Construction "A new Elevation Certificate will be required when construction of the building Is complete. C2. Elevaik:ns — Zones Al-,A30, AE, AH, AO, A (with BFE), VE, V1—V30, V (with BFE), AR, ARIA, AR1AE, ARMIAW, ARIAH, ARIAO, A99. Complete Items C2.a—h below according to the Building Diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: Center of S 27, T 18 N, R 18 E Vertical Datum: NAVD 1988 _ Indicate elevation datum used for the elevations In items a) through h) below. ❑ NGVO 1929 ® NAVD 1988 ❑ Other: Datum used for building elevations must be the same as that used for the BFE. Conversion factor used? [] Yes ❑s No If Yes, describe the source of the conversion factor in the Section D Comments area. Check the measurement used: a) Top of bottom Door (including basement, crowlspace, or enclosure floor): 1,594.10 ❑x feet ❑ meters b) Top of the next higher floor (see Instructions). N4& ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (see Instructions): ❑ feet ❑ meters d) Attached garage (lop of slab): 1,594.10 ❑x feet ❑ meters e) Lowest elevation of Machinery and Equipment (6+ &E) servicing the building (describe type of M&E and location In Section D Comments area): 1.593.70 ❑x feet ❑ meters h Lowest Adjacent Grade (LAG) next to building: ❑ Natural 0 Finished 1,592.10 feet [] meters g) Highest Adjacent Grade (HAG) next to building: 0 Natural ❑x M*hed 1,593.60 xn feet ❑ meters h) RnMed LAG at lowest elevation of attached deck or stairs, including structural support: N / ❑ feet ❑ meters 4 . A 1r = It 080.1Fl(Af This certification Is to be signed and sealed by a land surveyor, engineer, or architect authorized by state law to cerify elevation information. I certify ghat the Information on this Certifcats represents my best e(farts to Interpret the data ovaAabla. 1 understand that any false statement may be punishable by fine or Imprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude In Section A provided by a licensed land surveyor? [x] Yes ❑ No ❑ Check here If attachments and describe in the Comments area. Cerllfier's Name: Rick Skinner License Number 43619 Title: Professional Land Surveyor Company Name: Western Pacifle Engineering & Survey, Inc. Address: 1224 S. Pioneer Way t" J Zi Y City: Moses LAO State: WA ZIP Code: 98837 43619- t3�Q S Sigrrafure: '—M.Y Aa[ Data: ! LeJ iA1•tQ Telephone: (09) 765.1023 Ext.: Email: rskinner@wpoino.net Sea ere e, w .t Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) Insurance agenl/company, and (3) building owner. Comments (including source of conversion factor in 02; type of equipment and location par C2-e; and desoriptlan of any attachments): Heat Pump pad was measured at the top with the bottom of the heat pump raised an additional eight Inches with legs FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10122) Page 3 of 19 ELEVATION CERTIFICATE IMPORTANT, MUST FOLLOW THE INSTRUCTIONS ON PAGES 949 Building Street Address (including Apt.. Unit, Sulle. and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 3003 Dapple Gray Way Policy Number. City: Ellensburg State. WA ZIP Code. 98920 Company NAIL Number: 9-JO 1T 6- 'm d rut, 0%, MATO Q MIT FOR ALONE Z� R'A'P,,g4N AID,' wit !ML— � Ur For Zones AO, ARIAO, and A (without BFE), complete Items E I -ES. For Items EI-E4, use natural grade, if avaflab[e. If the Certificate Is intended to Support a Letter of Map Change request, complete Sections A. B, and C. Check the measurement used, In Puerto Rloo only, enter meters. Building measurements we based on: [] construction Drawings* L] Building Under Construction* [j] Firished Construction *A now Elevation Certificate will be required when construction of the building Is complete. El. Provide measurements (C.2.a In applicable Building Diagram) for the following and check the appropriate boxes to show whether the measurement Is above or below the natural HAG and the LAG. a) Top of bottom floor (including basement, crawlapam, or enclosure) Is: E] feet ❑ meters [] above or 0 below the HAG. b) Top of bottom floor (including basement, crawispace, or enclosure) Is, ❑ feet ❑ meters E] above or E] below the LAG. E2. For Building Diagrams 0-9 with permanent flood openings provided In Section A Items 8 andfor 9 (see pages 1-2 of Instruatlons), the next higher floor (C2,b in applicable Building Diagram) of the building Is: ❑ feet ❑ motors ❑ above or Ej below the HAG. E3. Attached garage (top of slob) Is. ❑ feet ❑ meters ❑ above or E] below the HAG. E4. Top of platform of machinery andtor equipment servicing the building Is: ❑ feet ❑ meters 0 above or E] below the HAG, ES. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated In accordance With the community's floodplain management ordinance? Yes E] No ❑ Unknown The local official must certify this Information in Section G. 0474146f 10ANA (OR *0TRI&O-A AQ,1 CAM The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without BFE) or Zone AO must sign here. 7he sleibmenfa in Section A, a and E are correct to the best of my knowledge rl Check here If attachments and describe In the Comments area. Property Owner or Owners Authorized Representative Name: Scott Hanson Addme: 1224 S. Pioneer Way city, Moses Lake State: WA ZIP Code; 98837 Signature: ...462t. 3 Dole: Telephone: (509) 765-1023 Ext.: Email. shonson@wpeinc.not Comments: FEMA Form rr-206-FY-22-152 (formerly 086-0-33) (10/22) Page 4 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 3003 Dapple Gray Way Policy Number: City: Ellensburg State: WA ZIP Code: 98926 Company NAIC Number: SECTION G — COMMUNITY INFORMATION (RECOMMENDED FOR COMMUNITY OFFICIAL COMPLETION) The local official who is authorized by law or ordinance to administer the community's fioodplain management ordinance can complete Section A, B, C, E, G. or H of this Elevation Certificate. Complete the applicable item(s) and sign below when: G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by state law to certify, elevation information. (indicate the source and date of the elevation data in the Comments area below.) G2•a• ❑ A local official completed Section E for a building located in Zone A (without a BFE), Zone AO, or Zone AR/AO, or when item E5 is completed for a building located in Zone AO. G2,b. iO A local official completed Section. H for insurance purposes. G3. ❑ In the Comments area of Section G, the local official describes specific corrections to the information in Sections A, 8, E and H. G4. 0 The following information (Items G5-1311) is provided for community floodplain management purposes. G5• Permit Number. FD-22-00010 G6. Date Permit Issued: 03/02/2022 G7. Date Certificate of Compliance/Occupancy Issued: G8. This permit has been issued for: 0 New Construction ❑ Substantial Improvement G9.0. Elevation of as -built lowest floor (including basement) of the building: 1,594.10 0 feet ❑ meters Datum: NAVD 1988 G9.b. Elevation of bottom of as -built lowest horizontal structural member: _ ❑ feet ❑ meters Datum: G10.a. BFE (or depth in Zone AO) of flooding at the building site: 1,591.60 0 feet ❑ meters Datum: NAVD 1988 G1 O.b. Community's minimum elevation (or depth in Zone AO) requirement for the lowest floor or lowest horizontal structural member: 1,592.60 feet ❑ meters Datum: NAVD 1988 G11. Variance issued? ❑ Yes O No If yes, attach documentation and describe in the Comments area. The local official who provides information in Section G must sign here. i have completed the Information in Section G and certify that it is correct to the best of my knowledge. tf applicable, i have also provided specific corrections in the Comments area of this section. Local Official's Name: Samantha Cox Title: Water Resources Specialist NFIP Community Name: Kittitas County Telephone: (509) 962-7523 Ext.: Email: pubIlcworks@co.kittitas.wa.us Address: 411 N Ruby St, Suite 1 City: Ellensburg State: WA ZIP Code: 98926 Signature: f Comments (including type of equipment and Sections A, B. O, E, or H): Date: _511111:5 - , per C2.e; description of any attachments; and corrections to specific information in FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 5 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 3003 Dapple Gray Way City; Ellensburg Policy Number: Efate: WA ZIP Code: 98926 Company NAIL Number: SECTION H — BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES (SURVEY NOT REQUIRED) (FOR INSURANCE PURPOSES ONLY) The property owner, owner's authorized representative, or local floodplain management official may complete Section H for all flood zones to determine the building's first floor height for insurance purposes. Sections A, B, and I must also be completed. Enter heights to the nearest tenth of a foot (nearest tenth of a meter in Puerto Rico). Reference the Foundation Type Diagrams (at the end of Section H Instructions) and the appropriate Building Diagrams (at the end of Section I Instructions) to complete this section. 1-111. Provide the height of the top of the floor (as indicated in Foundation Type Diagrams) above the Lowest Adjacent Grade (LAG): a) For Building Diagrams 1A,18, 3, and 5-9. Top of bottom floor (include above -grade floors only for buildings with subgrade crawispaces or enclosure floors) is: b) For Building Diagrams 2A, 213, A, and 6-9. Top of next higher floor (i.e., the floor above basement, crawispace, or enclosure floor) is: 2.00 ❑x feet ❑ meters ❑x above the LAG ❑ feet ❑ meters ❑ above the LAG H2, is all Machinery and Equipment servicing the building (as listed in Item H2 instructions) elevated to or above the floor indicated by the H2 arrow (shown in the Foundation Type Diagrams at end of Section H instructions) for the appropriate Building Diagram? ❑ Yes 0 No SECTION I — PROPERTY OWNER (OR OWNER'S AUTHORIZED REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and H must sign here. The statements in Sections A, B, and H are correct to the best of my knowledge. Note: If the local floodplain management official completed Section H, they should indicate in item G2.b and sign Section G. ❑ Check here if attachments are provided (including required photos) and describe each attachment in the Comments area. Property Owner or Owner's Authorized Representative Name: Address: Signature: Telephone: Ext.: Email: Comments: Date: State: ZIP Code: FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 6 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 BUILDING PHOTOGRAPHS See Instructions for Ttem AG. Building Street Address (Including Apt„ Unit, Sutter andlor Bldg. No.) or P.O. Route and Box No.: FOR INSU RANCE COMPANY USE 3003 Dapple Gray Way Policy Number: City: Ellensburg State: WA ZIP Code: 98926 Company NAIL Number: Instructions: Insert below at least two and when possible four photographs showing each side of the building (for example, may only be able to take front and back pictures of townhouseslrowhouses). Identify all photographs with the date taken and "Front View,"'Rear View," "Right Side View," or "Left Side View." Photographs must show the foundation. When flood openings are present, Include at least one dose -up photograph of representative flood openings or vents, as indicated in Sections A8 and A9. 7 Photo One Photo One Caption: Front View{;°(° trie` Photo Two Photo Two Caption: Side ViewIi;tQ`'wo FEMA Form FF 206-FY-22-152 (formerly 086-0-33) (10122) Page 7 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES "S BUILDING PHOTOGRAPHS Continuation Page Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 3003 Dapple Gray Way Policy Number; City: Ellensburg State. WA ZIP Code: 98926 Company NAIC Number., Insert the third and fourth photographs below. Identify all photographs with the date taken and "Front View,' "Rear View." 'Right Side View," or "Left Side View." When flood openings are present, Include at least one close-up photograph of representative flood openings or vents, as indicated in Sections A8 and A9. At N111 Photo Three I Photo Three Caption., Back View r-7 Photo Four Photo Four Caption: Side View qu FEMA Form FF-206-PY-22-152 (formerly 086-0-33) (10/22) Page 8 of 49 U.S. DEPARTMENT OF HOMELAND SECURITY OMB No.16W-0008 Federal Emergency Management Agency Expiration Date: November 30, 2022 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Cartficate and all attachments for (1) community official, (2) Insurance agent/company, and (3) building owner. SECTION A— PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owners Name Policy Number. SSHI LLC A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 2917 Dapple Gray Way City state ZIP Code 8lensbur+g Washington 98926 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Division 7 Lot 7, 962123 A4, Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latlude/Longitude: LeL N4T°01'29.56751" Long.W120°3444.95771" Horizontal Dalurn: ❑ NAD 1927 []x NAD 1983 A6. Attach at least 2 photographs of the building it the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1 B A8. For a building with a crawlspaoe or enclosure(s): a) Square footage of crawlspace or enclosure(s) NIA aq It b) Number of permanent flood openings in the cxawispace or anciosure(s) within 1.0 foot above adjacent grade NIA c) Total net area of flood openings in AB.b NIA sq in d) Engineered flood openings? ❑ Yes x❑ No A9. For a building with an attached garage: a) Square footage of attached garage 604.00 aU ff b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b OAO sq in d) Engineered flood openings? ❑ Yes ❑x No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State KtTTITAS COUNTY; 530095 KITTITAS Washington B4. MaplPanel 135. Suffix 86. FiRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) Number Date Effectivel Zone(s) (zone AO, use Base Flood Depth) Revised Date M37CIO84 D 09-24-2021 09-24-2021 AE 1590.2 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139: 0 FIS Profile ❑ FIRM ❑ Community Determined ❑ Other/Source: B11. indicate eevetion datum used for BFE in Item 89: ❑ NGVD 1929 []x NAVD 1968 ❑ OtherlSource: 812. Is the building located in a Coastal Bardter Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes FA] No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-"3 (12/19) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMPORTANT: In, these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, andfor Bldg. No.) or P.O. Route and Box No. Policy Number: 2917 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* EXI Finished Construction *A now Elevation Certificate will be required when construction of the building is complete. C2. Elevations -- Zones Al—A30, AE, AH, A (with BFE), VE, V1--V30, V (with BFE), Ali. ARIA, AR/AE, AR/A1—A30, AR1AH, AR/AO. Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: Center of S 27, T 18 N. R 18 E Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations In items a) through h) below. ❑ NGVD 1929 [E] NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) ff) feet ❑ meters b) Top of the next higher floor N/A ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet ❑ meters d) Attached garage (top of slab) 1591.3 x❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 1591.9 feet ❑meters (Describe type of equipment and Ivcalcan in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 1589.9 x❑ feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 1590.8 0 feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, Including structural support NIA ❑ feat ❑ meters SECTION D —SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This cartification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation Information. I certify that the Information on this Certificate represents my best etiaris to interpret the data available. I understand that any false statement may be punishable by fine or Impdsonmant under 98 U.S. Code, Sectlon 4001. Were latitude and longitude In Section A provided by a licensed land surveyor? l7 Yes ❑ No []Check here if attachments. Certifier's Name License Number Rick Skinner 43619 Title g]NAJV S ' WASyZ� Professional Land Surveyor U o Company Name t� e, 0. Western Pacific Engineering & Survey, Inc. rn ai Address 1224 S. Pioneer Way , r 819 ,$L City State ZIP Code Moses Lake Washington 98837 Signature Date Telephone E14Q�_ f (609) 765 1023 /-* /e 113 Copy all pa s of this Elevation derflocife Fend attachments fo 1) Wmniunity official, (2) insurance agenitoompany, and (3) building owner. Comments (including type of equipment and location, per C2(e). If applicable) The heat pump pad was shot with GPS to get elevation for the pad and added an additional 7 inches for the legs of the heat pump. FEMA Form 086-0-33 (12119) Replaces all previous editions. Form rage 2 of 6 ELEVATION CERTIFICATE OMB No. 1660,0008 Expiration Date: November 30, 2022 IMPORTANT: In These spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.Q. Route and Box No. Policy Number, 2917 Dapple Gray Way City Stale ZIP Code Company NAIC Number Ellensburg Washington 989226 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AD AND ZONE A (WITHOUT OFE) For Zones AO and A (without OFE), complete Items El —ES. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, Band C. For Items E1--E4, use natural grade, If available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawispace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 andlor 9 (see pages 1--2 of Instructions), the next higher floor (elevation C2.b In the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery andlor equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number Is available, Is the top of the bottom floor elevated In accordance with the community's floodplaln management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F — PROPERTY OWNER (Olt OWNER'S REPRESENTATIVE) CERTIFICATION The propertyy owner or owners authorized representative who completes Sections A. B. and E for Zone A (without a FEMA-issued or community -Issued BFE) or Zone AO must sign here. The statements In Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Scott Henson Address City State ZIP Code 1224 S. Pioneer Way Moses Lake Washington 98837 Signature Date Telephone (509) 765-1023 Comments ❑ Check here if attachments. FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No,) or P.O. Route and Sox No. Policy Number: 2917 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 . SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local of0dal who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, S. C (or E), and G of Ihis Elevation Certificate, Complete the applicable tiem(s) and sign below. Check the measurement used In Items G8--G10. in Puerto Rico only, enter meters. G1. ❑ Ths lnformation in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2 ❑ A community official completed Section E for a building located in Zone A (vAthout a FEMA-Issued or community -issued BFE) or Zone AO. G3 ❑ The following information (Items G4-G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy issued G7. This permit has been issued for. ❑ New Construction 0 Substantial Improvement G8. Elevation of as -built lowest floor (including basement) ❑del ❑meters Datum of the budding: GO, BFE or (In Zone AO) depth of flooding at the building site; ❑ feet ❑ meters Datum G10. Community'a design flood elevation: ❑ feet ❑ meters Datum Local Offlciars Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 4 of ti BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 2917 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 If using the Elevation Certificate to obtain NFIP flood Insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken, "Front View" and "Rear Vier`; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page, Phob On Photo One Caption Front View Clear Photo One r: i F.%F 'i max° i I�5 7T0m Iwo Photo Two Caption Side View Clear Pholo Two FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMB No. 1600-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Ap1., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 2917 Dapple Gray Way City State ZIP Code Company NAIC Number Ellensburg Washington 98926 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated In Section AS. '0. j r „4`..r. n RMWTW" Photo Three Caption gear VFaw Gear Photo Three AX Photo Four Photo Four Caption Side View Clear Photo Four FEMA Form 08"-33 (92/t9) Replaces all previous editions. Form Page 6 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 OMB Cord No. lew-mod 6apimilon Date: 030=26 copy an pages or tnrs t,ievatlon ueruticate and all attachments for (1) community official, (2) insurance agenVcompany, and 3) building owner. SEC FOR INSURANCE COMPANY USE Al. Building Owner's Name: SSHI LLC Policy Number: Aw- tsutlding Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box Company NAIC Number: No. :2915 lea le Gray Wa City: Ellensburg State: WA ZIP Code: 98926 A3. Properly Description (e.g., Lot and Block Numbers or Legal Description) and/or Tex Parcel Number: Division 7 Lot 8, 962124 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, eta): Residential A6. Laltude/Longlude: Lat. N47°01'28,32" Long, W120°34146.36" Horizontal Datum: ❑ NAD 1927 0 NAD 1983 Q WGS 84 A6. Attach at least two and when possible four clear photographs (one for each side) of the building (see Form pages 7 and 81 A7. Bullding Diagram Number: 1 B A8, For a building with a crawlspace or enciosure(s): a) Square footage of crowispace or enclosure(s): sq. fl. b) Is there at least one permanent flood opening on two different sides of each enclosed area? ❑ Yes ❑ No [fl N/A c) Enter number of permanent flood openings in the oraw ispace or enclosure(s) within 1.0 foot above adjacent grade: Non -engineered flood openings; Engineered flood openings: d) Total net open area of non -engineered (food openings In AB.c: &�`& $q. In. e) Total rated area of engineered flood openings in AB.c (attach documentation - see Instructions): _��"" sq. fl- f) Sum of A8.d and A8,e rated area (If applicable - see Instructions):- -— sq. fL A9. For a bugling with an attached garage: a) square footage of attached garage: 603.00 sq, ft, b) Is there at feast one permanent flood opening on two different sides of the attached garage? ❑ Yes [fl No ❑NIA c) Enter number of permanent flood openings In the attached garage within 1.0 foot above ad'acent grade: Non -engineered flood openings: &_±i Engineered flood openings: d) Total net open area of non -engineered flood openings in A9.a _ �1%f /� sq. in. e) Total rated area of engineered flood openings in A9.c (attach documentation -see Instructions); sq. ft. f) sum of A9.d and A9.e rated area (if applicable - see Instructions): sq. ft. - ' S Ctl'tQN f?OQD INSI)RAIE iTM1R t=IRM1111F_ .LN ` .�' r _ ... �- - r 81.9. NFIP Community Name: KITFITAS COUNTY 82. County Name: KiTTITAS Bl.b, NFIP Community Identification Number 630095 133. State: WA B4. Map/Panel No.: 53037C1064 Ba. Suffix; D 86. FIRM Index Date: 09/24/2021 87, FIRM Panel EffectivalRevised Date: 09/24/2021 88. Flood zone(s): AE 89. Base Flood Elevation(s) (BFE) (Zone AO, use Base Flood Depth); 1688.6 B10. Indicate the source of the BFE data or Base Flood Depth entered In Item 89: ❑x FIS ❑ FIRM ❑ Community Determined ❑ Other: 811. Indicate elevation datum used for BFE in Item 89: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Olhar/Souroe: B12. Is the building located in a Coastal Barrier Resouroas System (CBRS) area or Otherwise Protected Area (OPA)? [] Yes 0 No Designation Date: ❑ CBRS ❑ OPA B13. Is the building located seaward of the Limit of Moderate Wave Action (LWWA)7 Yes >< No FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10122) Page 2 of 19 ELEVATION CERTIFICATE IMPORTANT; MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 2915 Dapple Gray Way� Policy Number: _... City: Ellensburg State: WA ZIP Code: 98926 Company NAIC Number. Sk+;iTIt77 �¢ �fi111.1011V( EL�EVi�4�IQN`1Nf01#MA�i`19 �SlJ1i-1f�EQtifR�Rj' C1. Building elevations are based on: © Construction Drawings' ❑ Building Under Construction* Finished Construction 'A new Elevation Certificate will be required when construction of the budding Is complete, C2. Elevations - Zones Al A30, AS, AH, AO, A (with 8FE), VE, Vi-V30, V (with BFE), AR, ARIA, ARIAE, AR/A"30, AR/AH, AR/AO, A99. Complete Items C2.a-h below according 10 the Building Diagram specified In Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: Center of 8 27, T 18 K R 18 E Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations In items a) through h) below. 0 NGVD 1929 ❑x NAVD 1988 ❑ Other: Datum used for building elevations must be the some as that used for the BFE. Conversion factor used? ❑ Yes ❑f No If Yes, describe the source of the conversion factor In the Section D Comments area. Check the measurement used; a) Top of bottom floor (including basement, crawlspace, or enclosure floor): 1,590.00 Q feet ❑ meters b) Top of the next higher floor (see Inshudons): o2L feet ❑ meters c) Bottom of the lowest horizontal structural member (sae Instructions): ❑ feet ❑ meters d) Attached garage (top of slab): 1,590.00 ❑x feet ❑ meters e) Lowest elevation of Machinery and Equipment (M&E) servicing the building (describe type of M&E and location In Section D Comments area): 1,590.10 ❑x feet meters 0 Lowest Adjacent Grade (LAG) next to building: ❑ Natural Q Finished 1,588.80 0 feet ❑ meters g) Highest Adjacent Grade (HAG) next to building: ❑ Natural ❑x Finished 1,689.90 ❑x feet ❑ meters h) Finished LAG at lowest elevation of attached deck or stairs, Including structural support:%~' ❑ feet ❑ meters : S (3T UlIt SURV O t _ N( l�iEEft OR$Ai3 i 1T T ER• >FI j°►'Il0[ ' . - - - R.. �- - This oertiricatlon is to be signed and sealed by a land surveyor, engineer, or architect authorized by slate law to certify elevation Information. I certfly that the Information on this Cert"le represents my best efforts to lnterprel the data available. l understand that any false statement may be punishable by line orlmpdsonment under 18 U.S. Code, Section 1001. Were latitude and longitude'ln Section A provided by a licensed land surveyor? d Yes ❑ No Check here if attachments and describe in the Comments area. • R Certifiers Name: Rick Skinner License NumberA3619 Title: Professional Land Surveyor O VA Company Name: Western Pedfic Engineering & Survey, Inc. Address: 1224 S. Pioneer Way i-+ O City: Moses Lao Stale: WA ZIP Code; 98837 /Y , fSi1��' Signature: Date: 'K aI Telephone: (` 9176c5-1023 Ext.: Email: rskinner@WPelnc.tlet ,, .. ... Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) Insurance agent company, and (3) building owner. Comments (including source of conversion factor in C2; type of equipment and location per C2.e; and description of any attachments). - Heat Pump pad was measured at the top with the bottom of the heat pump raised an additional eight Inches with legs FEMA Form FF 206-FY-22-152 (formerly 086-0-33) (10122) Page 3 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 949 BuNdhg Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.D. Route and Box No.: FOR INSURANCE COMPANY USE 2915 Dapple Gray Way Policy Number. City: Ellensburg State: WA ZiP Code: 98926 Company NAIL Number. SECVON E-�BIJiLbI[ 1HlEi E1� A)IE I1FOlFtMAXION` SUR1IE1l' QT REQUIfq �) . 'FO�RZO1412 AQ;.aZQIU)E.d4�lAO,;At�D�Z4NE A �VlI1THOUT 8��� . . For Zones AO, ARIAO, and A (without SPE), complete Items E1-E6. For Items E1-54, use natural grade, If available. If the Cartilcate Is intended to support a Letter of Map Change request, complete Sections A, B, and C. Check the measurement used. In Puerlo Rico only, enter meters. Building measurements are based on: [] Construction Drawings' Building Under Construction" x❑ Finished Construction 'A new Elevation Certificate will be required when construction of the building Is complete, Ell. Provide measurements (C.2.n in applicable Building Diagram) for the following and check the appropriate boxes to show whether the measurement is above or below the natural HAG and the LAG, a) Top of bottom floor (including basement, orewlapaoe, or enclosure) is: _ _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspaoe, or enclosure) Is: ❑ feet ❑ meters [] above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions), the next higher floor (G2.b in applicable Building Diagram) of the building is: L] feet ❑ meters [] above or ❑ below the HAG. E3. Attached garage (top of slab) Is: ❑ feet ❑ meters ❑ above or ❑ below the HAti. E4. Top of platform of machinery and/or equipment servicing the building is: ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5, Zone AO only: If no flood depth number is available, is the top or the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown The local official must certify this information In Section G. SE I f=:. PFigFI=RT - 0 1r1 .((R QINIVEW A1T#AO 1ZE�-A1'"P, 011l +- TI' — The property owner or owneds authorized representative who completes Sections A, B. and E for Zone A (without BFE) or Zone AO must sign here. The statements In Sections A, S, and E are correct to the best of my knowledge ❑ Check here if attachments and describe in the Comments area. Property Owner or Owner's Authorized Representative Name: Scott Henson Address: 1224 S. Pioneer Way City; Moses Lake State: WA ZIP Code: 98837 Signature: gate:q Z ffh.3-j Telephone: (609) 765-1023 Ext.: Email: shenson@wpeinc.net I Comments: FEMA Form FF•-206-FY 22-162 (formerly 086-Q-33) (10122) Page 4 of 10 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 2915 Dapple Gray Way Policy Number - City! Ellensburg State: WA ZIP Code: 98926 Company NAIC Number: SECTION G -- COMMUNITY INFORMATION (RECOMMENDED FOR COMMUNITY OFFICIAL COMPLETION) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Section A, B, C, E, G, or H of this Elevation Certificate. Complete the applicable items) and sign below when: G1. ❑ The information in Section C was taken from other documentation that has been signed and seated by a licensed surveyor, engineer, or architect who is authorized by state law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area 'below.) G2.a. ❑ A local official completed Section E for a building located in Zone A (without a BFE), Zone AO, or Zone ARIAO, or when item E5 is completed for a Building located in Zone AO. G2.b. ® A local official completed Section H for insurance purposes. G3. ❑ In the Comments area of Section G, the local official describes specific corrections to the information in Sections A, B, E and H. G4. The following information (Items G5--G11) is provided for community floodplain management purposes. G5. Permit Number: FD-22-00013 G6. Date Permit Issued: 03/0212022 G7. Date Certificate of CompliancelOccupancy Issued: G8. This permit has been issued for: N New Construction ❑ Substantial Improvement G9.a. Elevation of as -built lowest floor (including basement) of the building: 1,590.00 0 feet ❑ meters Datum. NAVD 1988 G9.b• Elevation of bottom of as -built lowest horizontal structural ❑feet ❑meters Datum: member: G1O.a. BFE (or depth in Zone AO) of flooding at the building site: 1,588.50 0 feet ❑ meters Datum: NAVD 1988 G10.b. Comm unitys minimum elevation (or depth In Zone AO) requirement for the lowest floor or lowest horizontal structural member: 1,589.50 ❑x feet ❑ meters Datum: NAVD 1988 G11. Variance issued? ❑ Yes T]No if yes, attach documentation and describe in the Comments area. The local official who provides information In Section G must sign here. l have completed the Information in Section G and certify that it is correct to the best of my knowledge. If applicable, l have also provided specific corrections in the Comments area of this section. Local Official's Name: Samantha Cox Title: Water Resources Specialist NFIP Community Name: Kittitas County Telephone: (509) 962-7523 Ext.: Email: pubiiaworks@co.kittitas.wa,us Address: 411 N. Ruby Street, Suite 1 City: Ellensburg State: WA_ ZIP Code: 98926 Signature, Date. 09/2812023 Comments (ncluding a of equipment and location, per C2.e; description of any attachments; and corrections to specific information in Sections A, B, D, E. or H): FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 5 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O, Route and Box No.: FOR INSURANCE COMPANY USE 2915 Dapple Gray Way City: Ellensburg State. WA ZIP Code: 98926 Policy Number: Company NAIL Number: SECTION H — BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES (SURVEY NOT REQUIRED) (FOR INSURANCE PURPOSES ONLY) The property owner, owner's authorized representative, or local floodplain management official may complete Section H for all flood zones to determine the bullding's first floor height for Insurance purposes. Sections A. B, and I must also be completed. Enter heights to the nearest tenth of a foot (nearest tenth of a meter in Puerto Rico). Reference the Foundation Type Diagrams (at the end of Section H instructions) and the appropriate Building Diagrams (at the end of Section i instructions) to complete this section. H1. Provide the height of the top of the floor (as indicated in Foundation Type Diagrams) above the Lowest Adjacent Grade (LAG a) For Building Diagrams 1A,16, 3, and 5-9. Top of bottom floor (include above -grade floors only for buildings with subgrade crawlspaoes or enclosure floors) is. b) For Building Diagrams 2A, 2B, 4, and 6-9. Top of next higher floor (i.e., the floor above basement, crawlspace, or enclosure floor) is: 1.20 ❑x feet ❑ meters Q above the LAG ❑ feet ❑ meters Q above the LAG H2. Is all Machinery and Equipment servicing the building (as listed in Item H2 instructions) elevated to or above the floor indicated by the H2 arrow (shown in the Foundation Type Diagrams at end of Section H Instructions) for the appropriate Building Diagram? [:)Yes Q No SECTION I — PROPERTY OWNER (OR OWNER'S AUTHORIZED REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and H must sign here. The statements in Sections A. B, and H are correct to the best of my knowledge. Note: If the local floodplain management official completed Section H, they should indicate in Item G2.b and sign Section G. F] Check here if attachments are provided (including required photos) and describe each attachment in the Comments area. Property Owner or Owner's Authorized Representative Name: Address: City: Signature: Telephone: Comments: Ext.: Email: Date: ZIP Code: FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 6 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW TIME INSTRUCTIONS ON PAGES 9-19 BUILDING PHOTOGRAPHS See Instructions for Item A6. Building Street Address (Including Apt., Unit Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 2915 Dapple Gray Way City: Ellensburg State: WA ZIP Code: 98926 Policy Number: Company LAIC Number: Instructions: Insert below at least two and when possible four photographs showing each aide of the building (for example, may only be able to take front and back pictures of townhousestrowhousea). Identify all photographs with the date taken and `Front View," "Rear View," "Right Side View," or "Left Side View." Photographs must show the foundation. When flood openings are present, Include at least Ono close-up photograph of representative flood openings or vents, as indicated in Sections A8 and A9. Photo One Photo Two Photo Two Caption: Side View FEMA Form FF-206-FY 22-162 (formerly 086-0-33) (10/22) Page 7 of 19 ELEVATION CERTIFICATE IMPORTANT. MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.10 BUILDING PHOTOGRAPHS Continuatlon Page Building Street Address (Including Apt., Unit, Suite, andfor Bldg, No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 2915 Dapple Gray Way policy Number. City: Ellensburg State: WA zIP Code; 98926 Company NAIL Number. Insert the third and fourth photographs below. Identify all photographs with its; data taken and "Front View," "Rear View," "Right Side View," or "Left Side View." When flood openings are present, include at least one rose -up photograph of representative flood openings or vents, as indicated in Seotions A8 and Ag. Photo Three Photo Three Caption: Back View Photo Four Photo Four Caption: Side View FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10122) Page 8 of 119 U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency Natlonal Flood Insurance Program OMe Control No, IGBJI OODa f afplrallon bate: OB1=02$ ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.19 Copy all pages of this Elevation Cerlllicate and all attachments for (1) community of iclel, (2) Insurance agenUoompany, and (3) building owner. SECTION A— FROp.&T.Y INFORMATI©Id FOR INSURANCE COMPANY USE Al. Bullci ft Ownees Name: SSHI LLC Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box Company NAIL Number No-:2913 Rapple Gray Way --- Cliy: EilenSburg _ State: WA ZIP Code: 98926 A3. Property Description (e.g., Lot and Block Numbers or Legal Description) and/or Tax Parcel Number. Division 7 Lot 9, 962126 A4. Building Use (e,g., Residential, Non -Residential, Addition, Aooessory, etc.): Residential AS, Latituda/Longltude: Lat. N47'01'27.57" Long, W12W3446,88" Harlr_ontal Datum: ❑ NAID 1927 M NAD 1983 ❑ WG6 84 AS, Attach at least Iwo and when possible four clear photographs (one for each side) of the building (soo Form pages 7 and 6). A7. Building Diagram Number, 1 B A6. For a building with a crawispece or enckasure(s): a) Square footage of orawlepace or endosure(s): ty J'- sq. % b) Is thero at least one permanent flood opening on two different sides of each enclosed area? ❑ Yes ❑ No d N/A c) Enter number of permanent flood openings In the c rewispeco or enclosures) within 1.0 foot above adjacent grade: Nan -engineered (load openings, _.JjZ/ 47_ Engineered flood openings: d) Total net open area of non-eng1neered flood openings In AS,c: /A7 sq. in. a) Total rated area of engineered flood openings In AB.o (attach documentation — see Instructions): sq. ft. f) Sum of ASA and AB,e rated aroa (if applicable — see lnstrucWns):� sq. ft. A9. For a building with an attached garage: a) Square footage of attached garage: 451,00 sq. ft. b) Is there at least one permanent flood opening on two different sides of the attached garage? ❑ Yes ff] No ❑ N/A c) Enter number of permanent flood openings In the attached garage within 1.0 fool above adjacent grade: Non -engineered flood openings: A) [A_ Engineered flood openings: /(/ ff_' d) Total net open area of rwn-engineered flood openings in Ag.c: _/&� r sq. in. e) Total rated area of engineered flood openings In A9.e (attach documentation — sec Instructions): -NU sq. f. f) Sum of ADA and A9.e rated area (If applicable -- see InsinxAlons): _Nl+ sq. ft. aG4J runira � rr,.4»� 131.a. NFIP Community Name:KITTITAS COUNTY B2. County Name:KITTITAS 86. FIRM Index Dale: 09/24/2021 58. Flood zone(e): AE B1.b. NFIP Community Identification Number: 630095 B3. siate; WA B4. Map/Panel No.: 53037C1064 135. Suffix: D B7. FIRM Penal EffectivetRevised Date: 09)24/2021 B9. Base Flood Elevation(s) (OFE) (Zone AO, use Base Flood Depth): 1587.0 B10. Indicate the source of the BFE de la or Base Flood Depth entered in Item B9: 0 PIS ❑ FIRM ❑ Community Niermined ❑ Other, 1311. Indicate elevation datum used for BFE In Item BO: ❑ NGVD 1020 0 NAVD 1988 ❑ Othed/Sourco; 1312. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes M No Designation Date: ❑ CBRS ❑ OPA B13. Is the building located seaward of the Limit of Moderate Wave Action (LIMWA)? f7 Yes ❑x No FEMA Form FF-206-FY-22-152 (formerly 086-0.33) (10122) Page 2 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTrONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: 2913 Dapple Gray Way City. Ellensburg State: WA ZIP Code: 98926 C - BUILDING .ELEVATIOhi INFORMAMON {SURVE! FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number: C1. Building elevations are based on: d Construction Drawings' ❑ Building Under Construction" x❑ Finished Construction 'A now Elevation Certificate will be required when consiruatlon of the building Is complete. C2. Elevations - Zones Ai-A30, AE, AH, AO, A (with SFE), VE, V 1-V30, V (with SFE), AR, ARIA, AR/AE, ARJA1-A30, AR/AH, ARIAC), A99. Complete Items C2.a-h below according to the Building Diagram specified in Item A7. In Puerto Rico only, enter motors. Benchmark U1111aed: Center of S 27, T 18 N, R 18 E Vertical Datum: NAVD 1988 Indicate elevation datum used for the elavations In Items a) Through h) below. ❑ NGVD 1929 R)NAVD 198t1 ❑ Other. Datum used for building elevations must be the same as that used for the BFE. Conversion factor used? b Yes O No If Yes, describe the source of the conversion factor in the Section D Comments area. Check the measurement used: a) Top of bottom floor (including basement, crawlspaoa, or enclosure floor): 1,688.50 feet ❑ meters b) Top of the nerd higher floor (see Instructions): �/'� ❑ feel ❑ meters c) Bottom of the lowest horizontal structural member (see Instructions): /If ❑ feet ❑ meters d) Attached garage (top of slab): 1,588.50 feet ❑ meters a) Lowest elevation of Machinery and Equipment (M&E) servicing the building (describe type of M&E end location In Section D Comments area); 1,588.30 ❑x feet iJ meters f) Lowest Adjacent Grade (LAG) next to building: [] Natural n Finished 1,587.20 ❑ feet ❑ meters g) highest Adjacent Grade (HAG) next to building: ❑ Natural ® Finished 1,588.10 R1 feet ❑ meters h) Finished LAG at lowest elevation of attached deck or stairs, Including structural support: A © feel ❑ meters a w: rlv�r u ^ �vrcyC7 vim, FNV1PrrVK.2►K{rrll.I =U-rh11iA,1•lG7Pt this certification Is to be signed and sealed by a land surveyor, engineer, or architect authorized by stale law to certify elevation Information. ! codify that the information on this Cedithm(b rapmssnis my best efforts to Interpret the date available. ! understand that any false statement maybe punishable by fine orlWdsonment under f e U.S Code, Section 1001. Were letitudo and longitude in Section A provided by a licensed land surveyor? Q Yes: Q No © Check here If attachments and describe in the Comments area. Certifier's Name: Rfck Skinner License Number.43619 Title: Professional Land Surveyor Company Name: Western Pacific Engineering & Survey, Inc. Address: 1224 S. Pioneer Way City Moses L State: WA ZIP Code: 98837 Signature: Vk 4a. Date: Telephone: I ) 766-1023 ExL: Email: rsklnner@wpelnc.net Copy d pages of this Elevation Certificate and all attachments for (1) community official, (2) Insurance agenticompany, and (3) building owner. Commenls (including source of conversion factor In C2; type of equipment and location per C2.o; and description of any attachments): Heat Pump pad was measured at the top with the bottom of the heat pump ralsod an additional eight Inches with legs F'EMA Form FF 206-FY-22-162 (formerly 006-0-33) (10122) Page 3 of 18 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 0.19 Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.; FOR INSURANCE COMPANY USE 2913 Dapple Gray Way city: Ellensburg state: WA ZIP Code_ 98926 Panay Number: — Company NAIC Number: SEfaTION E BUIILI]1NG MEi tU' gMEN INFOR�IIIA' ON ($UfiV f NOT REQUIRED) pj FO UbNE-AO, ZONE AR1A0; AND ZONEA-(WITH61LIT BFE) For Zones AD, ARIAo, and A (without BFE), complete Items E1--E5. For Items E1-E4, use natural grade, If evababla. if the Cery ioate is Intended to support a Lsttor of Map Change request, complete Sections A, B, and C. Check the measurement used. In Puerto Rico only, enter meters. Building measurements are based on: ❑ construction Drawings' (] Building Under Construction• ❑ Finished Construction 'A new Elevation Certificate V411 be required when construction of the building is Complete, El. Provide measurements (C.2.a In applicable Building Diagram) for the following and check the appropriate boxes to show whether ills measurement is above or below the natural HAG and the LAG. a) Top of bottom floor (including basement, crawlspace, or enclosure) Is: ❑ feel ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, orawispace, or enclosure) Is: ❑ feet ❑ meters ❑ above or ❑ below the LAG, E2. For Building Diagrams 0-9 with pormonant flood openings provided In Section A Items 8 and/or 9 (see pages 1-2 or instructions), the next higher floor (C2.b In applicable Building Diagram) of the building W. ❑ feet ❑ meters ❑ above or [] below the HAG. E3. Attached garage (top of slab) Is; ❑ feet] meters ❑ above or n below the HAG. E4. Top of platform of machinery and/or equipment servicing the building Is: ❑ feel ❑ motors ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, Is the top of the bottom floor elevated in accordance with the onmmunitys fioodplaln management ordinance? ❑ Yes ❑ t4o. ❑ Unknown The local official must certify this Informatlan In Section G. S ECTOO)l F �- i'R PiERTY tiWIVLIZ (OR dWNER'8 AILIT'HOFtMft—ftEPR990TA'L1VE) OERTIFIGA'flt7N- ' The property owner or owner's authorized representative who completes Sections A, B. and E for Zone A (without BFE) or Zone AO must sign here. The statements In Ssotkm A. B, and E are correct to the best of my knowledge ❑ Chock here If attachments and describe In the Comments area. Property Owner or Owner's Authorized Representative Name: Scott Hanson Address: 1224 S. Pioneer Way city: Moses Lake — --- state: WA ZIP Code. 98837 Signature. Data: Telephone: (509) 755-1023 EA.. Email: shenson@nrpelnc.net Comments: FEMA Form FF-206-FY 22-152 (formerly 086-0-33) (10122) Page 4 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. route and Box No,: FOR INSURANCE COMPANY USE 2913 Dapple Gray Way Policy Number City: Ellensburg State: WA ZIP Code: 98926 Company NAIL Number: SECTION G — COMMUNITY INFORMATION (RECOMMENDED FOR COMMUNITY OFFICIAL COMPLETION) The local official who is authorized by taw or ordinance to administer the community's floodplain management ordinance can complete Section A, B, C, E, G, or H of this Elevation Certificate. Complete the applicable item(s) and sign below when: G1 • ❑ The information in Section C. was taken from other documentation that has been signed and seated by a licensed surveyor, engineer, or architect who is authorized by state law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2.a. ❑ A local official completed Section E for a building located in Zone A (without a BFE). Zone AO, or Zone AR1AO, or when item E5 is completed for a building located in Zone AO. G2.b. A local official completed Section H for insurance purposes. G3. ❑ In the Comments area of Section G. the local official describes specific corrections to the information in Sections A, B, E and H. G4. N The following information (Items G5--G11) is provided for community floodplain management purposes. G5. Permit Number. FD-22-00014 G6. Date Permit Issued: 03/02/2022 G7. Date Certificate of Compliance/Occupancy Issued: G8. This permit has been issued for: 0 New Construction ❑ Substantial Improvement G9.a. Elevation of as -built lowest floor (including basement) of the building: 1,588.50 ® feet ❑ meters Datum: NAVD 1988 G9.b. Elevation of bottom of as -built lowest horizontal structural member: Gi O.a. BFE (or depth in Zone AO) of flooding at the building site: G10.b. Community's minimum elevation (or depth in Zone AO) requirement for the lowest floor or lowest horizontal structural member: ❑ feet ❑ meters Datum: 1,587.00 0 feet ❑ meters Datum: NAVD 1988 1,588.00 ❑x feet ❑ meters Datum: NAVD 1988 Gil. Varianceissued? O Yes Z No If yes, attach documentation and describe in the Comments area. The local official who provides information in Section G must sign here. l have completed the information in Section G and certify that it is correct to the best of my knowledge. if applicable, l have also provided specific corrections in the Comments area of this section. Local Official's Name: Samantha Cox Title: Water Resources Specialist NFIP Community Name: Kittitas County Telephone: (509) 962-7523 Ext.: Email: publlcworks@co.kittltas.wa.us Address: 411 N. Ruby St., Suite 1 City: Ellensburg State: WA Signature: Date: 08/21/2023 ZIP Code: 98926 Comments (including type of equipment and location, per C2.e; description of any attachments; and corrections to specific information in Sections A. B, D, E, or H): FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10122) Page 5 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 2913 Dapple Gray Way Policy Number: City: Ellensburg State: WA ZIP Code: 98926 Company NAIC Number: SECTION H — BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES (SURVEY NOT REQUIRED) (FOR INSURANCE PURPOSES ONLY) The property owner, owners authorized representative, or local floodplain management official may complete Section H for all flood zones to determine the building's first floor height for insurance purposes. Sections A, B, and I must also be completed. Enter heights to the nearest tenth of a foot (nearest tenth of a meter in Puerto Rico). Reference the Foundation Type Diagrams (at the end of Section H Instructions) and the appropriate Building Diagrams (at the end of Section I Instructions) to complete this section. 1-11. Provide the height of the top of the floor (as indicated in Foundation Type Diagrams) above the Lowest Adjacent Grade (LAG): a) For Building Diagrams 1A, 16. 3, and 5-9. Top of bottom 1.30 x❑ feet meters g above the LAG floor (include above -grade floors only for buildings with subgrade crawlspaces or enclosure floors) is: b) For Building Diagrams 2A, 213, 4, and 6-9. Top of next NIN❑ feet ❑ meters ❑ above the LAG higher floor (i.e., the floor above basement, crawlspace, or endosure floor) is: 1-12_ Is all Machinery and Equipment servicing the building (as listed in Item H2 instructions) elevated to or above the floor indicated by the H2 arrow (shown in the Foundation Type Diagrams at end of Section H instructions) for the appropriate Building Diagram? ❑ Yes Q No SECTION I — PROPERTY OWNER (OR OWNER'S AUTHORIZED REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A. B, and H must sign here. The statements in Sections A. S, and H are correct to the best of mg knowledge. Note: If the local floodplain management official completed Section H, they should indicate in Item G2.b and sign Section G. ❑ Check here ff attachments are provided (including required photos) and describe each attachment in the Comments area. Property Owner or Owner's Authorized Representative Name: Address., City: State, ZIP Code: Signature: Date: Telephone: Fad.: Email: Comments: FEMA Form FF-206-FY-22.152 (formerly 086-0-33) (10I22) Page 6 of 19 ELEVATION CERTIFICATE IMPORTANT; MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.19 BUILDING PHOTOGRAPHS See Instructions for Item A& Building Street Address (including Apt., Unit, Suite, and/ar Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 2913 Dapp !e Gray Way City; Ellensburg State: WA ZIP Code: 98928 Policy Number. Company NAIC Number: Instructions: Insert below at least two and when possible Four photographs showing each side of the building (for example, may only be able to take front and back pictures of townhouses/rowhouses). Identify all photographs with the date taken and "Front View; "Rear View," "Right Side View," or "Left Side View' Photographs must show the foundation. When flood openings are present, Include at least one close-up photograph of representalive flood openings or vents, as Indicated In Sections AB and A9. Photo One Photo One Capton: Front View Clear photo One 41 11 ' �,'ti-� ♦� -�fytllLiy'' Z-01A. Iz-- 1 '4 •�ir.`i.'y1'I '{�,'i{/��il {S.�y{FP aL-. 11.:r Photo TWO Photo Two Caption: Side View wear Photo Two FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 7 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.19 BUILDING PHOTOGRAPHS Continuation Page Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Sox No.: FOR INSURANCE COMPANY USE 2913 Dapple Gray Way City: Ellensburg State: WA ZIP Code: 98926 Policy Number. Company NAIC Number: Insert the third and fourth photographs below. Identify all photographs with the date taken and "Front View," "Rear View," "Right Side Viaw ` or "Left Side View.' When flood openings are present, Include at least one Close-up photograph of representative flood openings or vents, as indicated in Sections A8 and A9. Photo Three Photo Three Caption: Back View Photo Four Photo Four Caption: Side View Clear Photo Three Cleer Photo Faur FEMA Form FF-206-FY-22-152 (formerly 0864-33) (10/22) Page 6 of 19 Policy Number. A2. Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box Company NAIC Number: NO-:2911 Dapple Gray)Noy rt_ City: Ellensburg slate: WA ZIP Code: 98926 A3. Properly Description (e.g„ Lot and Block Numbers or Legal Description) and/or Tax Parcel Number. Division 7 Lot 10.962126 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, eta): Residential _ A5. Latitudell-ongltude: Lot. N47001,34.91581 long. W120°34'37.02S Horizontal Datum: ❑ NAD 1927 [E NAD 1983 ❑ WGS 84 A6. Attach at least two And when possible four rear photographs (one for each side) of the building (see Form pages 7 and 8). AT Building plagram Number, 115 AS. For a building with a crawispace or enclosure(s): a) Square footage of crawlspace or enclosure(s): Al /* sq. ft. b) Is there at least one permanent flood opening on two different sides of each enclosed area? [] Yes Q No N/A c) Enter number of permanent flood openings In Ilia crawlspace or enclosure(s) within 1,0 foot above adjacent grade: Non-angineered flood openings: �1 / IA— ^ Engineered hood operngs: Aj%- d) Total not open area of non -engineered Rood openings in A8.c: .. Vi sq. in. e) Total rated area of engineered flood openings in AB.c (attach documentation — see Instructions):%� sq. ft. f) Sum of A&d and Ae.e rated area (it applicable — see Instructions): A9. For a building with an attached garage: a) Square footage of attached garage: 604.00 sq. fL b) is there at least one permanent flood opening on two different sides of the attached garage? ❑ Yes [x] No ❑ NIA c) Enter number of permanent flood openings in the attached garage with In 1.0 foot above adjacent grade: Non -engineered Hood openings: ___N /.f- Enginearad flood openings: d) Total net open area of non -engineered flood openings In AB.c. _ AWL sq. In, e) Total rated area of engineered flood openings In A9.c (attach documentation — see Instructions): _A/_� sq. R. f) Sum of Ag.d and AS.e rated area (if applicable — see Instructions): IV = sq. ft. _S�G`I"lUl►i g.—fifAOp°IlCgB��Ri#Ai�f_ RATI=>1VIAP (FlRlyli:II�FQRMA'TdON _ Bl.a. NFIP Community Name: KiTTITAS COUNTY 1311. NFIiCommunity Identification Number, 630095 B2. County Name:KITTITAS B3. State: WA B4. MaplPanal No.: 53037CIO64 65. Suffix: D 06, FIRM Index Dale: 0912412021 1218. Flood Zone(s): AE U.S. DEPARTMENT OF HOMELAND SECURITY OMB Co7aarro. ie$o-om Federal Emergency Management Agency ExplredmDale: 0OW2028 National Flood Insurance Program ELEVATION CERTIFICATE IMPORTANT. MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.19 Copy all pages of this Elevation Cartificste and all allachments for (1) community official, (2) Insurance agentlCompany, and (3) bulding owner. stdv N A — PROAEikr"Y. INFDRMAtWIiO FOR INSURANCE COMPANY uSE Al. Building Owner's Name: SSHI LLC B7. FIRM Panel Effective/Revlsad Date; 09/24/2021 B9. Base Flood Elevation(s) (BFE) (Zone AO, use Buse Flood Depth): 1585.9 B10. Indicate the source of the 8FE data or Base Flood Depth entered In Item 139: r❑ FIS [] FIRM ❑ Community Determined 0 Other: 811. Indicate elevation datum used for BFE in Item B9: r] NGVD 1929 0 NAVD 1988 Q Other/Source: B12. Is the building located In a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? © Yes x0 No Designation Date: [] CBRS C] OPA 013. Is the building located seaward of the Lsmn of Moderate Wave Action (LIMWA)? M Yes Fxl No FEMA Form FF-206-FY-22�152 (formerly 086-M3) (1 t1/22) Page 2 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No,: 2911 Dapple Gray Way City: EilensbuT state: WA ZIP Code: 98926 :(S LilZVEY�'F FOR INSURANCE COMPANY USE Policy.Number Company NAIL Number: C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction` [E Finished Constmalion 'A new Elevation Certificate will be required when construotbn of the building is complete. C2. Elevations- Zones Al-A30, AE, AN, AO, A (vrllh SFE=), VE, V1V30, V (with 8FE), AR, ARIA, ARIAS, AR/A1-A30, AR/AH, ARIAO, A99. Complete Items C2.a-h below according to the Building Diagrarn spedfled in Item Al. in Puerto Rico only, enter meters. Benchmark U1110ad: Center of S 27, T 18 N, R 18 E Verlicel Datum: NAVD 1988 Indicate elevation datum used for the elevations In items a) through h) below. ❑ NGVD 1929 d NAVD 1988 ❑ Othar: Datum used for building elevations must be the some as that used for the BFE. Conversion factor used? ❑ Yes 0 No If Yes, describe the source of the conversion factor in the Section D Comments area. Check the measurement used: a) lop of bottom Poor (including basement, cr2iwlspace, or enclosure Boar): 1,588.00 0 feet ❑ meters b) Top of the next higher Boor (see Instructions): - - j% L& ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (see Instructions): "4 [] feet ❑ meters d) Attached garage (top of slab): 1,588.00 x❑ feet ❑ meters e) Lowest elevation of Machinery end Equipment (M&E) servicing the building (descrbe type of M&E and location In Section D Comments area): 1.588.10 0 feet ❑ meters 0 Lowest Adjacent Grade (LAG) next to building: ❑ Natural Finished 1,586.70 0 feat ❑ meters g) Highest Adjacent Grade (HAG) next to building: E] Natural Finished 1.687.90 Q feet ❑ meters h) Finished LAG at lowest elevation of attached deck or stales, including structural support: 611A ❑ feet ❑ meters 1 octI6N 6- SURVE0-01t, ENGINEER, 6 k ARGNi ECf -C- &TiFIFA"h N This certIficallon Is to be signed and sealed by a land surveyor, engineer, or architect authorized by slate law to certByy elevation Information. I cenyty that the information on this Ced/ffcate represents my best efforts to interpret the data eveffahle. I understand that any false statement may he punishable by tine or imprisonment tinder 18 U.S. Code, Section 1001. Were laliluda and longitude in Section A provided by a licensed land surveyor? ❑x Yes [] No ❑ Check here if attachments and describe in the Comments area, Cerliffefs Name: Rlok Skinner License Number:43619 p 0...1•.MN V role.- Professional Land Surveyor Company Name: Western Pacific Engineering & Survey, Inc. 4� Ov _ f Address: 1224 S. Pioneer Way City: Mown s L State. WA ZIP Code: 98837 +� 43fi19f Signature: Date: Telephone: ) 766-1023 ExL: Email: rskinner@wpeinc.net oe sRAI Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) Insurance ageriftmpany, and (3) building owner. Comments (including source of conversion factor In C2; type of equipment and location per C2.e; and description of any attachments] Heat Pump pad was measured at the top with the bottom of the heat pump raised an additional eight inches With legs 1=EMA Form FF-206-FY-22-152 (formerly ON-0-33) (1002) Page 3 of 19 J ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.. FOR INSURANCE COMPANY USE 2911 Dapple Gray Way o icy Number: _ City: Ellensburg State: WA ZIP Code: 98926 Company NAIC Numbaf; $Ei0-i E;- 00l #lWG M-E'A S REMENr INFORNIATIOM ( 11RV ' 11t07 I:WJR�D} For Zones AO, AR/AO, and A (without BFE), complete Items E1-E& For llama Ei E4, use natural grade, if available. if the Certificate is intended to support a Letter of Map Change request, complete Sections A, B, and C, Check the measurement used. In Puerto Rloo only, enter meters. Building measurements are based on: ❑ Construction Orawings" ❑ Building Under Construction' ❑ Finished Construction iA new Elevation Certificate will be required when construction or the building Is complete. E1. Provide measurements (C.2.a In applicable Building Diagram) for the following and check the appropriate boxes to show whether the measurement Is above or below the natural HAG and the LAG. a) Top of bottom floor (including basement, aawlspace, or enclosure) is: (:1 feel ❑ meters ❑ above or [] below the HAG. b) Top of bottom floor (including beacmeniL crawlspace, or enclosure) is; ] feet ❑ meters ❑ above or ❑ below the LAG. E2, For Building Diagrams 6-9 with permanent flood openings provided In Section A items 8 and/or 9 (see pages 1-2 of Instructions), the next higher floor (C2.b in applicable Building Diagram) of the building Is; [] feet ❑ meters ❑ above or E] below the HAG. E3. Attached garage (top of slob) Is. [j feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building Is: ❑ feet ❑ meters 0 above or ❑ below the HAG, ES. zone AO only: If no Rood depth number Is available, is the top of the bottom floor elevated In accordance with the communitl/s Roodpiain managomont ordinance? 0 Yes ❑ No ❑ Unknown The local official must certify this informatlon In Section G. SEC- ON F= PROPERTY OWN r (OR OWNER"S-.AUTHORIZr=D•REPRESENTATIV:E.) CERTIFICATION The property owner or owner's authorized representative who completes Sections A. B, and E for Zone A (without BF12) or Zone AO must sign here. The alefe n6nis /n Sections A, 8, and l: are coffee( to the best of my knowledge ❑ Check here if attachments and describe in the Comments area. Property Owner or Owner's Authorized Representative Name: Scott Henson Address:1224 S. Pioneer Way City.. Moses Lake State: WA ZIP Code: 98837 signature., _ Dale: %� Telephone: (609) 765.1023 EA.: -_ Email: shenson@wpeinc.net Comments. FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 4 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE Polley Number: 2911 Dapple Gray Way City: Ellensburg State: WA ZIP Code: 98926 Company NAIL Number: SECTION to — COMMUNITY INFORMATION (RECOMMENOEO FOR COMMUNITY OFFICIAL COMPLETION) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Section A, B, C, E, G, or H of this Elevation Certificate. Complete the applicable item (a) and sign below when: G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer. or architect who is authorized by state law to certify elevation information. (Indicate the source and date of the elevation data In the Comments area below.) G2.a. ❑ A local official completed Section E for a building located in Zone A (without a BFE), zone AO, or Zone ARIAO, or when item E5 is completed for a building located in Zone AO. G2.b. A local official completed Section H for insurance purposes. G3. In the Comments area of Section G, the local official describes specific corrections to the information in Sections A, B, E and H. G4, The following information (Items G5—G11) is provided for community floodplain management purposes, G5• Permit Number: FD-22-00015 G6. Date Permit Issued: 03/02/2022 G7. Date Certificate of Compliance/Occupancy Issued: 08/18/2023 G8. This permit has been issued for: ❑x New Construction ❑ Substantial Improvement G9.a. Elevation of as -built lowest floor (including basement) of the building: 1,588.00 [K feet ❑ meters Datum: NAVD 1988 G9.b. Elevation of bottom of as -built lowest horizontal structural ❑ feet ❑ meters member: Datum: G 10.a. BFE (or depth in Zone AO) of flooding at the building site: 1,585,90 Q feet ❑ meters Datum: NAVD 1988 G10.b. Community's minimum elevation (or depth in Zone AO) requirement for the lowest floor or lowest horizontal structural member: 1,586.90 El feet ❑ meters Datum: NAVD 1988 G11. Variance issued? ❑ Yes 0 No If yes, attach documentation and describe in the Comments area. The local official who provides information In Section G must sign here. f have completed the information in Section G and certify that it is correct to the best of my knowledge, if appiicable, I have also provided specific corrections in the Comments area of this section. Local Official's Name! Samantha Cox Title: Water Resources Specialist NFIP Community Name: Kittitas County Telephone: (509) 962-7523 Ext.: Email: publicworks@co.kittitas.wa.us Address: 411 N. Ruby St., Suite 1 City: Ellensburg State: WA ZIP Code: 98926 Signature: Date: 08118/2023 Comments (including type of equipment and location, per C2.e; description of any attachments; and corrections to specific information in E, H): Sections A, B. D, or FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 5 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE Policy Number: 2911 Dapple Gray Way City: Ellensburg State: WA ZIP Code. 98926 Company NAIL Number: SECTION H — BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES (SURVEY NOT REQUIRED) (FOR INSURANCE PURPOSES ONLY) The property owner, owner's authorized representative, or local floodpiain management official may complete Section H for all flood zones to determine the building's first floor height for insurance purposes. Sections A, B. and I must also be completed. Enter heights to the nearest tenth of a foot (nearest tenth of a meter in Puerto Rico). Reference the Foundation Type Diagrams (at the end of Section H instructions) and the appropriate Building Diagrams (at the end of Section l instructions) to complete this section. Hi, Provide the height of the lop of the floor (as indicated in Foundation Type Diagrams) above the Lowest Adjacent Grade (LAG): a) For Building Diagrams 1A, 113, 3, and ". Top of bottom 1.30 Q feet ❑ meters ❑x above the LAG floor (include above -grade floors only for buildings with subgrade crawlspaces or enclosure floors) is: b) For Building Diagrams 2A, 213, 4, and 6-9. Top of next ❑ feet ❑ meters ❑ above the LAG higher floor (Le_, the floor above basement, crawlspace, or enclosure floor) is: H2. Is all Machinery and Equipment servicing the building (as listed in Item H2 instructions) elevated to or above the floor indicated by the H2 arrow (shown in the Foundation Type Diagrams at and of Section H instructions) for the appropriate Building Diagram? ❑ Yes ❑x No SECTION I -, PROPERTY OWNER (OR OWNER'S AUTHORIZED REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B. and H must sign here. The statements in Sections A, B, and H are correct to the best of mgknowledge. Note: If the local floodplain management official completed Section H, they should indicate in Item G2.b and sign Section G. ❑ Check here if attachments are provided (including required photos) and describe each attachment in the Comments area. Property Owner or Owner's Authorized Representative Name: Address: City. State: ZIP Code: Signature: Date: Telephone: Ext.: Email: Comments: 1=EMA Form FF-206-FY-22-152 (formerly 08"-33) (10/22) Page 6 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 BUILDING PHOTOGRAPHS See Instructions for item A6. Building Street Address (Including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No.-, FOR INSURANCE COMPANY USE 2911 Dapple Gray Way City: Ellensburg State, WA ZIP Code: 98926 Policy Number: Company NAIC Number. Instructions: Insert below at least two and when possible four photographs showing each side of the building (for example, may only be able to take front and back pictures of townhouses/rowhouses). Identify all photographs with the date taken and "Front View," "Rear View," "Right Side View," or "Left Side View." Photographs must show the foundation. When flood openings are present, include at least one Close-up photograph of representative flood openings or vents, as Indicated in Sections A8 and A9. Photo One Photo One Caption: Front View Photo TWO Photo Two Caption: Side View Cfear Photo One Geer Photo Twa FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (16122) Page 7 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 949 BUILDING PHOTOGRAPHS Continuation Page Building Street Address (including Apt., Unit, Suite, and/or Bidg, No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 2911 Dapple Cray Way City: Ellensburg State: WA ZIP Code: 98926 Policy Number. Company NAIL Number. Insert the third and fourth photographs below. Identify all photographs with the date taken and "Front View," "Rear View," "Right Side View; or "Left Side View." When flood openings are present, include at least one close-up photograph of representative flood openings or vents, as indicated in Sections A8 and A9. Photo Three Photo Three Cspiion: 6acl[ View Photo Four Photo Four Caption: Side View Clear Photo Three Clear Photo Pour FEMA Form FF-206-FY-22-152 (formedy 086-0-33) (10122) Page a of i9 U.S. DEPARTMENT OF HOMELAND SECURITY OMB Control No, 16804 B Federal Emergency Management Agency Eo`aft °ate' ors 2M National Flood Insurance Program ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Copy all pages of this Elevation Certificate and all attachments for (1) community official. (2) insurance anent/comnenv. and f31 bulldina owner. $ELONv4-pRDPEt31Y1NFO�M�!1TIf FOR INSURANCE COMPANY USE Al. Building Owner's Name: SSHI LLC Policy Number: A2. Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box Company NAIL Number: NO,: 2905 Dapple Gray Way City: Ellensburg State: WA ZIP Code: 98926 A3. property Description (e.g„ Lot and Block Numbers or legal Description) and/or Tax Parcel Number: Division 7 Lot 13, 962129 A4. Building Use (e.g., Residential, Non -Residential, Additlon, Accessory, etc.): Residentlai A6. Latitude/Longitude: Lat, N47°01'23.69" Lang, W120°3444.64" Horizontal Datum: ❑ NAD 1927 a) NAD 1983 ❑ WGS 84 A6. Attach at least two and when possible four clear photographs (one for each side) of the building (see Form pages 7 and 8). A7. Building Diagram Number: 1 B A8. For a building with a crawispaos or encloeure(a): a) Square footage of crawispaos or anclosure(s): Y� %,iE" sq, ft. b) is there at least one permanent flood opening on two different sides of each enclosed area? ❑ Yes ❑ No x❑ N/A c) Enter number of permanent flood openings in the crawlspace or andosure(s) within 1.0 foot above adjacent grade: Non -engineered flood openings: �L�— Engineered flood openings: A114 d) Total not open area of non-angineered flood openings in A8,c: sq. In. a) Total rated area of engineered flood openings In A8.c (attach documentation — see Instructions): Y— sq. ft. Sum of A8,d and A8.e rated area (if applicable» see Instructions): eq. ft, A9. For a building with an attached garage: a) Square footage of attached garage: 604.00 sq. ft. b) Is there at least one permanent flood opening on two different sides of the attached garage? ❑ Yes [fl No [] N/A o) Enter number of permanent flood openings In the attached garage within 1.0 foot above adjacent grade: Non -engineered Hoed openings: Z. Engineered flood openings: /yu�` d) Total net open area of non -engineered flood openings in A9.c:Zsq. In. e) Total rated area of engineered flood openings in A9.c (attach documentation —see Instructions): JV1 sq. fL f) Sum of A9.d and A9.a rated area (if applicable — see Instructions): sq. ft. - tiff7bi 8 '� 1`1D4b 1N 11 AIGE_R;4T 1tIi 0.P (FIRCillytlt FQR IxIi3N B1,a, NFIP Community Name: K)TTITAS COUNTY 131.b. NFIP Community Identification Number: 630095 82. County Name:KITTITAS B3. State: WA 134. Map/Panel No.: 63037C1064 85. Suffix: D 136. FIRM Index Date: 09/24/2021 B7. FIRM Panel Effective/Revised Date: 09/24/2021 Be. Flood Zone(s): AE B9. Base Flood Elevation(s) (BFE) (Zone AO, use Base Flood Depth): 1584.8 810. Indicate the source of the BFE data or Base Flood Depth entered in Item 139: [Z] FIS ❑ FIRM ❑ Community Determined ❑ Other 811. Indicate elevation datum used for BFE In Item 139: ❑ NGVD 1929 E NAVD 1988 ❑ Other/Source: B12. Is the building located In a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes R]No Designation Date: ❑ CBRS ❑ OPA 813. Is the building located seaward of the Limit of Moderate Wave Action (LIMWA)? ❑ Yes x No FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10122) Page 2 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.19 Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P,O, Route and Box No,: FOR INSURANCE COMPANY USE 2906 Dapple Gray Way ^ Policy Number: _ City: Ellensburg Stale: WA ZIP Code: 96926 Company NAIC Number: Ui>r... - C1. Building elevations are based on: ❑ Construction Drawinge ❑ Building Under Construction„ Finished Construction "A new Elevation Certificate will be required when construction of the building Is complete. C2. Elevations -Zones Al-A30, AE, AH, AO, A (with BFE), VE, V11--V30, V (with BFE), Aft, ARIA, AR/AE, AR/Al-A30, ARIAH, AR/AO, A99. Complete Items C2.a-h below according to the Building Diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: Center of S 27, T 18 N, R 18 E _ Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. [] NGVD 1929 ❑x NAVD 1988 ❑ Other: Datum used for building elevations must be the same as that used for the BFE. Conversion factor used? ❑ Yes 0 No If Yes, describe the source of the conversion factor In the Section D Comments area. Check the measurement used: a) Top of bottom floor (including basement crawlspace, or enclosure floor), 1587.40 ❑x feet ❑ meters b) Top of the next higher floor (we Instructions): &64 ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (see Instructions): /Vffj. ❑feel ❑meters d) Attached garage (top of slab): 1,587.40 [j] feet © meters e) Lowest elevation of Machinery and Equipment (M&E) servicing the building (describe type of M&E and location in Section D Comments area): 1,587.10 E feet ❑ meters f) Lowest Adjacent Grade (LAG) next to building: [] Natural ❑x Finished 1,586A0 Q feet ❑ meters g) Highest Adjacent Grade (HAG) next to building: ❑ Natural Finished 1,587A0 x[` feet ❑ meters h) Finished LAG at lowest elevation of attached deck or stairs, Including structural support: ❑ feet ❑ meters yr1.LIRV?YO, 11E�R, ORIR�I�IT!*il (t:RTllr1"4� -` j. This oertification is to be signed and sealed by a land surveyor, engineer, or architect authorized by state law to certify elevation Information. I codify that the Information on this Certtflcats represents my best efforts to Interpret the data available. / understand that any false statement maybe punishable by fine orimp6sonmenf under 18 U.S. Code, Section 1001. Were latitude and longfiude In Seotlon A provided by a licensed land surveyor? M Yes ❑ No ❑ Check here if attachments and describe in the Comments area. Certifier's Name: Rick Skinner License Number:43619 Tate: Professional Land Surveyor �, p WAS N. G Company Name: Western Pacific Engineering & Survey, Inc. a� c� 1 O} Address: 1224 S. Pioneer Way - city: Moses L 4 y State: WA Zip Code: 98837 361eQ: Signature: __--..� - Date:?// '1L-fvAi3� Telephone; (509} 765-1023 ExU Email: rskinner@wpeinc.net Pe i g►f �•r Copy all pages of this Elevation Certificate and all attachments for (t) community official, (2) insurance agenUcompany, and (3) building owner. Comments (including source of conversion factor in C2; type of equipment and location per C2.e; and description of any attachments): Heat Pump pad was measured at the top with the bottom of the heat pump raised an additional eight inches with legs FEMA Form FF-206-FY-22 162 (formerly 086-"3) (1(/22) Page 3 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 949 Building Street Address (Including Apt., Unit, Suhe, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE Policy Number.,. 2905 Dapple 9_Ty_Way City: Ellensburg Slate: WA ZIP Cade: 98926 Company NAlC Number CION'=f.�E7f1oD111G 11(tIF REI#EN7 iPIFOR11iIiTtOidSRE1f'tNOT-EWL)iE[?) y. FORt��11Lo AD; �01� I1R11O AND.ZQhI�-PrllNiiTFIOIJT BF ; For Zones AO, ARIAO, and A (without BFE), complete Items Ei—ES. For Items Et—E4, use natural grade, if available. If the Certificate Is Intended to support a Lefler of Map Change request, complete Sections A, B, and C. Check the measurement used. In Puerto Rica only, enter meters. Building measurements are based on: ❑ Construction Drawings' ❑ Building Under Construction' ❑x Finished Construction 'A new Elevation Certificate will be required when construction of the bullding is complete. E1. Provide meawsuraments (C.2.a in applicable Building Diagram) for the following and check the appropriate boxes to show whether the measurement Is above or below the natural HAG and the LAG. a) Top of bottom floor (including basement, crawispawce, or enclosure) Is: _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, orawlspace, or enclosure) Is: ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Olagrarns 6-9 with permanent flood openings provided In Section A Items 8 and/or 9 (see pages 1 2 of Instructions), the next higher floor (C2.b In applicable 9ulding Diagram) of the building is: ❑ feet ❑ meters ❑ above ar ❑ below the HAG. E3. Attached garage (top of slab) is: ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is: feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated In accordance with the oommunity's tioodplain management ordinance? ❑ Yes ❑ No j] Unknown The local official must certify this information In Section G. TO: _.'aID� . SE GYYR3IEFHA�- The property owner or ownee-9 aulhodzed representative who completes Sections A. B, and E for Zone A (Wthout BFE) or Zone AO must sign here. The statarnants In Sections A 8, and /= are correct to the best of my knowledge ❑ Check here If attachments and describe In the Comments area. Property Owner or Ownets Authorized Representative Name: Scott Henson Address: 1224 S. Pioneer Way City: Moses Lake State; WA ZIP Code: 98837 /] Signature: / Date: s�,r) Telephone: (509) 765-1023 Ext.: Email: shenson@wpeinc.net Comments: FEMA Form FF•206-FY 22-152 (formerly 086-0-33) (10122) Page 4 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt.. Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No.: 2905 Dapple Gray Way City: Ellensburg State: WA ZIP Code: 98926 FOR INSURANCE COMPANY USE Policy Number. Company NAIL Number: SECTION G - COMMUNITY INFORMATION (RECOMMENDED FOR COMMUNITY OFFICIAL COMPLETION) The local official who is authorized by law or ordinance to administer the community's floodplain management- ordinance can complete Section A, B, C, E. G, or H of this Elevation Certificate. Complete the applicable items) and sign below when: G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by slate law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2.a, ❑ A local official completed Section E for a building located in Zone A (without a BFE), Zone AO, or Zone AR/AO, or when item E5 is completed for a building located in Zone AO. G2.b. ® A local official completed Section H for insurance purposes. G3. ❑ In the Comments area of Section G, the local official describes specific corrections to the information in Sections A, B, E and H. G4, Z The following information (Items G5-1311) is provided for community floodplain management purposes. G5. Permit Number: FD-22.00018 136. Date Permit Issued: 03/02/2022 G1. Date Certificate of Compliance/Occupancy Issued; G8_ This permit has been Issued for: 9 New Construction ❑ Substantial Improvement G9-a. Elevation of as -built lowest floor (including basement) of the building: 1,587.40 x❑ feet ❑ meters Dalum: NAVD 1988 G9.b. Elevation of bottom of as -built lowest horizontal structural 1 ❑feet ❑meters Datum: member: �V G10.a. BFE (or depth in Zone AO) of flooding at the building site: 1,584.80 ❑x feet ❑ meters Datum: NAVD 1988 G10.b. Community's minimum elevation (or depth in Zone AO) requirement for the lowest floor or lowest horizontal structural member. 1,585.80 0 feet ❑ meters Datum: NAVD 1988 Gil. Variance issued? ❑ Yes M No if yes, attach documentation and -describe in the Comments area. The local official who provides Information in Section G must sign here. I have completed the information in Section G and Certify that it is correct to the best of my knowledge, if applicable, I have also provided specific corrections in the Comments area of this section. Local Official's Name: Samantha COX NFIP Community Name: Kittitas Cour Title; Water Resources Specialist Telephone: (509) 962-7523 Ext.: Email: publictivorks@co.khtitas.wa.us Address: 411 N. Ruby Street, Suite 1 City: Ellensburg Slate: WA ZIP Code: 98926 Signature., Comments (including t! Sections A, S, b, E, or Date.. 09/28/2023 of equipment and location, per C2.e: description of any attachments; and corrections to specific information in FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 5 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: 2905 Dapple Gray Way City: Ellensburg State: WA ZIP Code: 98926 FOR INSURANCE COMPANY USE Policy Number Company NAIL Number: SECTION H — BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES (SURVEY NOT REQUIRED) (FOR INSURANCE PURPOSES ONLY) The property owner, owner's authorized representative, or local floodplain management official may complete Section H for all flood zones to determine the building's first floor height for insurance purposes. Sections A. B, and I must also be completed. Enter heights to the nearest tenth of a foot (nearest tenth of a meter in Puerto Rico). Reference the Foundation Type Diagrams (at the end of Section H instructions) and the appropriate wilding Diagrams (at the end of Section I Instructions) to complete this section. H1. Provide the height of the top of the floor (as indicated in Foundation Type Diagrams) above the Lowest Adjacent Grade (LAG): a) For Building Diagrams 11A, 1 B, 3, and 5-9. Top of bottom floor (include above -grade floors only for buildings with subgrade crawlspaces or enclosure floors) is: b) For Building Diagrams 2A, 213, 4, and 6-9. Top of next higher floor (i.e., the floor above basement, crawlspace, or enclosure floor) is: 1.30 ❑x feet ❑ meters a above the LAG n [j feet ❑ meters El above the LAG 1i2. Is all Machinery and Equipment servicing the building (as listed in Item H2 instructions) elevated to or above the floor indicated by the H2 arrow (shown in the Foundation Type Diagrams at end of Section H instructions) for the appropriate Building Diagram? ❑ Yes 9 No SECTION I — PROPERTY OWNER (OR OWNER'S AUTHORIZED REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and H must sign here. The statements in Sections A, B, and H are correct to the best of my knowledge. Note: If the local floodplain management official completed Section H, they should indicate in Item G2.b and sign Section G. ❑ Check here if attachments are provided (including required photos) and describe each attachment in the Comments area. Property Owner or Owner's Authorized RepresentsWe Name: Address: City: Signature: Telephone: Comments: Ext.: Emall: Date: State: ZIP Code: FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10122) Page 6 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 949 BUILDING PHOTOGRAPHS See Instructions for Item AS. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 2906 Dapple Gray Way- - -_ -- - Policy hlumber. City: Ellensburg state: WA ZIP Code: 98926 Company NAEC Number: Instructions: insert below at least two and when possible Four photographs showing each side of the building (for example, may only be able to false front and back pictures of townhouseskowhouses). Identify all photographs with the date taken and "Front View," "Rear View,' "Right Side View," or "Left Side View," Photographs must show the foundation. When flood openings are present, include at least one dose -up photograph of representative flood openings or vents, as Indicated in Seollons A8 and A9. Photo One Photo One Caption: Front VlewIpr'Rhpi,prie'' :GIs ... :4 ;.:.'.. :�''•�'� art;. .. .. .. .. .. Y _ tfQ:�t•Ys:� Photo Two Photo Two Caption: Side ViewIegr FEMA Form FF-206•FY 22-152 (formerly 086.0-33) (10122) Page 7 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.19 BUILDING PHOTOGRAPHS Continuation Page Building Street Address (including Apt.. Unit Suite, andfor Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 2906 Dapple Gray Way Policy Number: City: Ellensburg state: WA ZIP Code: 98926 Company NAIL Number: Insert the third and fourth photographs below. Identify all photographs with the date taken and "Front View,' "Rear View; wRight Side View; or "Left Side View." When flood openings are present, Indude at least one close-up photograph of representative flood openings or vents, as Indicated In Sections AS and A9. Photo Three Photo Three Caption: Back View Photo four Photo Four Capiion: Side View Cle�a�Piioto:f~pur:. FEMA Form PF-206-FY-22-152 (formerly 086-0-33) (10f22) Page 8 of 19 320 MI Copy of Publicity KITTITAS COUNTY FLOOD CONTROL ZONE DISTRICT NOTICE OF AVAILABILITY OF SERVICE TO PROVIDE MAP INFORMATION FOR THE NATIONAL FLOOD INSURANCE PROGRAM The Kittitas County Flood Control Zone District has the responsibility of administering the National Flood Insurance Program in unincorporated Kittitas County. The Flood Control Zone District also provides flood map information services: telling inquirers if property is within a Special Flood Hazard Area (SFHA), which flood zone it is in, and the base flood elevation. The following information is available upon request: • Whether a property is in or out of the SFHA as shown on the current Flood Insurance Rate Map (FIRM), including the following information: the FIRM zone and base flood elevation or depth, if available; the Community Number, Panel Number and Suffix; the date of the FIRMS's Index; the elevation datum. • Whether a property is in the floodway. • Known flood problems that are not shown on the FIRM, such as dam failure inundation areas or drainage problems. a The depth of expected flooding (not available in all areas). Other flood related hazards, such as information relating to ice jams or erosion. Historical flood information and photos. • Information about areas that should be protected, such as wetlands or critical habitat. • Handouts on the National Flood Insurance Program. • Copies of completed elevation certificates. Ifyou would like to make an inquiry, please call 509-962-7523. Tell us the parcel number or street address. There is no charge for this service. Much of this information is also available on our COMPAS online mapping service at http://Ris.co.kittitas.wa.us/comoas/default.aspx and at FEMA's Mapping Service Center https://msc.fema.gov Visit the Kittitas County Floodplain Management webpage (www.co.kittitas.wa.us/public- works/flood) for: 4P more information on flooding in Kittitas County; • directions on how to use COMPAS to determine if a property is in the Foodplain; and • to conduct an online Elevation Certificate Search (many of county's elevation certificates are available online). 411 N Ruby St, Suite 1 T: 509.962.7523 Ellensburg, WA 98926 F: 509.962.7663 Ix LL a C r Lr r cr cr M IxI d rn 0 OI oO 0 In O In a1 E W a u t _ O Gi Q G U c = U3 I 00 x x W a m Lo O Rt m r. 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' \ ' \ \ n w 00 oo ao 'CO a+ rn j D W a C] v LO 0 M M n 0 In rn iN2 L _ u ]C KITTITAS COUNTY FLOOD CONTROL ZONE DISTRICT ((Owner First)) «Owner Last)) Wailing Address)) «City», ((State)) «Zip» October 2, 2023 Regarding Parcel # « All Parcel #sf> Dear ((Owner First» ((Owner —Last)), As cooler and wetter weather returns with fall, it's a good time to be thinking and preparing for potential flooding. El Nino is expected to continue through the 2023-2024 winter, bringing warmer than normal temperatures and higher precipitation. You have received this letter because your property listed above is in an area that has flooded several times. Here are some things you can do to reduce your flood risk: Contact the Flood Control Zone District for information about the extent of past flooding in your area. Department staff can share more information about the causes of repetitive flooding within your area, what the County is doing about it, and what would be an appropriate flood protection level. Our staff can visit your property to discuss flood protection alternatives. Easton Reach Flood Hazard Assessment Completed In 2023 Kittitas County completed a flood hazard assessment along an 11-mile Yakima River reach starting at the Easton Diversion Dam down to the I-90 river crossing. The goal of this assessment was to better understand, communicate about, and plan for these hazards. To view the assessment report, scan the QR code or visit: www.co.kittitas.wa.us/public- works/flood/reports.aspx Prepare for flooding: o Know how to shut off the electricity and gas to your house when a flood comes. Make a list of emergency numbers and identify a safe place to go. Y Make a household inventory, especially of basement contents. • Put insurance policies, valuable papers, medicine, etc., in a safe place. • Collect and put cleaning supplies, camera, waterproof boots, etc., in a handy place. • Develop a disaster response plan. See www.ready.gov/plan for information about preparing your home and family for a disaster. Consider permanent flood protection measures: • Mark your fuse or breaker box to show the circuits to the floodable areas. Turning off the power to the basement before a flood can reduce property damage and save lives. 411 N Ruby St, Suite 1 T: 509.962.7523 Ellensburg, WA 98926 F: 509.962.7663 Flood Control Zone District Page 2 • Consider elevating your house above flood levels. • Check your building for water entry points, such as basement windows, the basement stairwell, doors, and dryer vents. These can be protected with low walls or temporary shields. • install a floor drain plug, standpipe, overhead sewer, or sewer backup valve to prevent sewer backup flooding. • More information can be found at the FEMA's Homeowner's Guide to Retrofitting, Six Ways to Protect Your Home from Flooding (FEMA P-312). • Note that some flood protection measures may need a building permit and others may not be safe for your type of building, so be sure to talk to the Building Department. Their phone number is 509- 962-7506. Learn about financial assistance options: • Grant funding may be available for home elevation, home relocation, or property acquisition -- contact Flood Control District staff for more information. • Flood insurance helps pay for repairs after a flood and, in some cases, it will help pay the costs of elevating a substantially damaged building. Obtain flood insurance: • Homeowner's insurance policies do not cover damage from floods. However, because our community participates in the National Flood Insurance Program, you can purchase a separate flood insurance policy. This insurance is backed by the Federal government and is available to everyone, even properties that have been flooded. Because our community participates in the Community Rating System, you will receive a reduction in the insurance premium. • If your home is not within the 100-year floodplain, you may qualify for a lower -cost Preferred Risk Policy. • Some people have purchased flood insurance because it was required by the bank when they got a mortgage or home improvement loan. Usually, these policies just cover the building's structure and not the contents. There is usually more damage to the furniture and contents than there is to the structure. Be sure you have contents coverage. 4 Don't wait for the next flood to buy insurance protection. In most cases, there is a 30-day waiting period before National Flood insurance Program coverage takes effect. Contact your insurance agent for more information on rates and coverage. For more information on flooding within Kittitas County, visit the County's Flood Information Website at www.co.kittitas.wa.us/public-works/flood. Please contact us at 509-962-7523 if you have questions. Sincerely, Samantha Cox, CFM Water Resources Specialist CRS Activity 510 Annual Progress Report on Implementation of Credited Plan Which Plan is this for (use separate templates for each credited Plan): ® Floodplain Management Plan (Hazard Mitigation Plan) ❑ Repetitive Loss Area Analysis ❑ Floodplain Species Plan ❑ Substantial Damage Plan Name of Community: Kittitas County Date this Annual Progress Report was prepared (not the date of adoption of the credited Plan): October 04, 2023 Name of Plan: Kittitas County Multi -Jurisdictional Hazard Mitigation Plan Date of Adoption of Plan: 5 Year CRS Expiration Date: September 3, 2019 September 15, 2024 1 How can a copy of the credited Plan be obtained: A hard copy can be requested from Kittitas County Public Works Office, by making the request in person (411 N Ruby St # 1, Ellensburg, WA 98926) by phone: (509) 962-7523, or by e-mail: pubIicworks@co.kittitas.wa.us The plan is also available for download through our website: httr)s:l/www.co.kittitas.wa.us/public-works/hazard- miti ation- lanldefault.as x 2. Describe how this annual progress report (not the credited Plan) was prepared and how it was submitted to the governing body, released to the media, and made available to the public: Kittitas County Public Works staff reviewed the County -Wide and Unincorporated Kittitas County Mitigation Initiatives and provided a status update. On October 9, 2023, Kittitas County Public Works staff briefed the Kittitas County Board of Commissioners on progress implementing the Hazard Mitigation Plan. This information was presented at the Public Works Study session, a public meeting. The 2023 report has been posted to the Kittitas County's website and a press release was issued notifying the public about its availability. 3. Provide a description of the implementation of each recommendation or action item in the action plan or area analysis report, including a statement on how the project was implemented or not implemented during the previous year, Please see the attached report, which provides the description for each of the County -Wide and unincorporated Kittitas County Mitigation Initiatives. 4. Discuss why any objectives were not reached or why implementation is behind schedule: Implementation is generally progressing well through normal Kittitas County work programs, but tracking across all hazards and jurisdictions is hampered by a lack of regularly scheduled steering committee meetings. We plan to address this deficit during the Hazard Mitigation Plan update process. 5. What are the recommendations for new projects or revised recommendations? This year Kittitas County initiated efforts to update our Hazard Mitigation Plan before it expires on September 15, 2024. 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