HomeMy WebLinkAboutRES 2023-180BOARD OF COI.INTY COMMISSIONERS
COLINTY 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 l6,2023,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 ratifr the Chair's signature on the 2023 FEMA CRS
reporting documents.
DATED this 17th day of October 2023, at Ellensburg, Washington.
BOARD OF COUNTY COMMISSIONERS
C , WASHINGTON
Wright,
the Board- Julie Kjorsvik
Vice-Chairman
tr Deputy Clerk of qhe Bour{- Mandy Buchholz
Commissioner
Cor
ty
7
\,V
S^E,AL
DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
CRS COMMUNITY CER TIFICATIONS OMB Control Number: 1660_0022
iration: 10/3 1t2023Community Kittitas CountY
i/ofe.'Please cross out any incorrect items, below
CC-213 Recertification
(6-disit NFIP Community ldentification Number)
, as needed, and insert the updated information
ctD 530095State WA
Recertiflcation due date October 16,2023
Chief Executive Officer CRS Coordinator
Name
Cory Wright
Arden Thomas
Chairman, Board of Kittitas County
Title
Water Resources program Manager
205 West Sth Avenue, Suite 10g
Eilensburg, WA 98926
Address
411 Ruby Street, Suite 1
Ellensburg, WA 98926
Phone number (509) 962-7508
(509) 962-7690
cory.wrig ht@co. kittitas.wa. us
E-mail address
arden.thomas@co. kittitas.wa. us
cc-213-1
I hereby certifo that
[communpages as credited under the community Rating system and described in our
ity namel is implementing the following activities on the attached
original application to the CRS and subsequent modifications.
I hereby certify that' to the best of my knowledge and belief, we are in fulr compriance with the-minimum requirements of the NFrp and we;:ff1:1?::,lffiLff"Tfffiii:ll#..$i::'Jru:[:: i# n,'ifi"'.10,',e'"ni. or *," rvFrp we unoerstani-il;i ;i';"y time we are not to
l*"!"JJ;:ffljiil}:H'f::i:lfJi"Iil:t;x1j|,mfl,";1'j"Jl*:'ll5te'.:" a' new buirdings and substantiar improvements constructed in
I hereby certify that if there are one or more repetitive loss propertier..il oy, community thar we must take certain actions that includereviewing and updating the list of repetitive ioss propertier, r"dpinglepetitive ross "r""*, il.Joing tn"
""us" or ti'"-tirr"r, and sending anoutreach project to those-areas each year, and if *'" h"u" fifttG;;;;rore unmitigateo repetitive ross properties we must earn credit underActivity 510 (Floodplain Manageme"t pr'""i"gif"r either; ;;d"fit,;;;;ss area anar/sis (RLAA) or a floodprain management pran (FMp).
I hereby certify that' to thebest.of my knowledge and belief, we are maintaining in force flood insurance poricies for insurabre buirdings ownedby us and located in the speciar rrooJ H"t"io Area (siHAt;;#;" our Frood rnsurance Rate Map. r further unoerstand that disasterassistance for anv community-owned builffi iocated in tne'srHn is reduced ry tne amounl of Nationar Fi;";l;.;;;"ce program (NFrp)flood insurance coverage (structure
"no "oniJni*) that a "o*rr"iiy s"nouta oe cairying on ine luiroing, ,"grror"r"'oii;eme.. the communityrs carrytng a policy.
Signature
Date
(C hief Executive Officer)
lo
[continued on next page]
FEMA FORM 086_0_354 (10/23)
Page 2 of 11
CRS Program Data Table A. ln the SFHA
B. ln a regulated
floodplain outside
the SFHA
C. ln the rest of
community
ldings F)(line 6,report)reLast1 number buiofport's tn eth HASF (bs last 1,304
2. Number of new buildings constructed since last report +22
3. Number of buildings removed/demolished since last report 0
ldingsmNuofberbu affected m revisi ons +by ap srnce relast or(port )-16
by changesNumber5ofbuildiaffected +ngs limits rcorporateo()-3
Current total number of buitdings in the SFHA (bSF) (totat tines 1 -s)1,307
improvement/damag projectsINumbe7SUofbstantiae s nce last report 0
Number of repetitive loss properties mitigated since last report 0
(not MAs)mberNu Lof Mo andRs revtstons LOmap s nce ast re port 0
10. Acreage of the SFHA (aSFHA) as of the tast report (line 13, last report)21,207.8
Acreage by (11 of s affectedarea()revisions +map srnce last orreport )0
Acreage area(s)by (21 of affected +chalimits orcorporatenges )-77.8
13. Current acreage of the SFHA (total lines 10-1 2)21,130
14. Primary source for building data Risk information candmapbuilding buildin and flountys dataoodplainpermit
15. Primary source for area data DFIRM database
16. Period covered 1 0 - 1 5-2022- 1 0- 1 5-2023 Current FIRM date 09124t2021
lf available, the following data woutd be useful:
71 ofNumber new manufactured omesh insta siled lastnce report 0
ilv buildings18.umberN otherof 1new fam-4 stnceconstructed last report 22
9.1 mberNu alof other build constructed/ings sincenstalled last report 0
Community Kittitas CountY State WA ctD 530095
(6-digit NFIP Community tdentification Number)
Comments:
note the number of the line to which the comment
[continued on next page]cc-213-2
FEMA FORM 086-0-354 (10t23)Page3of11
Community Kittitas CountY State WA ctD 530095
(6-digit NFIP Community ldentification Number)
lnstructions
noot'fl:n:ili,iffi..:"5r1hne sFHA (the A and V Zones shown on the Flood tnsurance Rate Map) (FIRM). Use the FIRM currenly in effecr,
Fii,ili'i,i''"iil?fiii,'"iilJl,ff;"ffiXTltJffi:;"'fff#:$1fo''."nu'"'ing
roodprain deveropmenr outside the sFHA underActiv*y 410
column c numbers help relate what hapipens inlrre Roooptain to wir'at is happening in the rest of the community.Enter "0" if there are no numbers to report for this period.'Do not 6J; ; cell blank. Do not fill in the shaded boxes.
lnstructions for the Lines
Lines 1-7 dealwith buildings.
:Jijj:??3Jr:,;f$,ff,: !f,o;1t"ot"
Manuatdennes what constitutes a "buirdins" and rists exampres orstructures thar are noto section 302'a of the cRS coordinatols Manual describes how the cRS counts buirdings. For exampre, accessory structures are notcounted.
o As noted in section 302'a' to determine building counts, communities may use any method that yierds reasonabry good estimates ofthe number of building-s' Examples of acceptable methods are tisteo in section soz.a. precision is less important for large numbers. Forexample' the impact of the numbers will noi change much if there are to,ooo buildings or 10,100 buildings.o lf a building is out of the sFHA, but in a parcel-that is partiy in tne srHn, ft is not Jornt"J'in cotumn A -tn the SFHA.o ln line 14' note how the building counts were obtained or estimated. Use the comments area, if needed.
Atthefirstverificationvisitaftertheeffectivedateofthe20l3cRs coordinatolsManual,oNlyLlNES6ANDl3NEEDTOBEcoMPLETED' These lines form the baseline data about the number of buildings ano area of ti,e SFHA for when the table is completed aspart of the next annual recertification' The "period covered"
"nt"r"o in iine 16 ii the date that lines 6 and 13 are first completed.fl:il;ffJif*iliJ;i:,i""*T:iT;.",1t;:"j:-",",liTl; ;;il il enrire rabre i. "o'pLt"c rhe inrormati"" i;li,;! 6 and 13 rrom rhe
lnstructions for the Columns
Line 4 refers to map revisions' These include physical map revisions, Letters.of Map Revision (LoMR), and Letters of Map Amendment(LoMA)' lf a building is removed from the srAn-uy re un tnrorgh
"
LdMA, but ti,d "orrunit| .titt."orinirters its floodprain managementregulations on the property' the building should not be includeo i-n tne rine 4 count in corumn R'--tn tne sFHA. However, communrties that sti'fi:i':ffixXXffi;:ilJ"'r"ffi:ilj;.E;;:Fi:;;j;lffX[*Tf,:'r"Jr1;:ii;::ffi,n*,,,,."""iuing,,"r,
","oit,
tn" bu'dins-.-
dlfri"l fi:Tl:i"i:i:lJ:*r of buildinss that were substantiallv improved prus rhe number of buirdinss that were substantiaily damased
Lines 10 -13 dealwith areas.o These areas are based on the areas shown.on the community's FlRM.including LoMRs or LoMAs. section 403.b discusses thoseportions of the sFHA that are subtracted from the area of the srfun to calculate flie community,s asFHA used in credit calculations.o section 403'e of the cRS coordinatofs Manual discusses caicuiating areas for cRS purposes.o section 403'e notes that communities "should not spend
"n
inoioin"te amount oi tir" rl"rrring areas.,, As with buirdings,communities may use any method that yields reasonably good estimates..Examples oi""""pt"or" approaches are listed in section 403.e.o Line 13 asks for the current acreage of the sFHA. rneiesi ;;;* for this number is a Cis rayer that shows the sFHA. rf thecommunity does not have Gls, the county, regional
"g"n"y,-oirll" rrrrrp mappinj om"" r*vt"ve sFHA layers and may be able toprovide the data' lf the community has a ielatively t""int irirn,l, ir,"1tudy coniract6r or consutting engineer may have the data.o ln line 15' note how the area calculations were obtained or estimated. Use the comments area, if needed.
Lines 17 -19 are voluntary, if the numbers are readily available.o Line 17 includes replacing an existing manudctured home with a new one. The newly placed manufactured home is counted as a new,post-FlRM, buitding.o The totar of rines 17 -19 shourd equar the varue entered in rine 2.
cc-213-3
Daaa A al 44
FEMA FORM 086-0.354 fiO12g\
Community
County
Kittitas Co unty State WA ctD 530095
Kittitas
CO MM U N Iry RATI NG SYSTEM ANN UAL RECERTI FICATION
Your community has been verified as receiving cRS credit for the following Activities.' lf your community is still implementing thJse activities the cRS .ooioinrtor is requiredto put his or her initials in the blank (d-o not use a ctreckmark o1. "n;*t and attach theappropriate items' A blank wittr no initials indicates you are not implementing thatActivity anymore, and will result in loss iip"i"i. i"nd possiblu Cns'ctass).' lf the word "attached" is u.sed you must piovide th" ,"qr".ted documentation for thatActivity' lf no documentation h'as oeen i.qrir"o ior ttrat nctivity, prl"." explain whythere is no documentation from the past year.
- - -
[ 310 EC: Wg. ar9 maintaining Elevation certificates, Floodproofing certificates,Basement Floodprooring cirtificates ano v2one design certificaies on all new con-struction and su.bstantially imn-r1ve!-puitoings in our special Flood Hazard Area(SFHA) and make copiesof all certificrt"i lu"il"ble at our present office location.t-l lnitial here is you have had no ,"i ioiitrrction or s't nstintial improvement inthe SFHA in the last year.
Af 310 EC: Attached e -tl" permit tist for ontystructures in the sFHA that have ueen corip@ear. we have
l""j]]lTr"JffiJew building and substantiaiiritou"rents in tre-srHn J"r,nn-,ir',
Af 310 EC: Attached are all the Gertificates for new or substantially improvedstructures that have been co.mpleted dulng this reporting period that are in-cluded on the above permit lisi. (Noie; ir,"-tot"r number oT Etevation and Flood-proofing certificates should match the numbeioi p"rmits issuec and completed withinthe reporting period defined above. All permits issued for new construction or sub-stantial improvement within the V.on" rnorio r,"u" both an rtevaiion certificate andav Zone certificate, and all buildings witn uasements within the basement exemp-tion communities should have both in grevaiion c".tin.ate ano a easement Flood-proofing Certificate).
E-320 Ml 1: Wg, are providing basic flood information to inquirers. we also continue toprovide the following to inquirers:
4L Ml 2 additionat FIRM information
]!f Ml 6 historicalflood informationAf Ml 7 naturalfloodplain iunctions
Af 320 Ml: Attached is a copy of the publicity for the credited elements of thisservice this year.
Community Certifications cc-213-1 Edition:2017
Community
County
Kittitas C State WA ctD 530095
Kittitas
COMM U N ITY RATI NG SYSTEM ANN UAL RECERTI FICATION
lL 320 Ml: Attached is a copy of one page of the log, a letter, or other record thatwe kept on this service this year. --"' 5 'vrrv" vr t
AT F,il#" we are continuing to keep our FIRM updated and maintain otd copies of our
Afi- 330 oP: we continue to conduct or provide all credited outreach projects.
lr(- 440 BMM: We continue to maintain
AT 340 ODR: People looking to,purchase flood prone property are being advised of theflood hazard through our credite d hazard disciosure measures.
$L 350 LIB/LPD: Our public library continues to maintain flood protection materials.
lL 350 WEB: We continue to conduct an annual review and update of the informationand links in our flood protection website.
p( 410 MAP: We continue to use our additional regulatory flood data before a newdevelopment can proceed in our floodplain-
jr 420 osp: we continue to preserve our open space in the floodplain.
J\f 420 LZ/OSI: we continue to enforce our ordinance(s) for low-density zoning and/oropen space incentives- t-J tniti.at he_re if you haie'chang"iti" "ito-*ii|;;;';tyof development in any or your zoning districir, ,"ror"d paiets in the 1oodgain orchanged your open space incentivei. Attach a copy of the amended regulations,provide a summary of the changes, and iirx up'the i"giiilion indicatingwhat,s been changed.
Ar 430: we continue to enforce the.floodplain management provisions of our zoning,subdivision and building code ordinances for whici w" are r."."iuing credit.t-l lnitial here if yoi have amended your floodplgin regulatnni. Attach a copy ofthe amended regulations, provide a summ"ry of the ;ha;ie; and mark up theregulations indicating whits been "nangii.'Ar 430 RA: We continue to enforce our procedures for.administering our floodplainmanagement regulations. lf applicable, we also rwho tjok creditei trainins .o,ir."r. we curren,,rT:X:ff?Fir:::Ms and starr
lK 440 AMD: we continue to use and update our flood data maintenance system on anannual basis as needed.
if any Benchmarks were found to becorrect elevation or a description
our system of Benchmarks. / / lnitial heremlssing or inaccurate. Attacffipy of theof the missing Benchmark(s).
Comm un ity Certifications cc-213-2 Edition: 2017
Community
County
Kittitas Countv
Kittitas
Rrnt;l Lisf
6k.r- 1i,,,. G, [,ft.-k s
Copl o{ p,,bt;.;l-
Crnr- P.1r- .,i t-.,1 \
{&g* hl,w r-".q'u.il"-
A^-"..t P,o1.,ss fu?,F
State WA ctD 530095
COMMUNIry RATING SYSTEM ANNUAL RECERTIFICATION
{440 FM: We continue to maintain our historical Flood HazardBoundary Map, FIRMsand Flood lnsurance Studies.
iL 450 sMR: we continue to enforce the stormwater management and low impactdevelopment provisions of our zoning, subdivision
"nd
illdir; cooe ordinances fornew developments in the watershed . t-l tyitial nere i youoh"r" amended yourstormwate.r management regulations [hffiiil impact yorr'Cni-program. Attach acopy of the am.ended regulations, provide a-summary of the changes and makup the regurations indicating whai's been changed.
xL 450 ESCA/VQ: We continue to enforce the provisions of our zoning, subdivision andbuilding codes as they pertain to erosion and sediment controland water quality.
XL 502 RL: We.currently have _t6 ,"p"titive loss properties and send our notice toj"ll properties in the repetitive loss areas.
FT 502 RL: Attac.hed is a copy-of this year's notice on property protection, floodinsurance and financial assistanceihat we sent to our."f"iitiu" loss areas.
K 510 FMP: Attached is a copy of our floodplain management plan,s annualprogress report for the action items contained in thella;. w; have incluJ"o ,progress report template for you to use (in the email notifi'cation) if you Oon;t nru"-one of your own.
Af fJ:rlyij ,H: TIi,!fo"'o"d
copies orthis/these prosress reporr(s) to our sovernins
Additional Comments:
Attachments:
*"trto
3io
- jzo
* 3za
'- qJcZ
" 5ir)
GL
fc
n^l
'fn r
Ru
FnnP
Comm un ity Certifications cc-213-3 Edition:2017
CRS Activity 310
Elevation Certificate permit List
KITTITAS COUNW
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
A
AE
AE
AE
AE
AE
AE
AE
AE
AE
AE
AE
New Construction
New Construction
New Construcion
New Construction
New Construction
New Construction
New Construction
New Construction
New Construct'on
New Construction
New Construction
New Construction
Residential
Residential
Residential
Residential
Residential
Residential
Residential
Residential
Residential
Residential
Residential
Residential
78401Salmon La Sac Rd,
Ronald, WA 98940
390 Heron Farm Ln,
Ellensburg, WA 98926
I4770 Manastash Rd,
Ellensburg, WA 98926
2911 Roan Dr, Ellensburg,
wA 98926
2915 Roan Dr, Ellensburg,
wA 98926
2919 Roan Dr, Ellensburg,
wA 98925
3012 Dapple Gray Way,
Ellensburg, WA 98926
3010 Dapple Gray Way,
Ellensburg, WA 98926
3008 Dapple Gray Way,
Ellensbure, WA 98926
3005 Dapple Gray Way,
Ellensburg, WA 93926
3004 Dapple Gray Way,
Ellensburg, WA 98926
3002 Dapple Gray Way,
Ellensbrug, WA 98926
8/22/2079
7/2s/2027
10/7s/2027
L7/70/2O2L
77/10/2027
7u70/2027
17/70/202L
1,uLO/2027
7uL0/2021
77/70/2O2L
77/70/2027
71/t0/202r
FD-19-00015
FD-21-00002
FD-21-00034
FD-21-00035
FD-21-00036
FD-21-00037
FD-21-00038
FD-21-00039
FD-21-00040
FD-27-OOO47
FD-21-OOO42
FD-21-00043
Bldg Type
(Res, Non-Res, Addition,
Accessory, etc.)
Floodproofing
Certificate
Required?
V Zone
Design
Certificate
Required?
AddressPermit #Finished
Const. EC?
Permit
Final
FIRM
New Bldg or S|/SD Zone
Permit lssued
Date
830 Pebble Beach Dr, Cle
Elum, WA 98922 Residential New Constructicn
FD-21-OOO47 2/7/2022
310 Page 1 of 2
AE YES YES NO NO
CRS Activity 310
Elevation Certificate permit List
KITTITAS COUNry
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
AE
AE
AE
AE
AE
AE
AE
AE
AE
New Construction
New Construction
New Construction
New Construction
New Construction
New Construction
New Construction
New Construction
New Construction
Residential
Residential
Residential
Residential
Residential
Residential
Residential
Residential
Residential
3007 Roan Dr, Ellensburg,
wA 98926
3009 Dapple Gray Way,
Ellensburg WA 98926
3005 Dapple Gray Way,
Ellensburg WA 98926
3003 Dapple Gray Way,
Ellens burg, WA 98926
2917 Dapple Gray Way,
Ellensburg, WA 98926
2915 Dapple Gray Way,
Ellens wA 98925
2913 Dapple Gray Way,
Ellensbu wA 98926
2911 Dapple Gray Way,
Ellensb wA 98926
2905 Dapple Gray Way,
Ellensburg, WA 98926
3/2/2022
3/2/2022
3/2/2022
3/2/2022
3/2/2022
3/2/2022
3/2/2022
3/2/2022
3/2/2022
FD-22-00006
FD-22-OOOO7
FD-22-00009
FD-22-00010
FD-22-000t2
FD-22-00013
FD-22-00014
FD-22-00015
FD-22-00018
370 Page 2 of 2
U.S. DEPARTMENT OF HOMELAND SECURIry
Federal Emergency Management Agency
National Flood lnsurance program
OMB No. 1660-0008
Expiration Date: November 30, 2022
ELEVATION CERTIFICATE
lmportant Follow the instructions on pages 1-9
Copy all pages of this Elevation Certificate and all attachments for (1 ) community official, (2) insurance agenVcompany, and (3) building owner.
SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USEAl . Building Owner's Name
Evan and Lindsay Farris
Policy Number:
A2. Building Street Address (in
Box No.
cluding Apt., Unit, Suite, and/or B ldg. No.) or P.O. Route and
18401 Salmon la Sac Road
Company NAIC Number:
City
Ronald
State
Washington
ZIP Code
98940
A3. Property Description (Lot and
Kittitas County Tax Parcel Number
Block Numbers,
951655
Tax Parcel Number, Legal Description, etc.)
44. Building Use (e.9., Residential, Non-Residential, Addition, Accessory, etc.) Residential
46' 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) Squarefootageof crawlspaceorenclosure(s) t15S.0O sqft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade o
d) Engineered flood openings? ! yes E ruo
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
Long. -121'06'07.65"
c) Total net area of flood openings in A9.b 0.00 sq in
c) Total net area of flood openings in Ag.b 0.00 sq in
A5. Latitude/Longitude: Lat. 47'18'1 1.23"HorizontalDatum: I NAD 1927 E NAD 1983
d) Engineered flood openings? ! yes E No
RMATIEsBFLOODCTIONRANNSUEcRATEMAPRMFINFO ON
81. NFIP Community Name & Community Number
Kittitas County 530095
82. County Name
Kittitas
83. State
Washington
84. Map/Panel
Number
53037C0365
85. Suffix
D 09-24-2021
86. FIRM lndex
Date
87. FIRM Panel
Effective/
Revised Date
09-24-2021 A
88. Flood
Zone(s)
89. Base Flood Elevatlon(s)
(Zone AO, use Base Flood Depth)
2254.2
Bl0 lndicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in ltem 89:
f] FIS Profite ! FIRM ffi Community Determined ! Other/Source:
81 1' lndicate elevation datum used for BFE in ltem 89: I NGVD 1929 E NAVD i 98B fl otheri source
812' ls the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise protected Area (OpA)? ! yes I No
Designation Date fl CBRS ! oPA
FEMA Form 086-0-33 (12t19)Replaces all previous editions.Form Page 1 of6
ELEVATION CERTIFICATE OMB No 1660 0008
Exprralron Dale November 30 ?.02?,
IMPORTANT: ln thege Bpece!, copy lhe correspondlng lnformstlon from Secllon A FOR INSURANCE COMPANY USE
Buildrng stre€t Address (includrng Apl , unit. suile, and/or Bldg No ) or P o Roule and Box No
18401 Salmon la Sac Road
Slate
Washington
ZIP Code
98940
C'ty
Ronald
Policy Number
eompany ruAiC ttumuer
sEcTroN c - BUtLD|NG ELEVATTON TNFORMATTON (SURVEY REQUTRED)
C1 Buildrng elevaltons are based on. n Construction Drawings' I Building Undsr Conslructton' fi] Frnished Construction
'A new Elevslion Cerlilicate wll be required when conslruclion ol lhe building is complete.
c2 Elevalions - Zones A1-A30. AE, AH, A (wirh BFE), vE, v1-v30, v (with BFE), AR, AFyA, AR/AE. AFyAI-A30, AR/AH AR/AO
Complele llems C2 a-h below according to the building diagram specified in ltem A7. ln Puerlo Rico only, enter melers
lncl'cete elevalion dalum used tor the elevations in items a) through h) below,
Dalum used lor buildrng elevations must be the same as that used for the BFE
a) Top ol bottom Roor (induding basement, crawlspace, or enclosure froor)
b) Top of lhe nexl higher lloor
c) Bonom ol lhe lowesl horizontal structural member (V Zones only)
d) Attached garage (top of slab)
e) L_owest elevalion of machinery or equipmenl servicing the building' (Describe type of equipment ind locbtion in Comm€n-ts)
0 Lowest adjacent (finished) grade nexl to building (l3G)
gl Highest adjacent (linished) grade nexl to building (HAG)
h) Lo^resit adjacent grade at lowesi elevation of deck or stairs, lncluding
slructural support
2297.8
2286.0
2299.0
2286.0
2289.7 fi leet fl meters
2299.9 ffi feel E m€ters
N/A I feet I metrs
2289,7 fit feel ! meters
Benchmark Ulilrzed WSRN Verlical Daium: NAVD 88
n NGVD 1929 E NAVD 1988 [ Other/Source:
Check the measurement used
fi feet n mete6
filteet
fi feet
fi feet
I meters
I meten
I meters
sEcnoN D - suRvEYoR, ENG|NEER, OR ARCHITECT CERT|FICATION
Thrs certification is to be signed and sealed by a land surveyor, engineer. or architec{ authorized by law lo certify elovation rnformation
I @dny hal the inlormalioi on lhis C,edificatei represenls my besl dlo4s lo interprdt the datd avait'dble. t undedland that any lalse
si,atemenl may be punishable by line or imprisonment under 18 U.S. Codd, Sedion 1(NI.
WerelattudeandlongitudeinSedionAprovidedbyalioensedlandsurveyor?EvesENo@
/
t
Cornments (rnduding type ol equipm€nl and localioil, per C?(e), ll appllcal)lol
The typ€ of machln€ry *rvicrng the bulldrng, rn Eec{ron CZe , ls a lrvac unrl located ott lho oulstdd rtl lho rlotlhortl butlrlttlg rvall
Number
528/.3
Waehington
Name
Samuel R Ward
Name
Prolessional Land Surveyor
rte
APS Survey E Mapping
ZIP Code
9800s
StaloCity
Bellevue
Srgnature
?-b
Address
13221 SE 26th Sueet, Su(e A
Date
10"13.2022
Tolophono Exl
(4251 746 32oo il r
FEMA Fom 086-0-33 (12l1S)Replaces all ptovtout odtllons Fornr Page 2 of 6
ELEVATION CERTIFIGATE OMB No. 1660-0008
Expiration Date: November 30,2022
IMPORTANT: ln 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.
18401 Salmon la Sac Road
Policy Number:
City
Ronald
State
Washington
ZIP Code
98940
Company NAIC Number
sEcTtoN E - BUTLDTNG ELEVATION TNFORMATTON (SURVEY NOT REQUTRED)
FOR ZONE AO AND ZONE A (W|THOUT BFE)
For Zones AO and A (without BFE), complete ltems E1-E5. lf the Certiflcate is intended to support a LOMA or LOMR-F request,
complete Sections A, B,and C. For ltems E1-E4, use natural grade, if available. Check the measurement used. ln 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
b) Top of bottom floor (including basement,
crawlspace, or enclosure) is
! feet ! meters I above or ! below the HAG
! feet ! meters ! above or ! below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A ltems 8 and/or 9 (see pages 1-2 of lnstructions),
the next higher floor (elevation C2.b in
the diagrams) of the building is
E3. Attached garage (top of slab) is
E4. Top of platform of machinery and/or equipment
servicing the building is
! feet ! meters
! feet ! meters
Eteet n meters
! above or f below the HAG.
I above or ! below the HAG.
! above or I below the HAG.
E5. Zone AO only: lf no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's
floodplain management ordinance? ! Yes I No ! Unknown. The local official must certify this information in Section G
sEcTroN F - pRopERTy owNER (OR OWNER'S REPRESENTATTVE) CERT|F|CATION
The prop.erty owner or owner's aulhorized 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
I Cne* 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 3Q, 2022
IMPORTANT: ln 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.
18401 Salmon la Sac Road
Policy Number:
City
Ronald
State
Washington
ZIP Code
98940
Company NAIC Number
sEcTroN G - coMMUNlTy TNFORMATTON (OPT|ONAL)
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 ltems G8-G10. ln Puerto Rico only, enter meters.
G1. E 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. (lndicate the source and date of the elevation
data in the Comments area below.)
G2. I A c_ommunity official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE)
or Zone AO.
G3. I The following information (ltems G4-G10) is provided for community floodplain management purposes.
G4. Permit Number G5. Date Permit lssued G6. Date Certificate of
Compliance/Occupancy lssued
G7. This permit has been issued for: ! New Construction n Substantial lmprovement
G8. Elevation of as-built lowest floor (including basement)
of the building:
G9. BFE or (in Zone AO) depth of flooding at the building site:
G10. Community's design flood elevation:
! feet ! meters
! feet ! meters
! feet ! meters
Datum
Datum
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
IMPORTANT: ln 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
18401 Salmon la Sac Road
Policy Number:
City State
Washington
ZIP Code
98940Ronald
Company NAIC Number
lf using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the
instructions for ltem ,46. ldentify 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. lf submitting more photographs than will fit on this page, use the Continuation Page.
Photo One
Photo One Caption Front View 10-13-2022 Clear Photo One
Photo Two
Photo Two Caption Rear View 10-13-2022 , Clear Photo Two
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
See lnstructions for ltem 46.OMB No. 1660-0008
Expiration Date: November 30,2022
FEMA Form 086-0-33 (12119)Replaces all previous editions.Form Page 5 of6
IMPORTANT: ln 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.
18401 Salmon la Sac Road
Policy Number:
City State
Washington
ZIP Code
98940Ronald
Company NAIC Number
lf submitting more photographs than will fit on the preceding page, affix the additional photographs below. ldentify all photographs
with: date taken; "Front View" and "Rear View"; and, if required, 'rRight 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.
Photo Three
Photo Three Caption Right Side View 10-13-2022 'Clear Photo Three
Photo Four
Photo Four Caption Left Side Yiew 10-13-2022 Clear Pholo Four
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
Continuation Page
OMB No. 1660-0008
Expiration Date: November 30,2022
FEMA Form 086-0-33 (12119)Replaces all previous editions.Form Page 6 of 6
U.S. DEPARTMENT OF HOMEI.AND SECURITY
Federal Emergency Management Agency
National Flood lnsurance Program
ELEVATION CERTIFICATE
lmpoltanfi Follow the instructions on pages 1-9.
Copy all pages of ttis Elevation Certificate and all attadrmenb for (1) community oficial, (2) insurance agenUcompany, and (3)building owner.
OMB No. 1660-0008
Expiration Date: November 3Q,2022
SECNON A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE
A1. Building Owner's Name
GARY FAUSSET
Policy Number:
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or p.O. Route and
Box No.
390 HERON FARM LANE
Company NAIC Number:
civ
ELLENSBURG
State ZIP Code
98926Washington
A3. Property Description (Lot and Block Numbers, Tax Description, etc.)
TAX PCL. # 17-19-19053-0004; LOT llDWRlcHT CLUSTER PLAT
A4. Building Use (e.9., Residential, Non-Residentiat, Additon, Accessory, etc.) RESIDENTIAL
A5. LatituderLongitude; Lat. N46.9436"Long. W120.5134'Horizontal Datum: fl NAD 1927 E NAD 1983
A6. Attach at least 2 Photographs of the building lf the Certificate is being used to obtain frood insurance
A7. Building Diagram Number I
A8. For a building with a crawlspace or encloerre(s):
a) Square footage of cralvlspace or enclosure(s) 21 76.00 sq fi
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1-0 foot above adjacent grade 31
c) Total net area of flood openings in A8.b 2263.00 sq in
d) Engineeredflood openings? [ yes E ruo
A9. For a building wilh an attached gerage:
a) Square footage of attached garage 740.00 sq ft
b) Number of permanentflood openings in the attached garage within 1.0 foot above adjacent grade N/A
c) Total net area of ffood openings in Ag.b N/A sq in
d) Engineered f,ood openings? fl Yes fil No
SECNON B - FLOOD INSURANCE RATE MAP (FIRM) INFORIIIATIoN
81. NFIP Community Name & Community Number
KITTITAS COUNTY, WA 530095
82. County Name
KITTITAS
83. State
Washingrton
84. Map/Penel
Number
53037C1284
85. Suffix
D
86. FIRM lndex
Date
09-24-2021
87. FIRM Panel
Effec{ive/
Revised Date
09-24-2021
B8. Flood
Zone(s)
AE
89. Qase Flood Elevation(s)
(Zone AO, rse Base Flood Depth)
1445.5'
810. lndicate the sourc€ of the Base Flood Elevation (BFE) data or base iood depth entered in ltem 89:
I FIS Profile f] FIRM fi Community Determined I Other/Source:
Bl 1 . lndicate elevation datum used for BFE in ltem 89: I NGVD 1929 E NAVD 1 988 [ Other/Source:
812, ls the building located in a Coastal Banier Resources System (CBRS) area or Otherwise Protected Area (OPA)? [ Ves ffi Ho
Designation Date:fl CBRS n oPA
FEMA Form 08€-0-33 (12119)Replaces ell previous edilions.Form Page 1 of6
ELEVATION CERTIFIGATE OMB No. 1660-0008
Expiration Date: November 30,2022
IMPORTANT: ln these spaoes, copy the correspondlng lnformation fiom Secuon A.FOR INSURANCE COMPANY USE
Building Sfeet Addrem (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No
390 HERON FARM LANE
Policy Number:
City State
Washington
ZIP Code
98926ELLENSBURG
Company NAIC Number
sEcTtoN c - ButLotNG ELEVATTON TNFORMATTON (SURVEY REQUTRED)
1447.0
C'1. Building elevations are based on: f] Consfruction Drawings' ! Building Under Construc{ion* ffi Finistred Constsuction
*A new Elevation Certificate will be required vyhen construction of lhe building is complete.
C2. Elevations - Zones A1-A30, AE, AH, A (witl BFE), VE, V1-V30, V (with BFE), AR, AR/A, AFUAE, AR/A1*A30, AFyAH, AR/AO,
Complete ltems C2.a-h below according to the building diagram specified in ltem A7. ln Puerto Rico only, enter metens.
Benohmark Utilized: NcS MONUMENT S80592 Vertical Datum: NAVD88
lndicate elevation datum used for the elevations in items a) through h) below.
n NGVO 1S29 E NAVD 1988 flOther/Source:
Datumueedforbuildingelevationsmustbethesameast
Check lhe measurement used.
a) Top of bottom floor (induding bas€ment, crawlspace, or enclosure floor)
b) Top of the next higher floor
c) Bottom of the lowest horizontal sfructural member {V Zones only)
d) Attached garage (top ofslab)
e) Lowest elevadon of machinery or eguipment servicing the building
(Describe iype of equipment and location in Commenb)
f) Lowest adjacent (finished) grade next to building (LAG)
g) Highest adjacent (finished) grade next to building (HAG)
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
stuctural support
1443.5 ffi feet I meters
1M7.0 ffi feet I meters
N/A I feet I meters
1445.6 ffi feet ! meters
N/A fl feet fl meters
144/.1
r444.5
[Jfeet
fi feet
filfeet
! meters
f| meters
I meters
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
to certiff elevation informdion.
I underctand that any false
fl Check here if attachments.
This certificalion is to be signed and sealed by a land surveyor, engineer, or architoct authorized by law
I ceftify that the information on this Ceftificafe represenfs my best efforts to intenret the data available.
statement may be punishable by fine or imprisonmenl under 18 U.S. Code, Seciion 1001,
Were latitude and longitrde in Section A provided by a licensed land survoyor? E Yes I tto
Certifier's Name
CHRISTOPHER C. CRUSE
License Number
36815
35815
Tide
PROFESSIONAL I.AND SURVEYOR
Company Name
CRUSE & ASSOCIATES
Address
P.O. BOX 959
City
ELLENSBURG
State
Washington
ZIP Code
98926n
Date
02-28-2023
Ext.Signature Telephone
{509) 962-8242
Copy all pa!65-of uiis ElevationTeilincate and all altrachments for (1) communily ofiicial, (2) irsurance agent/compny, anU (S[OuiiAing owner.
Comments (induding type of equipment and location, per CZ(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.
89 & B1O - BASED ON KITTITAS COUNTY FLOOD PERMIT FD?1-OOOO2.
FEMA Form 0BC0-33 (12119)Replaces all previous editions.Form Page 2 ofO
IMPORTANT: ln tlrese spaces, copy the conespondlng lnformaton trom Secton A.FOR INSURANCE COMPANY USE
Building Steei Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
390 HERON FARM LANE
Policy Number:
City Stet€
Washington
ZIP Code
98926ELLENSBURG
Company NAIC Number
sEcTtoN E - BU|LDTNG ELEVATTON TNFORMATTON (SURVEY NOT REOUTRED)
FORZONE AO AND ZONE A (WTHOUT BFE)
For Zones AO and A (without BFE), complete ltems E1-E5. lf the Certificate is intended to support a LOMA or LOMR-F request,
complete Sections A, B,and C. For liems E1-E4, use natural grade, if available. Check lhe measurement used. ln Puerto Rico only,
enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevadon is above or below
the highest adjacenl grede (HAG) and the lowesl adjacent grade (LAG).
a) Top of bottom floor (including basement,
crawlspace, or enclosure) is
b) Top of boftom floor (induding basement,
crewlspace, or enclosure) is
I feet I meters ! above or I bebwthe HAG.
I teet f] meters I above or fl belowthe L{G.
E2. For Building Diagrans S-9 wilh permanent
fie next higher froor (elevation C2.b in
the diagrams) of the building is
flood openings provided in Sec-lion A ltems 8 and/or I (see pages 1-2 of lnstuctions),
E3. Attrached garage (top of slab) is
E4. Top of platform of machinery and/or equipment
servicing the building is
D feet I meters
I feet I metens
flfeet f]meten
I above or Ibelowthe HAG.
I above or Ibelowthe HAG.
fl aboveor flbelowthe HAG.
E5. Zone AO only: lf no flood depth number is available, is the top of tho bottom floor elevated in accordance wlth the community's
floodplain management ordinance? f] Yes f] No f] Unknown. The local ofiicial must oertifu thls lnformation in Section G.
sEcnoN F - PROPERTY OWNER (OR OWNER'g REPRESENTAnVEI CERT|nCAnON
The property owner or ownefs authorized representative who conpletes Sectons A, B, and E for Zone A (without a FEMA-issued or
community-issued BFE) or Zone AO must sign here. The s,tatemenb in Sec'tions A, B, and E are conect to tre best of my knowledge.
Property Owner or Ourne/s Authorized Representative's Name
Address City State ZIP Code
Signatrre Date Telephone
CommentE
n Check here if attachments.
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: November 3O,2022
FEMA Form 086-0-33 (12119)Replaces all previous editons.Form Page 3 of6
IMPORTANT: ln these spaces, copy the correspondlng lntormatlon tfom Secton A.FOR INSURANCE COMPANY USE
Building Sireet Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No
390 HERON FARM LANE
Policy Number:
City State
Washington
ZIP Code
98926ELLENSBURG
Company NAIC Number
sEcnoN G - coMMUNrw TNFoRMAnON (OpnONALl
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 Certiftcate. Gomplete the applicable item{s) and sign below. Check the measurement
used in ltems G8-G10. ln Puerto Rico only, enter meters.
G1. n The information in Section C was taken from other docunentation trat has been signed
engineer, or architect who is authorized by law to certify elevation information. (lndicate
data in the Commenb area below.)
and sealed by a licensed suNeyor,
lhe source and dale of lhe elevation
c2. [ ]?";;fffiY ofiicial completed Section E for a building located in Zone A (without a FEMA-issued or comrnunity.issued BFE)
63. n The following information (ltems G4-G10) is provided for community fioodplain managemcnt purposes.
G4. Permit Number G5. Date Permit lssued G6. Date Cefficate of
Compliance/Occupancy lssued
G7. This permit has been issued for: ! New Conskuclion I Substantial lmprovement
G8. Elevation of as{uilt lowest floor (including basement)
of the building:
G9. BFE or (in Zone AO) depft of flooding at ths bullding site:
G10. Community's design flood elevation:
fl feet I meters
fl feel fl meters
flfeel I meters
Dafum
Datum
Datum
Local Ofliciel's Name Title
Oommunity Name Telephone
Signaturc Datc
Commcnts (induding type of equipment and location, per C2(e), il4plicable)
! Check here if attachments.
ELEVATION CERTIFICATE OMB No.
Expiration
16604008
Date: Novembet 30,2022
FEMA Form 086-0-33 (12119)Replaces all previous editions.Forn Page 4 of6
ln these lnformaton from Sectlon A.the INSURANCE
Building Steet Address (including Apt", Unit, Suite,and/or Bldg. No.) or P.O. Route and Box No.
390 HERON FARM IANE
Policy Numben
City ztP
ELLENSBURG 98926Washingiton
Corpany NAIC Number
lf using the Elevadon Certificate to obtain NFIP flood insurance, affix at lsaet 2 building photogrephs below according to theinsbuctions for ltem 46. ldentiff all photographs wlth date taken; "Fr;nt VieW' and "Rear Vieu/-l inJ, if-iJiuireU, 'Right Side Viev/, and"Left Side Mew'" When a.pPlicable, phoiographs must show the foundation with representatiui exarpies of rhe-flood openings orvenb, as indicated in Section A8. lf submitting more photographs th*r will fit on tris plge, u"i tt e Contiiluation pagc.
orr
Photo One Caption TAKEN 02.10.2023; FRONT OF HOUSE FACING soUTHwEsT ClearPholo OnePHOTO
Two Caption TAKEN REAR OF HOU$E Cher Photo Ti,uo
Two
NORTHEAST
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
See lnsffuctions for ltem A0.
OMB No. 1660{008
Expiration Date: Novemb er 30, 20?2
FEMA Form 086-0-33 {12119')Replaces all previous edilione.Form Page 5 of6
ELEVATION CERNFICATE
BUILDING PHOTOGRAPHS
Continuation Page
OMB No. 1660{008
Explralion Date: November 30,2022
IMPORTANT: ln tfiese spaces, copy tlre correspondlng lnbrmatlon from Secdon A.FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit Suite, and/or Bldg. No.) or P.O. Routo and Box No.
390 HERON FARM LANE
Policy Number:
City State
washln$on
ZIP Code
96926ELLts,NSUU'(('
Company NAIC Number
lf submifing more photographs than will ft on the preceding pege, affx the additional photographs below. ldentiff all photographs
with: date taken; "Front View" and "Roar Vievy''; and, if required, "Right Slde View" and "Left Side Mew." Wren applicable,
photographs must show the foundation wittr representative examples of the flood openings or vents, as indicated in Section A8.
Photo Three
Fholo Th@
Photo Three Caption Clear Photo Three
Photo Four
Photo Four
Photo Four Capton gear Phob Four
FEMA Form 08&0-33 (12/19)Replaces all prevlous editions.Form Page 6 of6
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood lnsurance Program
ELEVATION CERTIFICATE
lmportant: Follow the instructions on pages 1*9.
OMB No. 1660-0008
Explration Date: November 30,2022
Copy all pages of this Elevation Cerlificate and all attachments for (1) communily ofiicial, {2) insurance agen!/company, and (3}building wner.
SECTION A . FROPERTY INFORMATION FOR INSURANCE COMPANY USE
A1, Building Owne/s Name
ROBERT HAZEL
Policy Number:
A2. Build.ing StreetAddress (including Apt., Unil, Suite, and/or Bldg. No.) or p.O. Route and
Box No.
14710 MANASTASH RD.
Company NAIC Number:
City State ZIP Code
98926ELLENSBURGWashington
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
TA)( PCL. f 17-17-18000-0015: LOT 5, 8OOK32 OF SURVEYS AT PAGES 81-92.
A4. Building Use {e.9., Residential, Non-Residenlial, Addition, Accessory, etc.) RESIDENTIAL
A5. Lalitude/Longitude: Lat. N 46.9629"Long. W 120.7551'Horizontal Datum: fl NAD 1927 El NAD 19s3
A6. Attach at least 2 photographs of lhe building if the Cerlificate is being used to obtain flood insurance.
A7. Building Diagram Number I
A8. For a building with a crawlspace or enclosure(s):
a) Square footage ofcrawlspace or enclosure(s) 944.00 sq ft
b) Number of permanent food openings in the crawlspaoe or enclosure(s) with:n 1.0 foot above adjacent grade 7
c) Total net area offlood openings in A8.b 1400.00 sq in
d) Engineered flood openings? [} V." ff po
A9. For a building with an attached garage:
a) Square footage of attached garage 764.00 sq ft
b) Number of permanent tlood openings in the atlached garage within 1.0 foot above adjacent grade 4
c) Total net area offlood openings in A9.b 1600.00 sq in
d) Engineered flood openings? ffi Yes fl No
SECTION B- FLOOD INSURANGE RATE MAP (FIRM) INFORMATION
81. NFIP Community Name & Community Number
KITTITAS COUNry 530095
82. County Name
KITTITAS
83. State
Washington
Bl. Map/Panel
Number
53037C1234
85. Sufllx
D
86. FIRM lndex
Date
a9-24-202'l
87. FIRM Panel
Effective/
Revised Date
09-24-2021
B8. Flood
Zone(s)
AE
B9. Base Flood Elevation(s)
{Zone A0, usd Base Flood Depth)
2480.O',
810. lndicat€ the source ot the Base Flood Elevation (BFEi daia or base flood depth entered in ltem Bg:
n FIS Prolile E] FIRM fl Community Determined I Other/Source:
B1'1. lndlcate Blevation datum used for BFE in ltem Bg: f] NGVD 192s I NAVD 1988 [ Other/Source:
812. ls the building localed in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? [ Yes @ No
Designation Date:I CBRS f] oPA
FEMA Fonn 086-0-33 ('12119)Replaces all previous editions.Form Page 1 of6
IMPORTANT: ln these specea, copy the corresponding infonnation from Sectlon A.FOR INSURANCE COMPANY USE
Bullding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
14710 MANASTASH RD.
Policy Number:
Company NAIC NumberState
Washington
ZIP Code
98926
City
ELLENSBURG
sEcTroN c - BUILDTNG ELEVATTON TNFORMATTON (SURVEY REQUTRED)
Cl . Building elevations are based on: f] Consiruc{ion Drawings* f] Building UndEr Construction* ffi Finished Conslruction
'A new Elevation Certificate wlll be required when construction of ihe building is complele.
C2. Elevations -Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO,
Complete ltems C2.a-h below according to the building diagram specified in ltem A7. ln Puerto Rico only, enter meters.
lndicale elevation datum used for the elevations in items a) lhrough h) below.
n NGVD 1929 E NAVD 1988 D Other/Source:
DatumusedforbuildingelevalionsmustbeFtesame"sth"
Check the measurement used,
a) Top of bottom floor (including basement, aawlspace, or enclosure floor)
b) Top of the next hlgher floor
c) Bottom of the lowest horizontal struclural member (V Zones only)
d) Attached garage (top of slab)
e) Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment and localion in Comments)
0 Lowest adjacent (finished) grade next to building (LAG)
g) Highest adjacent (finished) grade next to building (HAG)
h) Lowest adjacent grade at lowest elevation of deck or slairs, including
structural support
2462.1
2457.6
2457.8
2457.9
2456.8 E feet I meters
2461.6 @ feet fl meters
I feet f] meters
2458.2 fi!feet I meters
N/A
Benchmark Utilized: 580592
[| feet I meters
I teet
ffi feet
Slfeet
I meters
I meters
f] metars
Veriical Datum: NAVD 88
sEcTloN D - suRvEYoR, ENGINEER, OR ARCHTTECT CERTTRCATTON
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation lnformation
I cedify lhat the information on.this Certificate represenls my best efrods to interprct the data available, I understand that any false
slatement may be punishable by tine or impisonmdnt under 18 U.S. Code, SecUon 1001.
Were latitude and longitude in Section A provided by e licensed land surveyor? E yes fl tto f] Check here f attachm2B.
Gertifie/s Name
CHRISTOPHER C. CRUSE
License Number
36815
Tltle
PROFESSIONAL LAND SURVEYOR
Company Name
CRUSE AND ASSOCIATES
Address
P-O. BOX 959 5
State
WashingtonELLENSBUR%
ZIP Code
s8926
City
.4
Date
1V31-2022
Telephone
(509) 962-8242
Ext-Signalure
Copy all pa{es of this ElevalionTedilicale and all attachments for ('t) community official, (2) insurance agenUcompany, and (3) bulldlng owner.
Comments (including type of equipmenl and location, per C2(e), if applicable)
A8d andA9d. ENGINEERED SMARTVENT MODELS 1540.510 &.I540.5.11; C2a. EARTHEN CRAW- SPACE; C2b. FINISHED
FLOOR; Czd. CONCRETE SLAB; C2e. TANKLESS HEATER LOCATED lN GARAGE.
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Dale: November 30, 2022
FEMA Form 086-0-33 (12119)Replaccs all previqus editions.Fom Page 2 of 6
IMPORTANT: ln these spaces, Gopy lhe correspondlng information from Seclion A.FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unil, Suite, and/or Bldg. No.) or P.O. Route and Box No.
14710 MANASTASH RD.
Policy Number:
City State
Washington
ZIP Code
98S26ELLENSBURG
Company NAIC Number
sEcTloN E - BU|LDING ELEVATION TNFORMATTON (SURVEY NOT REQUTRED)
FORZONE AO AND ZONE A (WTHOUT BFE)
For Zones AO and A (without BFE), complete ltems E1-85, lf the Certificate is intended to support a LOMA or LOMR-F request,
complete Sections A, B,and C. For ltems E1-E4, use natural grade, if available. Check the measurement used. ln Puerto Rio only,
€nter meters.
E1. Provide elevation information for the following and cfreck the appropriate boxes to show whether the elevation is above or below
thc highcst adjacent grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom lloor (including basement,
crawlspace, or endosure) is
b) Top of bottom floor (including ba;emenl,
crawlspace, or enclosure) is
! feet flmeters I above or I belowthe HAG.
I feet n meters I above or n below the LAc.
E2. For Building Diagrams 6-9 with permanent
the next higher lloor (elevation G2.b in
the diagrams) of the building is
flood openings provided in Section A llems I and/or 9 (see pages 1-2 of lnstructions),
E3. Attached g€rage (top of slab) is
E4. Top of platform of machinery and/or equipment
servicing the building is
I feet f] meters fJ above or I below lhe HAG.
! feet f| meters fl above or [below the HAG.
f] feet n meters n above or I below the HAG.
E5. Zone AO only: lf no flood depth number is available, is the top of the bottom floor elevated in accordance with lhe communig's
floodplain management ordinance? [ Yes n No I Unknown. The local officiai must certify this information in Section G.
sEcnoN F - PROPERTY OWNER (OR OWNER',S REPRESEfiTAT|VE) cERTtFtCATtON
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 slatem€nts in Seclions A, B, and E are conect to the beet of my knowledge.
Property Owner or Owne/s Authorized R€presentative's Name
Address City State ZIP Code
Signature Date Telephono
Comments
I Ctrect here if attadrments.
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: Novembe r 3O,2A22
FEMA Form 08&0-33 (12l19)Replaces all previous edltions.Fom Page 3 of 6
IMPORTANT; ln these spaces, copy the corresponding information from Section A,FOR INSURANCE COMPANY USE
Building Streel Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Roule and Box No.
14710 MANASTASH RD.
Policy Number:
City
ELLENSBURG
Slate
Washington
ZIP Code
98926
Company NAIC Number
sEcTroN G - coMMuNrTY TNFORMATTON (OPTTONAL)
The local official who is authorized by law or ordinance to adminisler the community's floodplain management ordinance can complete
Sections A, B, C (or E), and G of this Elevalion Cerlificate. Complele lhe applicable ilem(s) and sign below. Check the measurement
used in ltems G8-G10. ln Puerto Rico only, enler meters.
G1. n The information in Section C was taken from other documentalion thal has been signed and sealed by a licensed surveyor,
engineer, or architect who is authorized by law to cerlifu elevation information. (lndicate the source and dale of lhe elevalion
data in lhe Commenls area below,)
n A community oflicial completed Seclion E for a building located in Zone A (without a FEMA-issued or community-issued BFE)
or Zone AO.
G3. I The following information (ltems G4-G10) is provided for community floodplain managemenl purposes
G2.
G4. Permil Number
FD-21-00034
G5. Date Permit lssued
11-10-2021
G6. Date Certificate of
Compliance/Occupanry lssued
12-22-2022
G7. This permit has been issued for: ffi New Construction I Substanlial lmprovemenl
2456.8
2460.0
2461.0
ffi feet I meters Datum NAVD 88
ffi feet f] meters Datum NAVD 88
ffi feet f] meters Datum NAVD 88
G9. BFE or (in Zone AO) depth of flooding at the building site:
G10. Community's design flood elevation
G8. Elevation of as-built lowest floor (including basement)
of lhe building:
Local Official's Name
SAMANTHA COX
Ti[e
WATER RESOURCES SPECIALIST
Community Name
KITTITAS COUNTY
Telephone
(509) 962-7523
Date
12-22-2022
ffi Ctreck here il atlachments
type of equ and localion, per C2(e), if applicable)
G8 is crawlspace floor, lop of finished floor is 2461 .6' NAVD88
Certificale for Smarl Venis attached
ELEVATION CERTIFICATE OMB No. 1660.0008
Expiralion Dale: November 30,2O22
FEMA Form 086-0-33 (12t19)Replaces all previous editions Form Page 4 of 6
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
See lnstructions for ltem r{6.
OMB No. 1660-0008
Expiration Date: November 30, 2022
IMPORTAI{T: ln these lpacea, copy the coresponding inlormation from Section A.FOR INSUMNCE COMPANY USE
Building StreetAddress (including Apt,, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
.14710 MANASTASH RD.
Policy Number:
City State
Washington
ZIP Code
98926ELLENSBURG
Company NAIC Number
lf using the Elevstion Certilicate to oblain NFIP flood insurance, affix Et least 2 building photographs below according to the
instructions for ltern A6. ldentify all photographs wilh dat€ taken; "Front Vieyy'' and "Rear Vierrrf; and, iireiuired, "Right Side View" and
"Lefl Side !.ew." \Mgn applicable, photographs must show the foundation with representalive exampies of ihe-flood openings or
vent6, a6 indicated in Seclion A8. lf submltting more photographs than will ltt on this page, use lhe Continuation Page.
Fholo (hr
Photo One Caption PHOTO TAKEN 8-24-2022 NORTH SIDE OF HOUSE, FACtNc SOUTH ClearPhoto Onc
Pholo Trrc
Photo Two Caplion PI'IOTO TAKEN 8-2+2022. VIIEST SIDE OF HOUSE ANO GARAGE, FACt!,tG EAST. ctcarphoroTwo
FEMA Form 086-0-33 (12119)Replaces all previous editions.Form Page 5 ofG
IMPORTANT: ln these spEces, copy lhe corresponding information from Scctlon A.FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P-O. Route and Box No.
147.I0 MANASTASH RD.
Policy Number:
City State
Washington
ZIP Code
98925ELLENSBURG
Company NAIC Number
lf submitting more photographs than will fit on the preceding page, affix the additional photographs below. ldentify all photographs
with: date laken; "Front Mew" and "Rear Vieil'; 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 venls, as indicaled in Section A8.
Photo Tlv!.
Photo Three Caption Clear Photo Three
Fhob Fdr
Photo Four Caplion Clear Photo Four
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
Continualion Page
OMB No. 1660-0008
Expiration Date: November 30,2O22
FEMA Form 0864-33 (12119)Replaces all previous editions.Form Page 6 of 6
mH lf r i ,
ICC-ES Evaluation Report ESR-2074
Rer.ssued February 2021
This repoft is subject to renewal February 2023.
raruvw.icc'es.oro | (800) 423-6587 | (562) 699-0543 A Subsidiary of the tnternationat Code Councit@
DIVISION: 08 00 O0-OPENINGS
Secllon: 08 95 43-Vents/Foundation Flood Vents
REPORT HOLDER:
SMART VENT PRODUCTS, INC.
EVALUATION SUBJECT:
SMART VENT@ AUTOMANC FOUNDATION FLOOD
VENTS: MODELIS #1540€20; #1840{21; #1i40{t0; #1540-
511 ; #1540670 ; *1*o$74; #1*O-524; #1540{14
FLOOD VENT SEALING KIT #1 540626
1.0 EVALUATION SCOPE
Compllanc€ with the following codas:
r 2018,.201 5, 2012, 2009 and 20A6 hbrnationat Buitding
Cod60 (lBC)
| 2018, 2015, 2012, 2009 and 2006 tnternational
Residentra/ Codeo (lRC)
r 2018 lntemational Energy Conservation Codeo (IECC)
r 2013 Abu DhabilntemationalBuilding Code (ADIBC)I
fThs ADIBC ls bs3€d on the 2000 tBC. 2009 IBC code 3€ctioffi.oferenced
in this reporl €r€ lha Bam€ saclions in the ADIBC.
Properties cvaluated:
r Physical operatlon
I Water flow
2,0 usEs
The Smart Venlo unils are engineered mechanically
operaled flood venls (FVs) employed to equalize
hydrostatic pressure on walls of enclosures subject lo
rising or falling flood waters. Cerlaln models also allow
natural venlilalion,
3,0 DESCRIPTION
3.1 General:
When subjected to dsing water, the Smarl Vento FVs
internal floats are acllvated, then pivot open lo allow flow in
either direction to equalize water level and hydrostatic
pressure from one side of the foundation to the olher. The
FV pivoling door is normally held in the closed Bosition by
a buoyanl release device. When subjected to rising waler,
the buoyant release device causes lhe unit to unlatch,
allowlng the door to rotrate out of the way and allow flow.
The water level stabilizes, equalizing the laleral forces.
Each unit is fabricated from stainless sleel. Smart Vento
Aulomatic Foundation Flood Vents are available in
various models and sizes as described in Table 1. The
SmartVENTo Slacking Model #1540-51 1 and FloodVENTo
Stacking Model #1 540-521 units each contain two
vertically arranged openings per unit.
3.2 Englneered Opening:
The FVs comply with the design principle noted in Section
2.7.2.2 and Section 2.7.3 ol ASCE/SEI 24-14 lseclion
2,6.2.2 of ASCE/SEI 24-os (2012,2009, 2006 tBC and
IRC)I for a maximum rate of rise and fall of S.0 feet per
hour (0.423 mm/s). ln order to comply with lhe engineered
opening requirement of ASCE/SEI 24, Smarl Vent FVs
must be installed in accordance with Section 4.0.
3.3 V€ntllation:
The SmartVENTs Model #1540-510 and SmartVENTo
Overhead Door Model #1540-514 both have screen covers
with 1/l-inch-by-l&inch (6.35 by 6.35 mm) openings,
yielding 51 square inches (32 903 mm2) of net free area to
supply natural ventilation. The SmartVENT@ Stacking
Model#1540-511 consists ol two Model #1S40-Sl0 unitsin one assembly, and provides 102 square inches
(65 806 mm21 of net free area to supply natuial ventilation.
Other FVs recognized in this reporl do not offer nalural
ventilation.
3.4 Flood Vent Saallng Kit:
The Flood Venl Sealing Kit Modet#1540-526 is used with
SmarlVENTs Model #1540-520. ll is a Homasote 440
Sound Barriero (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 SmartVENTo and FloodVENl$:
SmartVENTo and FtoodVENls are designed to be
installed into walls or overfiead doors of exisilng or new
conslruction from lhe exlerior side, lnstallalion of lhe
vents must be in accordance with lhe manufacturer's
instructions, the applicable code and this report.
lnstallation clips allow mounting in masonry and concrele
walls of any thickness. ln order to comply with the
engineered opening design principle noled in Sec{ion
2.7.2.2 and 2.7.3 of ASCE/SE| 24-14 [section 2.6.2,2 ot
ASCE/SEI 24-05 (2012,2009, 2006 IBC and IRC)], rhe
Smarl Vento FVs must be installed as foltows:
r With a minimum of two openings on different sides of
each enclosed area.
r Wih a minimum of one FV for every 200 square
Copyrighl@2o21 ICCEveluEtionSeNice,LLC. AilrighBrecorv€d. prgsio,!
ESR-2074 | Most Widely Accepted and Trusted Page 2 of 5
feet (18.6 '{n') of enctosed area, except that the
SmartVENTs Stacking Model #1s4d-si 1 and
FloodVENf Siacking Model #154O-SZ1 must be
installed with a minimum of one FV for every
400 square feet (37.2 m21 of enclosed area.
I Below the base |lood elevalion.
I With the bottom of the FV localed a maximum of
12 inches (305.4 mm) above the higher of lhe 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 FIoodVENTB' Model #1540-520. When
installed and tested in accordance wilh ASTM E283, the
FV and Flood Vent Sealing Kit assembly have an air
leakage rale of less than 0.2 cubic feet per minute per
lineal foot (18.56 l/min 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) conlained by the Flood
Vent Sealing Kit.
5.0 CONDITIONS OF USE
The Smart Vento FVs described in this report compty with,
or are suitable allernatives to whal is specified in, lhose
codes listed in Section 1.0 of this report, subject lo the
following conditions:
5.1 The Smart Vents'FVs must be installed in accordance
wlth this report, lhe applicable code and the
manufacturer's installation instruclions. ln the event of
a conflicl, the instruclions in this reporl govem.
5.2 The Srnarl Vent& FVs rnusl not be used in the place
ol "breakaway walls" in coastal high hazard areas, but
are permitted for use in conjunclion with breakaway
walls in other areas.
6.0
6.1
TABLE 1-MODEL SIZES
EVIDENCE SUBMITTED
Data in accordance with the ICC-ES Acceptance
Criteria for Mechanically Operated Flood Vents
(AC364), dated August 2015 (editoria[y revised
October 201 7).
6.2 Test reporl on air infiltration in accordance with ASTM
E283.
7.0 IDENTIFICATION
7.1 The Smart VENf modets and the Flood Vent Sealing
Kit recognized in lhis report musl be identified by a
label bearing the manufaclurer's name (Smartvenl
Products, lnc.), the model number, and lhe evaluation
reporl number (ESR-2074).
7.2 The reporl holder's conlact information is the
following:
SMART VENT PRODUCTS, INC.
430 ANDBRO DRIVE, UNIT 1
PITMAN, NEW JERSEY 08071
(877) 44t-8368
www.snra rtven-t.cor!
info@sqlgrlvqlil.conr
For Sl: 1 inch = 25.4 mm; 1 square fool =
MODEL NAME MODEL NUMBER MODEL SIZE (in.)GoVERAGE (sq.ft.)
FloodVENf 15/0-520 15"1i'x7rl4"200
SmarlVENTo 1 540-510 1E3ta" x73li'200
FloodVENf Overhead Door 1540-524 15"1a" X 7tla"200
SmartVENf Overhead Door 1540-514 1s3ln" x77la"200
Wood WallFloodVENf 1540-570 14" X lxlo,"200
Wood Wall FloodVENTa Overhead Door 15/0-574 14' X 8314"200
SmartVENTei Stacker '1540-511 16'X 16',400
FloodVento Stacker 1540-521 16'X 16'400
a -E i I i i. i::i i i;;;;; r i i !; & i I I L i a i ii r - i;tttttrttaatrta rrttitatitaltllallllttttr.t,ir'/rttr-,/Itlattartrtarilalalrrttta tttrttrr.rlltl:lllratli,rt! \,rJrr 4r:..ttttrrarlalillllfallF,,',,rt tt I irt rtrtattlralr ar r r r t r aa t I I tt. r lt a l t a t I I t: r a t a tr I I r a
t I I tt r I t at r I t a t I I t a - -r- r I ':i tt alllllrrtl!f rtllailrrr,rt r.ati-,tr.rttarrrttatrtlrtrar-. - <- -irirItlllllarrtatltt.r rr tl t. rr t Jt_rrlattrtattttttt, ,,r ,rt rr, .r Il al a lrt t al I r at I tat t ia it I I I rr a t I
a
ItlarataitIallltalai
Iata!tarta
tlttttrttt
-t
ta r
at
FIGURE 1-SMART VENT: MODEL 15.t0-510
ESR.2074 | Most Widety Accepted and Trusted Page 3 of 5
FIGURE 2-SMART VENT MODEL I540.520
FIGURE 3-SMART VEl.lT: SHOWN WITH FLOOD DOOR PTVOTED oPEN
INTERIOR EXTERIOR
FIGURE '0-FLOOD VENT SEALING KIT
E
ICC-ES Evaluation Report ESR-2074 CBC and CRC Supplement
Rer.ssued February 2021
This repoft rb sub1'ect to renewal February 2023.
www.icc:es.orq | (800) 423-6587 | (562) 699-0543 A Subsidiary of the lntemationalCode Council@
DIVISION: 08 00 00-OPENINGS
Soctlon: 08 95 43-VenterFoundetion Flood Vents
REPORT HOLDER:
SMART VENT PRODUCTS, INC.
EVALUATION SUBJECT:
SMARTVENToAUTOMATTC FOUNDAflON FLOOD VENTS: MODELS#1540"520;#15lo.521;#15{0.5'10; #1540€tl;#1040.
570; #1540.5741 #1il0$24t #1540-514
FLOOD VENT SEALING KIT #1 540.526
1.0 REPORTPURPOSE AND SCOPE
Purpoee:
The purpose of this evaluation report supplemenl is lo indicale thal Smarl Vent@ Automatic Foundation Flood Vents,
described in ICC-ES evalualion report ESR-2074,have also been evaluated for cornpliance with codes noted below,
Applicable code editlon;
I 2016 California Building Code (CBC)
r 2016 Califomia ResrUenl,a/Code (CRC)
2.0 coNcLusroNs
2,1 GBG:
The Smart VenF Automatic Foundation Flood Vents, described in Sections 2.0 through 7.0 of the evalualion reporl ESR-
2O74, comply wilh 2016 CBC Chapler 12, provided the design and installation are in accordance wllh the 2015 lniernational
Building Codoo (lBC) provisions noted in lhe evaluation report and lhe additional requirements of CBC Chapiers 12, 16 and
164, as appllcable.
2.2 CRC:
The Smart VenF Automatic Foundalion Flood Vents, described in Sections 2.0 through 7.0 of the evaluation reporl ESR-
2074, comply with the 2016 CRC, provided lhe design and installation ere in accordance wlth the 2015 tnternational
Residenlial Code@ (lRC) provisions noled in the evaluation report.
This supplement expires concurrenlly with the evalualion report, reissued February 2021.
ut anyftndmg or othgr niltter iD rl,tt relort. or o!- ti ailr pr.nluct <r*erctl ht, tlrc rcJnrt, A?H '.f.--.
Copyrlght O 2021 ICC Evaluation Service , LLC. All rlghts reroryod, prge 4 ot 6
tlHE rii l,t )i
i l-\1,
IGC-ES Evaluation Report ESR-2074 FBC Supplement
Reissued February 2021
This report rb subjecf lo renewat Fabruary 2023.
www,icgfs.org | (8001423-6587 | (562) 699.0543 A Subsidiary of the lnternationalCode Council@
DIVISION: 08 00 00-OPENINGS
Sectlon: 08 95 43-Vents/Foundation Flood Vents
REPORT HOLDER:
SMART VENT PRODUCTS, INC.
EVALUATION SUBJEGT:
SMART VENToAUTOMAilC FOUNDATION FLOOD VENTS: MODELS fin40-520;#15i10'521; #1i40-510; #1540{11;
#13O$70; #1 ffi..574; t104,0.54i #1540-514
FLOOD VENT SEALING KIT #15{0.526
1.0 REPORTPURPOSE ANDSCOPE
Purpose:
The purpose of this evaluatlon report supplement is to indicate lhat Smarl VenF Automatic Foundauon Flood Vents, described
ln ICC-ES evaluation report ESR-2074, have also been evaluated for compliance wilh the codes noled below.
Appllcable code editions:
. 2017 Florida Building Code-Building
| 2017 Florida Building Code-Residential
2.0 coNcLustoNs
The Smart VenF Automath Foundaton Flood Vents, described in Seclions 2.0 lhrough 7.0 of the evaluation report ESR-2074,
comply with the Florida Building Code-Building and the FRC, provided the design and installation are in accordance with
the 2015 lnternatlonal Building Code@ provisions noted in lhe evaluallon report.
Use of the Smart VenF Automalic Foundation Flood Vents has also been found lo be in compliance with the High-Velocity
Hurricane Zone provisions of the Florida Building Cod*Building and th6 Floida Building Code-Residenlial ,
For producls falling under Flodda Rule gN-3, verification that lhe report holder's qualily assurance program is audited by a
quality assurance entlty approved by the Florida Building Commission for the type of inspeclions being conducted is the
responsibility of an approved validation entlty (or lhe code official when the report holder does not possess an approval by
the Commission).
This supplement expires concurrently with the evaluation report, reiseued February 2021.
ta uty f;nling or olhct n .ttl{ in thi\ rcpart, ot as lo itn' prudu(t ct^,$ul h!, ilr' r4/rl.
CopyrlghtO 2021 ICC Evaluation Se|ic€, LLC. All rtghls r€3Brv6d.
Ng
Page 6 ol 5
U.S, DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
Nallonal Flood lnsurance Program
ELEVATION CERTIFICATE
lmportanh Follow the lnelructlons o,n pages 1-9.
Copy all pages of thls Elevation Certilicate and allatlachments for (1) communlty officlal, (2) lnsurance agenUcompany, and (3) bullding owner.
OMB No. 1660-0008
Explratlon Date: November 30, 2022
SECTION A - PROPSRTY INFORMATION FOR INSURANCE COMPANY USE
A1. Bulldlng Owner's Name
ssHl LLc.
Pollcy Numben
A2. pulldlng Street Address (lncludlng Apt., Unlt, Sulte, and/or Bldg. No.) or P.O. Route and
Box No.
2911 Roan Drive
Company NAIC Numben
City
Ellensburg
State
Washlngton
ZIP Code
98926
A3. Propeily Description (Lot and Block Numbers, Tax Parcgl Number, Legal Descrlptlon, etc.)
Dlvlolon 6 Lot 2, 981887
A4. Bulldlng Use (e.g., Resldentlal, Non-Resldenilal, Addilion, Accesory, etc.) Resldentlal
A5. Latltude/Longltude: Lat.N47'01'29.68532" 1ory,W120'3433,05814'HorizontalDetum: I NAD {927 E NAD 1983
46. Atlach at least 2 photographs of the building lf the Gertlficate le betng used to obtain llood lnsurancs,
A7. Bulldlng Dlagram Number 1B
A8. For a bulldlng wlth a crawlspace or enolosure(s):
a) Square footage of orawlspaco or oncloeure(s) N/A eq fl
b) Number of pemanent llood openlngs ln lhe orawlspace or enclosure(s) withln 1,0 foot above adjacent grade N/A
a) Total net arca ol flood openlngs in A8.b N/A sq ln
d) Engineered flood openings? E yes El t'to
A0. For a building with en attached garage:
a) Square footage ol attached garage 604.00 sq ft
b) Number of pormanont flood openlrps h lhe attadred garage wllhin 1.0 foot above adjacent grade 0
c) Tolal net area of llood openlngs ln A9.b 0.00 sq ln
d) Engineered fiood oponlngs? [ Yoe El tto
SSGTION B.FLOOD INSURANCE RATE MAP (FIRMI INFORMATION
B'1. NFIP Community Name & Conmunlty Number
KIIT|TAS COUNWI530095
82. County Name
KITTITAS
83. State
Washlngton
84. Mao/Panel
Nuinber
53037C1064
86. Sufflx
D
86, FIRM lndex
Date
0s-24-2021
87. FIRM Panel
Elfectlve/
Revlsed Date
09-24-2021
80, Flood
Zone(s)
AE
89. Baee Flood Elevation(s)
(Zono Ao, use Base Fldrod Depth)
1698,1 fr
810. lndicate lhe source of the Baae Flood Elevatlon (BFE) data or base flood depth entered ln ltem B9:
@ Fl$ Profile E FIRM I Commudty Deternlned fl Olher/Source:
Bl'1. lndlcate elevatlondatum usod lor BFE ln ltem B9: I NCVD {929 EI NAVD 1988 fl Other/Source:
812. ls lhe bullding located ln a Coastal Banier Resources System (GBRS) aroa or Othenrlse Protected Area (OPAp D Yes E] No
Designation Date: n CBRS I OPA
FEMA Form 086-&33 {12nsl Replaces all prevlous edltlons.Form Page 1 of6
IMPORTANT: ln theae spaces, copy the oorrespondlng lnformatlon from Seollon A.FOR INSURANCE COMPANY USE
Bullding $treet Address (including Apt., Unil, Sulte, and/or Bldg. No.) or P.O. Route and Box No,
2911 Roan Drive
Pollcy Number:
clty State
Ellensburg Washington
ZIP Code
98926
Company NAIC Numbet
SECT|ON C - BUILDING ELEVATTON TNFORMATTON (SURVEY REQUTRED)
C1. Bulldlng elevatlons aro based on: I Construction Drawlngs* [ Buildlng Under Gonstrucllonr B ftnfned Construollon
!\ new Elevatlon Cerlilicate wlll be requhed when constructlon of the bulldlng ls complete,
C2, Elevations - Zones A{-A30, AE, AH, A (wllh BFE), VE, V1-V30, V (wllh BFE}, AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO.
Complete ltems C2,a-b below according to lhe building diagram specilied in lteft A7. In Puerto Rlco only, enter metors.
Benchmark Utlllzed: Center of S 27 T 18 N, R 18 E VertlcalDalum: NAVD tS88
lndicate elevatlon daturn used for lhe elevations in items a) through h) below.
fl NGVD 1929 El NAVD 19ss flother/Sourcer
Datum used for building elevallons must be the same as that ueed for the BFE.
Chsok ths measurem'nt us€d.
a) Top of botlom fioor (lncludlng basement, crawlspace, or enclosure tloor)
b) Top of lhe next hlgherlloor
o) Boftom of lhe lowest horizontal struclural member (V Zones only)
d) Attached garage (top of slab)
e) Lowest elevation of machlnerv or eoulomeni serviclno {he bulldlno' (Dedcrlbe type of equlpment rind locratlon ln Commenle)
f) Loutest adjacent (finished) grade next to building (LAG)
g) Hlghest adjacenl (linished) grade next to bullding (HAO)
h) Lowest adfacent grade at lowest elevation of deck or slairs, includlng
etructural support
r 601.3 I feet I melers
N/A I feet I meters
N/A I feet fl meters
1601.3 @ feet I meters
1601.s
N/A E feet fl meters
1599,8
@ feet
@ feet
[] feel
! meters
I meters
fl meters1600.6
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
Thls certllicatlon ls lo be signad and s€aled by a land survoyor, englneer, or erchitect authorized by law to certify elevation lnformatlon,
I certlfy that the .lnformatbn on thig Certillcaki rcpresonls my besl etforls to lnterpret lhe data avallhble, I underdtand that any falso
slatemenl may ba punishable by llne or imprlsohmont undeir tA U,S. Code, Secllon 1001,
Were latltude and longltude ln Secllon A provlded by a llcensed land suweyor? ElYes fJ tto n Check here if attachments,
Cerllfle/s Name
Rick Skinner
Licenso Number
436.19
I I
TUe
Professional Land Surveyor
Company Name
Weslern Paclflo Englneerlng & Survey, lnc.
Address
1224S. Ploneer Way
Clty
Moees Lakf\
r",
gtate
Washlngton
ZIP Code
98837
Date Telephone
(509) 765-1023
Ext.
l
Copy all pdges of tfils Elevallon Goillflcate and allattachmonts fo/(1) coftmurfity offlclal, (2) lnsunnoe agenUcompany, and (3) bulldlng owner,
Comments (including type of equipment and locatlon, per C2(e), if applicable)
The elevation of the heat pump located outside of home wae measured by uslng a GPS and lhen adding the height of the legs for the
heat pump.
ELEVATION CERTIFICATE OMB No, 1660-0008
Explratlon Date: Novemb et 30, 2022
FElvlA Form 086-0-33 (12/19)Replaoes all prevlous editlons.Form Page 2 of6
ELEVATION CERTIFICATE oMB No. 1600-0008
Explralion Date: Novemb er 30, 2022
lUtgtlAltT: ln thess spaoos, copy the correspondlng lnformation from Seoflon A.FOR INSUMNCE COMPANY USE
Building Slreet Addreeg
2911 Roan Drive
(lncludlng Apt,, Unlt, Suite, and/or Bldg. No.) or P.O. Route and Box No.Policy Number:
cny Slato
Washington
ZIP Code
98926Ellensburg
Company NAIC Number
SECTION E - BUILDING ELEVATION
FORZONEAOAND
TNFORMATTON (SURVEY NOT REQUTRED!
zoNE A (WTHOUT BFE)
ForZones_AO and A (wllhou!BFE)r complete ltems El-E5. lf the Certillcate is intonded to support a LOMA or LOMR-F request,
complete Secllons A, B,and C. For ltems E1-E4, use natural grade, if avallable. Check the m6asurement used. ln Puerto Rlco only,
enter meterg.
E1. Provlde elevatlon lnformation for the followlng and ohec* the approprlate boxee to show whelher the elevation is abovo or belo,rr
the hlghest adjaoent grado (HAG) and the lowest adjacent grada (LAe).
a) Top of bottom floor (lncluding basement,
crawlspace, or enolosure) is
b) Top of bottom floor (includlng basemenl,
crawlspace, or enolosurQ ls
E feet E meters ! above or fl below th6 HAG.
fJfeet I metere I above or I bebw lhe LAG.
E2. For Building Diagrams 6-9wlth permanontflood
the nexl hlgher floor (elevatlon C2.b in
the diagrams) of the bulldlng is
E3. Attachsd garage (top of etab) le
E4, Top of platform of machinery and/or equipment
servicing lhe bulldlng 18
openlngs provided in Seclion A ltems 8 and/or g (see pages 1-2 of lnstructlons),
flfeet fimeters
flfeet I meters
Dfeet [meters
flabove or Ibetowthe HAG.
I above or f]bdow lhe HAG,
flabove or flbelow lhe HAG.
E5. ZonE AO only: lf no llood deplh number le avallable, is the top of the bottom floor elevated ln accordanoe wlth lho communlty's
floodplaln management ordinance? ! Yes I No fl Unknown. fie local officla] must c€rlify this information in gedtion G.
sEcTloN F - PROPERTY OWNER (OR OWNER'S REPRESENTATTVEI CERT|F|CAT|ON
The property ownelglo-lvner's authorhed representative who completes Seolione A, B, and E for Zone A (without a FEMA-lssued or
cornmunity.issued BFE) or Zone AO must slgn here. The statemerils ln Secliong A, b, ind E are correct lci the best of my knowledge.
Property Owner or Owne/s Authorlzed Representallve s Name
Scott Henson
AddreEs
1224 S PloneerWay
City
Moses Lake
State ZIP CodeWashlngton S8837
Signalure,,il ' 1,-U-^"" it l.....r'i..sr4z'j /{t1lr(<tr.r/l
Date
^ /, tt . -'r/lLl/ia7")
Telephone
(500) 865.51 12
Commente
D Check here lf attachments.
FEMA Form 086-0-33 (A$l Replaces all prevlous edltlons.Form Page 3 of 6
IMPORTANTT ln these apacea, copy the correspondlng informatlon from Sectlon A.FOR INSUMNCE COMPANY USE
Bulldlng Slreet Address (lncluding Apt., Unit, Suile, and/or Bldg. No,) or P.O. Roule and Box No.
291{ Roan Drlve
Policy Number:
State
Washington
ZIP Code
98926
Clty
Ellensburg
Company NAIC Number
SECTION G - coIrrlMUNlTY INFoRMATIoN (oPTIONAL)
The local ofllclal who ls authodzed by law or ordinance to admlnlster lhe community's lloodplain management ordlnance can complete
Sectlon$ A, B, C (or E), and G of this Elevation Geilifioate. Cbrnplele the applicabld item(s)'and sign below. Chack the measurembnt
used in ltems G8-G10. ln Puerto Rlco only, enler meters.
Cl. fl The lnfonnation in Seolion C was taken from other dooumentation lhal has been signed and sealed by a licensed surveyor,
englnear, or architect who ls authorlzed by law lo certlff ebvation lnformatlon. (lndlcate the source add date of the elevitlon
dala ln the Comments area below.)
G2, E fr?Jl3[gy *cial completed Seolion E for a building located ln Zone A (without a FEMAJssued or community-iesued BFE]
93. I The following lnformalion (ltems GGG10) ls provided for community floodplain managament purpoess.
G4, Pemit Number G5. Date Permit lssued G6. Date Certlflcate of
Compllance/Occupancy lssued
G7. Thls permlt has been lssued for; [| New Conetruclion ! Substantial lmprovement
G8. Elevation of as-built lowest floor {including basement)
of the building:
G9. BFE or (ln Zone AO) depth of floodlng at lhe building site:
G10, Communily's deslgn flood elevatlon:
flfeet f, metere Datum
E teet I metere Datum
I feet ! meters Datum
Looal Oflicial's Name Tltls
Community Namo Telephone
Date$lgnalure
Comments (lncludlng gpe of equlpment and locallon, per C2(e), if applicable)
fl Check here if atlachments,
ELEVATION GERTIFICATE No.1660-0008
Date: November30,202;2
FEMA Form 086-0-33 (12119)Replaceo all previous edilions.Form Page4 ofO
lnformallon from Seotlon A.lheln theee USEINSURANCE
Bullding Street Address (inoludlng Apl,, Unit, Sulte, and/or Bldg. No.) or P.O. Route and Box No.
2911 Roan Drive
Pollcy Number:
Company NAIC NumberState
Washlngton
ZIP Code
98926
City
Ellensburg
lf using the Elevalion Certlfloale to obtaln NFIP flood lnsurarne, afflx at least 2 bulldlng photographs below accordlng to the
lnstruc'tlons for ltem A6. ldentify all photographs wilh date taken; "Front Vlew" and "Rear Viewn; and, lf regulred, "Rlght Slde Verry'' and
"Leff Slde Vlew.n When applicable, photographs must show lhe foundation with representativo examples of lhe llood openinge or
vents, as indicated in Sectlon A8, ll submlttlng more photographs than will lit on this pag€, use the Continuation Page.
Phoio One Captlon Front 'cuaiehooone.
ftvo
Photo Two Captlon Slde ioear Fholq.Tlito.
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
$eo lnslructions for ltem A6.
OMB No. 16604008
Explratlon Date: Novemb er 3A, 2022
FEMAForm086-0-33 (A$Replaces all preMous edlllons.Form Page 5 of6
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
Continuatlon Page
OMB No. 1660-0008
Explratlon Date: Novembet 30, 2O22
IMPORTANT: ln these spaco$, oopythe conespondlng lnformafion from Secllon A.FOR INSURANCE COMPANY USE
Building Street Address (including Apt,, Unlt, Suite, and/or Bldg. No.) or P.O. Route and Box No,
2911 Roan Ddve
Pollcy Number
Company NAIC NumberState
Washlngton
ZIP Gode
98S26
Clty
Ellensburg
tf submitting more photographs than will flt on the preceding page, aflix the additional photographs below. ldentlfy all photographs
wilh: date taken; nFronl VleW" and "Rear View"; and, if required, "Rlght Slde Vie#' and "Left $ide View.u When applicable,
pholographs must show lhe foundation wilh representatlve examples of lhe flood openings or venls, ae lndicated ln Seclion A8.
Photo Three Caption Back Cleor P,holgT.hrso
..1,.1:
Photo Four Captlon Side joleef P.holo Fou.I,
FEMA Form 086-0-33 (12115)Replaces all prevlous editlons.Form Page 6 of 0
U.S. DEPARTMENT OF HOMELAND SECURIW
Federal Emergency Management Agency
Nallonal Flood lnsurance Program
ELEVATION CERTIFICATE
lmportanfi Follow lhe lnstruotlons on pages 1-9.
OMB No. 1660-0008
Exphatlon Date: November 30, 2022
Oopy all pages of thls Elevation Ceilifrcate and allattachmenle for (1) communi$ ofllolal, (2) lnsurance agenUcompany, and (3) bullding owner.
SECTION A - PROPERTY INFORMATION FOR INSUMNCE COMPANY USE
A1. Bulldlng Owne/s Name
SSHI LLC.
Polloy Number:
A2. pulldlng Streel Address (lnduding Apt., Unit, Sulle, and/or Bldg. No,) or P.O, Routo and
Box No.
2916 Roan Drlve
Company NAIC Number:
Clty State
Washington
ZIP Code
98926Ellensburg
A3. Property Desolption (Lot and Block Numbels, Tax Parcel Number, Logal Descriplion, ete)
Dlvision 6 Lot 3, 98'1888 .
A4. Bulldlng Use (e.9,, Resldentlal, Non-Resldenllal, Addition, Accessory, etc.) Resldentlal
A5. Latitude/Longitudoi Lat. N47'01'30.40067"Long.Wl 20"3433.83831 "HorlzontalDatum: fl NAD 1027 E NAD 1983
A6. Allach at least 2 photographs of the building if lhe Certilicate is belng used to obtain llood insurance.
A7. Building Diagram Number 18
A8. For a bulldlng with a crawlspaco or onclosure(s):
a) Squarefootageofcrawlspaceorenclosure(s) N1A sqft
b) Number of permanent llood openlngs ln the orawlspace or enclosure(s) withln 1.0 fool above adjacent grade N/A
c) Total net area olflood openings in A8.b N/A sq ln
d) Englneered l}cod openings? f] yes El tto
A9. For a bulldlng with an allached garage:
a) Square footage ol attached garage 520.00 sq ft
b) Number of permanent llood openlngs ln the atlached garage wllhln 1.0 foot above adjacent grade 0
c) Total nel area ol flood oponlngs in Ag.b 0,00 sq in
d) Engineeredfioodopenings? [ Yes E No
sEcTloN B- FLOOD INSURANCE RATE MAP (FlRIttl INFORMATION
81. NFIP Gommunity Name & Community Number
KITTITAS COUNW; 530095
82. County Name
KITTITAS
83. State
Waehlngton
84. Map/Panel
Number
53037C1064
85. Suflix
D
86. FIRM lndex
Date
0s-24-2021
87. FIRM Panel
Efiecllve/
Revlsed Date
os-24-2021
88. Flood
Zone(e)
AE
B9. Base Flood Elevatlon(s)
(Zone AO, uee Base Flood Depth)
1598.1 ft
810. lndicate lhe source of the Baee Flood Elevation (BFE) data or base flood depth eniered ln ltem 89:
El FIS Prollle I FIRM E Community Determined E Other/Source:
B11. lndlcate elevatlon datum usad for BFE ln ltern B9: f] NGVD 1929 E NAVD 1988 n Oher/source:
Bl2. ls the building located in a Coaslal Barrier Resourc,es System (CBRS) area or Otherwlse Proteoted Area (OPA)? ! Yes @ No
Deslgnatlon Date:E cBRS E oPA
FEMA Form 086-0-33 (419)Replaces all previous editions.Form Page 1 ofG
FOR INSURANCE COMPANY USEIMPORTANT: ln these epaoes, copy the oorrespondlng lnformalion from seclion A,
Building Street Address (ncluding Apt,, Unil, $ulta, and/or Bldg, No.) or P,O. Route and Box No,
2915 Roan Drive
Pollcy Number:
Company NAIC Numberstate
Washington
zlP code
98926
city
Ellensburg
SEGTTON C - BUILDING ELEVATTON TNFORMATION (SURVEY REOUIRED)
C1. Buildlng elevalions are based on: f] Constructlon Drawings* [ Buildlng Under Conslruotion* [] Finlshed Conslrucllon
'A new Elevation Certificate will be requlred when construclion of the bullding ls complete,
C2. Elevalions - Zones A1-A30, AE, AH, A (wilh BFE), VE, V{-V30, V (wlth BFE), AR, AR/A, AR/AE, ARfAI-A3O, AR/AH, AR/AO.
Complelo ltems C2.e-h below according to lhe bulldlng dlagram epecllled ln ltem A7, ln Puerto Rlco onln enter rnster$.
lndicate elevation datum used forthe elevations ln iteme a) through h) below.
E NGVD 1929 El NAVD 1988 flother/Sourco:
Datum used for bullding elevations must be the same as that used for the BFE.
Check the measurement uged,
a) Top of botlom lloor (includlng basement, crawlspa@, or enolosure floor)
b) Top ofthe nexthlgherlloor
c) Bottom of the lo!,ost horlzontal slruclural member (V Zones only)
d) Attached gerage {top of slab)
e) Lowest elevation of machinery or equipment serviclng lhe bulldlng
(Describe type of equipment and localion in Comments)
f) Lowest adjacent (flnlshed) grad6 next lo bulldlng (LAc)
g) Highest adJacent (llnlshedlgrade next to bulldirtg (HAG)
h) Lowest adjacent grade al lowest elerration of deck or staks, lncluding
slructural suppolt
1601.6
N/A
N/A
1600.0
Benchmark Ulilized: Center of S 27 T18
N/A
1601.2
l60t
,._ . ., 1600.9 [J feet f] meters
I feat fl meters
E]feet I meters
@ feet I meters
R 18 E Vettlcal Datum: NAVD 1988
@ feel
I feet
flfeet
fi feet
I meters
I meters
I meters
I meters
sEcTtoN D - 9URVEYO& ENGINEER, OR ARCHITECT CERT|F|CATION
Thls cerllllcation ls to be signed and sealed by a land suruoyor, ongln€6t, or archltect authorlzed by law to ceruFy elevation informatlon.
I ceillfy that lhe lnformatioi on lhls Certiflcatd represents my best effortd to lnterprel lhe data available. I understand that any lalse
slalerhent may be punishable hy line or lmprisonment under t8 U.S. Code, Sectlan 1001.
Were lalltude and longllude ln $eotion A provlded by a licensed land surveyor? E Ves n No I ctreck here if attachmenls,
Llcense
43819Rick Sklnner
Name
Professlonal Land Surveyor
Western Pacific Engineedng & Survey, Inc.
1224S. PloneerWay
ZIP Code
98837Moses Lake Washington
(50e) 765.1023
Date Ext.
all of and all atlachmenls (1)officlal, (2) lnsurance agenUcompany, and (3) building owner.
The elevation of the heat pump located outside of home was meesured by uslng a GPS and then addlng the helght of the legs for the
heat pump.
Commenls (includlng iype of equlpment and locallon, per applicable)
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: Novemb er 30, 2022
FEMA Form 086'0-33 (A191 Replaces all prevlous editions.Form Page 2 of0
IMPORTANT: ln theee apaces, copy the correspondlng information from Secllon A.FOR INSURANCE COMPANY USE
Building StreetAddress (lncludlng Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
2915 Roan Drive
Pollcy Numben
clty Stale
Washington
ZIP Code
98926Ellonsburg
Company NAIC Number
sEcTroN E- BUIJING ELEVATION TNFORMATTON (SURVEY NOT REQUTRED)
FOR ZONE AO AND ZONE A (WITHOUT BFE)
ForZones AO and A (wllhout BFE), complete lteme E1-E5, lf the Cedlllcate is lntended to support a LOMA or LOMR-F requesl,
complete Seclions A, B,and C. For ltems E1-E4, use natural grade, if available. Check the measurement ueed, ln Puerto Rlco only,
enler rneters.
E1. Provlde elevatlon infomatlon for lhe following and chsok the epproprlate boxes to show whether the elevation is above or below
the highest adjacenl grade (HAG) and the lowest adJacent grade (LAG).
a) Top of bottom floor (inaludlng basoment,
crawlspace, or enclosure) ls
b) Top of bottom floor (including basemenl,
orawlspace, or enolosure) ls
D feet D meters I above or E bdow the HAG.
! leel I meters f] above or I below lhe LAG.
E2, For Bullding Diagrams 6-9 wlth permanent
the next higher lloor (elevation C2.b ln
lhe dlagrams) of lhe bulldlng ls
83. Aftached garage (top of slab) is
flood openings provided ln Secllofi A ltems 8 and/or 9 (see pages 1*2 ol lnstrucllons),
Efeet E metere Iaboveor EbelowtheHAG.
E feet flmeterr I aboveor Ebelowthe HAG.
E4. Top of platform of machlnery and/or equlpment
sewicing lhe buildlng ls flfeet E meters flabovoor lbelowthe HAG.
E6, Zono AO only lf no llood depth numbor [s available, is lhe top of lhe bottom floor elevated ln accodanoe with lho community's
floodplaln management ordinance? [ Yes I No I Unknown, The local official must certlfr this informatlon ln Section G.
SECT|ON F - PROPERW OWNER (OR OWNER'S REPRESENTATIVEI CERTIFICATION
The property owner or owner's authorlzed representative who completes Secllons A, B, and E forZone A (wlthout a FEMA-lssued or
community-[eeued BFE) orZone AO must slgn here. The etalemerils in Sectlons A, B, and E are coneot to the best of my knowledge.
Pmperty Owner or Owner's Aulhorlzed Repreeentallvo's Name
Scott Henson
Address
1224 S PioneorWay
City
Moees Lake
State
Washington
ZIP Code
98837
Slgnaturo
.,9-" ^"{.1-
" "}l p. , , ^-,
Date
',t/(f fto;,>::
Telephone
(50e) 855-6112
Comments
U Cheok here if atlaohments.
ELEVATION CERTIFICATE OMB No.
Explration
1660-0008
Date: November3o,2022
FEMA Form 086-0-33 (12115')Replaces all previous edltlons.Form Page 3 of6
IMPORTANT: ln there spacos, copy the coresponding lnformatlon from Section A,FOR INSURANCE COMPANY USE
Bulldlng Street Addrees (lnoludlng Apt., Unit, Sulte, and/or Bldg. No.) or P.O. Route and Box No.
2916 Roan Drive
Polioy Numben
City State
Washlngton
ZIP Code
98926Ellensburg
Company NAIC Number
sEcTlON G - GoMMUNIW |NFORiIIATION (OPTIONAL)
The local ofticlal who is authorlzed by law or ordlnance to admlnlster the communl$'e floodplaln management ordlnance can completo
$ecllons A, B, C (or E), and G of thls Elevallon Certificate. Complete the appllcable ltem(s) and slgn below. Check the moasuremenl
used in ltems G8-G10. In Puerto Rlco only, enler melers.
G1. E The lnlormatlon in Section C was taken fiom other documentalion lhat has been signed and sealed by a licensed surv€yor,
- englneer, or archltect who ls authodzed by law to certlfy elevatlon lnformatlon, (lndlcate lhe sourc€ and date of lhe elevallon
data in the Commonls area below.)
c2. n fr?;xfltsy "fflclal
completed Sectlon E for a building located ln Zone A (wllhout a FEMA-issued or communlly-iseued BFE)
G3. E The following information (ltems Grrclo) ia provlded for communlty lloodplain management purposes.
G4. Permit Number G5. Date Permlt lssued G6. Dale Certlflcate ol
Complianoe/Occupanoy lssued
G7. This permit has been lssued for: P New Construcllon I Substantial lmprovement
c8. Elevallon of as-built lowesl floor (lncludlng basement)
of the bulldlng:
GS. BFE or (ln Zone Ao)deplh of flooding at lhe bullding site:
G10. Gommunlty's deslgn flood elevalion:
fl feet I meters Datum
I feot I meters Dalum
I feet f]meters Datum
Local offtclal's Name Tltle
Communlty Name Telaphone
Slgnature Date
Comments (lncludlng type of equipment and locallon, per C2(e), if appllcable)
I Check here if attachments.
ELEVATION CERTIFICATE
OMB No. 1060-0008
Explration Dale: November 30, 2022
FEMA Form 086-0-33 (A191 Replaces all prevlous editions.Form Page 4 of 6
ELEVATION GERTIFICATE
BUILDING PHOTOGMPHS
See lnstructlons lor ltem A6,
OMB No. 1660-0008
Expiralion Dale: November 30, 2022
IMPORTAI,IT: In these spaces, copy the conespondlng lnformation from Secllon A.FOR INSURANCE COMPANY USE
Buildlng Street Addrcss (including Apl., Unlt, Suite, and/or Bldg. No,) or P.O. Route and Box No.
2915 Roan Drlve
Polioy Number:
Company NAIC NumberState
Washington
ZIP Code
98S28
City
Ellensburg
lf using lhe Elevallon Certificate lo obtaln NFIP flood insurance, aflix at least 2 bullding pholographs below accordlng to lhe
lnstruollons for ltem 46. ldenll0 all photographs wlth date taken; "Front View" and oRear View"; and, if required, "Rlght Side VleW' and
"Left Slde Vlew." When applicable, photographs musl show lhe foundation with ropresentatlve examples of the flood openings or
vents, as indlcated in Seotion A8. ll eubmltllng more photographs than wlll fit on lhls page, use the Conllnuatlon Page.
Photo one Capllon Front ''Ctear.P.hoto gne:
Photo Two Caption Tlryo
FEMA Form 086-0-33 $419)Replaces all preMous edilions.Form Page 6 ol 0
IMPORTANT: ln these spaces, copy the corresponding informalion from Sectlon A.FOR INSURANCE COMPANY USE
Bulldlng Streot Address (lncludlng Apt., Unit, Suite, and/or Bldg, No.) or P.O. Route and Box No.
2915 Roan Drive
Pollcy Number:
Clty S(ate
Washlngton
ZIP Code
98926Ellensburg
Company NAIC Number
lf submlttlng morc photographs than will fit on the precedlng page, affix the additional pholographs below. ldenliff all photographs
wilh: date taken; I'Front VleW' and 'Rear Vlew"; aM, ll requlred, oRlght Slde Vlew" and "Left Side View." When applicable,
photographs must show lhe foundation wilh representative examples of lhe flood openinge or vents, as indlcatsd ln Section A8.
PholoThr6o
Photo Three Captlon Back C. lgar.Photo Thtqg
.:.\,.:,.'..1
Photo Four Gaplion Side ' 0fearPhoto Four
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
Continuallon Page
OMB No. 1680.0008
Explratlon Dale: Novemb et 3A, 2A22
FEMA Form 086-0-33 {121'19}Replaces all previous editlons,Form Page 6 ofO
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emorgency Managemont Agency
Nallonal Flood lnsurance Program
ELEVATION CERTIFICATE
lmportant: Follow the lnstructlons on pages 1-9,
Copy all pages of thls Elevatlon Certlflcale and all attachments for (1) communlly offlclal, (2) lneurance agenUcompany, and (3) bulldlng owner:
OMB No, 1660-0008
Explratlon Date: Novembsr 30, 2Q22
SEGTION A - PROPERW INFORTTIATION FOR INSURANCE COMPANY USE
A1. Bullding Owne/s Name
SSHI LLC.
Pollcy Numben
42. Full{lng Street Address (lncludlng Apt., Unll, Sulle, and/or Bldg. No.) or P.O. Route and
8ox Nci-
2919 Roan Drive
Company NAIC Nurnber;
Clty Slate
Washlngton
ZIP Gode
98926Ellensburg
A3. Property Descriptlon (Lol and Block Numbere, Tax Parcel Number, Legal Descriplion, etc.)
Division 6 Lot 4, 961889
A4. Bullding Use (e.9., Resldential, Non.Resldential, Addltion, Accessory, eto.) Resldentlal
A5. Latltude/Longltudo: Lat.N47'01'31.56960"Long.w120'3433.67385"HorizontalDatum: EINAD 1927 E NAD 1S83
A0. Atlach at least 2 photographs of the bulldlng lf the Certlficate ls belng used lo obtraln llood lnsurance.
A7. Bulldlng Dlagram Number 19
A8, For a bulldlng wlth a oawlspace or enclosure(s):
a) Square foolage of crawlspace or enclosure(s) N/A sq ft
b) Number of permanenl flood openings in lhe crawlspace or enclosure(s) wlthln 1.0 foot above adJacent grade N/A
c) Total net aroa ol flood openlngs ln A8,b NIA sq ln
d) Engineered flood openlngs? E yes E No
A9. For a buildlng with an attached garage:
a) Square footage of attached gange 520.00 sq ft
b) Number of pormanenl flood openlngs ln the attaohed garage udthln 1,0 foot above adJacent grade 0
c) Total nel area of flood openlngs ln A9,b 0O0 eq ln
d) Engineered llood openings? L Yes E No
sEcTtoN B - FLOOD TNSURANCE RATE MAP (FlRm) tNFORilATtON
B'1. NFIP Communlty Name & Communlty Number
KITTITAS COUNTY; 530095
82. County Name
KITTITAS
83. State
Washington
84. Map/Panel
Number
53037C1064
86. Sufflx
D
86. FIRM lndex
Date
0p-24-2021
87. FIRM Panel
Effectlve/
Revised Dats
09-24-2021
88. Flood
Zone(s)
AE
89, Base Flood Elevation(s)
(Zone AO, uoe Base Flood Deplh)
1597,9 fl
810. lndlcaia the sourco of tho Base Flood Elevatlon (BFE) data or base flood depth entered ln ltem B0:
@ FIS Profile E FIRM ! Communily Determined ! Ofirer/Source:
811. lndicate elevallon datum used for BFE ln ltem B9: n NOVD 1929 A NAVD 1988 [ CIher/Souroe:
B12. ls the bulldlng loceted ln a Coastal Barier Resourcoe Syst€m (CBRS) area or Othenplse Protecled Area (OPA[ [ Yes @ No
Designation Date:E CBRS n OPA
FEMA Form 086-0-33 l12l19l Replaces all prevlous edlllons,Form Page 1 ofO
IMPORTANT: ln these apaces, copy the correspondlnil lnformallon from Section A.FOR INSURANCE COMPANY USE
Bulldlng Street Address (lncluding Apt., Unit, Sulte, and/or Bldg, No,) or P.O. Route and Box No.
2919 Roan Drive
Policy Number:
cornpany NAIC NumberStale
Washington
ZIP Code
98S26
ciry
Ellensburg
sEcroN o - ButLDtNc ELEVATTON TNFORMATTON (sURVEv REOU|REDI
C1. Sullding elevations are based on: ! Conslrucllon Drawlngs* f] Bulldlng Under Constructlon' [] finisneC Gonstructlon
*A new ElevaUon Certlficate wlll be required when construction of lhe buildlng is comptete.
C2. Elevatlons - Zones A1-A30, AE, AH, A (with BFE), Ve, V1-V30, V (with BFE), AR, AR/A, AFI/AE, AFUAI-A3O, AR/AH, AR/AO,
Gomplole ltems C2.a-h below accordlng lo lhe bullding diagram epeclfied in ltem A7. ln Puerto Rlco only, enter meters.
Benchmark Utlllzed: Center of S 27,T 18 N, R 18 E Vertcal Datum: NAVD 1988
lndicate elevation dalum used for tho elevatlons ln ltems a) through h) below.
a) Top of bottorn floor (including basement, crawlspaco, or enclosure lloor)
b) Top of the next higher lloor
o) Boltom of the lowest horizontal slructural member (V Zones only)
d) Altached garage (lop of elab)
e) Lowest elevation of machinery or equipment serviclng the buildins
(Desolbe type of equlpment dnd location in Commanle)
Q Lowest adJacent (linlshed) grade nextto bulldlnS (LAC)
g) Hlghest adjacent (linlshed) grade next to bullding (HAG)
h) lowost adJacent grade at lowest €levetion of declt or stdre, includlng
slruclural support
1600.2
1600.0
1599.6
N/A
Datum used for buiiding elevations must be lhe eamo as that used lor lhe BFE.
1600.6 I feet ! melers
N/A fl feet flmeters
N/A I leet ! moters
1600,6 [| feet fl meters
E NGVD 1929 El NAVD 1988 [ other/Source:
Check lhe measurement ussd.
flfeet fl meters
E feet
fl feet
Elfeet
I meters
I melers
! meters
sEcTloN D - guRvEYoR, ENG|NEER, OR ARCHTTECT CERTIF|CAT|ON
Thls cerlificatlon ls to be slgned and sealed by a land surueyor, engineer, or archltect aulhollzed by law to ceillff elevation information.
I cerllfy that lhe lnformallon on.thlg Certlficatd repesents my beqt e-lfo(s fo iqterpret lhe dala avallhble. I undere'tand thal any false
statementmay be punlshabte by tlne or imprlsonment undeir l8 U.S. Code Secllon 1001.
Were lalllude and longitude ln Seclion A provided by a llcensed land surueyor? E ves n No f] check here if attachmente.
Cerlllie/s Name
Rlck Sklnner
Llcense Number
43619
Title
Profeselonal Land Suweyor
Company Name
Weetem Paoillc Engineering & Survey, lnc.
Addrcss
1224$. Pioneer Way
ctg
Moses Lake_.,,-1
,,
State
Washlngton
ZIP Code
98837 4
stgnature(r-l_t
ffi*\i__
Telephono
(60e) 766-1023
Date Ext.
e
Copy all pdfes of lhls Elevatlon Certilioate and all altaohmente for (f) oomfi{unlfofllclal, (2) lnsurance agenUcompany, and {3) bullding owner.
Comments (lnoludlng type of equlpment and looallon, per C2(e), if appllcable)
The elevatlon of the heat pump looated outside of home was measured by using a OPS and lhen addlng the height of the legs for lhe
heal purp.
ELEVATION CERTIFICATE OMB No.1660-0008
Explratlon Date: Novemb er 3Q, 2022
FEMA Form 086-0-33 (12l1Sl Replaces all prevlous edltlons.Form Pago 2 of6
IMPORTANT: ln these spacss, copy the corispondlng lnformatlon from Seoflon A,FOR INSURANCE COMPANY USE
Bulldlng sireet Address (including Apt., Unil, suite, and/or Bldg. No.) or p.o. Route and Box No.
2919 Roan Drlve
Pollcy Number:
State
Washington
ZIP Gode
98926
Clty
Ellensburg
Gompany NAIC Number
For Zones,AO.and A (wllhoulBfE)rcompleleltgms El-Es. lf the Cerlilicate ls lnlonded to support a LOMA or LOMR-F reguest,
complete Seotions A, B,and C. For ltems E1-E4, use natural grade, lf avallable. Check the m6isurement ueed. ln puerto F{ico only,
enter meters.
El. Provide elevation lnloma{ion for the following and chook the appropriale boxes to show whother the elevallon is above or below
the highest adjacent grado (HAG) and the toweet adjacent grait6 (LAG).
flood openinge provided in Seclion A ltems 8 and/or g (see pageo 1-2 of lnotrucllons),
E5. ?ong 49 only: lf no llood depth number is available, ls lhe top ol lhe bottom lloor elevatod ln accordance wlth the oommunitfs
floodplaln management ordlnance? ! Yes E No I Unknown. The tocat offioial must certifi this tnformailon tn Seilon G.
NOT REOUTRED)SECTION E- BUILDING ELEVATION INFORMATION
FORZONE AO AND ZONE A BFE)
84. Topof platform of.machlnery and/or equipment
sorviclng the bulldlno i6 fiteet flmeters D above or [belowthe HAG.
a) Top of bottom floor (inoluding basemont,
crawlspace, or enclosure) is
b) Top of boltom lloor (lncluding basement,
crawlspace, or endosure) ls
I teet D meters flabove or ! below the ule.
Efeet Imeters !aboveor fJbelowtheLAG.
E2, For Buildlng Dlagrams 6-9 with permanent
the next hlgher lloor (elevatlon C2.b ln
the dlagrams) of the bulldlng le
E3. Attached garago (top of slab) is
n feet I meters I above or I below the HAG.
Efeet Imeters [aboveor f]betowthe HAG.
sEcTtoN F - pRopERTy owNER (OR OWNER'S REPRESENTATTVE) CERT|F|CAT| ON
The prop.erty ownglqr_o.wnqt's authorlzed representative who completes Seotlons A, B, and E fol Zone A (wilhoul a FEMAlssued or
communlty.lssued BFE) or Zone AO muel olgn hele. The statemedts ln Sectlons A, B, and E are correct to the best of my knowledge.
Property Owner or Owne/s Authorized Representative's Name
Scott Henson
Addr€$g
12245 PloneerWay
crty
Moses Leke
State
Washington
ZIP Code
98837
.4^o{ "/Jn-.,:--
Date
;t./tll /;tc,d.3)
Telephone
(509) 855-5112
Slgnature
il Cnecf here lf eltechments.
Comments
ELEVATION CERTIFICATE OMB No,
Explration
1660.0008
Date: November30,2O22
FEMA Form 086-0-39 (121191 Replaces all previous edlllons.Form Page 3 of 6
IMPORTANT: ln these spaces, copy lhe corresponding lnformatlon from Section A.FOR INSURANCE COMPANY USE
Bulldlng Street Address (hcludlng Apt., Unit, Sulte, and/or Bldg. No.) or P,O. Route and Box No.
2919 Roan Drive
Pollcy Number:
clty State
Washlngton
ZIP Code
98926Ellensburg
Company NAIC Number
sEcTtoN G - coMMuNtw I{FoRMAT|ON (OPT|ONAL}
The local offlclal who le authorlzed by law or ordinance to admlnlster lhe communlty's floodplaln management ordlnance can complete
Seotions A, B, C (or E), and G of thls Elevatlon Cerlificate. Complete lhe appllcable ltem(s) and sign below. Check tre measurembnl
used in ltems G8-G10. ln Puerto Rico only, enter meters.
Gf . E The lnformatlon ln Sectlon C was taken from olher documentation thal has been slgned and sealed by a llcensed surveyor,
englneer, or architeot who lE aulholzed by law to oerli! elevatlon informalion. (lndloate the source and date of lhe slovallon
data ln the Commenls area below.)
G2. E A qlmmunity ofliclal completed Soction E for a buildlng loosted ln Zone A (without a FEMA-lssued or community-iesued BFE)
or Zone AO,
63. fJ The followlng lnformatlon (llems G4-G10) ls provlded for communlg floodplaln managemenl purposes.
G4. Permit Number G5. Date Permit lssued G6. Date Certlficate of
Compliance/Occupancy leeued
G7. Thls permit has been issued for: [f New Construction ! Subslantial lmprovement
G8. Elevatlon of as-bullt lowesl floor (lncluding basement)
of the buildlng:
G9. BFE or (ln Zone AO) deplh of flooding at the building site:
G10. Community'e design llood elevation:
flfeet I meters Datum
I feet f] meters Datum
I feet I meters Datum
Looal Ofliclal's Name Tltle
Communlty Name Telephone
Signature Dale
Comments (lncludlng gpe of equlpment and loaatlon, per C2(e), lf applicable)
I Cheok herc lf attac'hments.
ELEVATION CERTIFIGATE OMB No. 16604008
Expiralion Dale: Novembat 30, 2A22
FEMA Form 086-0-33 (12115)Replaces all prevlous edllions,Form Page 4of6
IMPORTANT: ln these spaces, copy the correepondlng lnformatlon from Sectlon A.FOR INSURANCE COMPANY USE
Bulldlng StroetAddress (lncludlng Apt., Unll, Sulte, and/or Bldg. No.) or P.O. Route and Box No.
2919 Roan Drive
Policy Number:
City State
Washinglon
ZIP Code
98920Blensburg
Company NAIC Nwnber
lf using ths Elovation Certillcate lo oblaln NFIP flood lnsuranoe, aflix at lEasl 2 building photographs below accordlng to the
instruclions for ltem A6. ldentifr all photographs with dats takenl "Front Vlew" and "Rear VleW'; and, lf rcqulred, "Rlght Side View" and
"Left Slde Mew." When applicable, photogtaphs musl show the foundatlon wlth represenlatlve example$ of the llood openlngs or
vents, as indicated ln Secllon A8. lf submittng more photographs than will lit on thls page, use the Conlinuatlon Page.
Photo ono
Photo One Captlon Front ,Clear,P.ho.to 9ne .
T\eo
Two
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
See lnstructions for ltem A6.
OMB No.1660-0008
Explretlon Dale; November 30,2022
FEMA Form 086-0-33 ({2/10}Replaces all prevlous edltlons.Fotm Page 5 of6
IMPORTANT: ln these apacea, copy the correspondlng lnformatlon from Sectlon A.FOR INSURANCE COMPANY USE
Bulldlng Street Address (lncludlng Apt., Unlt, Sulte, and/or Bldg. No.) or P,O. Route and Box No.
2919 Roan Drive
Pollcy Number:
Company NAIG NumberSlate
Washlngton
ZIF Code
s8926
City
Ellensburg
lf .submitting more photographs lhan wlll fit on the preceding Fa9o, affix the additlonal photographs below. ldenti! all photographs
with: dato taken; uFronl Vie#' and nRear View"l and, if required, "Right Side Vlew" and "Left Side View." When applloable,
photographs must show lhe foundatlon wllh representatlve examples of lhe flood openlngs or vents, as lndlcated in Section 48.
Plbto lhroo
Photo Three Caption Back Clear Phcio Threa
Pholo Fout
Pholo Four Capllon Side 'O,fe.g1Pfulo.Four
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
Contlnuallon Page
OMB No. 1660-0008
Expiration Dalo: Novembet 30,2022
FEMA Fonn 086-0-33 (A1s,Replaces all previous edilions.Form Page 0 of 6
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood lnsurance Program
ELEVATION CERTIFICATE
lmportant: Follow the instructions on pages 1-9.
OMB No. 1660-0008
Expiralion Date: November 3O,2022
Copy all pages of lhis Elevallon Cefilflcate and all ettachments for (1) oomrnunlV offlclal, (2) lnsurance agenUcompany, and (3) building owner.
SECTION A- PROPERTY INFORMATION FOR INSURANCE COMPANY USE
A1. Building Owne/s Name
ssHt LLc.
Pollcy Number:
A2. Bulldlng Slreet Address (indudlng Apt., Unit, Suile, and/or Bldg. No.) or P.O. Route and
Box No.
3012 Dapple Gray Way
Company NAIC Number:
City
Ellensburg
Siate
Washington
ZIP Code
98926
A3. Properly Description (Lot and Block Numberg Tax Parcel Number, Legal Descrlplion, elc.)
Divlslon 6 Lot 5, 961890
A4. Buildlng Use (e.9., Residential, Non-Residentiat, Additlon, Accessory, etc.) Residenlial
A5. Latllude/Longitude: Lat.N47"0'l'33.23464 1ong.Wl20"34'34.5883"HorlzontalDaium; I NAD 1927 E NAD 1983
46. Attach at least 2 photographs of the building if the Cerlificate is belng used to obtaln llood Insurance.
A7. Building Diagram Number 1B
A8. Fora bultding wlth a crawlspace or enclosure(s):
a) Square footago of crawlspace or enclosure(s) N/A sq ft
b) Number of permanent flood openings ln the crawlspace or enclosure(s) wllhln 1.0 foot above adJacent grade N/A
c) Total netarea offlood openings inA0.b N/A sq in
d) Engineered flood openlngs? fl yu" E ruo
A9. For a building with an aitaohed garage:
a) Square footage of attaohod garage 620.00 sq ft
b) Number of permanent flood openings in lhe attached garage within 1.0 foot above adjacent grade O
c) Tolal nel area of flood openings ln Ag.b 0.fi) sg in
d) Engineered flood openings? fl Yes El No
sEcTtoN B - FLOOD TNSURANCE RATE MAp (F|RM) TNFORMATTON
81" NFIP Community Name & Community Number
KITT]TAS COUNTY; 5300095
82. County Narne
KITTITAS
83, State
Washington
84. Map/Panel
Number
53037C1064
85. Suflix
D
86. FIRM lndex
Dale
09-24-2021
87. FIRM Panel
Effectlve/
Revised Date
09-24-2021
BB. Flood
Zone(s)
AE
89. Base Flood Elevation(s)
(Zone AO, use Base Flood Deplh)
15S7.0 ft
810. lndicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in ltem 89:
$ FIS Profile D FIRM I Community Determined I Other/Source:
811. lndlcate el€valion datum used for BFE in ltem Bg: f] NGVD 1929 El NAVD 19BB I olher/Source:
812. ls the bullding located in a Coaslal Banier Resouroes System (GBRS) area or Othenflise Protected Area (OPA)? f] Ves [] No
Deslgnatlon Date:fl cBRs I oPA
FEMA Form 086'0€3 (12ltg)Replaces all provious editions.Form Pago 1 of 6
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiralion Dalo; November 30,2022
IMPORTANT: ln lhose spaces, copy the correspondlng lnformatlon from Sectlon A.FOR INSURANCE COMPANY USE
Building Slreel Address (including Apt,, Unit, Suite, and/or Bldg. No.) or P.O. Roule and Box No.
3012 Dapple Gray Way
Policy Number:
Company NAIC NumberSlate
Washinglon
ZIP Code
98928
City
Ellensburg
sEcTtoN c - BUtLD|NG ELEVATTON TNFORMATTON (SURVEY REQUTRED)
C1. Building elevalions are based on: f] Conslruction Drawinge' fl Bulldlng Under Conslrucllon' @ Finistrcd Construction
'A new Elevalion Certificale will be required when conslruction of lhe building ls complete.
C2. Elevallons - Zones A1-A30, AE, AH, A (wilh BFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO.
Complele ltems C2,a-h below according to the bullding diagram specified in llem A7. ln Puerto Rico only, onler metors.
lndicale elevalion dalum used for the elevalions in items a) through h) below.
I NGVD 1929 E NAVD 1988 f] Olher/Source;
Daiumusodforbuildingelevalionsmustbolhesameustn
Check the measuremenl used.
a) Top of botlom lloor (including basement, crawlspace, or enclosure lloor)
b) Top of lho next higher floor
c) Bottom of lhe lowest horizontal struclural membor (V Zones only)
d) Altached garage (lop of slab)
e) Lowesl olovation of machinery or oquipmont servicing lhe bullding' (Oesorlbo lypo of oqulpmenl dnd bc'ation in Commenis)
l) Lowest adjacenl (finlshed) grade next to bullding (LAG)
g) Highest adjacent (flnished) grade next to building (HAG)
h) Lowest adJaconl grade al lowest elevalion ol deck or slalrs, lncluding
slruclural support
t 599.2
1597.8
1598.1
N/A
1s99.'l [] leet I meters
N/A I feet f] meters
NiA I leet ! meters
1s99,1 [] foot I molers
Benchmark Utilized: Cenler of S 27,T 1B N, R 1B E Vertical Datum: NAVD 'l9BB
fl feet fl meters
fi feet
@ feet
[] foet
I meters
I meters
I meiers
SECTION D _ SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
Were latilude and longltude in Seclion A provided by a llcensed land surveyor?
This .certific.a.ljon,is- lo be..signed..a.nd-seglgd by a land suryoyor, engineer, or archltscl aulhorized by law to certify elevalion informalion.I ce.rlify lhal the Inlormalion on.lhis Cerlilicala reprosenls my besl alforls lo inlerprot lhe dala avall'abte. t underiland lhal any lalse
stalemenl may be punishable by line or impisoirmenl unddr 18 IJ.S. Code, Seciiotr 1001.
EIYes[no @
C€dilior's Namc
Rlck Sklnner
Llcense Number
43619
Tltle
Professional Land Surueyor
Company Name
Weslern Pacllic Engineerlng & Survey, lnc.
Address
1224 S. Pioneer Way
clty
Moses Lake
State
Washlngton
ZIP Codo
98837
A
0{l
Telephone
(509) 705-1023
DaleSlgnature Exl.
Copy all pa$es of thls Elovation Certilicate and all atlachmenls fol (1) cohmunity official, (2) lnsuranco agenUcompany, and (3)building owner
Commenls (lndudlng typo of equipment and location, per C2(e), if applicable)
The elevation of lhe heat pump localed oulside of home was measured by uslng a GPS and lhon adding lhe height of tho legs lor iho
heat pump"
FEMA Form 086-0-33 (12l19)Replacos all prevlous edltions.Form Pago 2 of 6
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiralion Dale: November 30,2Q22
IMPORTANTT ln these spscea, copy the correspondlng lnformallon from $eclion A.FOR INSURANCE COMPANY USE
Building slreel Address (including Apl.. unil, suilo, andlor Blds. No,) or p.o. Route and Box No,
3012 Dapple cray Way
Pollcy Number:
City State
Washlngton
ZIP Code
98926Ellensburg
Company NAIC Number
SECTION E - BUILDING ELEVATION INFORMATION NOT REQUTRED)
FOR ZONE AO AND ZONE A BFE)
For Zones AO.and A (wilhout BFE), compLete ltems E1-E5. If lhe Corlilicats is lntended lo support a LOMA or LOMR-F requesl,
complete Sections A, B,and c. For ltems E1-E4, use nalural grade, if availabte. Check tho m6isurement used. ln Puerlo Fiico only,
enter melers.
E1. Provide elevation informatlon for lhe following and check the appropriate boxo$ to show whether lhe elevation is above or below
lhe hlghest adJacent grade (HAG) and the lowesl adJacont grade (LAG).
a) Top of bottom floor (including basemenl,
crawlspace, or onclosure) is
b) Top of bottom floor (including basemenl,
crawlspace, or onclosure) is
flfeet fJmeters fl abovo or I botow the HAG.
flfeet I meters ! abovo or I bobw tho LAG.
E2. For Bulldlng Diagrams 6-9 wilh permanenl flood
lhe nexl higher lloor (elevation C2.b in
lhe diagrams) of lhe building is
E3. Altached garago (top of slab) ls
E4. Top of platform of machinory and/or equipment
ssrvicing lhe building ls
openings provided ln Sectlon A ltems B and/or 9 (see pages 1-2 of lnstruclions),
!feet Imeters Iaboveor [bebwlheHAG.
I feet I meters I above or I below lhe HAG.
flfeel Imelers Iaboveor flbetowtheHAG.
E5. Zone AO only: lf no llood depth number is available, ls lhe top of lhe boltom floor elevalsd in accordance with lhe community's
lloodplain management ordinance? fl Yes I No f] Unknown, The local oflicial must c€rtiry thi6 inlormaton ln Seillon G.
SEGT|ON F - pROpERTy OWNER (OR OWNER'S REPRESENTATTVE) CERTIF|CAT|ON
The proporly ownsr or gwnor's aulhorizod represenlallvo who complelos Seclions A, B, and E for Zone A (wlthout a FEMA-issuod orcommunity-issued BFE) or Zone AO must slgn here. The statemerits ln Seclions A, B, and E are conect lci the best of my knowledge.
Proporiy Owner or Owner's Aulhorized Represenlalive's Name
Scolt Henson
Address
1224 S Pioneer Way
City
Moses Lake
State
Washington
ZIP Code
98837
Date
(509) 865-5112
Commonls
fl Ctreck hero if attachments.
FEMA Form 086-0-33 (12119)Replaces all previous editions.Fom Page 3 of 6
IMPORTANT: ln these spaces, copy lhe correspondlng lnformafion from Sectlon A.FOR INSURANCE COMPANY USE
Bulldlng Slreet Address (including Apt., Unlt, Suite, and/or Bldg. No.) or P.O. Route and Box No.
30'12 Dappte Gray Way
Policy Number;
City State
Washington
ZIP Code
98926Ellensburg
Company NAIC Number
sEcTloN G - coMMuNlTy TNFORMATTON (OPTIONAL)
The local offlclal who ls authorized. by law or ordinance to administer the communlty's lloodplain managemant ordinance oan complete
Sections A, B, G (or E), and G of thls Elevation Cerlificate. Complete the applicable item(s)'and slgn bdow Check the moasurem'ent
used ln ltems G8-G10. ln Puerto Rico only, enter motors.
G1. n The lnformation in Soction C was laken from olherdocumentation that ha$ been signed and sealed by a llcensed surveyor,
engineer, or architect who is authorized by law to certify elevation informalion. (lndicate the soutce and dale of the elevirlion
dala ln the Commenls area below.)
G2. I A community oflioial completed Seclion E for a buildlng tocated in Zone A (wilhout a FEMA.issued or oommunity-issued BFE)
or Zone AO-
Gg. tr The foilowing informallon (llems G4-G10) ls provided for community lloodplaln management purposes.
G4. Permit Number G5. Date Permit lssued G6. Date Cerlilicate of
Compliance/Occupancy lssued
G7. Thls permll has been issued for: fl New construcfton fl substantial lmprovement
GB. Elevatlon of as-built lowest floor (including basement)
of the bullding:
G9. BFE or (in Zone AO) depih of flooding at the buildlng site:
G10. Community's design flood elevation:
I feet I meters Datum
I teet I meiers Datum
I feet I meters Datum
Local Ofllclal's Name Title
Communlty Name Telephone
Signature Date
Gomments (including type of equipment and localion, per C2(e), lf appllcable)
f] Check hero if atlachmenls.
ELEVATION CERTIFICATE OMB No.
Expiralion
1660-0008
Oate: November 34,2022
FEMA Form 086.0-33 (12115)Replaces all prevlous €dltlons.Forrn Page 4 of 6
IMPORTANT: ln these spacos, copy lhe correspondlng lnformailon from secilon A FOR INSURANCE COMPANY USE
Building streel Address (including Apt., unit, suite, and/or Bltlg. No.) or p.o. Route and Box No
3012 Dapple cray Way
Policy Nunrber:
City ZIP Code
98S26EllensburgWashington
Company NAIC Number
lf using lhe Elevalion Csdilicato lo oblain NFIP flood insuranco, affix al least 2 building photographs below according lo theinslruclions for llem A6. ldentify all photographs with dato laken; "Fronl View" and "Rear Viow;; ind, iire{uirecl, ,,Right Side View', and"Lefl Side View." When applicablo, pholographs musl show lhe founclalion with roprosentative exampies oi the'floocl openings orvonls, as indicaled in Section AB. lf submitling more pholographs than will fit on this page, use lhe Continuation page.
ll
r{,e
Pholo Ono
Pholo One Caplion Front Clear Pholo One
\{
tJ
Photo Two
Photo Two Caption Side Clear Photo Two
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
See lnstruclions lor ltenl r\6.
OMB No. 1660-0008
Expiralion Date: November 30,2022
FEMA Form 086-0-33 (12l19)Replaces all previous edilions.Form Page 5 of 6
llre correspondlng lnfornratlon frorn Scclion A.IMPORTANT: ln lhese FOR INSURANCE COMPANY USE
Building Slreel Address (including Apt., Unit, Suile, and/or Bldg, No.) or p.O. Route an<j Box No.
3012 Dapple Gray Way
Policy Nunrber:
Slale
Waslrington
ZIP Code
98926
Cily
Ellensburg
Cornpany NAIC Number
lf .submilting ntore phologra.phs lhan will fit on lhe preceding page, affix lhe aclditional photographs below. ldonfify all pholographswith: dale laken; "Fronl View' antl "Rear view";'and, if iequiroir, "nighi sicle View' ancJ','t-ett sirie vicw.', 'ivrreil "ppfi;;i;i;;pholographs trtusl show tho foundation wilh represenlalive examples of tnellooct openings or vents, as indicateci in Seclion AB.
Pholo Thla0
#-
-x--
Photo Thr€e Caption Rear Clsar Photo Throa
Pholo Four
"id.
Photo Four Caption Side Clear Photo Four
I H Li
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
Conlinualion Pagc
OMB No. 1660-0008
Expiration Dalo: Novernbe r 3O, 2022
FEMA Forrn 0B6.0-33 (12l19)Replaces all previous edilions.Form Page 6 of 6
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
Natlonal Flood lnsurance Program
ELEVATION CERTIFICATE
lmporlant: Follow the lnstrucllons on pages 1-9.
OMB No. 1660-0008
Expirallon Date: Novamb er ?O, 2022
Copy all pages of this Elevation Cerlificate and all attachments lor (1) community ollioial, @ insurance agenUoompany, and (3) bullding owner.
SECTION A- PROPERW INFORMATION FOR IN8URANCE COMPANY USE
A1. Bulldlng ownsr's Name
ssHt LLc.
Pollcy Number:
A2. pulldlng Street Addless (lncludlng Apl., Unlt, Sulle, and/or Bldg. No.) or P.O. Route and
Box No.
3010 Dapple Grayway
Company NAIC Number:
crty State
Washinglon
ZIP Code
98926Elleneburg
A3, Property Description (Lot and Bloc* Numbers, Tax Parcel Number, Legal Descrlplion, elc.)
Divialon 6 Lot 6, 961801
A4. Bullding Use (e.9., Reeidential, Non-Reeldentlal, Addillon, Accessory, etc.) Residential
A5, Latllude/Longilude:Lat, N47'01'62,69399"Long.wl20"3#38,80056*HorlzontalDatum: D NaO 1SZZ El NAD 1983
A6. Attach at least 2 pholographs ol ihe bulldlng il the Ceiilicate is being used to oblain llood lnsuranoe.
A7. Building Diagram Number 18
A8. For a bulldlng wlth a orawlspace or endosure(s):
a) Square foolage of oawlspace or enolosure(s) N/A sg fl
b) Number of petmanent llood openlngs in the crawlspace or enolosure(s) withln 1 ,0 foot above adfacent grade N/A
c) Total nol area of llood openlngs in A8.b N/A sq in
d) Engineered flood openings? E Ves EJ tto
A9. For a buildlng wlth an attsched garage:
a) Squarofootageofaltached garage 520.00 sq fl
b) Number of pennanonl llood openlngs ln lhe altached garage wilhin 1.0 foot abovo adjacontgrade 0
c) Total net area of flood openlngs ln A9.b 0.00 sq ln
d) Engineeted flood openings? [ Yes E No
sEcTroN B- FLOOD TNSURANCE RATE MAP (FIRM) INFORMATION
81. NFIP Communl$ Name & Community Number
KITTITAS COUNW; 530095
82. Gounty Name
KITTITAS
83, Stale
Waehlngton
84. Map/Panel
Number
63037C1004
B5. Sufllx
D
86. FIRM lndex
Dale
09-24-2021
87. FIRM Panel
Eflectlve/
Revlsed Date
og-24-2021
88. Flood
Zone(s)
AE
89. Base Flood Elevation(s)
(Zone AO, use Base Flood Depth)
1695.5 ft
810. lndlcate the source of the Base Flood Elevation (BFE) data or baee flood deplh entered in ltem 99:
E FIS Protlle ! FIRM E Community Deteilnlned ff Other/Source:
811. lndlcate elevatlon datum ueed for BFE ln ltem B0l D NGVD 1S20 E NAVD 1988 ! Olher/Source;
812. le the building located in a Coaslal Barrler Resources System (CBRS) area or Othemriee Protected Area (oPA)? fl Yes I No
Deslgnalion Date:il CBRS D oPA
FEMA Fotm 086-0-33 (12119')Replaces all previous editions.Form Page 1 of6
IMPORTANT: ln these spaoss, copy the corresponding informatlon from Sscllon A.FOR INSURANCE COMPANY USE
Building Street Address (lncludlng Apt., Unlt, Suite, and/or Bldg. No.) or P.O. Route and Box No,
3010 Dapple GrayWay
Pollcy Number:
Clty
Ellensburg
State
Washlngton
ZIP Code
98S26
Company NAIC Number
sEcTloN c - BUILDTNG ELEVATION TNFORMATION (SURVEY REQUIRED)
C1. Bull<llng elevatlons are based on: I Constructlon Drawlnge* [ Buildlng Under Conetructlonr E Flnlshed Conelrucllon
*A new Elevatlon Certlficato will be requhed when conslruction ol lhe bulldlng ls complete.
G2. Elevatlons - Zonss A1-A30, AE, AH, A (wlth BFE), VE, V1-V30, V (wlth BFE), AR, AFUA, ARfAE, AR/A1-A30, AR/AH, AR/AO.
Complete ttems C2.a-h below accordlng to the bulldlng dlagram specllied in llem A7. ln Puerto Rlco only, enter melers,
Benchmark Utlllzed: Center ofS27 T 18 N, R 18 E VerticalDalum: NAVD 1S88
lndicate elevation datum used for the elevaUons ln ilems a) lhrough h) below
E NGVD 1929 E NAVD 1s88 [ other/sourcs:
Datum used for bulldlng elevations musl be the same as that used for the BFE,
Check the measurement used.
a) Top of bottom lloor (lnoludlng basoment, crawlspace, or enclosure lloor)
b) Top of the next hlgherfloor
c) Boltom of lhe lowest horlzontal structural member (V Zones only)
d) Atlached garags (top of slab)
e) Loweel elevation of machlnery or equlpment sewicing the bulldhg' (Descrlbe type of equlpment and locallon ln Comments)
f) Lowest adJacent (finlshed) grado ngxt to bulldlng (LAG)
g) Hbhest adjacent (flnlshed) grade next to bulldlng (HAG)
h) Lowest adjacent grade at lowest elevalion of deck or stalre, lncludlng
structural support
1598.3 [] feet I meters
N/A I feet f] meters
N/A I foet ! moters
1598.3 [] feet I moters
N/A fJ feet fl meters
I598.2
. r s96.8
1597.1
@ feet
@ feet
E feet
I metere
! melere
! melers
SEGTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
Thi6 certiflcatlon ls to be slcned and sealed by a land surveyor, englneer, or archltect authorlzed by law lo certifu elevatlon lnformalion.
I cerllfy that the lnformation on thls Certlflcala represenls my best eflorls lo lnterpret the data avallable, I undarstand that any lalse
slaterhent may he punlshable by flne or impisonmant undar 18 U.S. Codq Sectlon 1001.
Were latllude and longitude in Secllon A provlded by a licensed land surveyor? E Yes E ruo I Check here lf attaohments,
Gerllfie/s Name
Rlck Sklnner
Llconss Number
43619
oz
4L
Title
Prolesslonal Land Surveyor
Company Name
Western Paclfic Englneerlng & Survey, lnc
Address
1224 S, PloneerWay
Clty
Moses Lake
State
Washlngton
ZIP Code
98837
Date Ext.
).
Telephone
(50e) 765-1023
iieandallattaclrmerflg'to/11;cotiimunltyofflclal,(2)lnauranceagenUcompany,and(3)buildingowner,
Comments (lncludlng type of equlpmenl and locatlon, per C2(o), lf appllcable)
The elevatlon of the heat pump located outslde of home was measured by using q GPS and then adding the height of lhe legs for the
heal pump.
ELEVATION CERTIFICATE
OMB No. 1660-0008
Explratlon Date: November 30, 2O22
FEMA Form 086-0-33 (12l19l Replaces all prevlout editlons,Form Page 2 of I
IMPORTANT: ln those spsces' copy the oonesponding informalion lrom Section A,FOR INSURANCE COMPANY USE
Bulldlng Street Address (lncludlng Apt., Unit, Sulte, and/or Bldg' No.) or P.O. Route and Box No.
3010 Dapple Gray Way
Poliry Number:
Gily State
Washington
ZIP Code
98926Ellonsburg
Company NAIC Number
sEcTtoN E - BUTLDING ELEVATION INFORMATION (SURVEY
FORZONEAO ANDZONE A (WTHOUT BFEI
NOT REQUIRED)
For Zones AO and A (wlthout BFE), complete ltems E1-E5. lf the Certilicate ls lntended 1o supporl a LOMA or LOMR-F requosl,
comploto Soctions A,'B,and C. Foi ltems gl-E4, use natural grade, lf avallable. Checkthe measurement usad. ln Puerto Rico only,
entei meters.
El. Provide elovatlon lnformation for the following and check lhe approprlate boxee to ahow whether the elevation ls ebove or below
the hlghesl adJacenl grade (HAG) and lhe lowest ad,lacent grade (tAG)'
a) Top of boltom floor (including bagemenl,
crawlspace, or enclosure) ls
b) Top of boltom floor (lncludlng basement,
crawlspace, or enclosure) is
Fteet E meters E aboveor I belowlhe HAG.
I feet E meters I above or flbolow lhe LAG'
E2. For Bullding Dlagrams 6-9with permanent
the next hlgher floor (elevation C2.b ln
the dlagrams)of the building is
E3. Attached garage (top of slab) is
flood openlngs provlded ln Section A ltems 8 and/or 9 (see pages l-2 of lnstructions),
E feet fJmsters E above or E below the HAG.
fl feet fi meiers E above or E below the HAG.
E4. Top of platform of machinery and/or equipmenl
seivlcldg the bullding ie flfeet D meters E abovo or flbelow the HAG.
E5. Zone AO only: lf no flood depth number is avallabte, ls lhg llop of the bottom floor elevated in accordance with the communlty's
lloodplain minagement ordiiranoo? [ Yes D No l] Unknown, The local official muet cerliff this lnformatlon ln Section G.
9ECTION F - PROPSRTY OWNER (OR OWNER'S REPReSENTATIVE) CERTIFICATION
The orooerlv owner or owner's authorized represenlatlve who comoletes Seclions A, B, and E for Zone A (wlthout a FEMA'issued or
oorirrmuriity-fssueC Afel or Zone AO must slgn here. The statemerits ln Seclions A, B, dnd E are correc,t to lhe best of my knowledge,
Property Owner or Owna/s Authorlzed Representallve'e Name
$colt Henson
Addloss
1224 S PloneerWay
City
Moses Lake
State
Washington
ZIP Code
98837
Slgnature
"i!,"rful
Date Telephone
(50e) 855-51 12']/t,n t-.tt ,'),//yh07.7
Commenls
E ctreot trere if attaohments.
ELEVATION CERTIFICATE
OMB No. 1660-0008
Explralion Dale: November 30' 2022
FEMA Form 086-0-33 (tilf 9)Replaces all prevlous edltions,Form Page 3 of6
IMPORTANT: ln these spacesr coFv the correspondlng lnformatlon from Seolion A.FOR INSURANCE COMPANY USE
Bulldlng Street Addrees (includlng Apt., Unlt, Suite, and/or Bldg. No.) or P.O. Route and Box No.
3010 Dapple GtayWay
Policy Number:
Clty State
Washlngton
ZIP Code
98926Ellensburg
Company NAIC Number
sEcTtoN G - coMMuNlTy |NFoRMATION (OPT|ONALI
The looal offlolal who le authorlzed by law or ordinanoe to admlnlster the communlty'e floodplaln managemeni ordlnance can complete
Sections A, B, C (or E), and G of thls Elevation Cerliflcate. Complete the appllcable item(s) and slgn below. Check the measuremenl
ueed ln ltems G8-G10. ln Puerto Rico only, enter meterg.
G1. D The lnformatlon in Seciion C was taken from other documentallon that has been signed and sealed by a llcensed survelltlr,
englneer, or archltect who ls authorlzed by law to cetllff ebvatlon informalion. (lndlcate lhe source ard date of the elevation
data ln lhe Goinments area below.)
c, tr A community oftioial compleled Sectlon E for a building located ln Zone A (wllhout a FEMAplssued or communlty-lssued BFE)
or Zone AO.
Ca. E The following informatlon (ltems G,l-G10) is provlded for community floodplain management purpoees.
G4, Permlt Numbsr G5. Date Pormit lseued G6. Date Gertfficats ol
Gompllance/Occupanay lssued
G7. Thls permlt has been lssued fon @ New Conslructlon f] Subslantial lmprovement
G8. Elevalion of as-bullt loirrest floor (includlng basement)
of the bulldhg:
c9, BFE or (in Zone AO) depth of flooding at the bullding slte:
G10. Communlty's deslgn llood elevalion:
I feet f] meters Datum
I feet ! meters Datum
I feet ! meters Datum
Local Official's Name Tltle
Communig Name Telephone
Slgnature Date
Comments (lrtcluding type of equipmenl and locallon, per C2(e), lf appllcable)
I Cheok here lf attachmente.
ELEVATION CERTIFICATE
OMB No.1660-0008
Expkatlon Date: November 30,2022
FElr4A Form 080-0-33 (12119)Replaces all prevlous editiong,Form Page 4 ofG
IMPORTANT: ln these spaoes, oopy lhe corespondlng lnformation from Seatlon A.FOR INSURANCE COMPANY USE
Building Shest Address (lncluding Apt., Unit, Sulle, and/or Bldg. No,) or P.O. Route and Box No.
3010 Dapple Gray Way
Pollcy Numbor:
Company NAIC NumberSlate
Washinglon
ZIP Code
98926
City
Ellensburg
lf uslng the Elevation Csrllficate to obtain NFIP flood lnsuranco, aflix al least 2 bullding photographs below accordlng to the
lnstructions for llem 46. ldentlfy all photographs wilh date taken; "Front Vlew" and "Rear Vie$'; and, ll requlred, "Rlght Slde View" and
"Left Side View.' When appllcable, photographs must show tho foundatlon with representative examples of the flood openings or
vents, as indicated in Sectlon A8. lf submitting more photographs than wlllfit on this page, use the Continuatlon Page.
Photo one Caption Front ;clgar,Phgle 9lo ,
Photo T1'ro
Photo Two Captlon Side i9earPholoTwo:
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
S6e lnstructions for ltem A6.
oMB No. 1060-0008
Explralion Dale: November 30,2022
FEMA Form 0864-33 (12119,Replaces all pr€vlous editlons.Form Page 5 of6
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
Continuation Page
OMB No.1660-0008
Explrallon Date: November 3O, 2022
IMPORTANT: ln these spacea, aopy lhe corresponding information from Seetlon A.FOR INSURANCE COMPANY USE
Buildlng Street Addrese (lncludlng Apt., Unit, Suite, and/or Bldg, No.) or P.O. Route and Box No.
3010 Dapple GrayWay
Pollcy Number:
Clty State
Washington
ZIP Code
08926Ellensburg
Company NAIG Number
lf submltting more photographs than will llt on the precedlng page, afflx the addilional photographs below. ldentify all photographs
wllh: date taken: r'Front Mew" and "Reaf Vlew"i and, if requarod, ,'Rlght Slde Vlew,' and "Left Side Vlew." When applicablo,
photographs must show lhe foundation with representative examples of the flood openings or vents, ae lndlcated ln Seclion A8.
Photo Tbroe
Photo Three Caption Rear ClegrPhojq Jhroe
f,our
Photo Four Captlon Slde .Qtp.sr.PhplO.fpur
FEMA Form 086-0-33 (12h9)Replaces all prevlous editbns.Form Page 6 of6
U.S. DEPARTMENT OF HOMELAND SECURIry
Federal Emergency Management Agency
National Flood lnsuranoe Program
ELEVATION CERTIFICATE
lmpodanl: Follow lhe insiruotions on pages 1-9.
OMB No. 1660-0008
Expiretlon Daie: Novembsr 30, 2022
Copy all pages ol lhis Elevation Certificate and all attachments for (1) communlty otrlcial, (2) lnsurance agenUcompany, and (3) building owner
SEGTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE
A1. Bullding Owner's Name
ssHl LLc.
Policy Number:
A2, Bullding Street Address (inotuding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Box No.
3008 Dapple Gray Way
Company NAIG Number:
City
Elleneburg
State
Washington
ZIP Code
98920
A3. Property Descrlplion (Lot and Blook Numbers, Tax Parcel Number, Legal Descrlption, eto.)
Divislon 6 Lot 7, 961892
A4. Building Use (e.9., Resirlential, Non{esidential, Addition, Accessory, eto.) Resldenilal
A5. Latltudo/Longitude: Lal N47"01'31'64862" Long.W120'34'40.20136" Horizontal Datum:fl NAD {e27 E NAD {S83
46. Attach at least 2 photographs of the buildlng lf the Ceriilicate ls belng used to obtaln flood lnsuranoe.
47. Buildlng Dlagram Number 1B
A8. For a building with a cralvlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) N/A sq ft
b) Numbef of permanent llood openlngs ln the crawlspace or enclosure(s) wllhin 1.0 lool above adjaoent grade N/A
c) Total net area of flood openings in AB.b N/A sq in
d) Engineered flood openings? [ yes E t'to
A9. For a bulldlng with an atiached gamge:
a) Square footage ofatlached garage 520.00 sq ft
b) Number of permanent flood openings in the a(ached garage wllhln 1,0 foot above adjacent grade 0
c) Total net aree of flood openings in A9.b 0,00 sq in
d) Engineeredfloodopenings? [Yes ENo
sEcTroN B -FLOOD TNSURANCE RATE MAP (F|RM) TNFORMATTON
81. NFIP Community Namo & Gommunity Numbor
KITTITAS OOUNW;530095
82. County Name
KITTITAS
83. State
Washington
B4. Mao/Panel
Nuinber
53037C1064
85. Sufflx
B
86. FIRM lndex
Date
os-24-2021
87. FIRM Panel
Effecttue/
Revised Date
w-2+2021
88. Flood
Zone(s)
AE
89. Base Flood Elevation(s)
(Zone AO, use Base Flood Depth)
1594.2fi
810. lndicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in ltem B9:
E FIS Proflle E FIRM fl Communlty Determined I Other/Souroe:
811. lndicate elevation dalum used forBFE in ltem B9: ! NGVD 1929 E NAVD 1988 fl Other/Source:
B12. ls the building located in a Coasial Barrier Rosources System (CBRS) area or Otherwise Proteoted Area (OPA)? f] Yes fl No
Deslgnation Date:I cBR$ f] oPA
FEMA Form 086-0-33 (2/191 Replaces all previous editions.Form Pago 1 of6
IMPORTANT: ln these spaces' copy ihe correspondi ng informallon hom $ection A.FOR INSURANCE COMPANY USE
Bulldlng Street Address (lncludlng Apt., Unit, $ulte, and/or Bldg. No.) or P.O. Routo and Box No.
3008 Dapple cray Way
Policy Number:
Clty
ElJensburg
Slate
Washington
ZIP Code
98926
Company NAIC Number
$ECT|ON C - EU|LD|NG ELEVATION TNFORMATTON (SURVEY REAUIRED)
G1. Bulldlng elevations are based on: ! Consbuction Drawingsn I Building Under Construclionn I finistreO Construction
nA now Elevatlon Certificate will be roquired when construc'tion of the building is complete.
C2. Elevatlons - Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AF/A, AR/AE, AR/A1-A30, AR/AH, AR/AO.
Complele ltems C2.a-h bolow according to the bulldlng dlagram specified in ltem A7. ln Puerto Rico only, enter meters.
Benchmark Utillzed: Center of S 27 T18N R 18 E Vertlcal Datum: NAVD 19BB
lndicate elevation datum used for the elevations in ltems a) lhrough h) below.
fl NGVD 1929 E NAVD lgBB ! Other/Source;
Datum used for bullding elevations must bo the same as that used for the BFE.
Cheok the measuremeni used.
a) Top of bottom floor (including basement, crawlspace, or enclosure floor)
b) Top of the nexi hlgherfloor
c) Bottom of iho lowost horizontal structural member (V Zones only)
d) Attached garage (top of slab)
e) Lowest elevation of machinery or equlpment seruicing the building
(Describe type of equipment and locatlon ln Comments)
f) Lowest adjacent (finished) grade next to bullding (LAG)
g) Highest adjaoent (finished) grade nsxt to buildlng (HAG)
h) Lowest adjacent grade at lowest elevation of deck or stalrs, including
structural support
159.5.2 @ feet I meters
N/A ! feet I meters
N/A I feet I metors
1595,2 I feet I meters
N/A il feet I meters
1595.2
1594.,1
1594.7
Fl feel
fl feet
El laet
I meters
I meters
fl meters
SECTION D _ SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
Thls cerilflcatlon ls to be slgned and sealed by a land survoyor, ongineor, or archltect authorized by law io certlfy el€vation informatlon,
I certlfy that the information on thls Cartificate represenfs my best efforts to lnterpret the data available. I understand thal any false
statement may be punishable by fine or imprtsonment under 18 U.S. Code, Section 1001,
Were latltude and longitudo in Sectlon A provided by a lioensed land surveyor? EIYet n ruo E Chect here if attachments.-@
Certifiefs Name
Rick Skinner
Llcense Number
4361 I
,t)
Title
Professional Land Surveyor
Gompany Name
Weslem Pacific Englneerlng & Survey, lnc.
Address
12249. Pioneer Way
Clty
Moses Lake
State
Washlngton
ZIP Code
98837
8lg tl Tolophono
(509) 765-1023
Ext.
Cofy all pages of this Elevation Certlficate and all atlachmefits for (1) communlty officlal, (2) insurance agenVcompany, and (3) buildlng owner
Comments (lndudlng type of equipment and location, per C2(e), if applicable)
Heat pump wag on extsrior of bulldlng and on a concrete pad that was msasursd wlth gps. The bottom of the heat pump is rosting on
logs that raise at a mea$ured helght of 6" above the concroto pad. Tho olovation for the equlpment ls to tho bottom of the heat pump,
ELEVATION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 3O, 2O22
FEMA Form 086'0-33 (12119)Rsplac€6 all previous editions.Form Page 2 of B
IMPORTANT: ln these spaoeg, copy the corresponding information from Section A-FOR INSURANCE GOMPAI'{Y USE
Bullding SlreelAddress (including Apt., Unlt, Suite, and/or Bldg. No.) or P.0. Route and Box No
3008 Dapple Gray Way
Policy Number:
City State
Washington
ZP Code
98926Ellensburg
Company NAIC Numb€r
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED)
FOR ZONE.AO AND ZONE A (WTHOUT BFE)
For Zones Ao and A
complete Seclions A,
enter meters.
(wlthout BFE), complete ltems E1-E5, lf the Certiticate is intended to support a LOMA or LOMR-F request,
B,and C. For ltems E'l-€4, use nafural grade, if evallable. Check the measurement used. ln Puerto Rico only,
E1. Pfovide elevation informafion for the following and check the appropriate boxes to show whether the elevation is above or belot/v
the highest adjacent grade (HAG) and lhe loweet adjaoent grade (LAG).
a) Top of bottom floor (induding basemont,
crawlspace, or enclosure) is
b) Top of bottom tloor (indudirg basemont,
crawlspace, or enclosure) is
nfeet n rneters
lfeet [meters
fl above or ! below the HAG.
fl abovs or I bebw the LAG.
E2. For Building Diagrams 6-9 with permanenl flood oponings provided in Section A ltems 8 and/or g (see pages 1-Z of lnstruc.tions),
the next higher floor (elevation C2,b ln
the diagrams) of the building is
E3. Alteched garage (top of slab) is
E4. Top of platform of machlnery and/or equipmenl
servlclng lhe bulldlns ls
Ifeet !meters Iaboveor Ebelowthe HAG.
! foet ! meters I above or I below the HAG.
nfeet n meters fl above or I bebw the HAG.
E5. Zone AO only: lf no flood depth number is available, is lhe top of the bottom floor elevaled in accordance wlth the mmmunitfs
floodplain management ordinanoe? ! Yes I tto ! Unknown. The local offioial must cerfiIy this information in Section G
sEcTtoN F - pRopERw owNER (oR owNER'S REPRESENTATIVE) CERTTFTCATION
The property owner or ownefs authorized reprasentatfue who completes Sections A, B, and E lor Zone A (without a FEMAFissued or
community-issued BFE) or Zone AO must sign here. The statements in Sectlons A, B, and E are correct to ihe best of my knowledge.
Property Owner or Ownefs Authorized Representatlve's Name
Scott Henson
Address
1224 S PioneerWay
Gity
Moses Lake
State
Washington
ZIP Code
98837
Signature
-%^ffi'l'----
Date
Lt/ t7/soxt-
Telephone
{509) 855-5112
Comments
E Ctreck here if attachments.
ELEVATION CERTIFICATE
OMB No. {660-0008
Expiration Date: November 3O,2022
FEMA Form 086-0.33 (12/19)Replaoes all provious editions.Form Page 3 ofG
IMPORTANT: In these spaces, copy the correspondlng lnformation lrom Sectlon A.FOR INSURANCE COMPANY USE
Building StreetAddress (inc{uding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
3008 Dapple Gray Way
Policy Number:
City State
Washington
ZIP Code
98926Ellensburg
Company NAIC Number
sEcTroN c - coMMuNtTy TNFoRMAT|oN (opTtoNAL)
The looal official who is authorized by law or ordlnance to administer the communiiy's lloodplaln management ordinance can complete
Seotions A, B, C (or E), and G of thie Elevation Certiffcate. Complete the applicable item(s) and sign below. Check {he measurement
used in ltems G8-G'10. ln Puerto Rlco only, ent€r meters.
G1. n The informatlon in Seotion C was laken from olher documerrtation that has been signed and sealed by a licensed surveyor,
engineer, or architect who is auhorked by law to oertity elevalion information. (lndicate the source and date of the elevatlon
data in the Comments area below)
G2.fl A communily official completed Sestion E lor a building located in Zone A (without a FEMAlssued or community-issued BFE)
or Zone AO.
Gg. D The following information (ltems G4*G10) is provided for community floodplain management purposes.
G4. Permlt Number G5. Date Permit lssued G6. Date Certificato of
Compllance/Oocup€ncy lssued
G7. Thls permlt has been lssued for: E New Construction I Substantial lmprovement
G8. Elevstlon of ae-bullt lowest floor (including basement)
of the bullding:
G9. BFE or (in Zone AO) depth of flooding at the bulldit'rg slte:
G10, Community's design llood elevation:
flfeet ! meters
! feet I meters
! feet flmeters
Datum
Datum
Datum
Local Offldal's Name Tlte
Community Name Telephone
Signaturo Date
Comments (includlng type of equlpment and locaton, per C2(e), lf appllcable)
f] Check horo if attachmonts.
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiralion Date: November 30,2022
FEMA Form 086-0-33 (12l19l Replaoes all previous editions.Form Page4 of6
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
$ee lnstructions for ltem A6.
OMB No. 1660-0008
Expiration Date: Novernbe r 30, 2022
IMPORTANT: ln the$e spaces! copy the corresponding informatlon fronr $oction A,FOR INSURANCE COMPANY USE
Bulldlng Street Address (lncludlng Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and tsox No.
3008 Dapple Gray Way
Policy Number:
City
Ellensburg
State
Washington
ZIP Code
98S26
Company NAIC Number
lf uslng the Elevation Certificate to obtain NFIP flood insurance, affix at leaot 2 building photographs below acc-ording to the
inslructions for ltem 46. ldentify all photographs with date taken; "Froni VieW' and "Rear Viewn; and, if required, "Right Side VieW' and
"Left Side View." When applicable, photographs must show the loundation with representative examples of the flood openlngs or
vents, as indicated in Section AB. lf submitting more photographs than wlll flt on thls page, use the Continuation Page.
Photo One Caption Front of House Olear:Fttoto0ne
Photo Two Captlon Side of House ' Clear Photo Two
FEMA Form 086.0-33 (12l19)Roplaoes all previous editions.Form Page 5 of 6
IMPORTANTT ln these epacos, copy the corresponding informatlon from 9ectlon A FOR INSURANCE COMPAI.{Y USE
Building Street Address (lncluding Apt, Unit, Suite, and/or BIdg. No.) or P.O. Route end Box No.
3008 Dapplo Gray Way
Pollcy Number:
City
Ellensburg
State
Washington
ZP Code
98926
Company NAIC Number
lf submitting more photographs than will fit on the preceding page, afflx the additional photogrephs bolow. ldentiff all photographs
with: date teken; "Fronl View" and 'Rear Mew'; and, lf required, "Right Side View" and "Left Side View." When applicable,
photographs must show lhe foundation urlth representative examples of the ftood openings or venls, as lndlcated in Section AB,
Pholo Three Captlon Back of House Clesr PholsTirB€
Photo Four Caption Side of house Cl6er Photo Four
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
Continualion Pago
OMB No. '1660-0008
Expiration Date: N<rvember 30, 2022
FEMA Form 086-0-33 (12119)Replaces all previous editions,Form Page 6 of 6
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
Nalional Flood lnsurance Program
ELEVATION CERTIFICATE
lmporlant: Follow lha lnslruclions on pages 1-9.
OMB No. 1660-0008
Expiraiion Dale: November 30,2022
Copy all pages of thls Elevalion Certlficale and 6ll allachmenls for ('l) communlty officlal, (2) lnsurance agenUcompany, and (3) bullding owner.
SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE
A1. Building Owner's Name
ssHl LLc.
Policy Number:
42. Bullding Slreet Address (including Apt., Unil, Suile, and/or Bldg. No.) or P.O. Route and
Box No.
3006 Dapple Gray Way
Company NAIC Number:
City State
Washlngton
ZIP Code
98926Ellensburg
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Division 6 Lol B, 96'1893
A4. Buildlng Use (e.9., Residential, Non-Resldential, Addilion, Accessory, elc.) Residential
A5. Latitudo/Longitude: Lat. N47"0'l '30'81 169" Long. W120"34'41'0441'l'HorizontalDatum: I NAD 1927 E NAD 1983
A6^ Atlach al least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Dlagram Number 18
AB. For a buildlng wlth a crawlspaoe or enclosure(s):
a) Squarefootageofcrawlspaceorenclosure(s) N/A sqft
b) Numbor of p€rmanent llood openings ln the crawlspace or enclosure(s) wllhln 1.0 foot above adjacent grade N/A
c) Total nel ar€a of flood openings in AB.b N/A sq ln
d) Engineered llood openings? n y"s El tqo
A9. For a building wilh an attached garage:
a) Square footage of atlached garage 604.00 sq fl
b) Number of permanent flood openlngs in lhe attached garage wilhin 1.0 foot above adjacent grade 0
c) Tolal net aroa of llood oponlngs in A9,b 0.00 sq ln
d) Engineered llood openings? [ Yes E] tlo
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B'1. NFIP Gommunlly Name & Communlty Number
KITTITAS COUNW;530095
82. County Name
KITTITAS
83. State
Washington
84. Map/Panel
Number
53037C1064
85. Suflix
D
86. FIRM lndex
Dale
09-24-2021
87. FIRM Panel
Effecllve/
Rovised Date
0s-24-2021
88. Flood
Zono(s)
AE
89, Base Flood Elevatlon(s)
(Zone AO, uso Base Flood Doplh)
1592,9 fr
810. lndicale lhe source of the Base Flood Elevalion (BFE) data or base llood depth entered in ltem Bg:
El FIS Prollle E FIRM I Community Delsrmined I Othor/Sourco:
811. lndicate elevation datum used for BFE ln llem 89: f] NGVD 1929 EJ NAVD 19BB I other/$ource:
812, ls the bullding located in a Coaslal Barrier Resourcos System (CBRS) area or Othenryise Prolected Area (OPA)? [ Yes @ No
Designalion Dale: I CBRS fJ OPA
FEMA Form 086-0-33 (12119)Replaces all provious editions.Form Page 1 of 6
IMPORTANT; ln theso spac€s, copy lhe correspondlng informatlon frorn Sectlon A.FOR INSURANCE COMPANY USE
Building Slreol Address (including Apl., Unit, $uite, and/or Bldg. No.) or P.O. Route and Box No.
3006 Dapple Gray Way
Policy Numbor:
City
Ellensburg
State
Washington
ZIP Code
98926
Company NAIC Number
sEcTloN c - BUTLDTNG ELEVATTON TNFORMATTON (SURVEY REQUIRED)
N/A f] feel ! moters
N/A I feet ! meters
rs94.B [] feel I meters
b) Top of the next higher floor
c) Bollom ol lhe lowest horizonlal struclural member (V Zones only)
d) Altached garage (top ol slab)
e) Lowost elevalion of machinery or equipment servicing the building
(Descrlbo typo of equipmonl and localion ln Commenis)
f) Lowest adjacent (finished) grade next to bulldlng {LAG)
g) Highesi adjacent (finlshed) grado nexl to bullding (HAG)
h) Lowost adjacont grade al lowest elevation of deck or stairs, includlng
slructural support
c1. Building elevations are based on: ! Conskuclion Drawings' fl Building Under Conslruclion' @ Finisheo Conslruction
'A new Elevalion Certificale will be required when conslruction of ths building is complete.
C2. Elovations - Zonos A1-A30, AE, AH, A (wilh BFE), VE, V1-V30, V {with BFE), AR, AFyA, AFVAE, AR/A1-A30, AR/AH, AFUAO,
Complete ltems C2.a-h below according lo tho building diagram specified in ltem A7. ln Puerto Rico only, enier melers.
Bonchmark Ulillzed: Center of S 27,T 18 N, R 18 E Vertical Datum: NAVD 19BB
lndicato olevalion datum used for lhe elevalions in items a) lhrough h) below.
fl NGVD 1929 E NAVD 19BB I olher/Source:
Dalumusgdforbuildingelevalionsmuslbelhesameastt'"
Check lhe measuromenl us6d.
a) Top of botlom lloor (including basemenl, crawlspace, or enclosure floor)1594.B p feel f| meters
1s94.6 I feet
I feet
p feet
I meters
I meters
f] molers
1593.4
1593.9
N/A ! feet fl meters
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
Thls cerlification is to be signed and sealed by a land surveyor, engineer, or architscl aulhoriz€d by law to certify elevallon informalion.
I corlily thal tho lntormalion on lhis Cedilicate represenls my hesl elfotls to inlerprol tho dala available. I undorsland lhal any false
slatemenl may be punishable by fino or impisonmant under 1B U.S. Code, Section 1001.
Were latiludo and longitude in Seclion A provided by a licensed land surveyor? Elyes fl tto ! Check here if attaohmenls,mx
Cerllllgr's Name
Rlck Sklnner
Llcense Number
43619
1
Title
Professional Land Surveyor
Company Name
Weslern Pacilic Engineering & Suwey, lnc.
Address
1224 S. Pioneer Way
Clty
Moses Lakl
^
Stale
Washington
ZIP Code
98837
Telephone
(5oe) 765-1023
Ext.
Copy all [ages of lhis Elevation Cerlilicate and all allachmofits for (1) community official, (2) lnsurance agenUcompany, and (3) building ownor
Comments (including type of equipment and localion, per C2(e), if appllcable)
The elevation of the heat pump localed oulside of home was measured by using a GPS and then adding lhe helght of the legs for lhe
heat pump.
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Dalo: November 30,2022
FEMA Form 086-0-33 (12l19)Replaces all provious edilions.Form Page 2 ol 6
IMPORTANT: ln lhese spacea, copy lhe corresponding information from Sectlon A,FOR INSURANCE COMPANY USE
Building Slreet Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No
3006 Dapple Gray Way
Policy Numbor:
City Stale
Washington
ZIP Code
98926Ellonsburg
Company NAIC Number
sEcTroN E - BUILDING ELEVATTON TNFORMATTON (SURVEY NOT REQUTRED)
FOR ZONE AO AND ZONE A (W|THOUT BFE)
For Zones AO and A (wilhout BFE), complele ltems E1-E5. lf the Certificate is intended lo suppod a LOMA or LOMR-F requesl,
complele Soctions A, B,and C. For ltems E1-E4, use nalural grade, if available, Ghock lhe measurement used. ln Puerto Rico only,
enler meters.
E1. Provide elevalion informalion for the followlng and check lhe appropriate boxos to show whelhor lhe elevalion l$ above or below
the highest adJacent grade (HAG) and lhe lowesl adJacent grade (LAG).
a) Top of boltom floor (including basemenl,
crawlspace, or enclosure) ls
b) Top of bottom floor (includlng basemenl,
crawlspac€. or enclosure) ls
fl feet I melers I above or f] below lhe HAG.
I feel I meters I above or I below the LAG.
E2. For Building Diagrams 6-9 with permanonl llood
the next higher lloor (elevation C2.b in
lhe diagrams) of lhe bullding ls
E3. Atlaohed garage (top of slab) is
E4. Top of platform of machlnery and/or egulpment
serviclng lhe bullding is
openings provided in Seclion A llems B and/or 9 (soe pages 1-2 of lnslructions),
lfeet flmeters !aboveor flbebwlhe HAG.
Ifeel Imeters Iaboveor flbdowlheHAG.
flfeel Imoters Iaboveor flbelowlheHAG.
E5. Zone AO only: lf no llood depth number is available, ls the lop of the bottom floor elevaled ln accordance wilh the communily's
lloodplain management ordinance? ! Yes fl No f] Unknown. The locsl oflicial musl cerlify lhis informallon in Seclion G.
sEcTloN F- PROPERTY OWNER (OR OWNER'S REPRESENTATTVE) CERT|F|CAT|ON
The property owner or owne/s aulhorized representalive who completes Sections A, B, and E tor Zone A (wllhout a FEMA-lssuod or
community-lssuod BFE) or Zone AO musl slgn here. The statemenls ln Seclions A, B, and E are correct to the best of my knowledge.
Proporly Owner or Owne/s Authorlzed Representalive's Name
Scotl Henson
Address
1224 S PloneerWay
Cily
Moses Lake
Slale
Washington
ZIP Code
98837
Slgnature
--K-zhlor^r--
Date
I /J-i /**z
Telephone
(509) 855-51 12
Comments
f] Ctreck hero if attachmenls.
ELEVATION CERTIFIGATE OMB No. 1660-0008
Expiralion Date: November 30,2022
FEMA Form 086-0-33 (12119)Replaces all previous edilions.Form Page 3 of 6
IMPORTANT: ln lhese 6paces, copy the corresponding informallon from Secllon A,FOR INSURANCE COMPANY USE
Bulldlng Slroel Address (including Apt., Unlt, Suite, and/or Bldg, No.) or P.0. Route and Box No.
3006 Dapplo Gray Way
Policy Number:
City Slale
Washington
ZIP Code
98926Ellensburg
Company NAIC Number
sEcTloN G - coMMUNtTy TNFORMATTON (OPT|ONAL)
The local officlal who ls aulhoriz€d by law or ordinance to administer the community's floodplain management ordlnance oan complste
Secllons A, B, C (or E), and G of thls Elevation Certificale. Complete ihe applicable item(s) and sign below. Check the measurement
us€d in ltems GB-G10. ln Puerto Rico only, enter meters.
G1. U The informalion in Seclion C was taken from other documenlation that has been signed and sealed by a llcensed surveyor,
engineer, or architect who is aulhotized by law lo cerlify elevatlon informalion. (lndicate llre source and date of lhe elevalion
data ln lhe Comments area below.)
c2. fl
G3. I
A community of{icial completed Section E for a building located in Zone A (wilhout a FEMAissued or community-issuod BFE)
or Zone A0.
The following informalion (ltems G4-G10) is provided for communlty floodplain management purposes.
G4. Permit Number G5. Dale Pormit lssued G6. Date Certilicate of
Gompliance/Occupancy lssued
G7. This permil has been lssu€d lor: fl New Construction E Subslanlial lmprovement
GB. Elsvatlon of as-bullt lowest floor (lncluding basement)
of lhe buildlng:
G9. BFE or (in Zone AO) depth of flooding al lhe bullding slte:
G10. Community's design llood elovation:
I feet I moters
fl feet fl meters
I fool f] melers
Dalum
Dalum
Dalum
Local Offlcial's Name Tille
Communily Name Telephone
Slgnature Dala
Comments (lncludlng typo of equlpment and locatlon, per C2(e), lf appllcable)
fl Check here if attachmenls.
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: November 30,2022
FEMA Form 086-0-33 (12l19)Replaces all previous €ditions.Form Page 4 of 6
IMPORTANT: ln lhese spaces, copy the corresponding lnformallorr fronr SecUon A FOR INSURANCE COMPANY USE
Building Street Address (including Apl., Unit, Suite, and/or Bldg, No.) or p.O. Route ancJ Box No.
3006 Dapple Gray Way
Policy Number:
Cily
Ellensburg
Stale
Washington
ZIP Code
98926
Company NAIC Number
lf using lho Elcvation Cortificate to obtain NFIP flood insurance, affix at least 2 building photographs below accordirrg 1o the
inslruclions for llem 46. ldenlify all pholographs with date taken; "Fronl View" and "Rear Viewi; ind, iirequired, "Right Side Vlew" and
"Left Side View." When applicable, pholographs musl show lhe foundalion wilh represenlalive exanrpies ol the-floocl openings or
vents, as indicaled in Seclion AB. lf subrnitting more photographs than will fit on lhis page, use lh6 Continualion Page.
,s
!
i\- |l
tl-\:
Pholo One Caption Fr<lnl Clsar Photo Ono
r1'."..
gjs,-\
.-f,!
.t -----:-C-r-
etr
.?
Pholo Two Caplion Sicle Clear Photo Trvo
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
See lnslruclions for llern 46.
OMB No. '1660-0008
Expiralion Date: Novemlret 30, 2022
FEMA Fonn 086-0-33 (12l19)Replaces all previous editions.Form Page 5 of 6
IMPORTANT: ln lhese spaccs, copy the corresporrdlng ilrformation from Seclion A.FOR INSURANCE COMPNNY USE
Building Slreol Address (including Apt., Unit, Suite, and/or Bldg. No.) or P,O, Route and Box No,
3006 Dapple Gray Way
Policy Numbcr;
City
Ellensburg
State
Washington
ZIP Cotle
98926
Company NAIC Number
lf submilting more pholographs lhan will fil on tho preceding page, affix the additional photographs below. l<Janlify all photographs
with: date taken; "Front View" and "Rear Vlew"; and, if required, "Right Side View" ancl "Lelt Side Vi€w." When applicable,
pholographs musl show llte foundalion with representalive exanrples ol lhe llood openings or vents, as indlcaled in Section AB.
.-,#ilii-
Pholo 1 lsc6
Pholo Three Caplion Rear Clear Photo Throe
-
Pholo Four
-
Pholo Four Caplion Side Cloar Photo Four
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
Continualion Page
OMB No. 1060-000B
Expiralion Dale: Novenber 30,2022
FEMA Form 086-0-33 (12l19)Replaces all provious editions.Form Page 6 of 6
U,S. DEPARTMENT OF HOMELAND SECURIW
Federal Emergency Management Agency
Natlonal Flood lnsurance Program
ELEVATION CERTIFICATE
lmportant Follow the inslructions on pages 1-9.
Copy all pages of lhis Elevatlon Cerlilicate and all attachmenls for ('l) community olficlal, {2} lnsuranoe agenUcompany, and (3} bulldlng ownsr.
1660-0008
Date: November30,2022
SECNON A- PROPERTY INFORMATION FOR INSURANCE COMPANY USE
A1. Bulldlng owner's Name
ssHt LLc.
Pollcy Number:
A2. Bulldlng StreetAddress (lncludlng Apt., Unit, Suite, and/or Bldg. No.) or P,O. Route and
Box No.
3004 Dapple Gray Way
Company NAIC Number:
Clty State
Waehlngton
ZIP Code
98920Ellensburg
A3. Property Desctiptlon (Lot and Block Number, Tax Parcel Number, Legal Doscripllon, olc.)
Divislon 6 Lot 9,961894
A4. Building Use (e.9., Residential, Non-Resldential, Additlon, Accessory, etc.) Resldentlal
A5, LatitudE/Longltude:Lat. N47'01'30.01248'Long.w120"34?1.85858'HorizonlalDatum: il NAD 1927 E NAD 1983
46. Atlaoh at least 2 photographs of tho buildlng lf tho Cer{iflcate ls belng used lo obtaln llood lnsurancE.
A7. Bullding Dlagram Number 18
A8. For a bulldlng wllh a orawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) N/A sq ft
b) Number of permanent flood openings in the crawlspace or enoloeure(s) wlthln 1.0 foot above adlaoent grade N/A
c) Total nel aroa olllood openlngs in A8.b N/A sq in
d) Englneeredfloodopenlngs? Dyee E No
A9. For a building with an attached garage:
a) Square footage ol attached garage 520.00 sq fl
b) Number of permansnt llood openings in the atlached garage wlthin 1.0 foot above adjacent grade 0
c) Total nsl area of llood openlngs ln A9.b 0.00 sq in
d) Engineeredfloodoponings? flVes E No
sEGiloN B - FLOOD INSURANCE RATE MAP (FIRM) TNFORMATION
81. NFIP Communlty Name & Gommunity Number
KITTITAS COUNW;530095
82. County Name
KITT'TAS
83. State
Washington
84. Map/Panel
Number
53037C1064
86. Suffix
D
86. FIRM lndex
Date
w24.2021
97. FIRM Panel
Effective/
Rovlsed Date
0s-24-2021
88. Flood
Zone(s)
AE
B9. Base Flood Elevatlon(s)
(Zone AO, use Base Pl6od Depth)
1592.4ft
B{0, lndioate lhe sourco of the Base Flood Elevatlon (BFE) data or base flood depth entered in ltem 89:
@ FIS Prollle E fnu flcommunlty DEtermlned [ CIher/Source:
B11. lndbare etevalion datum used lor BFE in lletn 99: fl NGVD 1929 EI NAVD 1S88 f| Orher/Source:
812. ls the bulldlng localed ln a Coastal Barrler Resources System (CBRS) area or Olhenyiee Prolsotod Area (OPA)? ! Yes @ No
Designatlon Datel E 0BRS E oPA
FEMA Form 086-0-39 (12119)Replaoes all pravloue edltlons.FormPagel of0
IMPORTAi{T: ln these sploeo, oopy the oonespondlng lnformatlon from $eclion A,FOR INSURANCE COMPANY USE
Bulldlng Sfeet Address (lncludlng Apt,, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
3004 Dapple GrayWay
Policy Number
City
Ellensburg
State
Washington
ZIP Gode
98926
company NAlc Number
sEcTroN c - BUTLDTNG ELEVATTON TNFORMATTON (SURVEY REOU|REDI
C1. Bulldlng elovatlons are based on: ! Construolion Drawlngsi ! Bulldlng Under Conslructlon* [i Finished Construotion
*A new Elevation Cerllflcate wlll be requhed when construcllon of the bulldlng ls oomplete.
C2. Elevatlong - Zones A1-A40, AE, AH, A (wlth BFE), VE, V1'V30, V (wllh BFE), AR, AF/A, AR/AE, AR/A1-A30, AFUAH, AR/AO,
Complete llems C2.a-h below ascordlng lo the building diagram spsclfl€d ln ltem A7, ln Puerto Rlco only, enter meters.
Benohmark Utllizedl Center of S 27, T 18 N, R 18 E Verllcal Dalum: NAVD 1988
lndicate elevation datum used for the elevatlons ln items a) through h) below.
n NGVD 1929 E NAVD 1988 ff omerlSourco
Datum used for bulldlng €levetlons must be lhe Bamo as lhat used for the 3FE.
Cheok the measurement used.
a) Top of bottom floor (lncludlng basement, crawlepace, or enclosure floor)
b) Top of the next higher lloor
c) Bottom of the lowest horlzonlal structural member (V Zones only)
d) Attached garage (top of slab)
e) Lowest elevatlon of maohinery or equipment servlclng the bulldlng
(Describe typs of squlpmenl and location ln Gomments)
f) Lowest adlaoent (llnlshed) grade noxt to bulldlng (LAG)
g) Highest adjaoent (finlshed) grade next to bullding (HAG)
h) Lowest adjacent grade at lowest elevation of deck or slalre, lnoludlng
elruclural support
1s93,7 Elfeet fl meters
N/A I feel fJ metere
N/A fl feel flmeters
1593.7 [Jfeet I meters
1s93.8
t592.8
fl feet fl meters
t503.0
[Jfeet
[J feet
[] feet
! meters
I meters
! meters
SECTION D - SURVEYOR, ElrlGlNEER, OR ARGI{ITECT CERTIFICATION
lo cerlifu elevatlon infonnation,
I undenitand that any lalse
! Check here if
Thls ceriifrcatlon is to be slgned and sealed by a land suiloyor, englneer, or archltect authorized by law
I cedlfy that lhe lnlormalloi on Ws Ceililicate represents W besl e/forfs to lnterpret the data avalldbla,
statement may be punishabb by fine ot lmprlsonmenl under t8 U,S. Coda, Sectlon 1001,
Were latltude and longitude in Seclion A provided by a llcensed land surveyor? Elyes fl No
Cerlllie/s Name
Rick Sklnner
Llcense Number
43619
oz
Ti$e
Professional Land Surveyor
Company Name
Western Paclflc Englneeilng & Survey, lno.
Address
1224A, PioneerWay
City
Moses Lako
Slate
Washlngton
ZIP Code
98837
Date
at
1_..
(609) 765-1023
Copy all pales of lhiii Elevation Cedincale and all altachmentd for (tlcommtnlty ofliclal, (2) lnsurance agenUcompany, and (3) bullding owner
Comments (includlng type of eguipment and location, per G2(e), lf appllcable)
The elevatlon of the heat pump located outeide of home wae measured by using a GPS and then adding the helght of the legs for lhe
heat pump.
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiralion Date: November 30,2022
FEMA Fom 080-0-33 (1U15',Replaces all previous editlons.Form Page 2 of 6
IMPORTANT: ln these spac€s, copy the conerpondlng lnformatlon from Seolion A.FOR INSURANCE COMPANY USE
Building Street Addrees (lnoluding Apt., Unit, Sulte, and/or Bldg. No.) or P,O. Route and Box No.
3004 Depple G.ray Way
Pollcy Number:
city State
Washlngton
ZIP Code
98926Ellensburg
Cornpany NAIC Number
SECTION E - BUILD ING ELEVATION INFORMATION {SURVEY NOT REQUI RED}
FORZONE AO AND ZONE A(WTHOUT FFE)
For Zones AO and A (wilhout BFE), complete ltems E1-E6, lf the Certilioate ia intended to support a LOMA or LOMR-F reguesl,
complete Sections An B,and C. For ltems El-E4, use natural grade, if available. Cheok the measuremont used. ln Puerto Rico only,
enter meters.
El. Provide olevation lnformatlon for lhe followlng and oheok the approprlate boxes to show whether the elevation is above or below
lhe highest adjaoent grade (HAG) and lhe lowest adjacent grade (LAG).
a) Top of bottom floor (includlng basement,
crawlepace, or enclosure) ls
b) Top of bottom floor (lncludlng basement,
crawlspace, or enclosure) is
flfeet Imeters Iaboveor E belowtho l"lAG.
E feet E melers I above or E below the LAG.
E2. For Buildlng Dlagrams 6-9 wllh pennanent llood
the next higher tloor (elevation C2.b ln
lhe dlagrams) of the buildlng lB
E3. Attached garage {top of slab) ia
E4. Top ol platform of rhachlnery and/or equlpment
servlcing the building ls
openingo provlded in Seotlon A ltems I and/or g (see pages 1-2 of lnslructlons),
D feel I melers E above or il below the HAG.
I teet ! meters D above or E uelow the HAG.
flfeet ilmeters Eaboveor Ebelowthe HAG,
86. Zone AO only: lf no llood depth number ls available, is lhe top of lhe bottom floor elevated in accordance wlth lhe community's
floodplaln management ordlnance? ff Yes E No f| Unknown, The localofficial must ceili$ lhis lnformallon ln Section G.
sEcTtoN F - pRopERry owNER (oR owNER's REPRESENTATIVE) CERTTFTCATTON
The orooertv owner or owner'e aulhorized reoreeentatlve who comrleles Seolions A, B, and E for Zone A (without a FEMA-lssued or
communttyJssued BFE) or Zone AO must slgn here, Ths etatemedta in Sections A, B, irnd E arc oorect to the besl of my knowledge.
Pnoperty Ovner or Owne/s Aulhorlzed Representallve's Name
Scott Henson
Address
1224 S Ploneer Way
Clty
Moses Lake
State
Washlngton
ZIP Code
98837
Date
(509) 85&5112
E Cheok here if attachments.
ELEVATION CERTIFICATE
OMB No. 1660.0008
Expiratlon Datel Novombor 3O,2022
FEMA Form 08&0€3 (12l1gl Replacee all prevlous ediliona,Fom Page 3 of6
IMPORTANT: ln thege e pacea, aopy the correepondlng informatlon from Section A.FOR INSURANCE COMPANY USE
Bullding $treet Address (includlng Apt., Unll, Sulte, and/or Bldg. No.) or P.O. Route and Box No.
3004 Dapple GrayWay
Policy Number:
City State
Washlngton
ZIP Godo
98926Ellensburg
Company NAIC Number
sEcTtoN G -coMMuNrw TNFoRMAT|ON (OPT|ONAL)
The local offlcial wtro ls authotlzed by law ot ordinanc€ lo administer the communlt/s floodplaln management ordlnance can complete
Sections A, B, Q (or E), and G of thls Elevation Certificate, Gomplete the applioable ltem(s) and sign below. Oheok lhe moasurement
used ln lteme G8-G10. ln Puerto Rlco only, enter metere.
G 1 . D The lnfomallon ln Seolion C was taken from other documentatlon that has been slgned and sealed by a licensed Burv€yor,
englneer, or archltecl who le authorlzod by law to cerllff elevatlon lnformallon. (lndlcale the sourco and date of the elevalion
data in lhe Commenls area below.)
C2. n fr?fif;fty "*lal completed Sectlon E for a bulldlns loceted ln Zone A (wllhout a FEMA-issued or communlly-lssued BFE)
63. D The fotlowlng informalion (ltems G4-G1O) ls provided for communig floodplain management purposes.
G4. P€rmlt Number G5. Date Pennlt lssued G6. Dale Cerlilicate of
Compliance/Oc,cupancy lssued
G7, Thi$ pemit has beon issued for: [] New Conslruclion fl Substantial lmprovement
G8. Elevatlon of as-buill lowest floor (including basement)
of the buildingr
c9. BFE or (in Zone AO) depth of llooding at the bullding site:
G10. Community's deslgn flood elevation:
! feet I metets Datum
! feet I meters Datum
I feet I mebrs Datum
Local Offlclal'e Name Tltle
Communlty Name Telsphone
Signature Date
Commenls (lncluding type of equlpment and locatlon, per C2(e), if applicable)
I Check here if altachments.
ELEVATION CERTIFICATE OMB No. 1660-0008
Explralion Date November ?O,2022
FEMA Form 086-0-33 (12119')Replaces all prevlous editions.Form Page 4 of 6
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
See lnstruotions for ltem A6.
OMB No. 1660-0008
Expiration Dale: Novemb et 30, 2022
IMPORTANT: ln lhese spaces, copy the corespondlng lnformation fiom Section A.FOR INSURANCE COMPANY USE
Buildlng Slreet Address (lncludlng Apl., Unil, Sulte, and/or Bldg. No.) or P,O. Route and Box No.
3004 Dapple GrayWay
Polloy Number;
Company NAIC NumberState
Washington
ZIP Code
s8926
city
Ellensburg
lf uslng lhe Elevatlon Certlficate lo obtaln NFIP fiood lnsurance, afflx at least 2 bulldhg photographs below accordtng to the
inslructlons for ltem A6. ldentlfy all photographs with date taken; "Front View'' and "Rear View'r; ind, lf reiulred, "Rlghl Slde View" and
"Lelt Side Vlew." l/Vhen applloable, photographs musl show lhe foundation with represenlative exampies of ihe-llood openings or
vents, as indlcated in Section A8. lf eubmittlng more photognphs than wlll llt on thls page, use the Conliiuation Page.
PhotoOne
Photo One Capllon Front ,pteei,Fhe,ilihliil
FEMA Form 086'0-33 (121191 Replaces all previous editions.Form Page 6 ol6
IMPORTANT: ln these spaces, oopy the conerpondlng lnlonnation from Secllon A.FOR INSURANCE COMPANY USE
Bulldlng Street Address (inoludlng Apt., Unit, $uito, and/or Bldg. No,) or P.O. Route and Box No'
3004 Dapple Gray Way
Pollcy Number:
clty State
Washington
ZIP Code
98926Ellensburg
Company NAIC Number
lf submltting more pholographs than will lit on the preceding page, afiix the additional phoiogra$ts below ldentlfy all photographs
wlth: date laken; 'iFront- Vlew" and nRear Vle#'; and, il requlred, *Right Side Vlerd' and "Left Side Vlew." When appllcable,
photographs must show the foundatlon wlth representative examples of the llood openings or v€nts, as lndicated ln Section A8.
Pholo ltoo
Photo Three Caplion Rear Cleaf,PhoJO T.hree
Photo Fout
Photo Four Caption Side ioteai Pbolo,Fplr
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
Qontlnuation Page
OMB No. 1660-0008
Explration Date: November 30,2022
FEMAFoTm 086-0-33 (A$)Replaces all prevlous edilions,Form Page 0 ofO
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
Nallonal Flood Insurance Program
ELEVATION CERTIFICATE
lmportant Follow the lmtrucllons on pages t-9.
Copy all pages of this Elevation Certilicate and all atlachments for {1) communlty offcial, (2} ineurance agenUcompany, and (3) buildlng owner.
OMB No. 1060-0008
Expiration Date: Novembor 30, 2022
SECTION A- PROPERTY INFORMATION FOR INSURANCE COMPANY USE
A1. Building Ownefe Name
ssHt LLc.
Polloy Number:
42. Eullding Street Addrese (including Apt., Unit, Sulte, and/or Bldg, No,) or P.O. Route and
Box No.
3002 Dapple Gray Way
Company NAIC Number:
Clty State
Washington
ZIP Code
98926Ellensburg
A3. Prope*y Description (Lot and Blook Numbers, Tax Parcel Number, LegalDescriplion, etc.)
Divlsion 0 Lot 10,961895
A4. Bulldlng Use (e.9., Reeldentlal, Non-Residential, Addillon, Accessory, otc.) Resldenllal
A5. Latitude/Longltude: Lat.N47'0129'43926" Long.W120'34'42,53203'HorizontalDatum: f] NAD 1927 EINAD 1983
A6. Atlach at least 2 photographs of the building if lhe Certilicate is belng used lo obtaln flood insurance.
A7, Buildlng Diagram Number . l.F ,
A0. For a bulldlng wllh a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) N/A sq ft
b) Number of permanent flood openlngs In the crawlspace or enclosure(s) wilhh 1.0 foot above adlacent grade N/A
c) Tolal nal area of llood openlngs in AO.b N/A sq in
d) Enghroered llood openings? E Ves El tto
A9. For a bulldlng wlth an atlsched garags:
a) Square footage of attached garage 520.00 sq fl
b) Number of permanenl flood openings ln lhe atlachad garage withln 1.0 foot abovo adjacent grade 0
c) Total net area of flood openlngs ln A9.b 0.00 sq in
d) Engln€ered flood openlngs? [ Yea E t',to
sEcTtoN B - FLOOD INSURANCE RATE MAp (FlRm' TNFORMATTON
Bl. NFIP Gommunity Name & Community Number
KITTITAS COUNW;530095
82. County Name
KITTITAS
83. State
Washlngton
84. MaplPanel
Number
53037C1064
B5. Suflix
D
86. FIRM lndex
Date
09-24-2021
87. FIRM Panel
Etfeclive/
Revlsed Date
09-24.2021
88. Flood
Zone(s)
AE
89. Base Flood Elevatlon(s)
(Zone AO, use Base Flood Deplh)
1591.2ft
810, lndicate the source of the Base Flood Elevallon (BFE) data or baee llood depth entered ln ltem 89:
[| FIS Proflle I FIRM ! Communlty Delermined fJ Oher/Source:
811. lndlcate elevatlon datum ussd lor BFE in ltem 89: fJ ttovo tezs m NAVD 1988 rl olher/Source:
812. ls the bulldlng locat€d ln a Coaslal Banier Resources System (CBRS) area or Othenrlse Protected Area (OPAp fl Ves ffi No
Deslgnallon Dete:n oBRS n oPA
FEMA Fom 086.G.33 l12l19l Replaces all prevlous edlllons.Form Page 1 of6
IMPORTANT: ln thece Bpacos, copy the correcpondlng lnformatlon from Sectlon A.FOR INSURANCE COMPANY USE
Bulldlng Street Address (lncluding Apt., Unil, Sulte, and/or Bldg. No.) or P.O. Route and Box No.
3002 Dapple Gray Way
Pollcy Number:
Clty
Ellensburg
State
Washlngton
ZIP Code
98926
gompany NAlg Number
sEcTroN c - BurLDtNc ELEVATTON TNFORMATTON (SURVEY REQUIREDI
C1. Bulldlng elevallons are based on: I Conslrucllon Drawlngs' f] Bulldlng Under Construcllon' El Fhlshed Gonstrucllon
'A new Elevatlon Certilicale will be requlred when construclion of lhe buildlng is complete.
C2. Elevatlons - Zones Al-A30, AE, AH, A (wllh BFE), VE, V1-V30, V (wllh BFE), AR, AR/A, AR/AE, ARiAI-A30, AR/AH, AR/AO.
Complete lloms Cz.a-h below accordlng to tho bulldlng diagram specllied ln lt€m A7. ln Puerto Rico only, enter meters.
Benchmark Utillzed; Center of S 27 T 18 N, R 18 E VedlcalDalum: NAVD 1988
lndlcale elevallon datum used for the elevations ln items a) through h) below.
fl NGVD 1929 E NAVD 1988 fJ other/Source:
DatumusedforbulldlngiGvailonsmustbelhesameaetha
Check the moasurement ussd.
a) Top of boltom lloor (lncludlng basement, crawlspace, or enclosure floor)
b) Top of the next hlgher lloor
c) Bottom of lhe lowesl horlzontal slructural member (V Zones only)
d) Altached garago (top of slab)
e) Lowest elevallon of machlnery or equlpment servlcing the bulldlno
(Descrlbe type of equlpment and location ln Commenl.s)
f) Lowest adJacent (flnlshed) grade next lo bulldlns (LAG)
g) Hlghost adjac€nt (llnlshed) grad6 noxt to bulldlng (HAG)
h) Lowest adJacent grade at lowest elevatlon of deck or alalre, lncludlng
slruclural support
1592.3 fl feel I meters
N/A I feel E meters
N/A ! feet fl meters
1s92,3 @ feat fJ meters
N/A I feet I meters
1591.6
1592,3 [| feet
fl feet
[Jfeet
I meters
fl meters
I metersr591.8
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
Thls cerlllicallon le io bs signed and eealed by a land surveyor, en0lneer. or archltect authorized by law lo certlfu elevatlon lnformallon.
I cedffy that lhe lntormallon on.lhls_ Cedllicaki_ reprcsenls my besl elo1ls to lQtarprct lho dala avall-able. I underiland that any talse
slatementmaybepunishablabytineorimprtsonmantunderlS U.S.Coda, Secllon1001,
WerelatltudeandlongltudelnSectlonAprovldedbyallceneedlandsurveyor?EYeeENotrffi;
Cortlllels Nams
Rick Sklnnor
Llcenso Number
43619
Tllle
Profeselonal Land Surveyor
Gompany Name
Weslern Paclllc Englneerlng & Survey, lnc.
Address
1224 S. Pioneer Way
Clty
Moses Lake
Slate
Washlngton
ZIP Gode
98837
Slgnature Date Telephone
(50s) 705-1023
Ext.
Copy all pages of this Elevallon Cerlllicate and all attachmenls for (1) community officlal, (2) lnsuranca agenUcompany, and (3) bulldlng owner
Commenls (lncludlng type of equlpmenl and locallon, per C2(e), if appllcable)
The lop of the slab for the heat pump was measurs by GPS. The heat pump was restlng on legs so lhe helght dlfference bstweon the
bottom of heat pump and lhe top of slab was meagured and accounled for ln lhe elevallon,
ELEVATION CERTIFICATE OMB No.
Explratlon
1660.0008
Date: November3O,2022
FEMA Form 086-0-33 (12l1Sl Replaces all prevlous edltlons.Form Page 2 of0
IIvIPORTANT: ln these spacGs, copy the correspondlng lnformatlon from Seaflon A.FOR INSURANCE COMPANY USE
Building Slreet Address (including Apt., Unit, Suite, and/or Bldg, No.) or P.O. Route and Box No.
3002 Dapple Gray Way
Pollcy Number:
State
Washlngton
ZIP Code
s8926
City
Ellensburg
Company NAIC Number
sEcTroN E- BUTLDTNG ELEVATTON TNFORMATTON (SURVEY NOT REQUTRED)
FOR ZONE AO AND ZONE A {WTHOUT BFE}
ForZones AO and A (wlthout BFE), complete ltems E1-E5. lf the Certiflcate ls lntended to support a LOMA or LOMR.F request,
complele Sections A, B,and C. For ltems F1-E4, use natural grade, if avallable. Check lhe measurement used, tn Puerto Rico only,
onter metsrs.
El. Provlde elevatlon lnformatlon for lhe followlng and oheck lhe approprlate boxes to show whelher the olevallon le above or below
tha highest adjacenl grade (HAG) and the lowest adjacent grade (LAG).
flood openings provided ln Section A ltems I and/or 9 (see pages 1-2 of lnstructlons),
E5. Zone AO only: lf no fiood d€pth number le avallabls, ls the top of the botom floor etevaled ln accordance wlth the communlty's
floodplaln management ordlnance? fl Yes I No I Unknown. The local oflioial must certiff this informatlon in Saction G.
a) Top of boftom lloor (lncludlng basemont,
crawlepace, or enclosure) ls
b) Top of bottom lloor (including baaement,
crawlspace, or enclosure) ls
I fest I meters I above or ! bebw the HAG.
D feet I melers I above or fl below the LAG.
E4. Top of platform of machlnery and/or equlpment
servicing lhe building ls Dfeet I meterE f]aboveor flbolowthe HAG.
82. Fot Building Oiagrams 6-9 with psrmanont
the neK hlgher floor (elevation C2.b in
lhe diagrams) of the bullding is
E3. Attachod garago (lop of slab) is
E leet fJ meters D above or I below the HAG.
Iteet Emeters Daboveor f]belowlhe HAG.
sEcTloN F - PROPERTY OWNER (OR OWNER'S REPRE$ENTATIVE) CERT|F|CAT|ON
The property ownor or owna/s authorlzed representallve who completes Secllons A. B, and E for Zone A (wlthout a FEMAJssued or
communlty-lssued BFE) or Zone AO must sign here. The statemenls in Sections A, B, and E are correct to the bost of my knowledge.
Property Owner or Ownefs Authorized Represenlalive's Name
Scoft Henson
Addrass
1224 S Ploneer Way
Clty
Moses Lake
Stete
Washlngton
ZIP Code
98837
5lt (509) 8556112/
! Gheck here if atlachments,
Commenls
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: November 30, 2O22
FEMA Form 086-0-33 ('l2l1S')Replaces all previous edilions.Form Page 3 of 6
IMPORTANT: ln these apaces, copy tho correspondlng lnformatlon from $actlon A,FOR INSURANCE COMPANY USE
Bulldlng Street Address {lncludlng Apt.. Unlt, Sulte, and/or Bldg. No.) or P,O. Route and Box No.
3002 Dapple GrayWay
Pollcy Number:
City Slate
Washlngton
ZIP Code
98926Ellensburg
Company NAIC Number
sEcTloN G - coMMuNtTy |NFoRMAT|ON (OPT|ONAL)
The local offlclal who ls authorlzed by law or ordlnance to adminlster the community's floodplain managemenl ordinance can complele
Sections A, B, C (or E), and G of thls Elevation Cerliflcate. Complete the appllcable item(s) and slgn betow. Check the measulement
used in ltems G8-G10. ln Puerto Rico only, enter meters,
Gl. I The lnlonnation ln Sectlon C was taken from other documentatlon that has been slgned and sealed by a llcensed suryeyor,
englneer, or architect who ie authorlzed by law to certiff elevation information, (lndicate the source arid date of the elevillon
dala in the Comments area below.)
c2. I A community official completed Seclion E for a building located ln Zone A (without a FEMA.issued or community.issued BFE)
or Zone AO.
GO, I The followlng lnformatlon (ltems G4-G10) ls provlded for communlg floodplaln management purposes,
G4, Permit Number G5, Date Permit lssued G6, Dale Cerlificate of
Compllance/Occupanoy lssued
G7. This permlt has been issued for: fl t'tew Consiruction f] Substantial lmprovement
G8. Elevatlon of as-bullt lowesl floor (lncludlng basement)
of the building:
G9. BFE or (ln Zone AO) deplh of floodlng at the bulldlng site:
G10. Gommunity's desigrr llood elevation:
I feet f] meters Datum
flfeet ! meters Detum
I feet fJmeters Datum
Local Ofilclal's Name Tltle
Communlty Nam€Telephone
Slgnature Date
Commsnta (lncludlng type of equlpmont and locallon, per G2(e), if applicable)
fJ Checf here lf atlachments.
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: November 3O, 2A22
FEMA Form 086-0-33 (12119)Replaces all previous edltions.Form Page 4 of 6
IMPORTANT: ln theee apacos, copy the correspondlng lnformatlon from Sectlon A.FOR INSURANCE COMPANY USE
Building slreet Address (includlng Apt., unit, suite, and/or Bldg. No.) or p.o. Route and Box No.
3002 Dapple Gray Way
Pollcy Number:
Clty State
Washington
ZIP Gode
98926Ellensburg
Company NAIC Number
lf using the Elevallon Cerlillcate to oblain NFIP flood insurance, aflix at least 2 buildlng photographs below accordlng to lhe
instructions for ltem 46. ldentifr all photographs with dato taken; "Front VieW'and "Rear Vlew;; ind, lireluired, nRight Side View" and
"Left Slde View." When appllcable, photographs must ehow the foundalion with represenlatlve exampies of the-flood openlngs or
v€nls, as lndlcated ln Sectlon A8. lf submilllng moro photographs than will lil on ihis page, uss lhe Contlnuation Page.
Photo One Captlon Back View of House GlearPhoto Onc
i
i
Photo Two Caplion Side View of House Cloar Pholo TWo
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
See lnstrucllons for ltem A6.
1660-0008
Date: November30,2022
OMB No,
Explration
FEMA Form 086-0-33 (12l1Sl Replaces all prevlous editions.Form Page 5 of6
IMPORTANT: ln theee sprcos, copy tho correspondlng lnformatlon from Section A.FOR INSURANCE COMPANY USE
Building Stroet Address (lncludlng Apt., Unit, Sulte, and/or Bldg, No,) or P.O. Route and Box No.
3002 Dapple Gray Way
Pollcy Numbar:
Clty State
Washlngton
ZIP Code
98926Ellensburg
Company NAIC Number
lf submllllng more photographB than wlll flt on ths pr€cedlng pago, affix the addltional photographs below. ldenllfo all photographs
wilh: date taken; "Fronl Vlew" and "Rear View"; and, if requlred, "Rlghl Side Visw" and nLeft Slde View," When applicable,
pholographs must show lhe foundallon wllh represenlalive examples of lhe flood openings or vents, as lndlcated in Seclion A8.
):t,
i
Photo Three Captlon Fronl Vlew of Houee Clear Photo Three
Photo Four Caption Slde Vlew of Houss Clear Pholo Four
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
Contlnuallon Page
OMB No. 1660-0008
Expiralion Date: November 3O,2022
FEMA Form 086-0-33 (12115)Replaces all prevlous edlllons,Form Page 6 of6
H;[#;F,ffi H5I,',",:{:#"'f tr',?sEcu*rY
ELEVA
lmporlant:
TION CERT IFICATE
Follow the instruclions on pages 1_9.Copy all pages of this Elevation Cerlificate and ail att€chmenls for (1) community official,(2) insurance agenUcompany, and (3) building ounrer
Bl0. lndicate lhe source of the Bass Flood Elevailon {BFE)
El Fls profite E FIRM fJ community Determined
dala or base flood depth entered ln llem 89:I other/Soure,e:
81 1, lndicate elevation darum used for BFE in ltem Bg: fr NGVD 1929 E NAVD 1988 fr other/source:
B'12. ls the building localed in a Coaslal Banier
Designalion Dale:
Resources syslem {cBRs) area or
'rherwise
protected o,." ,o;;;;[] cBRs D oPA
OMB No-1 660-000s
Expiratlon Date:Novem ber 30,2022
AsEcTtoN'INFORMA TION FOR I NSURANCE COMPANY USEKurt Lustig/ Tara Ailen
A1 Name
No.) or P Route and
830 Pebble Beach Drive
Box
Streol
Company NAIC Number:
Ztp CodeEl ssszzWashington
State
City
Cle Elum
elc.)
Property and(Lot TaX Parcel NumberLot LegalSunCounlryEslates3rdAddilionTax#893234
A8. For a building with a crawlspace or enctosure(s):
a) Square footage of crawlspace or enclosure(s)
b}NumberofpermanentlIoodopenings*.n"."ffi,]1
c) Total net area of ltoorl openings in AB.b
d) Ensineered nood openinss,
"
; ;.; !;;-----$ 'r i'
ft
.0 foot above adjacent grade n7g
lhe atlached garage within 1.0 foot above adjacent grade 2
400 sq in
rance.
44, Building Use (e.g., Residential Non-Residential, Addition Accessory, etc.)A5. Lalitude/Longilude; Lat. 47.1 1-05.054 N Long. 121-03-01.80 W Horizontat Dalum:46. A{tach at least Z photographs of the
NAD 1e27 El NAD 1983building if the Cerlificate is being used to obtain floocl insuA7. Buitding Diagram Number 18 El
b) Nurnber of permanent flood openings in
c) Iotal net area of flood openings ln A9.b
330 sq tr
d) Engineeredfloodopenings? fi yes E ruo
A9. For a building with an aftached garage:
a) Square footage ofattached garage
BSECTION FLOOD INSURANGE RATE IVIAP (FtRnt)81. NFIP Communiry Name & Comrnunity Number
Kitlitas County S30095
82. County Name
Kittitas
EI
83. State
Washington
53037C0666
84. Map/panet
Number
85, Suffix
D 09-24-2021
86. FIRM lndex
Date
87. FIRM panel
Effective/
Revised Date
09-24-202'l AE
88. Flood
Zone(s)Bg. Base
{Zone
2007.8 ft.
Flood Elevalion/s)
AO, use Base Ckioa Depth)
FEMA Form 086-0-33 (12/19)Replaces all pr€vious editions.
Form Page 1 016
ELEVANON CERTIFIGATE OMB No-Eglndfi 1660-0008
Dah: Norcrnbcr 30,20?,th€ln thcra fi!m S€ctbn A.Stro€lBullding Addrcsc (indudirW APt,Unll,and/orsub'8lds.P0rllo,)Rqlu,o.830 sldPebble Eor No.Bsa.tr Oriv6 PoEcy
Cle gum
Wo*,f,Cbn sa92J2
cSECTtolt BUILDI}IG ELEVANON lilFORtuATtOl,tcl.
c2.
I.UA
N/A
2m7.9Lorwst cteyr[on(o*nibc tnr of
oTmachlnctyor
Gqupmrd.nd _eqtfl'prnenl 33rvtuno 0lelocalion ln Commcnls;20090
2m5.0
1007.0Louast sdjrcont grade
stn c0,ml support
th€Chcctra)otTop bottom nFagullmcntfoor lrtod.ondudhg bascment,crewlspace,or sndosuro floor)ftrt mCtcrr2008.9 B nb)ttcof nadTop hi$er lloor
fccttr tnetqsuBotbmc)thed lqul8st horizonlal f[ucntr€l mrmber Zonee(v only)rbdtr hohtEAtta*edd)ofgangt(lop slab)
irctE tr mrl?ne)
bufiding
tocttr mOtrttLorrrustf)adjacent graalefinlghcdl bnaxt buildins (tAG)fsattr IDolorstrHiohsts)edtscent (ftri$ed)noxtgrade to bu!dirng (HAG)
lEGttr mebrsnh)rt lovrlst of9lc\rallon orded(indudhoEblrs,
i6ot meb'3trl.l/A
sEcnoN D _OR ARCHFECT
Brrndon lA/krters. pLS
4580:l
Presldent
Chrd$ok e Vilntcls Lend Surveylng
1422 t'lw 85th St.
Sea$lc Wartringbh 98t17
Dolo
t2-12a0x2 (2081 2e7-0ss0Gopydloftll
ownct
.nd dl
Elev"non Dalum ' Ptol'ct €lGv'tma ctr rElEtivc to l,lAvD 8B-as-dcrlved by dirccl ficH dca to FElrtA RM53, r<lJurt d by rnslbltn thdNGVD ts2gl t\lAvD 88 convcrslon. -o "Jil uv iilul-g-Ps ouservatorr u0tbing tEtcA cps ,ecciver-
tyF pcr
Hcel locdedC2(e)pump 8ouilralong rlde 6 attrdnd wNll.golrtr
FEMA F6m 060+33 {lzts}Replacoo all pruvlous edllloac.Form 2 ol€
EtEVAnolt
30,20?2lnllxeiltrfiontA.SGction
or P.o.end Box
Apt, Unlr,Sulte and/or Bldg.830 PebUe Beedt DdYe
Stcet
Nunfer:
Clc Ehan
lVehlrUbn s69lu
bilEFOR AO AT{D ZOt'lE A
tn
l3R $'t'*r#ff ilt"u "n"o,
cquipmcnr
ffi*"
Socdamenpctc A,inhfidod tonchJrdfte
E1
n
he
lha
tcot tr
ForZonaEAO endA l-Es. lt0r.Ccrtifioatr irenbrlhdftr.gnde. lf nailaHc. Chcc*
borc* to chov *trelhcr lho alourtnn ia cbovc or bolorr
[tt"t Enron labovuor bclrn thgHAG.
[ruot flr"rors Eabweor Eboql,tret-ae.E2. For
llood opcnirgs providod h Srcuon A ncms S end/or g {crr pagcs i_2 of lnrbuclionc),
E3. A0edted garyB $opof cNeb) lB
mdors Erbouaor EtrUrtrcnnA.
Elfrt Dmcten flaborcc DbcbwthcHAe.
E5.Zone AO
fioodplCn
OYYI{ERB
EECTIOil F PROPERTY o{yt{ER
tlplcsGntslive
sigrr here. The FEll4Ajccrrad or
of mykro*ldgp.or
Steb
ff orra<mruf arbdtmcnb.FEMA Form 08&0€3(r40)
Rcplaocr rl revlou$rdlflom,Form P.ge 3 of8
llt/IPoRTANT: ln 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.
830 Pebble Beach Drive
Policy Number:
City
Cle Elum
State
Washington
ZIP Code
98922
Company NAIC Number
SECTION G - COMMUNITY INFORMATION {oPTroNAL)
The local oflicialwho is autho-rized by law or ordinance to adminisler the community's floodplain managemenl ordinance can complelesections A' B' C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign oirow. Check the measuiemlnrused in ltems G8-G10. ln Puerto Rico only, enter meters.
Gl. n The information in Seclion C was taken from other documentation thal has been signed and sealed by a licensed surveyor,engineer, or architecl who is authorized by law to certify elevation informalion. (lndicate lhe source and date of lhe elevationdata in the Comments erea below.)
c2. D 1 1ommt1ltv official compleled Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE)or Zone AO.
G3. El The following informalion (ltems G4-G10) is provided for communiiy lloodplain managemenl purposes.
G4. Permit Number
FD-21-00047
G5. Date Permit lssued
02-01-2022
G6. Date Certificate of
Compliance/Occupancy lssued
12-16-2022
G7. This permit has been issued for: ffi New Conslruction I Substantial lmprovement
ffi feet l_l meters
fi]feet I meters
ffi feet n mebrs
Datum NAVD gg
Datum NAVD 88
Datum NAVn 88
2008.8
2007 8
2008.9
G10. Community's design flood elevation:
G9. BFE or (in Zone AO) depth of ftooding at the buitding site:
G8. Elevation of as-buill lowest floor (including basement)
of the building:
Title
Water Resources SpecialistSamantha Cox
Name
(509) 962-7523Kittitas Coung
Community
12-16-2022
2 Smart Vents, model number 1540-520, installed in the garage. Certificalion for vents altached.
ffi Cne* here if aflachmenls,
type of equipmenl and location. per C2(e), if applicabte)
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Dale: November 30,2022
FEMA Form 086-0-33 (12t19)Replaces all previous editions.Form Page 4 of6
IMPORTANT: ln these information from Secllon A.spaces, copy lhe FOR INSURANCE COMPANY USEBuilding Street Address (including Apt,, Unit, Suite,and/or Bldg No.) or P.O. Route and Box No.
830 Pebble Beach Drive
Policy Number:
City
Cle Elum Washington 98922
P Code Company NAIC Number
lf using the Elevation Certificate to oblain NFIP flood insurance, affix at lea.sj_z building photographs below according lo theinslructions for ltem 46. ldentify all photographs with date taken: "Front View'; and "Rear Viewi; JnO, if"required, ',Right Side Mew,,and"Left side View'" \Men applicable, photbgiaphs must show the foundation with represeniati"e e'r"mpres of lhe flood openings orvenls' as indicated in seclion A8. lf submitting more photographs than will fit on this pige, use lhe Contiriuation eage.
Photo One Caption Rear view (east side) lahen 121j6t2022 Clear Photo One
View ( west side) taken 12t16t2022Photo Two Caption
Cl6ar Photo Two
Fronl
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
See lnslruclions for ltem 46.OMB No. 1660-0008
Expiration Date: November 30,2022
FEMA Form 086-0-33 (12t191 Replaces all previous edilions.Form Page 5 of6
ANT: ln these spaces,the corresp informatlon from Seclion A.FOR COMPANY
Address (inciuding Apt., Unit, Suite, and/or Bldg. No.) or p.O. Roule and Box No_
830 Pebble Beach Drive
Building Streel Policy Number:
Cily
Cle Elum
State
Washington
ZIP Code
98922
Company NAIC Number
lf submitting more pltolographs lhan will fit on the preceding page, affx the additional photographs below, ldenlify ail photographswilh: dale taken: "Front View" and "Rear View"; an!, if requireO, ,,Right Side Viev/' and,;ieff SiOe View.,, When'"pp[.r6f",photographs must show ihe foundalion wilh representalive examples of thtflood openings or venls, ". indicated in Seclion A'C. -
Pholo Thre6
Photo Three Caption Clear Pholo Three
Photo Fout
Photo Four Caption Clear Pholo Four
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
Conlinuation Page
OMB No 1660-0008
Expiralion Dale: November 30,2022
FEMA Form 086-0-33 (12t15)Replaces all previous editions.Form Page 6 of 6
F lt.
ICC-ES Evaluation Report ESR-2074
Reissued February 2021
This report r.s subT'ect to renewa! February 2025.
www.icc-es.orq I (800) 42g-6597 I (562) 699-0543 A Subsidiary of the lnternationatCode Council@
DIVISION: 08 00 00-OpENlNcS
Section: 08 95 43-Vents/Foundallon Flood Vents
REPORT HOLDER:
SMART VENT PRODUCTS, INC.
EVALUATION $UBJECT:
SMART VENIS AUTOiIATIC FOUNDANON FLOOD
VENTS: IVIODELS #1540.520; #i&10.521; fie[06i0; #1840.
511; #1540€70; #1540674; #i6f0-524; #i840{l{
FLOOD VENT SEALING KlT #1540628
1.0 EVALUATION SCOPE
Compllence with the followlng codee:
t 2018,_2015,2012,2009 and 2006 tnternational Building
Codeo (lBG)
:2018, 2015, 2012, 2009 and 2006 tnlernationat
Residenliat Code@ (tRC)
r 2018 lnternational Energy Conserualion Code6) (IECC)
r 2013 Abu Dhabi lntemational Buitding Code (ADIBC)I
qhe ADIBC iB bsied on the ?009 lBC. 2009 tBC code section8 roferenced
in thi8 r€porl are lhe 3ame seclions in the ADIBC.
Properliee evaluated:
r Physical operation
r Water llow
2.0 usEs
The Smart VenF units are engineered mechanically
operated llood vents (FVs) employed to equalize
hydrostalic pressure on walls of enclosures subjecl to
rising or falling flood walers. Certain models also allorv
natural ventilation.
3,0 DESCRIPTION
3,1 General:
When subjected to rising waler, lhe Smart Venl@ FVs
internal floats are activated, then pivot open to allow flow in
either direction to equalize waler level and hydrostatic
pressure from one side of the foundalion to the olher. The
FV pivoting door is normally held in ihe closed position by
a buoyant release device. When subjected to rising walei,the buoyant release device causes the unit to unlatch,
allowing lhe door to rotale out of the way and allow flow
The water level stabilizes, equalizing the laleral forces.
Each unit is fabricated from stainless sleel. Smarl Vent@Automatic Foundalion Flood Vents are available in
various models and sizes as described in Table .l . The
SmartVENToStacking Model #1540-Sl 1 and FtoodVENT@Slacking Modet #1940-521 units each conlain two
vertically arranged openings per unil.
3.2 Englneered Opening:
The FVs comply with the design principle noted in Seclion2.7.2.2 and Section 2.1 .3 ol ASCE/SE| 24_.t4 [$ection2.6.2.2 ot ASCE/SE| 24-05 (2OjZ, 2009, 2006 rbc and
IRC)J for a maximum rale of rise and fall of 5,0 feet per
hour (0.423 mm/s). ln order to comply with the engineeied
opening requirement of ASCE/SEI 24, Smart Vent FVs
musl be installed in accordance with Section 4.0.
3.3 Ventllation:
The SmartVENT6 Model #1S40-S10 and SmartVENTo
Overhead Door Model #1540-514 bolh have screen coverswith. lLinch-by-1&-inch (6.35 by 6.35 mm) openings,
yielding 51 square inches (32 903 mm2y of net free area tosupply natural ventilation. The SmartVENTo Stacking
Model #1540-511 consists of two Model #.t540_510 uniti
il - qlq assembty, and provides 102 square inches(65 806 mm2) of nel free area to supply natuial ventilation.
Other FVs recognized in this report do not offer nalural
ventilation"
3.,0 Flood Vent Seallng Klt:
The Flood V,ent Seating Kit Modet #15/;0-526 is used with
SmarlVENTo Model #1540-520. lt is a Homasote 440
Sound Baniero (ESR-1374) insert with 2t - 2_inch-by_2_
inch (51 mm x 51 mm) squares cut in il. See Figure 4
4.0 DESIGN AND INSTALLATION
4.1 SmartVENTo and FloodVENTo:
SmartVENT@ and FloodVENlo are designed to beinstalled into walls or overhead doors of existing or new
construction from the exterior side. lnstallation of thevents must be in accordance wilh lhe manufacturer,s
instruclions, the applicable code and this reporl.
lnstallation clips allow mounting in masonry and concrete
vralls of any thickness. ln order to coinply with the
engineered opening design principle noted in Sec,tion
2.7.2.2 and 2.7,3 of ASCE/SE| 24-,t4 [Secrion 2.6.2,2 olASCE/SEI 2+05 (2012, 2009, 2006 rsG and tRC)1, the
Smart Venl@ FVs must be installed as follows:
r Wilh a minimum of two openings on differenl sides of
each enclosed area.
r Wift a minimum of one FV for every 200 square
k) ailtJiililnJ!.r' ilth.1' noiltr in thit rcpott, .tt .l h, onl,pntln t ttti.std l),llx, reltott.
Copyrighl € 2021 ICC Evaluelion SeNico, LLC. Alt rights res€rved.
Ntlll*F.@
Pago 1 of 5
ESR-2074 I Most Wi(lcty Accepr" anrl Tntsled Page 2 of 5
feet (18.6 Jn') of enclosed area, excepl thai theSmartVENT Slacking Modet #1540-51 1 and
Floo<tVENTs'stacking Model #1S40-b21 must be
installed wilh a minimum of one FV for every
400 sguare feet (37.2 m2; of enclosed area.
r Below the base flood elevation
r With lhe botlom of lhe FV located a maximum of
12 inches (305.4 mm) above the higher of the final
grade or floor and flnished exlerior grade immedialely
under each opening
4.2 Flood Vent Sealing Kit
The Flood Vent Sealing Kit Modet 1540-526 is used in
con,junction with FloodvEttf' Model #1540-520 When
installed and tested in accordance with ASTM E283. the
FV and Flood Venl Sealing Kit assembly have an air
leakage rale of less than 0.2 cubic feet per minute per
lineal fool (18.56 l/min per lineal meter) al a pressure
differential of 1 pound per square foot (50 pa) based on
12.58 lineal feet (3.8 lineal melers) contained by lhe Flood
Vent Sealing Kit.
5.0 coNDtTtONS OF USE
The Smart Ventd'FVs described in lhis report comply with.
or are suitable alternalives to what is specilied in, lhose
codes listed in Section 1.0 of this reporl, subjecl to the
following conditions:
5,1 The Smarl Vent6 FVs musl be installed in accordance
with this report. the applicable code and the
manufacturer's installation instruclions. ln lhe evenl of
a conflict. the inslructions in this report govern,
5.2 The Smart Venln'FVs must nol be used in lhe place
of "breakaway walls" in coastal high hazard areas, bul
are permitted for use in conjunction wilh breakaway
walls in olher areas.
6.0 EV]DENCE SUBMITTED
6.1 Data in accordance with the ICC-ES Acceptance
Crileria for Mechanically Operated Flood Venls
(AC364), dated August ZljS (edilorially revised
October 201 7),
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 lhis report must be identified by i
label bearing lhe manufacturer's name (Smartvent
Producls, lnc ), the model number, and lhe evalualion
reporl number (ESR-2074 ).
7.2 The reporl holder's contact informalion is the
following:
SMART VENT PRODUCTS, INC.
430 ANDBRO DRIVE, UNIT 1
PITMAN, NEW JERSEY O8O71
(877) 441-8368
www.cu-a_dy9-u!.9-9u
i n f q(Qg jlladIgll-t. c ACIl
For Sl: 1 inch = 25.4 mmt I square fool =
TABLE 1*MODEL SIZES
MODEL NAME MODEL NUMBER MODEL SIZE {in.)COVERAGE {sq" ft.)
FloodVENf 1 s40-520 153|a'X73la"200
SmartVENT@ 1 540-51 0 1s3ta" x73la"200
FIoodVENTE Overhead Door 1540-524 15"L" x 7'l0"200
SmartVENf Overhead Door 1 540-51 4 1s3lq" x73l^"200
Wood Wall FloodVENTd '1540-570 14" X B3/a"200
Wood Wall FloodVENT6 Overhead Door 1540-574 14" X 81a"200
SmarlVENf Stacker 1540-51 1 16" X 16"400
FloodVenlt Stacker 1 540-521 16'X 16"400
raat
!f!!t!!
tttt
rair(r!!.rtriitatrrFlartrarttrrrraarrrrrrrr.taaarrtarr..rrrattattrttatla.r:rrrr.irtr
!!!!
ttt
!!!!|:!!!!
tttt
tt
ttl
tat !:!
FIGURE 1-SMART VENT: iIODEL I540.510
ESR-2074 I Most Wtulely Accept - rnd Trusled Page 3 of 5
FIGURE 2-gfitART VENT ilODEL t5a0-520
FIGURE HIIARTVEilN SHOW}T UVITH FLOOD DOOR PIVOIEO OPETI
II{TERIOR CNEf,K'N
FIGURE,I-FLOOD VEI{T gEALll{G KIT
ICC-ES Evaluation Report ESR-2074 CBC and GRC Supplement
ReissuedFebruary 2021
This repoft is subiect to renewal February 2023.
Wllw.icc'es.orq | (800)423-6587 I (562)6994543 A Subsidiary of the lnternationalCode Councit@
DIVISION; 08 00 00-OPENINGS
Sectlon: 08 95 43-VentE/Foundatlon Flood Vents
REPORT HOLDER;
SMART VENT PRODUCTS, INC
EVALUATION SUBJECT:
SMARTvENTCIAUTOMATIO FOUNDAflON FLOOD VENTS: MODELS#15$€20; fi5a0.621; #18f0{10; #iS40{t; #1&t0-
57 0 ; #1 &0 67 4 ; trl ilO $24 ; #t 54{l-51 4
FLOOD VENT SEALING K]r#1540{26
1,0 REPORTPURPOSE ANDSCOPE
Purpose:
The purpose of lhis evaluation report supplement is to indicale that Smart Vento Automatic Foundalion Flood Venis,
described in ICC-ES evalualion report ESR-2074, have also been evalualed for compliance with codes noted below.
Applicable code editlon:
r 2016 Califomia Building Code (CBC)
r 2016 California Residential Code (CRC)
2.0 coNcLusroNs
2.I CBC:
The Smarl Venle Automatic Foundation Flood Vents, described in Sections 2.0 through 7.0 of the evaluation report ESR-
2074. comply with 2016 CBC Chapler 12, provided the design and installation are in aeordance with the 2015 tniarnalionat
Building Codeo (lBC) provisions noted in the evalualion report and the addilional requirements of CBC Chapters 12, 16 and
164, as applicable.
2.2 CRC;
The Smart VenF Automalic Foundation Flood Vents, described in Seclions 2.0 through 7,0 of the evaluation report ESR-
2074, comply with the 2016 CRC, provided lhe design and inslallation are in accordance with the 2015 tniernational
Residential Code@ (lRC) provisions noted in lhe evaluation report.
This supplement expires concurrently with lhe evaluation reporl, reissued February 2021 .
nntlJintltngu'uhcrwiltLrrnilnrrcpilr.arorb.nD'ftorhil.'ut(slh)th!rcptfl, ffif ."**=fa.-
Copyrighl @ 202 1 ICC Evduation Servic€. LLC. All rights reserv6d prge { of s
1.0 REPORT PURPOSE AND SCOPE
Purpose:
The purpose of this evalualion reporl supplement is to indicale that Sman VentsAutomatic Foundalion Flood Vents, described
in ICC-ES evaluation report ESR-2074, have also been evaluated for compliance with the codes noted below.
Applicable code editions:
. 20'17 Florida Building Code-Buitding
. 2017 Flonda Building Code-Residentiat
2.0 coNcLustoNs
The Smari VenF Automatic Foundation Flood Venb, described in Seclions 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 insiallation are in accordance with
the 2015 lnlernational Building code@ provisions noted in the evaluation reporl.
Use of the Smart VenF Automatic Foundation Flmd Vents has also been found to be in compliance with the High-Velocity
Hurricane Zone provisions of the Florida Building Code-Buitding and lhe Florida Buitding Code-Residential .
For products falling under Florida Rule gN-3, verification that the report.holder's qualily assurance program is audited by aqualily assurance entity approved by the Florida Building Commission for the type oiinspections beiig conducteO is iheresponsibiliiy of an approved validation entity (or the code oflicial when the report holder dbes not possiss an approval by
the Commission).
This supplemenl expires concurrenlly with the evalualion reporl, reissued February 2021 .
ICC-ES Evaluation Report ESR-2074 FBC Supplement
RercsuedFebruary 2021
This report is subl'ecl to renewal February 2025.
www.icc-es.Qrq | (800) 423-6587 | (562) 699-0543 A Subsidiary of the lnternationat Coda Council@
DIVISION: 0E 00 00-OPEN|NGS
Section: 08 95 43-Vents/Foundation Flood Vents
REPORT HOLDER:
SMART VENT PRODUCTS, INC.
EVALUATION SUBJECT
SMARTVENI0AUToMATIC FOUNDAilON FLOOD VENTS: MODELS #15l|{}{20; #1540€21; flS40-510;#t&l11{11;
#14|0670; #154{l$71i *15404U; #1640{14
FLOOD VENT SEALING KIT#18rc€26
kt.ilt.l,.litrlhrlorniltrilttltrtntfu\NlxrLtrro\ut(tu'!tn\lt4t.ot\Ndhtthcttl\rr!,
[H _H*
Copyright @ 2021 ICC Evduation Seruice, LLC, Ail rights rss€rved. page S of 6
U.S. DEPARTMENT OF HOMELAND SECURITY. Federal Emergency Management Agency
Natlonal Flood lnsurance Prograln
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE tNsTRucTtONS ON pAcES 9-,tS
all of thls Elevatlon Certllicate and all attachments tor olllclel,lnsurance
OMB Cohlrol No. 1660.0000
Fxdrollon Oara; 06n0/2026
and owner
FOR INSURANCE COMPANY USE
Pollcy Numbor: _-.**---.*-=.
Company NAIC Numtrer:
A'1. Building OwneCs Name: SSHI LLC
A2, Bulldlng slrsel Addrees (lncludlng Apt,, Unlt, $ulte, and/or Bldg. No.) or p.o. Rout€ snd Box
No.:3667 Roan Dr,
cny;Ellensburg stele: WA Ztp Code: 9Bg26
A3. Property Descrlption (e,9., Lol and Block Numbers or Legal Descrlplion) and/or Tux Parcel Number:
Divislon 7 Lol I s62117
44. Bulldlng use (e.9., Rosldenllal, Non-Resldenllal, Addllion. Accessory, elo,): Resldential
A6, Latitudo/Longltudo; Lat,N47"0l'3:1..*9158{ Long.W,l20'34'37.029 HorlzonlalDatum: ENAD iszT EINAD 1983 fJWGs84
A6' Allach al least two and whon possible lour clear pholographs (one for each sldo) of the building (see Form pagas 7 end g).
A7. Buildlng Oiagram Number: 1B
AB, For a bulldlng wlth a crawlspace or enclosure(s):
a) Squaro footag€ of crawlspace or enclo$ure(s)l eq.fl,
b) ls lhere al leasl one permonent flood oponlng on lwo dlfferent sldes of eaoh enclosecl area? [ yes f] No E N/
c) Enler number of pelmanenl llood oponlngs ln lha crawlspaco or €nclosure(s) wlthln '1.0 Jool above arlJacenl grade:
Non-engineerod flood opontng": _1,) /A Englneared 0ood openlngs: _/liUL
d) Tolal nol open aroa of non-onglneered flood oponlngs ln A8,q // tF sq- tn.
o) Tolal ral€d ersa of englneered flood openlnga ln AB.c (atlach documentallon - see lnstrucllone):
f) $um of AB.d gnd AB,e rated aroa (lf applicable - see lnslruclions): lv /4 sq. ft.
sq. ft.
A9. For a building with an sllaohed oarage:
a) Square footage of atlached garage:604.00 sq.ft,
e) Totel rated erea of englneeted flood opanlnge ln Ag,c (attach documentatbn - soo lnstrucllons):sq.ft.
f) Sumof Ag.d andAg.e raled area (if applicable,-see lastrucUons): ll n sq. ll.
b) ls lhore al loasl ono perrnanont flood openlng on lwo difforent sldes of the attached garage? [ yes @ No f,] N/A
c) Enler number of parmanenl flood openlnge in lhe allached garage within 1.0 foot above odjsconl grad6:
Non-englneered llood openlngs: N /4 - Engineered llood openings: n/A
d) Tolal nol open area of non-engineered llood openlngs ln Ag,c; N/k sq, ln.
89. Base Flood Elevallon(s) (8FE) (Zone AO, use Base Flood Depth): 15g6.g
810. lndicale lhe eource of lhe BFE dala or Base Flood Doplh ontorod in ltom 89:
E FIS n FIR[4 E Communtty Determtned fJother:
Bl 1, lndlcale elevatlon datum u6ed lor BFE ln ltom B9: fJ NGVD 1S29 E NAVo 19ss tl other/Sourco:
Barrier Resourcss systom (cBRs) area or othenvlse prolected Area (opA)? [ yes [t No
flcBRs EIoPA
81.b. NFIP Communlty ldonllflcation Number: 53009s
85. Suffix D
86. FIRM lndsx Date: 0912412021 87. FIRM Pansl EffscliyelRevlsed Dala: 09f2412021
83. $tate:WA B4. Map/Panel No.: $3037C1064
BB. Flood Zona(s):AE
813, ls lhe bulld located seaward of the Llmil ol Moderale Wave Aclion Yes No
81.a. NFIP Communlty Name: KITTITAS COUNTY
82. County Namo: KITTITAS
812, ls lhe bulldlng locatsd in a Coastal
Dosignation Dalel
FEMA For.n F F -20VFY -22-1 52 ({orrnerly 086.0-9 A) (1 0tZZ)Page 2 of 19
ELEVATION CERTIFICATE
IMPORTANT: MUST FoLLOW THE tNSTRUCT|ONS ON PAGES 9.1S
FOR INEURANCE COMPANY USERulldlng slroel Address (including Apl., unll, sulto, and/or Bldg, No,) or 1,.o. Roulo and Box No.;
3007 Roan Dr.
Clty:Ellensburg Stalo: WA ZIP Codo: $8926
Company NAIG Numbsr;
Pollcy Number:
fl construction Drawings' l] Bullcllng under conslruclion. [J Flnlshod conslrucllon
required whon conslrrrcllon ol the building ls complele.
lndicale elevatlon dalum used for tho €lovallons ln lrems a) through h) below.
[:l NGVD 1e2s El NAVD le8s [ 0ther:
C1. Buildir4 olsvations are baeed on:
'A new Elevallon Gertificale wlll be
C2. Elsvslions -Zones At-A30, AE, AH. AO, A (with BFE), VE, V1-V00, V (wth BFE), AR, A|VA,AR/AE, AR/A1-A30, AR/AH, AFYAO,A99. Complote llems C2,a-h below according lo the Buitding Diagram spoclfled ln ltem A7, ln Fuerlo Rlco only, enler msl€rs,
Benchmark Utillzad: Center of S 27,T 18 N, R 18 E Vorlical Dalum: NAVD 1988
Datum used for bulldlng elovallons rnusl be lhe same as that used for tho BFE. Conversbn factor used?lf Yes, describa lhe source of lhe converslon lsclor in lho geoilon D commenls aroa.
a) Top of bollom lloor (incruding basemenl, crawlspaoe, or enclosure lroor):
b) Top of the nexl hlgher lloor (see lnslrucilons):
c) Botlom of the lowest horizonlal slruclural membor (soo lnslructlons):
d) Atlached garage (top of slab):
e) lgwesl elevarion ol Machlnory and Equlpment (M&E) servloing lhe buildlng(descrlbe lypo of M&E and loiallon ln bdcilon O Cornments arlall
f) Lowest Adjacont Grade (LAG) nexl to bulldingl I Naturat [J finisnert
g) Hlphosl AdJacent Grade {HAG) noxl lo bulldlng; I Natural I flntstreO
h) Flnlshed LAG al lowesl elevalion of allached deck or slalrs, lncludlng slrucluralsupport:
-il4
,1,600.30
N (k I leel fl melers
1,600.30 @ faet I meten
._.!600.10
1,598.90
[J feet I meters
llJ feel I mators
1,600.00 lB foet I merers
* il-fA_ fl feer fl merers
ll Yos El No
Check lha msasuromenl uoed;
ffi feel I meters
fl leet [] metors
436 r
were lalltudo and longllude ln $ecllon A provlded by a licensed land survoyor? [J yes I No
I Check hsre ll altaehrnenls and desoribe in the Gommenls area.
Copy all pagos of thls Elevalion Cerliticalo and all attachments lor ('l) communily official, (A) lnsumnco
Addrese: '1224 S. Pioneer Way
Clly: Moses
Company Name:Woslorn Paclfic Englneering & Survey, lnc.
Commenls
Emall:not
3
Ext.
State; WA ZP Gode: 98837
(Includlng source of convorslon faotor ln c2;lype of ogulpmenl and por G2.6; and of any aftaohmenls)lHeal Pump pad was measured at tho top wlth the bottom of the hoat purnp ralsed an addllional elghl lnchee wllh legs
englnoer,certlllaallonThls tols be sealedend asigned landby arohlteotor aulhorlzedsuruayoI,lawslele loby llonel€V€cerlllyInformallon.lhal lnformatlonthe thteoncefllfy Gartillcate Desl loef{orls lhar6ptoso/,fs my dalalnterpret undersland lhalavallable,anyfalseslalamonlbeorlinsmaybypunlshablaundorB8.Ulmplsonment Seo0on 1001Code,
Ceilifle/s Name: Rlck Sklnner Llcense Numbsr:43619
Tllle: Professlonal Land
765-1023
Dst€:Slgnaturo:
Telephone:
)
FEMA Form FF-206-FY-2?.-152 (formedy 086-0-33) (10[22)Page 3 of 19
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTTONS ON pAcEs 9-19
Bullding streol Addross (lncludlng Apl., unlt, tiulte, and/or Bldg. No.) or p,o. Route and tsox No.:
3007 Roan Dr.
FOR INSURANCE COII,IPANY USE
City;Ellensbu Slato: WA ZIP Code; 98926
Policy Number: ._='=_--*
Company NAIG Number:
'FORIZONE zoN
For Zones AO,Att/ o,snd A {wlthout BFE ),complote llems E 1*E5.For Items E -E4,us6 nalural grade,r avallable.il ths Certificats l9lntondedlosupportaLellerofMapChangor€qu€sl,complete Sections A,B,and c.Ghock lh€measuremont ueed.In Puerlo Rico only,onlor melers.
Buildlng measuroment$ ale baued on: I construcllon Drawlngs* fl outHlnp Under Conslruclon. I Finlshed Conslrucllon
'A new Elevatlon Certlflcale wlll be requlred when conslructlon of lhe bulldlng ls complolo
E"l. Frovlde rneasuremenls (C,2.a ln apptlcable Bulldlng Dlagram) for lhe tollowing and check lhe appropriate boxee lo show whether lhomeesurement ls above or balow the nalural HAG anct lhs LAG.
a) Top of bollom floor (including basement,
crawlspace, or enclosure) ls:
b) Top ol bollom lloor (lncluding basemeni,
lf feel I metors I above or l] below tbe HAG.
crawlspaoe, or enclosure) ls: fl leet I molers I above or I below lhe LAG.
E2. For Building Dlagrams 6-9 with permanenl llood oponings provlded ln Seclion A ltems I snd/or g (seo pagos 1-2 of lnstrucllons), thenext highor floor (C?,b ln appllcabloBuildingDiagramloflhebulldlngls: [] feet I melors I aboveor fl belowtheHAG.
E3. Atlached garage (top ot stab) ls:
E4, Top ol plntform of machinory and/or oqulpment
servlclng lhe bullding ls:
I foet l._l melers I aboveor [J betowthoHAG.
fl leet fl meters I abovo or I below the HAG.
E6. Zono AO only: lf no llaod deplh number ls availabls, is tho top of lhe boltom lloor etevated ln accordanco with the communit/sfloodplalnmanag6msntordlnanco? [ Yes f] tto I Unknown Thelocal olllclal muslcertifylhisinlormailoninSocuonG
oR.
The proparly owoer or owner's aulhorlzed reprosentalive who
slgn here. 7ho slalornents ln Secllons A, B, and E aro correcl
complelos Soclions A, B, 6nd E lor Zone A (wllhoul BFE) or Zono AO musl
lo the besl of my htowlodgo
! Check here lf altachmonls and descrlbe ln the Commenls area,
Prop€rty Owner or Owner's Authorized Roprosonlallv€ Namfi Scott Henson
Address: 1224 S, Pionoer Way
Clty: Moses Lako Slato; WA ZIP Code: 98837
Slgnalure;*!*-A*-r)ta, ^.t+t Dale:ft i-'t
Telephono: (509) 765-1023 Exl.:Email:
Cornmenls:
FEMA Fonn FF-206-FY-22"152 {fomerly 086.0"33} tl0/22)Pago 4 of 19
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.,t9
FOR INSURANCE COMPANY USEBuilding Street Address (including Apt., Unil, Suite, and/or Bldg. No.) or P.O. Route and Box No.
3007 Roan Dr.
Cily:Ellensburg Stare: WA Ztp Code: 98926
Company NAIC Number:
Policy Number:
sEcTloN G - coMMuNrTY TNFORMATION (RECOMMENDED FOR COMMUN|TY OFFIC|AL COMPLETTON)
The local official who is aulhorized by law or ordinance to adminisler the community's floodplain management ordinance can complete
Section A, B, C, E, G, or H of lhis El6vation Certificate. Complete the applicable itein(s) an<i sign belod when:
G1' D fne information in Section C was taken from other documenlation that has been signed and sealed by a licensed surveyor,
engineer, or architect who is aulhorized by state law to certify elevation information. (lndicate the source and dale of the
elevation datra in the Comments area below.)
G2.a. fl 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.
El A bcal official completed Section H for insurance purposes.
f} tn tfte Comments area of Section G, the local oflicial describes specific corrections to the information in Sections A, B, E and H.
E fne following information (ltems GS-G1 1) is provided lor community floodplain management purposes,
Permit Number: FD-22-00006 G6. Date Permit tssued 0310212022
Dale Certilicate of CompliancelOccupancy lssued
This permit has been issued for: E ruew Construction ! Substantial lmprovement
Elevaiion of as-built lowest lloor (including basement) of thebuilding: 1,600.30 8l feet
G2.b
G3.
G4.
G5.
G7.
G8.
G9.a
I meters Datum: NAVD 1988
G9,b' Elevation of bottom of as-built lowesl horizontal structural
member:I teet Datum:
G10.a. BFE (or depth in Zone AO) of flooding at the building site:
G10.b' 66rnnrunily's minimum elevation (or depth in Zone AO)
requirement for the lowest floor or lowest horizontal structural
member:
1,596.90 @ feet Darum: NAVD 19BB
1,597.90 B feet flmeters Datum: NAVD 1988
G11. Variance issued? [ Ves E Xo lf yes, altach documentation and describe in lhe Comments area.
The local official who provides information in Section G must sign here- I have_ completgd thg informalion in Section G and cenily thal it is
correct to lhs Ossl of my knowledge. lf applicable, I have also provided specific corrections in the Commenls area of this sectlon.
Local Official's Name: Samantha CoX, CFM Tiile: Water Resources Specialist
NFIP Communily Name Kittitas Countv
f] meters
n meters
Telephone: (509) 962'7523
Address:411 N. Ruby St., Suite 1
Email:publicworks@co. kittitas.wa. usExt.
City:Ellensburq State: WA Ztp Code: 98926
ss6,OBl21l2O23
ol equipment and location, per C2.e: description of any attachments; and conections to specific informalion in
Signature:
Commenls
Seclions A,,D,E,
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
FOR INSURANCE COMPANY USEBuilding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.:
3007 Roan Dr.
City:Ellensburg State: WA Zlp Code: 98926
Company NAIC Number:
-_-
Policy Number:
SECTION H - BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES(suRVEy NOT REQUTRED) (FOR TNSURANCE PURPOSES ONLY)
The property owner, owner's authorized representative, or local floodplain management official may complete Seclion H for all flood zones
to determine lhe building's first floor height for insurance purposes. Sections A, B, and I must also be completed. Enter heights to the
nearest lenth of a loot (nearest tenth of a meter in Puerto Rico). Reference the Foundation Type Diagrams ht the end of Section Htnstruclions) and the appropriate Building Dlagrams (at ahe end of Section I lnstructioni)'to coriplete irls section.
H1. Provide the height of the top of lhe 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 bonom 1.50 EJ feet I meters EJ above the LAG
floor (include above-grade floors only for buildings with
subgrade crawlspaces or enclosure floors) is:
H2. t?rall Machinery and,Equipme,nt.serYicing the building (as.listgd in. ltem H2 instructions) elevated to or above the floor indicated by the
H2 arrow (shown in the Foundation Type Diagrams al end of Section H instructions) foi the appropriate Building Diagram?
f, Yes E tto
fl feet I meters I above the LAGb) For Buildlng Diagrams 2A,28,4, and 6-9. Top ol next
higher floor (i.e., the floor above basemenl, crawlspace, or
enclosure floor) is:
sEcrloN l - PRoPERTY OWNER (OR OWNER'S AUTHORTZED REPRESENTATTVE) CERT|F|CAT|ON
The properly owner or owner's authorized representative who completes Sections A, B, and H must sign here. Ihe sfalenenls ln Seclions
A, B, anl H are c,orrect to the best of my knowledge. Note: lf the local floodplain management official completed Section H, they shouldindicate in llem G2.b and sign Section G.
I Check here if altachments are provided (including required photos) and describe each attachment in the Comments area.
Property Owner or Owner's Authorized Representalive Name
Address:
City:State:_ ZIP Code:
Signature:
Telephone:Ext.: _ Email
Date:
Comments:
FEMA Form FF-206-FY-22-152 (formerty 086-0-33) (i1t12l Page 6 of 19
ELEVATION CERTIFICATE
IMPoRTANTT MUST FOLLOW THE |NSTRUCT|oNS ON pAcES 9-19
BUILDING PHOTOGRAPHS
See lnslruclions for llem l{6.
FOR INSURANCE COMPANY USE
Polioy Number; _
Company NAIC Number:--
Bulldlng street Addross (lncludlng Apt., unll, sulle, and/or Bldg. No.) or p.o. Route end Box No.:
3007 Roan Dr.
Clly:State: WA Ztp Code: g8g26
lnsertlnslructions:albelow lwolea6t and when fourpossible slde6ach ofphotographs lheshowing (forbuildlng bemeyexample,onlyloablefronllakeb€ckand olpicturss allldenlifytownhoussVrowhous€s),lhewith takendalepholographs 'Fmntand View,"Rear View'Side or "Lefl"Righl Vlew,Side View.musl lheshowPholographs Whenfoundalion,llood ateopenlngs atlnclude leaslpr€sent,on6oflloodclose-up photograph represenlalivo oropenings v€nls,lndicated Seclionsln andA8 49.
Clesr Photo One
Photo One Gapllon: Front Vlew
Photo Two
Clear Photo Two
Photo Two Caption: Side Mew
FEMA Form FF-20&FY-22-152 (formedy 086-0-A3) ("t}t22'l Page 7 of 19
ELEVATION GERTIFICATE
IMPoRTANT: MUST FOLLOW THE tNSTRUcTtoNS ON PAGES 9-lg
BUILDING PHOTOGRAPHS
Conllnualion Page
FOR INSURANCE COMPANY USE
Company NAIC Numbor:
Policy Number:
Building slroet Address (lncludlng Apt., unir, suite, and/or Bldg. No.) or p.o. Route and Box No.:
3007 Roan Dr.
Cily:Ellensburs State: WA Zp Code: 98926
View,"
photographs
'When flood
lnserl the andlhlrd foudh below.allldenlify thewlth lakendatepholographs uFrontand 'Rear VlewVieu Slde"RighlorSide*Lefl Vlew.are include atopenlngeprosenl,leasl one ofclose-up photograph lloodr€presenlallve oropeningslndicatedasvonts,Seclionsln A8 and AS,
Photo Thrse
Oear Pholo Three
Fholo Three Capfion: Back Vlew
Photo Four
Clear Pholo Four
Photo FourCaplion: Slde View
FEMA Form FF-206-FY-22-152 (formerty 0s6-0-39) t1}t22l Page I of 19
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood lnsurance Program
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOWTHE INSTRUGTIONS ON PAGES 949
all es of thls Elevatlon Certilioate and all attaohments lor lnsurance
OMB Conlrol No. 16A0-0008
Expkatlon Dnlo: 08i30/2026
and owner
FOR INSURANGE COMPANY USE
41. BuildingOwne/s Name: SSHI LLC Polioy Number:
A2. Buitding StreetAddress (includlng Apt, Unit, Sulte, and/or Bldg. No.) or P.O. Route and Box
No.:3ggg Daoole Grav Wav
Company NAIC Number: _
ctty: Ellensburg Stater WA ZIP code: 98926
A3. Property DesoripLion {e.9,, Lot and Block Numbers or Legal Descrlption) and/or Tax Parcel Number:
Division 7 Lol2 9621 18
44. Building Use (e.g., Residentlal, Non-ResHenlial, Addltion, Accessory, etc,):Residantial
A6. Lalitude/Longitude;Lat. N47'01'34.12'Long. W120"34'39.97" Horizontal Datum: fl NAD 1927 EINAo 1eB3 fJwcss4
A6. Altach at least two and when posslble four clear photographs (one for each side) of lhe buildlng (see Form pages 7 and B).
A7. Building Diagram Number: 1B . .
A8. For a bulldlng with a crawlspace or enclosure(s):
a) Sguare footage of crawlspace or enclosure(s):$q. fl,
b) ls lhere at leasl one pormanenl flood opening on two different sides of each enclosed area? [ Yee I No E NIA
c) Enter numbor of perrnanenl flood openings ln the crawlspace or enclosure(s) withln 1.0 foot above adJaoent grade:
Non-engineered flood openings; A//* Englneered llood openingst ,l t /A
d) Total net open area of non-engineered flood openlngs in AB.c: A) /lJ. sq, in,
e) T6tal rated aroa of engineorsd flood openlngs in A8.c (atlach documenlalion - see lnstructions): N /t4 sq. ft.
f) Sum of AB,d and AB.e raled area (if applioable - see lnstructions):. . . *1V14" . sq. ff.
A9. For a buildtng wilh an altaohed garage;
a) Square footage of attached garage:603.00 sq. ft.
b) ls there at least one pormanent flood openlng on two different sldes of lhe altached garage? [ Yee [] No - N/A
c) Enternumberof permanenl llood openings in the
flood openingst lJ ,rlf-___f_1_
atlached garaoo within 1.0 fool above adjacent grade:
openingsr lr+Non-engineered Engineered llood
d) Total net open area of non-ongineered flood openings in A9.o:
^)
/*sq, ln.
e) Total rated area of engineered flood openings in A9.o (altach documenlation * see lnstructions),r/t*sq.tt.
f) Sum of A9.d and A9.e ralod area (if applicable - see lnslructions);sq. ft.
83. Stde: WA 84. Map/Panet No.: 53037G1064, 85. Suffin D
B10, lndicate {he source of the BFE dala or Base Flood Depth enter€d in ltem Bg:
E FIS I FIRM [Communlty Determlned I Other:
811, lndlcate elevalion datum used for BFE ln ltem B9: tl NGVD 1929 EINAVD 1988 [ Olher/Source:
812. ls the bulldlng located ln a Coastal Banler Resources System (CBRS) area or Olhoruise Protected Area (OPA)? ! Yes [J No
813. ls the buildlng locat€d seaward of the Llmit of Moderate Wave Action (LIMWA)? fl Yes I No
87. FIRM Panel EffectivelRov{sed Dale: 0912412021
89. Base Flood Elevation(o) (BFE) (Zone AO, use Base Flood Depth)l 1595.5
82. County Name:KITTITAS
81.a. NFIP Community Name:KITTITAS COUNTY 81.b, NFIP Communlty ldenllflcallon Number: 530095
86. FIRM lndex Date: 09124t2021
88. Flood Zone(s); AE
Designation Date:ncBRs noPA
FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22)Pege 2 of 19
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.{9
FOR INSURANCE COMPANY USEBuildlng Street Address (including Apt,, Unit, Suite, and/or Bldg. No.) or P,O. Route and Box No.:
3009 Dapple Grav Wav
City;Ellensburq Stale: WA ZPCode: 9B926
Pollcy Number; _
Company NAIC Number:
Cl. Building elevatlons are based on: I Construotion Drawings* [ Buildlng Under Conslruotion* [ Finished Construclion
*A new Elevation Certificale will be required when conslructlon of the building is complete.
C2, Elevations - Zones A1-A30, AE, AH, Ao, A (wllh BFE), VE, V1-V30, V (wilh BFE), AR, AR/A, AFVAE, AR/A1*A30, AFyAH, AR/AO,
A99. Comptete lteme C2.a-h below according to lhe Buildlng Diagram speoified ln ltem A7. ln Puerto Rico only, enter meters.
lndicate eleve{ion datum used for lhe elevations ln ltems a) through h) below.
Dalum used for building elevalions must be the same as that used for lhe BFE. Gonversion factor used?
lf Yes, describe the source of lhe conversion factor in lhe Seclion D Comments aroa.
a) Top of bottom floor (includlng basement, crawlspace, or enolosure floor);
b) Top of lhe next higher lloor (see lnsiruciions);
c) Bottom of lhe lowest horizonlal slructural member (see lnslructlons);
d) Attaohed garage (lop of slab):
e) Lowest elevation of Machinery and Equipment (M&E) sewicing the buitding
(descrlbe type of M&E and looatlon ln Section D Comments area):
Q Lowest Adjacent Grade (LAG) next to bulldlng: f] Natural [J RntstreO
g) Highost AdJacenl Grade (HAG) next to bulldlng: I Nalural fi finisneO
h) Flnlshed LAG at lowest elevallon of ailached deck or staiys, including slructural
suppor!:
1,597.60
1,597.40
tt/*I leet I meters
1 597.60
Benchmark Utilized: Center of S 27 TlBN R18E Vertical Datumr NAVD 1908
{,597,8q
1,596.10
[Yes ENo
Check the measurement used:
I feel I meters
! leet I meters
fl feet I meters
I feet f] meters
-----att*-tlr*-
@ feei I meters
[J leet I meters
[f feet I meters
n NGVD 1e2e E NAVD 1e88 flother:
o
This certlflcation ls to be signed and sealed by a land survoyor, engineer, or arohiteot authorized by state law to cer{ifo elevatlon
informalion, I certify that the lnformatlon on thls Cefliflcale represents my besl efforls lo inlerpret the data avallable. I undersland that any
false s(afemenl may be punlshable by fine or lmprlsonmont under 18 U.S. Code, Section 1001,
Were latitude and longitude in Seotion A provlded by a llcensed land surueyor? [ Yes I No
ICheck here if altachments and describe in lhe Comments erea.
Certifiels Name: Rick Sklnner Llcense Numben 43619
Copy all pages of lhie Elevation Certilicate and all attachments for (1) community olficlal, (2) insurance agenUcompany, and (3) building owner,
Heat Pump pad was measured at the lop with the boltom of the heat pump raised
Tilei Professional Land Surveyor
Company Name: Western Pacific Engineeri ng & Survey, lnc.
CZ,e; end description of any
an additional eight inches
attaohments):
State; WA ZIP Code: 98837
Commenls (including source of conversion factor ln C2; type of equlpment and location per
with legs
Addressr 1224 S. Pioneer Way
Emall: rskinner@wPeinc.net765-1023
City: Moses
D"b,J/&ISignalure:
Telephone:Ext,:
FEMA Form FF-20&FY-22-152 (formerly 080-0-33) (10/22)Page 3 of 19
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS oN PAGES 9-,I9
FOR INSURANCE COMPANY USEBuilding street Address (including Apt., unit, sulte, and/or Bldg. No.) or p.o. Route and Box No.:
Cityr EllensQur-g
3009 Dapple Gray Way
Slate: WA Zlp Code: 98926
Policy Number;---.-'*_-
Company NAIG Nurnber:
For Zones AO, AR/AO, and A (without BFE), compleie ltems EI-ES. For ltems E1-E4, use
lntended to suppoil a Letterof Map Change request, complele Sections A, B, and C. Check
enter meters.
Bulldlng measurements are based on: fl Construclion Drawings" f] Buildlrg Under Construction* [ Finished Construction*A new Elevatlon Certificate will be required when conslrucllon of the bullding is complete.
E1. Provlde measurements (C2.a in applicable Building Dlagram) for the following and cheok the appropriate boxes to show whelher lhe
measurement is above or below the nalural HAG and the LAG.
E2. For Building Dlagrams 6-9 with permanent flood openings provldod in Section A llems 8 andlor g (see pages 1*2 of Instruclons), the
nexl higher lloor (C2.b in applicaNe
E5. Zone AO only: lf no flood depth number is available, is lhe top of the boltom floor elevated in acoordance wilh the communibr's
floodplain management ordinance? E yes f] No E unknown The local ofliclal must cerli$ this information in secfion G.
nalural grade, lf avallable, lf Cerlificate is
the measurement used. ln Puerto Rico only,
a) Top of boitom lloor (including basemenl,
crawlspaco, or enclosure) is;
b) Top of bottom floor (including basement,
orawlspace, or enclosure) is:
I feet I meters I aboveor I betowtheHAG,
fl feet I meters I above or f] below the LAG.
Building Diagram) of lhe building is:
E3. Attached garage (top of slab) is:
E4. Top of platform of machinery and/or equipmenl
serviclng the bulldlng ls:
I feet I melers
fl feel ! metere
I feet I meters
I above or I below the HAG.
fl above or I below the HAG,
fl above or I botow the HAG.
The property owner or own€r's aulhorized represenlalive who completes Se otions A, B, and E for Zone A (wilhout BFE) or Zone AO musi
sign here. rfe slalernenls in sectionsA, B, and E are coffect to the best of my knowledge
fl Check here if attaohments and descrlbe in the Commenls area.
Propedy Owner or Owner's Authorized Representative Narne: Scott Henson
City:Moses Lake
Date:1 / {4/.wt-l
nel
Slate: WA ZP Code: 98837
Email: shenson@wpeinc.
Address: 1224 S. Pioneer Way
Comments:
Slgnature;
Telephone: (509) 765-1023 Ext.;
FEMA Form FF-2$6-FY-22-152 (fomerly 096-0-33) (10l22l Pago 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 8ox No.
3009 Dapple Gray Way
City:Ellensburg State: WA ZIP Code: 98926
FOR INSURANCE COMPANY USE
Policy Number;
Company NAIC Number: _
sEcTloN G - coMMUNTTY TNFORMATION (RECOMMENDED FOR COMMUNITY OFFTC|AL COMPLETTON)
The local oflicial who is authorized by law or ordinance to administer the community's floodplain management ordinance can complele
Section A, B, C, E, G, or H ol this Elevation Certificate. Complete lhe applioable item(s) and sign below when:
G 1 ' f] m" information in Section C was taken from other documenlation that has been signed and sealed by a licensed surveyor,
engineer, or architecl who is aulhorized by state law lo certify elevation information. (lndicale the source and date of the
elevalion data in lhe Comments area below.)
G2.a f A local official completed Section E for a building located in Zone A (without a BFE), Zone AO, or Zane AR/AO, or when item
E5 is compleled for a building located in Zone AO.
El A local oflicial completed Section H for insurance purposes.
f] ln thu Comments area of Seclion G, the local official describes specific corrections lo the information in Sections A, B, E and H
E f ne following information (ltems G5-G11) is provided for community floodplain management purposes.
PermitNumber: FD-22-00007 G6. Date Permit lssued:0310a2a22
Date Certificate of Gompliance/Occupancy lssued:
G2.b
G3.
G4,
G5,
G7.
GB.
G9.a
This permit has been issued for: EJ tl"w Construction I Subst"ntiul lmprovement
Elevation of as-buill lowest tloor {including basement) of thebuilding: 1,597.60 I teet I meters Datum: NAVD 1988
G9'b. Epu"1lon of bollom of as-buill lowesl horizontal structural
member:h/ lA fl reer I melers
f] meters
Dalum:
G10.a. BFE (or depth in Zone AO) of flooding at the building site:
G10'b' g666unily's minimum elevation (or depth in Zone AO)
requirement {or the lowest floor or lowest horizontal structural
member:
1,595,50 EJ feet Daturrr: NAVD 1S88
1,596.50 @ teet I melers Datum: NAVD 1988
G11. Variance issued? f] Ves I t'to ll yes, allach documentation and desoribe in the Comments area.
The local official who provides informalion in Section G must sign here. I have completed the informatian in Section G and certlfy that it is
correct lo the besl of my knowledge, ll applicable, I have also provided specific correclions in lhe Commenls area of this seclion.
Local Official's |1sms. Sornsntha Cox Tille: Water Resources Specialist
NFIP Community Name: Kittitas Cou
Telephone:(50S)962-7523 Ext.:_ 96611;publicworks@co.kittitas.wa.us
Address:411 N. Rubv Street. Suite 1
City:Ellensburg State: WA Zlp CoOe: 98926
Signature:
Comments
Seclions A,
of
Oate:0912812023
and location, per C2.e; description of any atlachmenls; and corrections to specific informalion in
or ):
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. Rouie and Box No
3009 Dapple Gray Way
City Ellensburg State: WA 71p 6e6s; 98926
FOR INSURANCE COMPANY USE
Policy Number:
Company NAIC Number:
SECTION H - BUILDING'S FIRST FLOOR HEIGHT II.IFORMATION FOR ALL ZONES
(suRVEY NOT REQUTRED) (FOR TNSURANCE PURPOSES ONLY)
The property owner, owner's authorized represenlalive, or local floodplain management official may conrplete Section H for all flood zones
to determine lhe building's first floor height for insurance purposes. Seclions A, B, and I must also be completed. Enter heights to ihe
nearest lenth.of a lool (nearest tenth of a meter in Puerto Rico). Feference lhe Foundation Type Dlagrams (at the end of Sectlon Hlnstructions) and the appropriate Building Diagrams (at lhe end of Seclion t Instructioni)'to cotiptete lbis seclion.
H1, Provide lhe height of the lop of lhe floor (as indicated in Foundation Type Diagrams) above the Lowest Adjacent Grade (LAG):
a) For Bulldlng Dlagrarns 1A, 18, 3, and 5-9, Top of bottom
floor (include above-gracJe floors only tor buiidings with
subgrade crawlspaces or enclosure floors) is:
't .50 [] feet I meters I above the LAG
b) For Building Diagrams 2A,zFi,4, and 6-9. Top of next
higher floor (i,e., the floor above basemenl, crawlspace, or
enclosure lloor) is:
I feet I meters ! above the LAG
H2. Jl^all Machinery and.Equipment.servicinglhe building (as lisled in ltem H2 instructions) elevated to or above the iloor indicated by the
H2 arrow {shown in the Foundalion Type Diagrams at end of Section H lnstructions) for the appropriate Building Diagram?
[Yes 8uo
sEcTloN l- PRoPERW OWNER (OR OWNER'S AUTHORTZED REPRESENTATTVE) CERT|F|CAT|ON
The property owner or ownel's authorized representative who completes Sections A, B, and H musl sign here. Ihe stalernenls n Sectjons
A, B, and H are correct to the best .of my knowledge. Note: lf the local floodplain management olficial completed Section H, they should
indicate in ltem G2.b and sign Section G.
I Check here if attachments are provided (including required photos) and describe each attachment in the Comments area.
Property Owner or Owner's Authorizecl Representative Name:
Address:
City:State:ZIP Code
Signature:
Telephone:
Date:
Ext.: _ Email
Comments;
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 9.1S
BUILDING PHOTOGRAPH$
See lnstrucllons for ltem A6.
FOR INSURANCE COMPANY USE
Pollcy Number: _
Company NAIC Number: _
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No,) or P.O. Route and Box No.:
3009 Dapple Grav Wav
lnslructlons: lnserl below at least two and when posslble four pholographs showing each side of the building (for example, may only be
able to take fvont and back plctures of townhouses/rowhouses). ldentify all photogtaphs with the date taken and "Front View,n "Rear View,*
"Right Slde View," or "Left $lde Vlew." Photographs must show the foundation. When flood openings are presenl, include at leasl one
close-up photograph of representallvo flood openings or venls, as indioated in Seotions AB and A9.
City: Ellensburg State; WA ZIP Code: 98926
Photo One
Photo One Caption: Flont View
Pholo Two
Clpgi.P.ho-to lwo-.Photo Two Caption: Side View
FEMA Fotm FFAO6-FYQ2-152 (formerly 086-0.33) (10/22)Page 7 of 19
ELEVATION CERTIFICATE
IMPORTANTI MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.{9
BUILDING PHOTOGRAPHS
Continuation Page
Euilding Street Address (including Apt., Unlt, Suite, and/or Bldg. No.) or P.O. Route and Box No.:
3009 Dapple Grav Wav
City: Ellensburg State: WA ZIP Code: 98926
lnsort lhe third and fourth photographs below. ldentify all photographs wlth the date taken and "Front Vlew." "RearVlew,'' "Rlgfrl Slde
View," or'Left Side View." When llood openings are presenl, include at least one close-up photograph of representative flood openlngs or
venls, as indicated ln Seoliono A8 and Ag,
Photo Three
Photo Thtee capllon: Back View qeCg,elp.qto.lltrCg
Photo Four
Pholo FourCaplionl $lde View CI9eiPtt6lo;Foui
FEMA Form FF-26-FY-22-152 (forrnerly 086-0-33) (10122)Page B of 19
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
Nalional Flood lnsurance Program
ELEVATION CERTIFICATE
lmportantl Follow the instructions on pages 1-9,
OMB No. 1660"0008
Explratlon Date: November 30,2022
Copy all pages of thle Elevatlon Certificate and all attachments for (1) comrnunl(y offlcial, (2) insurance agenUcompany, and (3) bullding owner,
SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE
41. Building Owner's Name
ssl-il LLc
Policy Number
A2, Euilding Slreet Address (includlng Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Box No.
300$ Dapple Gray Way
Company NAIC Number:
City Stals
Washlngton
ZIP Code
98926Ellensburg
A3. Property Description (Lot and Block Numbsrs, Tax Parcel Number, Legal Description, eto.)
Divislon 7 Lot 4, 962120
A4. Building Use {e.9., Resldential, Non-Residential, Addition, Accessory. etc.) Residential
A5. Lalitude/Longltude: Lat:N47'01'32'42590" Long.W120"34'41.74535"HorizonlalDatum: I NAD 1927 E NAO 1983
46. Attach at least 2 pholographs of lhe bullding lf lhe Certiftcate is being used to oblaln flood insurance.
A7. Building Diagrarn Number 18
A8. For a building with a crawlspace or enc{osure(s):
a) Square footage of crawlspace or enclosure(s) N/A sq fl
b) Number of permanent flood openings in lhe crawlspace or enclosure(s) wlthin '1.0 foot above adlacent grade N/A
c) Total net area of llood openlngs in A8.b N/A sq in
d) Engineered llood openings? flVes El t{o
A9. For a buildlng wlth an atlached garage:
a) Square foolage of altached garage 604.00 sq ft
b) Number of permanenl flood openings in lhe altached garage within 1.0 fool above adjacent grade 0
c) Tolal net area of llood openlngs in A9.b 0.00 sq in
d) Engineered llood openings? ! Yes El No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM} INFORMATION
81. NFIP Community Name & Community Number
KITTITAS COUNTY; 530095
82. County Name
KITTITAS
83. State
Washington
84. MaplPanel
Number
53037C1064
85. $uffix
o
86. FIRM lndex
Date
09-24-2021.
87. FIRM Panel
Efi€ctive/
Revised Daie
09-24-202',1
88. Flood
Zone(s)
AE
89, Base Flood Elevation(s)
(Zone AO, use Ba$e Flood Deplh)
1593.3
B10. lndicate lhe source of the Base Flood Elevation (BFE) data or base flood depth ontered in ltem Bg:
@ FIS Profile I FIRM fl Communlg Determlned I Other/Source:
B'11. lndicate elevation datum used lor BFE ln ltem 89: f] NGVD 1929 E NAVD 198s I Othor/Sourcer
812. ls lhe building located ln a Coaslal Barrier Resources System (CBRS) area or Othenruise Protected Area (OPA)? fl Yes El No
Deslsnation Date: fl CBR$ fl OPA
FEMA Form 086-0-33 (12115)Replaces all prevlous edltlons.Form Page 1 of 6
ELEVATION CERTIFICATE OMB No. 1660-0008
Explralion Oate: November 30,2O22
IMPORTANT: !n lhese spacesr copy ihe correspondlng lnformallon from Sectlon A.FOR INSURANCE COMPANY USE
Bullding Street Address (including Apt., Unit, Sulle, and/or Bldg. No.) or P,O. Roule and Box No.
3005 Dapple Gray Way
Pollcy Number:
City State
WashingtonEllensburg
ZIP Code
98926
Company NAIC Nunrber
sEcTtoN c - BUTLDING ELEVATTON INFORMATTON (SURVEY REOUTRED)
a) Top of botlom lloor (including basement, crawlspaco, or enclosure lloor)
b) Top of the next hlgher lloor
c) Botlom of the lowesl horizontal structural member (V Zones only)
d) Attached garage (lop of slab)
e) Lowest elevallon-of machinery or equlpment servicing tho bulldlng
(Describe type of equipmenl and localion ln Comments)
f) Lowesl adJacent (finished) grade next lo building (LAG)
g) Hlghosl adJacenl (finished) grade next lo building (HAG)
h) Lowest adjacent grade al lowest elevatlon of deck or stairs, lncluding
slruclural supporl
N/A I feot ! moters
N/A I feel I meters
1s95.0 I feet I meters
C1. Building elevations aro based on: I Conslruction Drawings' fl Building Under Construcliont @ Finished Conslruction
*A new Elevation Corlificale will be required wh€n conslruction of the buildlng ls complele.
C2. Elevalions - Zones A1-A30, AE, AH, A (wilh BFE), VE, V1-V30, V (wilh BFE), AR, AFUA, AFUAE, AR/A1-A30, AF/AH, AR/AO.
Complete ltems C2.a-h below according to iho building diagram specllled in ltem A7. ln Puerlo Rico only, enter molers.
Benchmark Ulilized: Conler of S 27,T 1B N, R 1B E Verlical Datum: NAVD 19BB
lndicalo olevalion datum used for lhe elevalions in items a) through h) below.
fl NGVD 1929 E NAVD 19BB I Other/Source:
Datumusedforbuildingelevationsmustbethesamoasttr
Check lhe measurement used.
1595.0 [] feet ! meters
1595,1 fl feet
[] feet
[] leet
! meters
fl meters
f] meters
r593.B
1594.4
N/A fl feet I meters
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
Thls.cerlificalion.is- lo be.signed..a.nd^seql-ed _by a land surueyor, englneer, or archilecl aulhorized by law lo cerlify elevalion lnformatlon.
I cellily lhal lhe.informelion on.lhis Ceflilicale rapresonls ryy pgst effo4s lo inlerpret lhe data avaihblo. I underiland lhal any lalse
stalement may ba punlshablo by line or imprisonment undcir 18 U.S. Code, Seciion 1001,
Were lalitude anrt longitude in Seclion A provlded by a llcensed land surveyor? E Y"" I tto I Chect< here lf attachments.
mlN
Rick Sklnner
License Number
43619
Professional Land Surveyor
Western Pacllic Englneering & Survey, lnc.o
1224 S. Pioneer Way
Clty
Moses Washington
ZIP Code
98837
Ext,S Telephone
(509) 765-1023
Copy all pageb-dfth'iB Elevaiion Cedilicate and all attachmontsTollt; c6nfmunity olficial, (2) insurance agenUcompany,and (3) building owner.
Comments (lncluding type of equipment and localion, per C2(e), if applicable)
Heat pump pad was shot with GPS and lhe elevalion was calculaled wilh an addillonal 7 lnches were added lo lhe elevalion due to tho
heat pump belng risen with legs.
FEMA Form 086-0-33 (12119)Replaces all previous editions,Form Pago 2 of 6
IMPORTANT: ln lheso spacos, copy lhe correspondlng lnforrnatlon from Secllon A.FOR INSURANCE COMPANY USE
Building Slreol Address (including Apl., Unit, Sulte, and/or Bldg. No.) or P.O. Route ancl Box No.
3005 Dapple Gray Way
Policy Number:
Cily State
Washington
ZIP Code
s8926Ellensburg
Company NAIC Numbsr
sEcTloN E - BU|LD|NG ELEVATTON INFORMATTON (SURVEY NOT REQUTRED)
FOR ZONE AO AND ZONE A (W|THOUT BFE)
For Zonos AO and A (without BFE), complete llems E1-E5. lf lhe Certilicato is intended to support a LOMA or LOMR-F request,
complele Sections A, B,and C. For ltems E1-E4, use nalural grade, if avallable. Check the measurement used. hr Puerlo Rico only,
enter melers,
E1. Provide elovalion information for lhe following and check lhe appropriate boxes lo show whelher the elovalion ls above or below
tho highesl adJacenl grade (HAG) and lhe lowest adjacenl grade (LAG).
a) Top of boltom floor {including basemenl,
crawlspaco, or onclosure) is
b) Top of bollom lloor {including basemenl,
crawlspace, or enclosuro) ls
ff feot fl meters ! above or ff below lhe HAG,
I feei I melers I above or n below the LAG.
E2. For Building Diagrams 6-9 wilh permanent
the nexl higher floor (elevation C2.b ln
lhe diagrams) of the building is
flood openings provided in Seclion A llems B and/or I (see pages 1-2 of lnslructions),
E3. Attached garage (lop of slab) Is
E4. Top of plalform of machlnery and/or equipment
ssrvlclng the bullding ls
!feet Imeters
Efeol [meters
Dfeel flmoters
I above or flbebw the HAG.
I above or Ibelow the HAG.
I above or nbebw lhe HAG.
E5. Zone AO only: lf no flood deplh number ls available, is lhe top of the bollom floor elevated in accordance wilh lhe community's
lloodplaln management ordlnance? [ Ves I No ! Unknown. The local official musl cerlify ihis inforrnation in Section G.
sEcTtoN F - PROPERTY OWNER (OR OWNER'S REPRESENTATTVE) CERTIF|CAT|ON
The properly owner or owner's aulhorizod reprosenlalivo who complelos Seclions A, B, and E for Zone A (without a FEMA-issued or
community-issued BFE) or Zone AO must sign here. The slalemenls in Sections A, B, and E are correct lri lho besl of my knowledge.
Properly Owner or Owne/s Aulhorized Represenlative's Name
Scoll Henson
Address
'12245, PloneerWay
Clty
Moses Lake
State
Washington
ZIP Code
98837
t Date
6/Q />t>a
Telephone
(509) 765.1023
Comments
I CnecX here if allachments.
ELEVATION CERTIFICATE OMB No, 1660-0008
Explrallon Date: Novombsr 30,2022
FEMA Form 086-0-33 (12119)Roplaces all previous edilions.Form Page 3 ot 6
IMPORTANT: ln lhese spaces, copy the correspondlng lnformallon lrom Secfion A.FOR INSURANCE COMPANY USE
Buildlng Street Address (includlng Apt., Unit, Sulte, and/or Bldg. No.) or P.O. Route and Box No.
3005 Dapple Gray Way
Polioy Number;
Cily Slate
Washington
ZIP Code
98926Ellensburg
Company NAIC Number
sEcTtoN G - coMMUNtTy TNFORMATTON (OPT|ONAL)
The local official who is autho_rized by law or ordinance lo administer the community's lloodplaln management ordlnanoe can oomplele
Seclions A, B, C (or E), and G of thls Elevatlon Certiflcate, Complete the applicable itom(s) and sign below. Check lhe measuremenl
used in ltems GB-G10. ln Puerto Rico only, enter meters.
Gl. f] The-informatlon in Section C was taken from otherdocumontation that has been signed and sealed by a licensed $urveyor,
englneer, or architect who is aulhorized by law to certifu elevatlon information. (lndicate the source and date of lhe elevation
data in the Comments area below.)
G2, D A cjrrnmunity official compleled Seclion E for a building located in Zone A (wlthout a FEMA{ssued or communily-issrred BFE)
or Zone AO.
G3. n The lollowing informalion (ltems G4-c10) ls provided for community floodplain rnanagemenl purposes.
G4. PermitNumber G5, Date Permit lssued G6. Date Certilicale of
Compfiance/Ocoupancy lssued
G7. Thls perrnit has been issued for; fl New conslructbn n substantial lmprovement
G8. Elevatlon of as-built lowest floor (including basement)
of lhe building:
G9. BFE or (in Zone AO) depth of flooding at lhe buildlng slte:
G'10. Community's deslgn llood elevatlon:
I feet ! meters Detum
I feet I meters Dalum
I feel ! meters Datum
Local Ofliclal's Name Tltle
Communily Name Telephone
Slgnature Date
Comments (including type of equipment and locallon, per C2(e), if appticable)
I Check here if attachmenls.
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: November 30,2022
FEMA Form 086-0-33 (121'lS)Replaces all previous edltlons.Form Page 4 of 6
IMPORTANT: ln lhese spaces, copy lhe corresponding informallon from Secllon A.FOR INSURANCE COMPANY USE
Building Streot Address (includlng Apt., Unit, Suite, and/or Bldg. No.) or P.O, Roule and Box No.
3005 Dapple Gray Way
Policy Number;
City Slate
Washington
ZIP Code
98926Ellensburg
Company NAIC Numbor
lf uslng lhe Elevation Cerlilicate to oblain NFIP llood insurance, affix al least 2 building pholographs Lrolow according lo the
inskuclions for llem A6. ldentify all pholographs with date laken; "Front View" and "Rear Viewi; and, iireguhed, ,,Right Side Visw,, and
"Left Side View." When appllcable, pholographs musl show lhe foundalion wilh representative exampies of lhe flood openings or
vonts, as indicated in Seclion AB. lf submitling more photographs lhan will fit on this page, use lhe Conlinualion Page.
=I
'1
Ono
Photo One Captlon Front Viow Cloar Photo Ono
Photo Two Caption Side View ; Clear Photo Two
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
See lnslruclions for ltem A6.OMB No. 1660-0008
Explrallon Date: November 30,2022
FEMA Form 086-0-33 (12l19)Replaces all previous editions.Form Page 5 of 6
IMPORTANT: ln these spaces, copy lhe correspondlng lnforrnallon from Section A.FOR INSU'IANCE COMPANY USE
Building Street Address (includlng Apl., Unil, Suile, and/or Bldg. No.) or P.O. Roule and Box No.
3005 Dapple Gray Way
Policy Number:
Company NAIC NumberCity
Ellonsburg
$late
Washington
ZIP Code
98926
lf .submllllng more photographs_ than will fit on tho preceding page, affix lhe adclilional photographs below. ldenlify all pholographs
wilh: daie laken; "Front View" and "Rear View"; and, if required, "Right Side Vieu/' anrl "Lofl Sido Viow." Wtren appticabte,
photographs musl show the foundalion with representalive examples of the flood openings or vonls, as indicaled ln Seclion A'8.
Phoio Three Caption Rear Viow ,Cl€ar Photo Throe
Pholo Four Caplion Side View Clear Photo Four
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
Conlinualion Page
oMB No. 1660-0008
Expirallon Dste: November 30,2022
FEMA Form 086-0-33 (12l19)Replaces all provious edilions.Form Page 6 of 6
U.S, DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood lnsurance Program
ELEVATION GERTIFICATE
IMPORTANTT MUST FOLLOWTHE INSTRUCTIONS ON PAcEs s4s
all of thls Elevatlon Certifloate and all attachments lor official,lnsurance
OMB Control No. 1680-0008
Explralion Dalo: 06/30/?026
and owner,
FOR INSUR.ANGE COMPANY USE
A1. Building Owner's Name: SSHI LLC Pollcy Number:
42. Bulldlng Street Address (including Apt,, Unit, Suite, and/or Bldg. No.) or P.O. Routo and Box
No.:3993 Dapole Grav Wav
Company NAIC Number: ,'
Gltyr Ellensburg $tale: WA ZIP Gode: 98926
A3. Property Description (e.9., Lot and Block Numbers or Legal Desoription) and/or Tax Parcel Number:
Division 7 Lot 5, 962121
44. Bullding Use (e.9., Residential, Non-Residenlial, Addiiion, Accessory, eto,); Residential
A5. Latltude/Long Itude: Lat, N47'01'31.69'Lon9.W120"3442,64" Horizontat Datum: I NAD 1927 E NAD 1e83 [ WGS 84
46, Attach at least two and when possible four clear photographs (one for each slde) of the bulldlng (see Form pages 7 and 8).
A7, Bulldlng Dlagram Number: 18
AB, For a buildlng wlth a crawlspace or enclosure(s):
a) Squarefootageofcraw'spaceorencloeure(s): N /ft s1,n
b) ls there at leasl one permanent flood openlng on two different sides of each enclosed area? f] Yes I No E N/A
o) Enler number of permanent llood openings ln lhe crawlspace or enclosure(s) wilhln 'l .0 foot abovs adJacent grade:
Non-englneered flood openlngs: t//A Englneered llood openings: N/r+
d) Total nel open ar€a of non-englneered tlood openings ln AB.o: N /,t .. , "q.
ln.
e) Totel rated area of engineered llood openings in AB.c (attach documentalion - see lnstruclio nsl: /1//4 sq.tt.
0 Sum of As.d and AB.e rated area (if applicable * see lnstrucllons): tV f + sq. fl.
A9. For a buildlng with an altached garage:
a) Square footage of attached garage:603.00 sq. ft
b) ls there at least one permanent llood opening on two different sides of the altached garage? ! Yes [] No I N/A
c) Enter number of pennanent flood openings in the altached garage wlthln 1.0 foot above adjacent grade:
Non-engineered0oodopenings U1.# Englneeredfloodoponingsl N1,4-
d) Total net open area of non-englneered flood openings in A9.c: /y7+ sq. in.
e) Total rated aree of engineered flood openings in A9.c (attach documentation - see lnslrucllons):lU /* sq.ft,
Q Sum of A9.d and A9.e rated area (if appllcable - see lnslruollons): il/* sq.R.
81,a. NFIP Community Name:KITTITAS COUNTY 81.b. NFIP Communily ldentif ioation Numben 530095
82, Gounty Name:KITTITAS 83, Statel WA 84. Map/Panel No.: 53037C1064 85. Suffix: D
86, FIRM lndexDale: 0912412021 87. FIRM Panel Effective/Revised Dale: 0912412021
BB, Flood Zone(s); AE 89. Base Flood Elevalion{s) (BFE) (Zono AO, use Baee Flood Depth):1591.6
810. lndloate the source of lhe BFE data or Base Flood Depth entered in ltem 89:
E FlS n FIRM flCommunity Determined I other;
811. lndlcale elevalion datum used for BFE ln ltem B9: I NGVD 1S29 E NAVD 1988 n Oher/Souroe:
B12. ls the bulldlng located ln a Goastal Banler Resources $ystem (CBRS) area or Otherwise Prolected Area (OPA)? [ Yes fl No
Deslgnation Date:EcBRs floPA
813. te the building located seaward of the Limit of Moderale Wave Action (LiMWA)? fl Yes I No
FEMA Forn FF-206-FY-22-162 (formerly 086-0-33) (10122,Page 2 of 19
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCT]ONS ON PAGES 9.1S
FOR INSURANCE COMPANY USEBualdlng Street Address (including Apt., Unlt, Sulte, and/or BldS, No.) or P.O. Route and Box No.:
Q003 Dapple Gray Way
City; Ellensburg slate; WA ZP Code: 98926
Policy Numben
Gompany NAIC Number:
C1. Buildlng elevalions are based on: fl Constructlon Drawlngs' I Bullding Under Conskuolion* [] Flnished Construollon
*A new Elovalion Cerlificate will be required when construolion of the building ls complete.
C2. Elevallons - Zones A1-A30, AE, AH, AO, A (wllh BFE), VE, V1-V30, V {with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AFyAO,
A99. Gomplete ltems C2,a-h below according to the Bullding Diagram specified in ltem A7. ln Puerto Rico only, enter meters.
lndicate elevatlon datum used Jor lhe elevallons ln llems a) through h) below.
Datum used for bulldlng elevallons must be the same as lhal used for the BFE, Conversion faclor used?
lf Yes, describe lhe source of the converslon factor ln the Sectlon D Comments area.
a) Top of boltom floor (including basement, crawlspace, or enclosure lloor):
b) Top of lhe next h$her floor (see lnskuctions):
c) Botlom of lhe lowest horizonlal structural member (see lnstructions):
d) Attaohed garage (top of slab):
e) Lowest elevation of Machlnery and Equlpment (M&E) servlcing the building
(describe type of M&E and locatlon ln Seclton D Comments area):
f) Lowesl Adjacent Grade (LAG) next to building: I Natural [J Finished
g) Highest AdJacenl Grade (HAG) next to buildlng: I Natural I Finished
h) Finlshed LAG at lowest elevation of altachsd deck or stalrs, includlng structural
supportl
1,594.10
'1,594.10
fl feel ! metersAI /L
1.593.70 I feet f] meters
[] feet I meters
[] feet I meters
Benchmark Utillzed: Center of S 27 TlBN
n NGVD 1e2e E NAVD les8 [ other
Nt'4
N1+
1,592.10
1,593.60
[Yes ENo
Checl< the measurement used:
[f feet I meters
I feet f] melers
f] leet I meters
I feet ! meters
R 1B E Vertical Datum: NAVD 1988
4361
Thls certiflcation is 1o be signed and sealed by a land surveyor, engineer, or archltecl authorized by state law lo cerllfy elevation
informatlon. I cedlfy thatthe lnformatlon on lhis Certitlcate represents my best efforts to Inlerpret lhe dala avallable. I understand thal any
false statemenl may be punlshable by llne or lmprlsonmenl under 18 U. S. Code, Sectlon 1001 .
Wore latitude and longitude in Section A provided by a licensed land surveyor? @ Yes fl No
ICheck hore if attacfiments and descrlbe in the Comments area,
Certifier's Name: Rick $kinner Llcense Number:43619
Copy all pages of lhis Elevation Certifioate and all attachmenls for (1) community ofliclal, (2) insurance agenVcompany, and (3) building owner
Comrnenls (including source of conversion faolor in C2; lype of equipment and looation per C2.e; and description of any altachments):
Heat Pump pad was rneasured at the top with the bottom of the heat pump raised an addilional eight inches with legs
Tilb: Professional Land Surveyor
1,,'
Company Name:Western Paclflo Englneerlng & Survey, lnc.
City:Moses Stale: WA ZP Code; 98837
Email: rsklnner@wpoino.net
Date:
Address: 1224 S, Pioneer Way
765.1023 Ext.:
Slgnature:
Telephone:
FEMA Form FF-2O6-FY-22-152 (formerly 086-0-33) (10/22)Page3of19
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES S-'19
FOR INSURANCE COMPANY USEBulldlng StreetAddress (lncludlng Apt,, Unll, $ulte, and/or Bldg. No.) or P.O. Route and Box No.
Cily: Ellensburg state: WA 4P Gode: 98926
3003 Dapple Gray Way
Polloy Number:
Comoanv NAIC Number
For Zones Ao, AR/AO, and A (wllhout BFE), complete ltems E1-E5. For ltems E1-E4, use nalural grade, if avallable. lf lhe Certiflcate is
inlended lo support a Letter of Map Change request, complete Seotlons A, B, and C. Check lhe measurement used. ln Puerto Rico only,
enter meters.
Bulldlng measuremenls are based on; I Conshuction Drawings* f] auitOing Under Conslrucl'on* [] Finished Construclion
*A new Elevation Gertificate will be required when construction of the building is complete.
E1. Provide measursmenls (C.2.a in applicable Bulldlng Diagram) for lhe following and check the appropriate boxes 1o show whelher the
measurement is above or below the natural HAG and lhe LAG.
E2. For Building Diagrams 6-0 with permanent flood openings provided in Section A ltems 8 and/or I (seo pagee 1-2 of lnstruotions), lhe
I feet I melers f] aboveor fl belowlheHAG,
E5. Zone AO only; lf no llood deplh number is available, is the top of the botlom floor elevated in acoordance with tho community's
lloodplain managemenl ordinance? [ Yee n No D Unknown The local ofliolal must certify thls lnformatlon in Sectlon G,
I feet I melers f] above or fl below the HAG,
a) Top of boltom floor (including basement,
crawlspace, or enclosure) is:
b) Top of bottom floor (lncluding basemenl,
crawlspace, or enclosure) ls:I feel I meters [aboveor I belowthelAG.
nexl higher floot (C2.b in applicable
Bullding Diagram) of the building is:
E3. Attached garage (top of slab) Is:
E4. Top of platform of machinery and/or equlpment
servlclng ihe bulldlng ls:
I feel I meters I above or f] below the HAG.
fl feet fl meters I above or ! below lhe HAc,
Ths property owner or owne/s authorized represenlalive who compleles Sections A, B, and E for Zone A (wllhout BFE) or Zone AO must
sign here. fhe statdrnenfs in Secfions A, B, and E ara correct to the best of my Rnowledge
f] Check hete if allaohments and desoribe in lhe Commenls area.
Clty; Moses Lake
Commenls;
Property Owner or Ownefs Authorized Representative Name: ScottHenson
Email:etExl.:
Slate: WA ZP Code; 98837
Address: 1224 A, Pioneer Way
Telephone: (509) 765-1023
Slgnature:Date: 1/ ll /rcc-1
FEMA Form FF-206-FY-22^152 (formerly 080-0-33) (10/22)Page 4 of 19
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.19
FOR INSURANCE COMPANY USEBuilding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
3003 Dapple Gray Way
City:Ellensburg Slate: WA ZtP Code: 98926
Company NAIC Number:
Policy Number
sEcTloN G - coMMuNrTY TNFORMATION (RECOMMENDED FOR COMMUNTTY OFF|C|AL COMPLETTON)
The local official who is aulhorize{by law or ordinance to administer the com.munity's floodplain management ordinance can complete
Section A, B, C, E, G, or H of this Elevation Certificate. Complete the applicable itein(s) and sign beloW when:
G1. fl fne information in Section C was taken from other documenlation that has been signed and sealed by a licensed surveyor,
engineer, or architecl who is authorized by state law to cerlify elevation inlormation. (lndicate the source and date of the
elevation data in the Comments area below.)
G2.a. f, 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. E A bcal official completed Section H for insurance purposes.
G3. fJ tn ttte Commenls area of Section G, the local official describes specific corrections to the information in Sections A, B, E and H
G4. E ff," following information (ltems GS-G11) is provided for community lloodplain management purposes.
G5. permit Number: FD-22-00010 G6. Date perml tssued- 0310212022
G7. Date Certificate of Compliance/Occupancy lssued:
G8. This permit has been issued for: El ru"* Construction n Substantial lmprovement
G9'a. Ebvation of as-built lowest floor (including basement) of lhebuilding: 1,594.10 fi teet I meters Datum: NAVD lggg
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;
G10.b' gornlunity's minimum elevalion (or depth in Zone AO)
requirement for the lowest floor or lowest horizontal struclural
member:
[] feet
1,591.60 S feet Datum: NAVD 1988
1,592.60 Eteet Imeters Darum: NAVD 1988
G11. Variance issued? [ Ves EJ ruo lf yes, attach documentalion and describe in the Comments area.
The local olficial who provides information in Section G must sign here. I have. completecl thg information in Seclion G and cedify that it is
correct to the besl of my knowledge. lf applicable, I have also provided specific corrections in the Comments are€ of this section.
Local Oflicial's Name: Samantha Cox Tile: Water Resources Specialist
NFIP Community Name: Kittilas Countv
I meters
I meters
Datum
Telephone: (509) 962'7523
Address:411 N Ruby St, Suite 1
Ext,; _ Email publicworks@co. kittilas.wa.us
City:Ellensburg State; WA Ztp Code: 98926
Signature:Date
Commenls (including type of equipment and
Sections A, B, D, E, or H):
per C2,e; description of any attachments; and corrections to specific inlormation in
ql\\,tb
FEMA Form FF-2O6-FY-22-152 (formerly 086'0-33) (10122)Page 5 of 19
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGEs s-1s
Building Street Address (including Apt., Unit, Suite, and/or Bldg, No.) or P.O, Route and Box No.
3003 Dapple Gray way
EllensburgCity:State: WA Zlp Code: 98926
FOR INSURANCE COMPANY USE
Policy Number:
Company NAIC Number:
SECTION H - BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES(suRvEy NoT REQUIREDI (FOR TNSURANCE PURPOSES ONLY)
The properly owner, owner's authorized representative, or local floodplain management oflicial may complete Section H for all flood zones
to determine the building's firsl floor height for insurance purposes. Seclions A, B, and I must also be completed. Enter heights to the
nearestlenth.of a Jool (nearest tenth of a meter in Puerto-Rico). Retere,n-ce the Foundallon Type Diagrams (at the end of Section Hlnslructions) and the appropriate Building Diagrams (at the end of Seclion I tnstructioni)'to codptete ihis section.
H1. Provide the height of the top of the floor (as indicated in Foundation Type Diagrams) above the Lowesl 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 crawlspaces or enclosure floors) is:
2.00 E feet f, meters E above the LAc
b) For Building Dlagrams 2A,28,4, and 6-9, Top of next
higher floor (i,e., the floor above basement, crawlspace, or
enclosure floor) is:
fJ feet fJ meters fl above the LAG
H2, ls all Machinery and Equipment servicing the building (as listed in ltem H2 instructions) elevated to or above the floor indicated bv the
H2 arrow (shown in the Foundation Type'Diagrams al end of Section H instructions) foi the appropriate Building Diagram?fl Yes El t'to
sEcTloN I - PROPERTY OWNER (OR OWNER'S AUTHORTZED REPRESENTATTVE) CERT|F|CATION
The property owner or owner's authorized representative who completes Sections A, B, and H musl sign here. The statemenls in Secilons
A, B, and H are correct lo the best .of my knowledge. Note: lf the local floodplain management official completed Section H, they should
indicate in ltem G2.b and sign Seclion G.
I 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:
Telephone
Date:
Ext.:Email
Commenis
FEMA Form FF-2O6-FY-22-152 (formerly 086-0-33) (10122J Page 6 of 19
ELEVATION CERTIFICATE
IMPORTANT; MUST FOLLOW THE lNsTRUcTlONs ON PAGES 9-19
BUILDING PHOTOGRAPHS
See lnstruqtions for ltem 46,
Building Sheet Address (includlng Apt,, Unit, Sulte, and/or Bldg. No,)or P.O. Route and Box No.
3003 Dapole Grav Wav
Cltr Ellensbu State: WA Zlp code: 98926
lnstruotions: lnserl below at leasi two and when posslble four photographs showing eaoh side of the building (for example, rnay only be
able to take front and back pictures of townhouseslrowhouses). ldentifu all photographs wilh the date iaken and "Front View," "Rear Viow,"
"Right Side View," or nLeft Side View'" Pholographs musl show lhe foundatlon. When flood openlngs are present, include al least one
close"up pholograph of fepresenlalive llood openings or venls, as indicaled in Sections AB and A9.
Photo One
Photo One Captlon: Front View rcfn---m,U",.rffi,1.7
Photo Two
Photo Two Caption: Side View
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
Contlnuation Page
Bulldlng Street Address (ineluding Apt,, Unlt, Sulte, and/or Bldg. No.) or P.O. Route and Box No,:
3003 Dapple Gray Way
City:Ellensburq Stale: WA ZP Gode: 98926
lnserl the lhlrd and fourth photographs below, ldenlify all photographs with the date laken and "Front View,u "ReaJ Vlew,o iRight Side
View," or "Lefl $ide View." When tlood openings are present, include at least one close-up pholograph of representative flood openlngs or
vents, as indicated in $estions AB and A9.
Photo Three
Photo Three Caption: Baok View tEffiF,f,o.F,,trfiffi
Photo Four
Photo Four Captlon: Slde Vlew
FEMA Form FF-208-FY-22-152 (formerly 080.0-Sg) (10/22)Page B of 19
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
Nalional Flood lnsurance Program
ELEVATION CERTIFIGATE
lmportanl: Followthe instruclions on pages 1*9.
Copy all pages of lhls Elevatlon Certllicate and all attachments for (1) communlty offlclal, (2) lnsuiance agenVcompany, and (3) bulldlng owner.
OMB No. 1660-0008
Expiration Dale: November 3A,2O22
SECTION A - PROPERTY ]NFORMATION FOR INSURANCE COMPAAIY USE
41. Building Owne/s Name
SSHI LLC
Policy Number:
A2. $uilding Slreot Address (includlng Apt., Unit, Sulte, and/or Bldg. No.) or P.O. Route and
Box No.
2917 Dapple Gray Way
Company NAIG Numbel
City
Ellensburg
Slale
Washlngton
ZIP Code
98926
A3. Property Descriplion (Lot and Block Numbers, Tax Parcel Number, Legal Description, eto.)
Division 7 Lot 7, 982123
A4. Building Use (e.9., Residential, Non-Residenlial, Addltion, Accessory, etc.) Residential
A5. Latitude/Longltude: Lat. N47'0129.56751"Long.W120"34'44.95771" Horlzontal Dalum:fINAD 1e27 E NAD 1983
46. Atlach at least 2 photographs of lhe building if the Gertificate is being used to obtain llood lnsuranc€.
A7, Buildlng Diagram Number 1El
A8. For a bulldlng wlth a crawlspace or enclo$ure(s):
a) Squarefootageofcrawlspacoorondosure(s) N/A sqfl
b) Number of psrmanent flood openings in lhe crawlspac€ or enclosure(s) withln 1.0 foot above adlacent grade IVA
c) Total nei area offlood openings in A8.b N/A sq in
d) Engineered flood openings? fJ ys" E ruo
A9. For a bullding wilh an allached garage:
a) Squarefoolageofattachedgarage 604.00 sqfl
b) Number of permanont flood openings in the attached garage wilhin '1.0 foot above adjacent grade 0
c) Tolal net area of flood openlngs in A9.b 0.00 sq in
d) Engineered flood openings? [ Yes E No
sEcTroN B - FLOOD INSURANCE RATE MAP (F|RM) TNFORMATTON
81. NFIP CommunilyName & Communlty Number
KITTITAS COUNTY; 530095
82, County Name
KITTITAS
83. State
Washington
84. Map/Panel
Number
53037C1004
85. Sufllx
D
86. FIRM lndex
Dale
09-24-2021
87. FIRM Panel
Effeclive/
Revised Date
09-24-202'l
88. Flood
Zone(s)
AE
89, Base Flood Elevation(s)
(Zone AO, use Base Flood Deplh)
1590.2
810. lndicate lhe source of the Base Flood Elevation (BFE) data or base flood depth eniered in ltem 89:
B FIS Profile n FIRM fl Community Determlned fl Other/Source;
Bl 1. lndicate elevation datum used for BFE in ltem Bg: n NGVD 1929 El NAVD 19BB fl Other/Source:
812. ls the bulldlng locetod in a Coaslal tsarrier Resources System (CBRS) area or Othenruise Prolected Area (OPAP I Yes @ No
Designation Date:fl CBRS fl oPA
FEMA Forn 086-0-33 (12l19l Replaces all previous editions Form Page 1 of6
ELEVATION CERTIFICATE OMB No. 1660.0008
Explralion Date: Novomber 30,2022
IMPORTANT: In lhese spaces, copy the correspondlng informalion from Ssctlon A,FOR INSURANCE COMPANY USE
Buildins Slreel Address (lncludlng Apl,, Unlt, Suile, and/or Bldg. No.) or P.O. Route €nd Box No.
2917 Dapple Gray Way
Policy Number:
ZIP Code
98926
SlateCity
Ellonsburg Washington
Company NAIC Number
sEcTtoN c - BU|LDTNG ELEVATTON TNFORMATTON (SURVEY REQUTRED)
C1. Building elevations are bassd on; I Construclion Drawings' I AuiHing Under Conslruclion' [} Finished Conslruclon
rA new Elevation Cerlificalo will be roquired when conslruclion of the building is complote.
C2. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (wilh BFE), AR, AFyA, AFUAE, AR/A1-A30, AR/AH, AFyAO.
Complete llems C2.a-h below according to lhe lruilding diagram specified in ltem A7. ln Puerlo Rico only, entor melors.
Bonchmark Utlllzed: Cenlerof S 27,T 1B N, R 1B E Vertical Datum: NAVD 1SBS
lndicale elevallon dalum used for lhe elevations ln ilems a) through h) below,
fl NGVD 1929 El NAVD 19BB I olher/Source;
Dalumusedforbuildlngelevalionsmuslbelhesame"stha
Check the measurement used.
a) Top of bottom lloor (including basement, crawlspace, or enclosure floor)
b) Top of lhe nexl hlghor lloor
c) Bottom of tho lowest horlzonlal slructural member (V Zones only)
d) Attached garage (top of slab)
e) Lowest elevation of machinery or equipment servicing the bulldlng
(Describe type of equipment and localion in Commenls)
f) Lowosl adJacent (flnlshed) grade next lo building (LAG)
g) Highest adJacent (finlshed) grade next to bulldlng (HAG)
h) Lowest adJacent grade at lowesi elevalion of deck or stahs, lncluding
struclural support
t 59r.3
1589.9
rs90.8
N/A
1s91.3 [| feel I meters
N/A I leet I meters
N/A f] feet I melers
1591.3 @ feet I melors
I feel I meters
I feet
I feel
[| feet
! melors
I meters
I metors
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
to certify elevallon informalion.
I undersland lhal any lalse
flCheck here if attachmenls,
Thls certiflcalion ls lo be slgned and sealed by a land surveyor, enginoer, or archllecl aulhorized bv law
I cerlily lhat the information on lhls Cerlllicale rcprosenls my bosl oftorts lo inlerpret lho data avaltbble.
slatemenl may be punlshable by line or lmprisonment undor 1B U.S. Code, Seciion 1001,
Were lalltude and longilude in Seclion A provided by a llconsed land surveyor? Elyes fl tlo
mf,
4361S
1224 S. Pioneer Way
Moses Lake
Numbor
1
Professional Land Survoyor
Certifier's Name
Rick Sklnner
State
Washington
ZIP Code
98837
Company Name
Weslern Pacilic Engineerlng & Survey, lnc.
Telephone
(509) 765-1023
Copy all pagbs of this Elevati-on CerlilicCle and all atlachmenls-to/(t 1 idmmunity ofliclal, (2) insurance agonUcompany, and (3) bullding owner
Commsnts (lncludlng type of equipmsnl and localion, per C2(e), if applicable)
The heal pump pad was shol wilh GPS lo get elevalion for lhe pad and added an addilional 7 lnches for the legs of lhe heat pump.
FEMA Form 086-0-33 (12l19)Replaces all prevlous editions.Form Page 2 of 6
IMPORTANT: ln lhese Epaces, copy the correspondlng lnformatlon from Sectlon A FOR INSURANCE COMPANY USE
Building Slreet Address (including Apt., Unil, Suite, and/or Bldg. No.) or P.O. Routo and Box No.
2917 Dapple Gray Way
Pollcy Number:
City Stale
Washington
ZIP Code
98926Ellensburg
Company NAIC Number
sEcTtoN E - BUTLD|NG ELEVATTON TNFORMATTON (SURVEY NOT REAUTRED)
FOR ZONE AO AND ZONE A (W|THOUT BFE)
For Zones AO and A (wilhout BFE), complele ltems E1-E5. lf the Corlificate ls inlended to supporl a LOMA or LOMR-F r€quesl,
complele Seclions A, B,and C. For llems E1*E4, use nalural grade, if avallable. Check lhe measurement used. ln Puerto Rico only,
enter molers.
El. Provide elevation lnformation for lhe following and check the appropriate boxos lo show whether lhe elovalion is above or below
the highost adJacent grade (HAG) and tho lowesl adJaconl grade (LAG).
a) Top of bottom floor (including basement,
crawlspace, or enclosure) is
b) Top of bottom floor (including basement,
crawlspace, or enclosure) ls
I feet f] meters fl above or I below the HAG.
I feet I meters f] above or f] below lhe LAG.
E2. For Building Diagrams 6-9 wilh permanent
lho nexl highor lloor (elevalion C2,b ln
lhe diagrams) of tho bulldlng ls
E3. Altached garage (top of slab) is
llood openings provided in Soclion A llems B and/or g (seo pages 1-2 of lnslruclions),
I feet I meters I above or f]below lhe HAG.
I feei f]meters flabove or flbelow the HAG.
E4. Topof platform of machinery and/or equipment
seryicing the building is flfeet I metors f] above or flbelow the HAG.
E5. Zone AO only; lf no llood depth number ls avallable, ls the top of lhe bottom floor elevated in accordance with the community's
lloodplain managemenl ordinance? [ Yes I No f] Unknown. The local oflicial must cerlify thls information ln Section G.
sEcTloN F - PROPERTY OWNER (OR OWNER'S REPRESENTATTVE) CERT|F|CAT|ON
The property owner or owner's aulhorized represenlalive who completes Seclions A, B, and E lor Zone A (wilhoul a FEMA-issued or
community-issued BFE) or Zone AO must sign here. The statemenls in Seclions A, B, and E are correcl t<i lhe best of my knowledge.
Property Owner or Owne/s Authorized Represenlallvo's Name
Scott Henson
Address
1224 S. Ploneer Way
City
Moses Lake
State
Washington
ZIP Code
98837
Signature -.*-tr--Zlr**r,t Dale
6/9/y>t
Telephone
(50e) 765-1023
Commenls
il Check here if atlachmenls.
ELEVATION CERTIFICATE OMB No. 1660-0008
Expirallon Dalol November 30,2022
FEMA Form 086-0-33 (12119)Roplaces all previous edilions.Form Page 3 of 6
IMPORTANT: ln these spaces, copy the conosponding lnformatlon from Section A.FOR INSUMNCE COMPANY USE
Buildlng Street Address (including Apt., Unit, $uile, and/or BldS. No.) or P.O. Route and Box No.
2917 Dapplo Gray Way
Pollcy Number:
Clty State
Washington
ZIP Code
98926 ,Ellensburg
Company NAIC Number
sEcTloN G -coMMuNITY TNFORMATTON (OPTTONAL)
The local oflicial who is authorized by law or ordinance to admlnister lhe community's floodplain managemenl ordlnance can comptete
Sections A, B, C (or E), and G of lhls Elevallon Certificate. Complete lhe applicable llem(s) end slgn below. Gheck the measurement
used ln llems G8-G10. ln Puerlo Rico only, €nter meters.
Gl. fl The information in Section C was laken from olher documenlallon lhat has been slgned and sealsd by a licensed surveyor,
engineer, or architect who is au{horized by law to cefifo elevatlon ln{ormation. (lndioate lhe source and date of lhe elevatlon
data in the Comments area below.)
G2. fl A communlty olficlal completed Seclion E for a bullding located in Zone A (without a FEMA-issued or community-issued BFE)
orZone AO.
ff. n The followlng information (ltems G4-G10) is provided for communily lloodplain managemenl purposes.
G4. Perrnit Number G5. Dat€ Permit lssued G6. Date Cerlificate of
Compllance/Occupency lssued
G7. This permit has been issuod for: fJ New Construclion I Substantial lmprovemenl
G8. Elevalion of as-built lowesl lloor (including basement)
of lho building:
G9. BFE or (ln zone AO) depth of ltoodlng at lhe bulldlng slte:
G10. Communlty's design llood €levalion:
I foet I meters Datum
flfeet I metero Datum
ff feet I meters Darum
Local Offioial's Name Tille
Gornmunity Name Telephone
slgnature Date
Comments (including type of equipmenl and localion, per C2(e), if applicable)
I Check here if attachments.
ELEVATION CERTIFICATE OMB No. 1660"0008
Explration Date: November 30,2022
FEMA Form 086-0-33 {1A$)Replaoes all previous edilions.Fotm Page 4 ofG
IMPORTANT: ln these spaces, copy the correspondlng lnformatlon from Sectlon A.FOR INSURANCE COMPANY USE
Building Elroet Address (lncludlng Apt., Unlt, Sulte, and/or Bldg, No,) or P.O, Routo and Box No.
2917 Dapple Gray Way
Policy Number:
City
Ellensburg
Stato
Washington
ZIP Code
98926
Company NAIC Number
lf using lho Elsvalion Cerlificate to oblaln NFIP llood lnsurance, affix at least 2 building pholographs below according to the
inslruclions for llem 46. ldenlify all photographs with dats laken; "Fronl View" and "Roar View"; and, ilrequlred, "Rlghl Side View" and
"Left Side View." When applicable, pholographs musl show lhe foundallon wilh represenlative examples of the flood openings or
vents, as indicated in Seclion AB. lf submitling more photographs lhan will fit on this page, use lhe Conlinualion Page.
Photo om
Photo One Caption Fronl View Clear Photo One
I
Photo Two Gaption Side View Clear Photo T\flo
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
See lnslruclions for ltem 146.
OMB No. 1660-0008
Expirallon Date: Novembet 30,2022
FEMA Form 086-0-33 (12119)Replaces all previou$ edilions.Form Page 5 of 6
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
Conlinualion Page
OMB No. 1060-0008
Expiralion Dale; November 30,2022
IMPORTANT: In lhese spacss, copy lhe correspondlng lnformallon from Secllon A,FOR INSURANCE COMPANY USE
Bulldlng Slr€6t Address (includlng Apt., Unil, Suite, and/or Bldg. No.) or P.O. Roule and Box No.
2917 Dapple Gray Way
Policy Numbor:
Cily Slate
Washinglon
ZIP Code
98926Ellensburg
Company NAIC Numbor
lf submltting more photographs than will fil on the preceding page, affix lhe addilional photographs below. ldenlify all photographs
wilh: date laken; "Front Viow" and "Roar Vlew"; and, if required, "Right Side Vied' and "Lsft Side View." When applicable,
photographs must show lhe foundalion wilh representalive examples of lho flood oponlngs or vonls, as lndlcated ln Secllon AB.
Photo Three Capllon Rear Vlew Cleor Photo Three
+: .jjq:= b;,: " '..i
I
!
Pholo Four Caplion Side View ' Clear Pholo Four
FEMA Form 086-0-33 (12119)Replaces all prevlous edillons.Form Page 6 of 6
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood lnsurance Program
ELEVATION CERTIFICATE
IMPORTANTT MUST FOLLOWTHE INSTRUCTIONS oN PAGES 9-19
all of this Elevation Certilioate and all attachments for offigial,tnsulanc6
OMB Control No. 1660-0008
Explrallon Date: 00/30/2026
and owner.
FOR INSURANCE COMPANY USE
A{. Building Owne/s Name: SSHI LLC Pollcy Numbec
A€. Bullding Slreet Address (lncluding Apt., Unit, Suite, and/or Bldg. No.) or P,O. Route and Box Company NAIC Number:'..-...-..----.._N0.r2915 Dapple Gray Way
City: Ellensburg State: WA ZIP Code; 98926
A3. Property Doscription (e.9., Lot and Blook Numbers or Legal Descriplion) and/orTex Parcel Number:
Division 7 Lot 8. 962124
A4. Bullding Use (e.9., Residenlial, Non.Resi'Jential, Addition, Accessory, otc.): Residential
A5, Latitude/Longitude:Lat.N47o01'28,32' Long,W120'34'46.36' Horizontat Datum:ilNAD 1e27 EINAD 1eS3 XWGSS4
46. Attach al least two and when possible four clear pholographs (ono for each side) of the bullding (see Form pages 7 and 8).
A7. Bullding Diagram Number: 1B
A8, For a buildlng with a crawlspace or enclosure(s):
a) $quarefootageofcrawlspaceorenclosure(s)t tf/ /'i+* sq.fi.
b) ls there al least one permanent flood openlng on two different sldos of each enclosed area? [ Yes I No E N/A
o) Enler number of permanent flood openlnqs.in the crawlspace or €ndosure(s) within '1.0 foot above adJaoent grade:
Non-englneered flood opening": tU/t? Engineered flood openings, /U/rf
d) Total net open area of non-engineered flood oponings in A8.cl _&_ sq. ln,
e) Total rated area of engineered flood openings in A8.c (attach documenlation - see lnstructions):A//A*sq. fl.
f) Sum of A8.d and AB.e rated area (if applicable - see lnstrucilons):
A9, For a building wllh an attached garage:
sq.ft.
a) Square foolage of altsched garagel 603.00 sq. fi,
b) ls there at leasl one permsnent flood opening on two different sides of the attached garage? [ Yes I No
c) Enter number of permanenl flood openings in lhe atlachod garage rrvllhln 1.0 foot above adjacent grade:
Non-engineered flood opening ", tl/ttf ' Englneered flood openings , N //1'
d) Total nef open area of non'engtneered flood openlngs in A9,c: il I F ""*
I N/A
e) Total raled area of engineered flood openlngs ln Ag,c (attadr documentation - see lnslruclions):
f; Sum of A9.d and A9.e rslsd area (if appllcable - see lnstructions): _L*,k sq.ft.
,,1//,4-sq.ft.
81.a, NFIP Gommunity Name:KITTITAS COUNTY 81,b. NFIP Community ldentiflcation Number: 530095
82. County Name:KITTITAS BS.State:WA 84. Map/PanelNo,: 63037C1064 85. SuffixlD
86, FIRM lndex Date: Ogl24l2021 87. FIRM Panel Effective/Revlsed D ale; 0912412021
88. Flood Zone(s): AE 89, Base Flood Elevatlon(s) (BFE) (Zone AO, use Baee Flood Depth):1588.5
810. lndlcale the source of the BFE data or Base Flood Depth €ntered in ltem 89:
E] nS n FIRM D Communlty Oetermined I Other:
811. lndicateelevationdatumusedforBFEinltemBg: f]NGVD192SENAVD1988 [Olher/Source:
812, ls lhe building looated in a Coastal Barrler Rssources System (CBRS) area or Otherwiso Proteoted Area (OPA)? [ Yes ffi No
Designation Date:ncBRs noPA
813. ls lhe localed seaward of the Limit of Moderale Wave Acllon Yes lTl No
FE MA Form FF -246-FY-22-1 52 ({ormedy 088.0"33) ( 1 0/22)Page 2 of 19
ELEVATION CERTIFICATE
IMPORTANT; MUST FOLLoW THE INSTRUCTIONS ON PAGES 9-ie
FOR INSURANCE COMPANY USEBuilding StreetAddress (lncluding Apt., Unlt, Suite, and/or Bldg. No,) or p.O. Route and Box No,:
City:Ellensburg
2916 Oapple Gray Way
Ststs: WA ZIP Code: 98926
Polioy Number;
---Company NAIC Number;
C1. Building elevations are based on: f] Conetruotlon Drawings" f] Building Under Conslruotion* [] Flnlshed Construcflon*A new Elevalion Certiflcale will be required when conskuction of lhe building ls oomplele,
C2. Elevailons - Zones A1-A30, AE, AH, Ao, A (with BFE), VE, V1*V30, V (wlth BFE), AR, AR/A, AR/AE, ARfAI-A30, AR/AH, AR/Ao,
A99. Complete ltems C2.a-h below according to the Buildlng Diagram specified in ltom A7. ln Puerto Rico only, enier melers.
lndicale elevation datum ueed for lhe elevations in ltems a) through h) below.
n NGVD 1e29 m NAVD less fJother:
Datum used for building elevatlons must be {he same as that used for the BFE. Conversion factor used?
lf Yes, describe lhe source of lhe conversion factor ln lhe Seotlon D Comments area.
e) Top of bottom lloor (inoludlng basement, crawlspace, or enolosure floor):
b) Top of lhe next hlgher floor (see lnstructlono);
o) Bottom of lhe lowest horizontal slructural member (see lnstruotions);
d) Attached garage (lop of slab):
e) Lowest elevatlon of Machlnery and Equlpment (M&E) seMclng the building
(describe type of M&E and bcation in Section D Gomments area):
fl Lowest Adjacent Grado (LAG) nexl to building; f] Naturat [] Finished
g) Highesl Adjaoent Grade (HAG) naxt to buitdingr fJ Natural I rinisheO
h) Flnlshed LAG al lowest elevation of attached deck or stairs, lnoluding structural
supporl:I feet I meters/u/k
ilir*^f, feet fl meters
N /.k fl feet I metere
1,590,00 fl feet I meters
Benchmark Utilized: Center of S 27 T18N
. :1,5.90:10
1,588.B0
1,589.90
I feel I meters
p feet ! melers
fl leet I moters
[Yes ENo
Check lho measuroment used;
1,590.00 @leet Imeters
R 1B E VerlicalDatum: NAVD 1988
This certificatlon is to be signed and sealed by a land surveyor, engineer, or architect aulhorized
lnformatlon. I ceilify that lhe lntormatlon on thls Ceilflcate represents my best etforls to lnterpret
false statement may be punlsltable by lino or lmprlsonment under 1B lJ.$. Code, Secllon 1001,
Were latitude and longitude in Section A provided by a licensed land surveyor? [ yes f] No
I Cheok here if altachmenls and desoribe in the Commenls area.
Certlfle/s Name: Rlck Sklnner License Number:43619
pages of this Elevation Cerlilicate and all attachments lor (1) community official, (2) insurance agenUcompany, and (3) bullding owner.
Tifle: Professlonal Land Surueyor
company Name: Western Paclfic Englneerlng & Survey, lnc.
City;Moses Stale: WA ZtP Code: 98837
Gommenls (tncludlng source of conversion factor in C2; type of equipment and loaation per C2.e; and description of any atlachm€nts):
Heat Pump pad was measured at lhe top with the bottom of the heat pump raised an additional eight lnches with legs
by slate law to oertify elevation
the data available. I understand that any
Copy all
Address: 1224 S, Pioneer Way
Slgnature:
76s'1023Telephonel Ext,r Emall:
FEMA Form FF-206-FY-22-152 (formerly 086.0-33) (1OI2z)Page 3 of 19
ELEVATION CERTIFICATE
IMPORTANT: MU$T FOLLOWTHE INSTRUCTIONS ON PAGES 9.19
FOR INSURANCE COMPANY UgEBulldlng Streel Address (lncludlng Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.:
2915 Dapple Gray Way
City:Ellensburs State: WA ZP Gode: 98926
Company NAIC Number:
Pollcy Number:
For Zones AO, AR/AO, and A (wilhout BFE), compleie llems E1-E6, For ltems E1-E4, use natural grade, jf available. lf the Certificate is
intended to support a Letter of Map Change requesl, complete Seclions A, B, and G. Check the measuremenl used. ln Puerto Rlco only,
enter meters,
Building measuremenls ere based on; I Constructlon Drawings* [ auitCing Under Consbucl'on* [] Finlshed Conslruclion
"A new Elevalion Certificate will be required when construclion of the buitding is mmplete,
E1. Provide meaouromenls (C,2.a in applicable Building Diagram) for lhe following and cheok the appropriate boxes to show whelher ihe
measuremenl is ebove or below the nalural HAG and the LAG,
a) Top of boltom floor (including basement,
crawlspace, or enclosure) ls: tr feet I melers I above or f] betow the HAG.
b) Top of boltom floor (including basement,
crawlspace, or enclosure) ls: I feet ! melers f] above or I below the LAG.
E2. For Buildlng Diagrams 6-9 with permanenl flood openings provided in Section A ltems I and/or 9 (see pages 1-2 of
I feet I meters fJaboveor I belowlheHAG.
E5, Zone AO only: lf no flood depth number is available, is the top of the bottom floor elevated ln accordance wlth lhe communlly's
floodplain management ordinanoo? fl Yes n No I Unknown The local official musi certify thls infonnation in Seclion G.
n
lnstructions), the
I feet meters fl above or below the HAG.
nexi higher lloor (C2.b in applicable
Buitding Diagram) of lhe building ie;
E3. Attached garage (lop of slab) ls:
E4. Top of platform of machinery and/or equipment
serviolng lhe bullding ls:fl feet I melers I above or I below lhe HAG.
The property owner or ownorrs aulhorized represenlative who compleles Sections A, B, and E for Zone A (wilbout BFE) or Zone AO must
sign here. The stalements ln SecllonsA, B, and E are correctlo the best of my knowledge
I Check here if attachments and describe ln the Commenls area,
Propedy Owner or Owne/s Authorlzed Representallve Name: Scott Henson
Cityr Moses Lake
Emall: shenson@wpeinc.netExt.:
Gomments:
oa.rl; 4 / /4j/p+7
state; wA ZIP code: 98837
Telephone: (509) 765'1023
Signature:
Addressr 1224 S. Pioneer Way
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
FOR INSURANCE COMPANY USE
Company NAIC Number
Policy Number:
Building street Address (including Apt., Unit, suite, andior Bldg. No.i or P.o. Route and Box No.
98926CityEllensb
2915 Gray Way
state: WA ZIP code:
(RECOMFORMATION LETIONNUCOMPITYOFFICIALENMEDDCOMMFORGcoMUMINNITYNECTIOs
The local oflicial who is aulhorized by law or ordinance to administer the community q 1l."oggt_ql-nan€gement ordinance can complete
Slj"ti"" A, e, C E, G, ;in;ii6l etdvition Certificate. Complele the applicable itein(s) and sign below when:
G1. n fn" information in Seclion C was taken from other documentation that has been signed and sealed by a licensed surveyor'
enqineer, or architect who is authorized by state law to certify elevation information. (lndicate lhe source and date of the
eleialion data in the Comments area below,)
GZ.a. I A local official completed section E for a building located in Zone A (wilhout a BFE), Zone Ao, or Zqne AR/AO' or when ilem
ES is completed foi a building localed in Zone AO.
G2.b. m A local official completed Section H for insurance purposes'
G3. n tn the Comments area of Section G, the local official describes specifio conections lo the information in Seclions A, B' E and H
G4 . E fn" following information (ltems G5-G 1 1 ) is provided for community floodplain managemenl purposes.
G5. Permit Number: FD-22-00013 G6. Date Permit lssued:03t02t2022
G7. Date Cerlificate of Compliance/Occupancy lssued:
Gg, This permit has been issued for: E ttuw Conslruction il Substantial lmprovement
G9.a. E1sv61;on ol as-buill lowest floor (including basementi of the
building:
G9.b' E16vs11on o{ bottom of as'built lowest horizonlal struclural
member:
G10.a. BFE (or depth in Zone AO) ol flooding at the building site:
G10'b' gonr*rnity's minimum elevation (or depth in Zone AO)
requiremenl for the lowesl floor or lowest horizontal slructural
member:
1,590.00 EJ feet I melers p61um. NAVD 1988
t.,J lR flreet f] melers
n meters
Dalum:
1,588.50 Elfeet gslurn. NAVD 1988
1 589.50 fi feet fl melers Datum NAVD 1988
G11. Variance issued? [ yes E ruo I yes, attach documentation and describe in the Comments area'
The local official who provides information in Section G musl sign here. !have compleled the lnformation in Section G and cenify thal tl ls
;;;;;ii; ti;;;;iir fr;i k;;;,i;';;; y";;p:in;bt"',1 nivC a,tso frovided spectfic coirections in the comments area ot this section.
Local Official's Name Samantha Cox Title Water Resources SPecialist
NFIP CommunilY Name:Kittitas Countv
Telephone: (509) 962-7523 Ext.Email: Pu blicworks@co. kittilas.wa. us
Address 411N.Street, Suite'l
CitY;Ellensburg Srate: WA 71P 6s6s 98926
Signature:oare: 09128/2023
Comments
Sections A,
of equipment and location, per C2.e', description of any attachments; and correclions 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 Slreel Address (inchrding Apt., Unit, Suite, and/or Bldg. No.)or p.O. Route and Box No.
2915 Dapple Grav way
City:Ellensburq Stale: WA Zlp Code: 98926
FOR INSURANCE GOMPANY USE
Policy Number:
Company NAIC Number: -_=_---
SECTION H - BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES(suRvEy NoT REQUTRED) (FOR TNSURANCE PURPOSES ONLY,
The properly owner, owner'g aulhorized representalive, or local floodplain management official may complete Section H for all flood zones
lo determine the building's first floor heighl for insurance purposes. Sections A, B, and I must also be completed. Enter heights lo the
lealesl].9nlh.of a lo.ot (nearest tenth of a meter in Puerto_Rico|. Refere,n-ce lha Foundation Type Dlagrcms (et the end ot Section Hlnstructions) ancl the appropriate Buildtng Diagrams (at lhe end of Section I lnstructioni)'to cotiptete this section.
H1. Provide the height of the top of the floor (as indicaled in Foundation Type Diagrams) above the Lowesl Adjacent Grade (LAG):
a) For Bullding Diagrams 1A, 18, 3, and S-9. Top ol bo(om
floor (include above-grade floors only for buildings with
subgrade crawlspaces or enclosure floors) is:
1.20 @ {eet fl meters E} above the LAG
b) For Building Diagrams 2A,28,4, and 6-9. Top of next
higher floor (i.e., the lloor above basement, crawlspace, or
enclosure lloor) is:
N I A I feet f] melers I above the LAG
H2. .ls all Machinery and Equipment servicing tlre building (as.listqd in. ltem H2 inslructions) elevated to or above lhe floor indicated by theH2 arrow (shown ln the Foundation Type Diagrams a-i end of Section H instructions) foi the appropriate BuildintDiagramT----
nYes EJuo
SEGTION I - PROPERTY OWNER (OR OWNER'S AUTHORTZED REPRESENTATTVE) CERT|F|CAT|ON
The properly o\A,ner or owner's authorized representative who completes Sections A, B, and H musl sign here. Ilre slalemenls rn Secflons
A, B, and H are correct to the best ol my knowledge. Note: ll the local floodplain management official completed Section H, they shouldindicate in ltem G2.b and sign Section G.
I Check here if attachmenls are provided (including required photos) and describe each attachment in the Commenls area.
Property Owner or Owner's Aulhorized Representative Name:
Address:
City:Slale: ZIP Code
Signature:
Telephone:
Date
Ext.: _ Email:
Comments:
FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (1O\2ZJ Page 6 of 19
ELEVATION CERTIFICATE
IMPORTANTI MUST FOLLOW THE INSTRUCTIONS ON PAGES S.I9
BUILDING PHOTOGRAPHS
See lnslruclions for ltem 46.
Building street Address (lnoludlng Apt., unit $uite, and/or Bldg. No.) or p.o. Route and Box No.:FOR INSURANCE COMPANY USE
29'15 Dapple Gray Way
Pollcy Number:
City:Ellensburo State: WA Zlp Gode: 98926
Company NAIC Number: _-
lnstructlons; lnsert below at least two and when posslble four photographs showing each slde of the buildlng (for example, may only be
able to take front and back pictures of townhouses/rowhouses). ldentifl all photographs with the date takenlnd 'Fronl View," ;Reai View,o
"Right Slde View," or "Left Side View." Photographs must show the foundation. When flood openlngs are present, include at loasl one
close'up photograph of representative flood openings or vents, as indicated in Seclions AB and A9,
Photo One
Photo One Caption: Front View ffii,'ffi,.i---
Photo Two
Photo Two Caption: Side View
FEMA Form FF-206-FY-22-152 {formerly 086-0-33) (10/22)Page 7 of 19
ELEVATION GERTIFICATE
IMPORTANT: MUST FoLLOW THE TNSTRUCTTONS ON PAGES 9..f 9
BUILDING PHOTOGRAPHS
Continuation Page
Bullding street Address (includlng Apl,, unit, suite, and/or Bldg, No.) or p.o. Route and Box No
2915 Daoole Gray Wav
City:Ellensburo State: WA ZtP Code: 98926
lnsert the third and fourth pholographs below. ldentis all photographs with the dale taken and nFront View,"'Rear View," ',Right Slde
View," or nLeft Side View"' When flood openings are present, include at least one close-up pholograph of represenlative floodipenings or
venls, as indicated in Seollons AB and A9.
Photo Three
Phoio Three Gaptlon: Back View ldl
Pho(o Four
Pholo Four Capllon: Side Vlew
FEMA Form FF-206-FY-22-152 (fomerty 086.0-s3) {10/22)Page B of 19
U.S, DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood lnsurance program
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE |NSTRUCT|ONS ON PAGES
all of lhls Elevatlon Gerllficate and all attachmenls for
OMB Conhol No. t660.000S
Fxpkallon Dale; 06/9012026
9.19
lnsurance and bulld ownsr.
FOR INSURANCE COMPANY USE
Pollcy Number:
CompanyNA|C Number:_-
A1. BulldingOwne/s Name: SSHILLC
A2, Buildlng slrset Address (indudlng Apt., unlt, sutte, and/or Bldg" No.) or p.o. Routo and Box
No.:29'13 Dapple Gray Wav
Cllv: Ellcnsburo Stale: WA Zlp Code: 98926
A3, Property Descrlptlon (e.g,, Lot and Block Numbsrs or Logal Descrlptlon) aM/or'l'ax Parcel Numbor:
Divislon 7 Lol 9,962125
A4. Bullding use (e,g., Resldential, Non-Resldenllal, Addltlon, Accessory, atc.)i Resldential
A5, Latitude/Longlltrde: 1at.N47"0127.57'Long. W129.'- 4 46.88" Hortzonlal Dalurn: I NAD 1927 E NAD ls8g [J WGS B4
46' Altaoh at leasl lwo and when posslble four clest photographs (one for each side) of the buildlng (sce Form pagas 7 anrt B),
A7. Building 0iagram Numbsr: 1El
AB. For a building wlth a crawlspaco or anclnsure(s):
a) Square foolage of orawlspaco or enc{osuro(e):sq.tt.
b) ls thero al leasl one pennanont flood opening on two difforont sides of each enclosed area? [ yes I No m N/A
c) Entet number of perrnansnt llood oponlngs ln lho crawlspaco or enclosur6(s) wllhln 1.0 loot above adJaconl gredo:
Non-onglneered ftood opentngsi j4 /t:_ Engtnoorod ftood openlngs, lV/tr
d) Tolal nel open area of non-englneered flood oponlrps in Ag,c: N /F- "q.in.e) Total ralod area of engineered llood oponings ln AB.c (atlach documsnlalion - see lnslrucllons):
f) Sum of A8,d and AB.o ralod aroa (if appllcable * see lnslructions)r N//Y sq. ft,
///r sq.lt,
lnslnrctlons): _1rl &_ to. o.
6q.tt.
A9, For a bulldlng wllh an allach€d garagel
a) Square foolago of allached garage:451.00 sq. lt.
b) ls lhere al lessl one permanent flood openlng on two difforent stds$ of the altached garage? flyos IEJ No n N/A
c) Enler number of perrnanent llood oponlngs ln the altached gerege wilhin 1.0 fool ebovo adiaconl orads:
Non-engineered flood openings; il ,{k Englnoered flood openings | _N.J/F_
d) Totelnelopenaroaofnon-englneeredfloodopenlngsinAg.c: AJ,/t -sq.ln.
e) Total raled area of enginoercd llood openlngs ln Ag,c (attach documenlafion * soo
Q Sum of A9.d and Ag.o ralod area (lf appllcable - seo lnslrucilons):/v/A-
810' lndlcate lhe sourco of the BFE date or Bos€ Flood Depth enlered ln llsm Bg:
FJ FIS n flRM flCornmunlty Determtned I Orhor:
811' lndlcete elovalion dalum used lor BFE in llsm B9: fl NGVD lg2g El NAV0 lSsS il other8ourco:
812' ls lhe building located ln e Coastai Barrlsr Resources Syslem (cBR$) aroa or Olherwise protectod Area
81.b. NFIP Communlty ldenllllcailon Number S300Ss
86. Sufflx: D
86. FIRM lndex Dato: 0512412021 87, FIRM Panel Efl scllve/Revlsed O ate: 09 124 I 2021
83, $lalo:WA 84. Map/Panel No,: 53037C1084
CBRS OPAll
89, Base Flood Elevatlon(s) (BFE) (Zone AO, use Baso Flood Depth):1587.O
(oP )? flyes fi No
Designalion Dale;
813, ls lhe bulldlng located eeaward of the Llmit of Modsralo Wavo Aollon Yes No
81.a, NFIP Communlty Name:KITTITAS COUNTy
82. County Name;KITTITAS
BB. Flood Zone(s): AE
FEMA Form FF-20A"FY-22-152 (formerty 0B6,0"9A) (1otZZ)Page 2 of 19
ELEVATION CERTIFIGATE
IMPORTANT; MUST FOLLOW THE INSTRUCTTONS ON pAcES 9.1S
FOR INSURANCE COMPANY USE(lncludlng Apt., Unlt, Sulto, and/or BldS, No.) or p.(), Route and Box No.:
Grav Wav
Clty: Ellonsburg
Bulldlng Streel Address
2913 Dapple
Stale: WA Zlp Codo: 98926
Pollcy Number:
Company NAIC Number;
E.!i ilitEri
C1. Building olevallons are ba$ed on: I Conslruction Drowingsr fl Bullcllng ljnder Conslruclion, E Finlshed Oonslruclion
'A now Elevalion Cerlificale will bo roquired whon conslroctlon of lhe building ls complele,
lndlcale elevallon datum used lor the elevalions ln items a) lhrough h) below.
n NGVD 1s2s EINAVD 19ss flottrer:
Datum used for building olsvallons musl be lhe sarne as lhal used lor ths BFE. Converslon faclor used?ll Yes, descrlba ihe sourco ol lhe convsrslon lactor in lhe soolion D commenls sroa.
a) Top of botlom floor (including basenrent, clawlspace, or enclosure floor);
b) Top ol lhe nexl hlgher lloor (seo lns(ructions)l
c) Bottom of lhe lowes( horizonlal slruclural msmbor (soo lnslructions);
d) Atlached gerage (lop ol elab):
e) Lowesl elevalion ol Machinory and Equlpment (M&E) seMcing the bullding
(descritre lype of M&E end locailon in Socllon D Conimenls arla)t
l) Lowcst Adjacent Grade (LAG) nexl to bulldlng: I Natural EJ f inisnoO
s) Highesl Aruec€nt crade (HAG) next lo bulldtng: f] Naturot $ Fintshed
h) Flnlshed LAG at lowest elevelion ol allsched deck or rlalrs, inclucllng slructural
supp0rlr
[J leet lJ meters
BFE),
the
N,
[!] feel fl meters
1,588.50 @ feet I melers
G-
C2. Elovallons - Zones A1-A30, AE, AH, AO, A (with VE, V'l-V30, V (wllh BFE), AR, AR/A, AR/AE, AF/A1-A3O,AR/AI.I, AR/AO,A99, Complcte ltems C2.e-h below according to Bullding Diagram speclfled ln ltem A?. ln Puerto Rlco only,snlsr mctsrs,
Benchmark Ullllzod; Genter of S 27, T '18 RlBE Vortical Da{um: NAVD 1988
__. 1,588.50
N /.L
Al/A-
,1,5-98.30
1,587.20
I Yas El No
oheck lhe measurenrenl used:
[| feet [*] melers
I feal I meters
[J feot f] meters
. 1,588,10 [] feet fl motors
A//ft ll faet I morers
l{ero laliluda and longllude ln secllon A provlded by a lioensed land suloyor? EJ yes I No
flChock here lf altachm€nls snd describe in the Commenl$ area.
Gerllller's Narne: Rlck Sklnner License Nurnber:4361g
rite: Prolessljrn?l Land 9urveyor..
Company Nams; Western Paclfic Englleering & Survey, lnc.
Copy all pages of this Elevallon Cerlificalo and all altachments lor ('t)community ofliclal, (2) lnsurance aBonucompany, and (3) bulldlng ownor
Clly: Mosas
egulprnenl and lacallon per
of lhe heat pump ralsod
C2.€; and doscrlplton of any
an additlonal elght lnches
(including atluchments):
bottom
Address; 1224 S, Pioneer
slate: WA Zp code: 98837
Email: rs
source of convolsion faclor ln C2;lype of
Heat Pump pad was msasured at the lop wllh the wlth legs
cerllllcationThls tol3 be and sealed landaslgned or archltectby6Uryeyorenglnaer aulhorlzed stale lolewby elevstloncortlfy
lnformallon.lhat the lnformalion on this Qsrllltcalacertily 0est lool{orlstapresonlsmy dalalhe availahlo.inlerpret lhalunclorsland anytalsaslalor?enl be orlinemaybypunlshable underimprlsonmenl tl,18 s.10a1$eolipnCodo,
Signaluro;Dale:
765-1023 €xt.:Telephone:
FEMA Form FF-206-FY-2?-152 (forme.ty 0S6-0-33) {10/22}Pego 3 of 18
ELEVATION CERTIFICATE
IMPORTANTI MUST FOLLoW THE INSTRUCTIoN$ oN FAGES g.Is
FOR INSURANCE COMPANY U$E
Pollcy Numbert
-.*-Company NAIC Number:
Bullding SlreetAddress (lncluding Apt., unil, suite, and/or Bldg, No.) or tr.o. Roule and Box No.:
2913 Dapple Gray Way
clly:Ellensburo glate: WA Zlp code: 98926
Bulldlng measuremenls are baood on: I oonstrucllon Drawlngs' I Bulldlng Undor Construcllon, I Flnlshsd Construction
'A new Elovalion Corlificalo will be requlred when conslruclion ot lhe building is complete
E1, Provids moasuromonls (c.Z.a ln appllcable Building Diagram) lor lhs followlng and check the apprspriate boxos to show whether lherneasurement is abov6 or below ths natural HAG and lhe LAG.
a) Top ol botlorn lloor {inoludlng basomonl,
crawlspaco, or enclosure) ls;
-,_ f| feot f] meters I abovo or f] below lhe HAG.
E?' For Buildlng Diagrams 0-9 wilh pormanenl llood openlngs provlded ln secllon A ltems B anrt/or g (seo pages 1-2 of lnstrucllons), thenexl hlgher floor (Cz.b ln applicablo
servicing the bulldlng ls: [-] feet fl rnolors l-l above or fl below the HAG.
E5. Zone Ao onlyl lf no llood depth numbor is avallable, ls lhe top of the boltom floor elevated in accordance wllh il* riommunlly'sRoodplaln manegement ordinance? [ Yes fl No [] unknown The local official must ceriify thls lnformailon ln secllon G,
AO'
orF Zones andAO,AR/AO,A {wlthoul E1-E5.llems ForcompleteBFF),llems -E4E1 naluuse ral itgrade,avallable.ihtf Cerlifioete lslolnlendedsofLstlersupporlSeclionsChangeMapcompleteroque6l,A,and Oheckc.B,he usedmoasutemenl ln Puorlo Rico onlymenloreters,
Buildlng Dlagram) of lhe butl<ling lsl
E3, Attached garag€ (top of stsb) ls:
E4. Top of plal{orm of machlnery and/or equlprnent
I foet f] melers I above or f) betow lha HAG,
fJ feet I meters I abovo or I batow the HAG,
b) Top ol bollom floor (lncluding basement,
crawlspaco, or enclosure) ls:ll feot f] metors fl above or f] betow the LAG.
completes Secllons A, B, and E for Zone A (without BFE) orZone AO mu$t
lo lhe best of my knwledge
fl Ghock hore if allachmonts arxl describe in lhe Commenls aroa.
Properly Ownsr or Ownor's Aulhorleed Represenlailve Name; Scolt Henson
Clly:Moses Lake
/n*-4,-
State; W4_*-ZIP Code: 98837
7
Tho proporty owner or owns/e uulhorlzed repressnlalive who
sign horo, The slatemenls in $ecllons /, B, and E are correcl
Commenlg:
Email; shenson@wpelnc.nel
Addross: 1224 S. Ploneer Way
$lgnalure:Dalo: P t
Telophone: (509) 765-1023 Exl.:
FEMA Form FF-2O6.FY-22-152 (fornerly 0S0-0-gg) (10/22)Page 4 of 19
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOWTHE INSTRUCTIONS ON PAGES 9-19
FOR INSURANCE COMPANY USEBuilding Streel Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No,
2913 Dapple Gray Way
State: WA Ztp Code: 98926City;Ellensburg
Company NAIC Number:
Policy Number:
sEcTloN G - CoMMUNTTY TNFORMATTON (RECOMIITTENDED FOR COMMUN|TY OFF|C|AL COMPLETTON)
The local official who is authorized_by law orordinance lo administer the community's floodplain management ordinance can complete
Section A, B, C, E, G, or H of this Eklvation Certificale, Complete lhe applicable iteinls) and sign bebd when:
G1' f fne information in Section C was taken from other documenlation that has been signed and sealed by a licensed surveyor,
engineer, or architect who is authorized by slate law lo certify elevation information. (lndicale the source and date of the
elevation data in the Comments area below.)
Gz.a. fl A bcal official completed Section E for a building localed in Zone A (wilhout a BFE), Zone AO, or ZoneAR/AO, or when item
E5 is completed for a building located in Zone AO.
Gz.b. E A bcal official completed Section H for insurance purposes.
G3. f] tn the Commenls area of Section G, the local offlcial describes specific corrections to the information in Sections A. B, E and H
G4. E fne following information (ltems GS-Gl 1) is provided for community floodplain management purposes.
G5. Permit Number FD-22-OOO14 G6. Date permit tssuedt 0310212022
G7, Date Certificate of Compliance/Occupancy lssued:
G8. This permit has been issued for: E ru"* Construction I Subrtanli"l lmprovement
G9.a' Ebvation of as-built lowest floor (including basement) of thebuildlng: 1,588.50 I feet I meters Datum: NAVD 1988
G9.b. Elevation of bottom of as.built lowest horizonial structural
member:I feet I meters
flmeters
Dalum:
G'|0.a. BFE (or depth in Zone AO) of flooding at the building site:
G10'b' 6ortlunity's minimum elevation {or depth in Zone AO)
requiremenl for the lowest floor or lowest horizonlal structural
member:
1,587.00 $ feot Datum: NAVD 1988
1,588.00 Eteet Dmeters Dalum: NAVD 1988
G11. Variance issued? [ Ves [] t'to lf yes, attach documentalion and describe in the Comments area
The local official who provides information in Seclion G must sign here. I have_ completgd th9 information in Sectlon G and certify that il is
correct to the best ol my knowledge. lf applicable, I have also provided specific corrections in lhe Commenls area ol this section.
Local Official's Name: Samantha Cox Title:Water Resources Specialist
NFIP Community Name Kittitas Countv
Telephone: (509) 962-7523 Ext.Email:oublicworks@co. kittltas.wa. us
Address;411 N. Ruby St., Suite 1
City:Ellensburg State: WA Zlp Code: 98926
Slgnature oare:0812112023
Comments
Sections A,D. E,
of equipment and location, per C2.e; description of any attachments; and corrections to specific informalion in
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 Slreel Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No,:
2913 Dapple Gray Way
City:Ellensburg State: WA Ztp Code: 98926
FOR INSURANCE GOMPANY USE
Policy Number:
Company NAIC Number:
SECTION H - BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES
(suRVEY NOT REQUTRED) (FOR TNSURANCE PURPOSES ONLY)
The property owner, owner's authorized representative, or local floodplain management official may complete Seclion H for all flood zones
lo 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 loot (nearest tenth of a meter in Puerto Rico), Reference lhe Foundalion Type Diagrams (at the end of Section H
lnstructlons) and the approprlate Buildtng Dlagrams (at the end of Sectlon I lnstructions) to complele tnis section,
H1, Provide the height of the top of the floor (as indicated in Foundalion Typo Diagrams) above the Lowest Adjacent Grade (LAG):
a) For Building Dlagrams 14, 18, 3, and 5-9. Top of bottom 1.30 B feet X meters I above the LAG
floor (include above-grade floors only for buildings with
subgrade crawlspaces or enclosure floors) is:
b) For Bulldlng Dlagrams 2A,2E,4, and 6-9. Top of next
higher lloor (i.e., the floor above basement, crawlspace, or
enclosure floor) is:
N lA n feet I merers I above rhe LAG
H2. .ls^all Machinery and Equipment.servidngihe building (as lis,tqd in ltem H2 instructions) elevated to or above lhe floor indicated by the
H2 arrow (shown in the Foundation Type Diagrams at end of Section H instructions) for the appropriate Building Diagram?
[Yes Eruo
sEcTroN I - PROPERTY OWNER (OR OWNER'S AUTHORTZED REPRESENTATTVE) CERT|F|CATION
The property owner or owner's aulhorized representative who completes Sections A, B, and H musl sign here. The statements in Sectrrrs
A, Q, and H are correct to the best of my knowledge. Note: lf the local floodplain management official completed Section H, they should
indicate in ltem G2.b and sign Section G.
I Checf here if attachments are provided (including required photos) and describe each attachment in the Comments area.
Property Owner or Owner's Authorized Representalive Name:
Address:
City;State:ZIP Code;
Signalure:
Telephone:
Date:
Exl.Email
Comments:
FEMA Form FFAA6-FY-22-152 (formerly 086-0-33) (10122')Page 6 of 19
ELEVATION CERTIFICATE
IMPORTANTT MUST FOLLOW THE TNSTRUCTTONS ON PAGES 9.r9
BUILDING PHOTOGRAPHS
See lnstrucfions lor llem 46.
FOR INSURANCE COMPANY USE
Company NAIC Number:
Policy NumberClty:
Way
Bulldlng Street Address (tncludlng Apt., Unlt, Sulte, and/or Bldg, No.) or P.O. Route and Box No.:
2913 Dapple
Slate: WA ZpCode: 98926
View,"Mew.'
lownhouses/rowhouses).
Pholographs musl show
lnserllnslrucllons:atbelow leasl lwo whenand fourposslble sideeach theofshowingphotographs be(lorbuildlng example,mey onlyablelaketoandfrontbackofplc{ures all wllh lheldenllfy date andlaken 'Fmntpholographe "RearView,Vlew.Sidehr or Slde'Lefl"Rlg tho foundalion.When flood ar€openings prossnl,atinclude oneleaslolphotographtloodclose-up r€pressntallye or lndlcatedas lnopenlngsvenls,Ssclions andA8 49.
Clear Photo One
Pholo One Captlon: Fronl Vlew
Photo Two
CleEr Photo Tnro
Photo Two Caption: Side Vlew
FEMA Fonn FF-206.FY-22-152 (formedy 086-0-3A) (10/22)Page 7 of 19
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE TNSTRUCTTONS ON PAGES 9_19
BUILDING PHOTOGRAPHS
Continualion page
FOR INSURANCE COMPANY USE
Policy Number:
Company NAIG Number:
below. ldonlify all photographs with lhe dete taken and ,,Front View," ,'Rear Vhw." ,'Right sldeopenlngs are presenl. lnolude at least one close-up pholograph of representalve flood-openlngs orA9.
Cily:
Way
Bulldlng Street Address {indudlng Apt., Unit, Sulte, and/or Bldg. No.) or P.O. Rout€ and Box No.:
2913 Daople Grav
State: WA Zlp Code: 98926
Inserl lhe lhhd ond fourth pholographs
Vlew,'or "Lefl Slde Mew., When flood
venls, as lndlcated ln $eclions AB and
Photo Threa
Clear Photo Three
Pholo Three Capllon: Back Vlew
Pholo Four
Clear Pholo FourPholo FourCaptton: Slde View
FEMA Form FF-206-FY-22-152 (fonnorty 0S6-0-39) (10/22)Page I of 19
U.S, DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
Natlonal Flood lnsurance Program
ELEVATION CERTIFICATE
IMPORTANT: MU$T FOLLOW THE TNSTRUCTTONS oN pAGEs s.t9
all of thls Elevatlon Cerilltcate and all auachmenls for ofliclal lnsurance
oMts Control No. 1$60-0008
Etpk6Uon Dato; 0€/30i2026
and owner,
FOR INSURANCE COMPANY USE
Company NAIC Numbor: *
Policy Number41. Buildins Owne/s Name: SSHI LLC
A2. Bulldlng SVeet Address (lncludlng Apt., Unit, Suito, ond/or Bldg. No.) or P.O. Route and Box
No.:2911 Dapple Gray Way
Cily:Ellensbur0 WA ZIp Co<te: g8926
A3. Proporty Descriplion (e.9,, Lot and Block Numtlere or Legal Dcscriplion) and/or Tax psrcel Number:
Division 7 Lol 10, 962126
Stale:
A4. Bulldlng Use (e,9., Residenlial, Non-Residential, Addition, Accessory, etc.): Resldential
A5. Latitude/Longllude: Lat. N47"0'1'34-9'!58{ Long.W120"34'37.04 HorizontatDatum: fJNAD 1927 ENAO 10Bg ll Wcs s4
A6. Attach al leasl two end when posslble four clear pholographs (one for each slde) of the bulldlng (aee Form pages 7 and B).
47. Bulldlng Dlagram Number; 1B
AB. For a bulldlng wilh a crawlspace or enclosure(s);
a) $quare footago of crawlspace or enclosure(s): N /ft sq, ft.
b) ls lhore al lsast one permanenl llood openlng on two different sldes of each cnclosod area? f] yes [J No I N/A
c) Entor number of permanenl flood openlrtgs ln lhe crawlspaoe or enclosuro(s) within 1"0 fool ebove adJaconl grado:
Non-onglnoorod llood openlng s: AlfLl. Engineered llood openings | . /U /*
d) Tolal nol ope n area of non-snglneered flood openings ln AB.c: J/i-__sa. in.
e) Tolal rsled area ol engineered flood openlngs in A8,c (ottach documenlallon * see lnstruotio ns1: /U/t ,- .. sq, ft.
0 Sum of AB,d and AB,e raled area (il applicabto - sso lnslructlonqt . N f /T ._ aq. fl.
A9, For a bullding with an atlached gar6g€:
a) $quare foolage ol atlachod garage 604,00 sq. fl.
b) ls there et loa$t on€ permanenl flood openlng on two dlfferent sides of ths ailached garage? ft yes [f No f] N/A
c) Enlor number of perrnanent llood oponlngs in lhe aiiachsd garage wllhln 1.0 foot above adlacent grade:
Non-engineered flood openings: -A/^_/k_ Engineored lloorl openlngs: ,il/ A-
d) Tolal nel open area of non-enginoorod llood openlngs ln Ag.c: /// * W.tn.
e) Tolal faled area of engineered flood openlngs ln Ag.c (atlach documenlalion - see lnstruclions): *-_,1V 1!F a9. tt.
f) Sum of A9,d and Ag.o ratcd aroa {tf appllcable - see Instrucllons): ___Nl &* sq.n.
89. Base Flood Flsvation(s) (BFE) (Zone AO, use Base Flood Dopth); 1SBS.9
B10. lndlcale lhe source of the BFE dala or Bese Flood Deplh enlered ln ltern Bg;
E FIS D FIRM n Communtty Determlned l_JOther;
B'l 1. lndlcate elevallon delum used for BFE in ttem B0: I ttcvo 1929 E NAVD 19Bg fJ Olher/Source;
nler Resourc€s syslem (CBRS) area or olherwiso proleclocJ Area (opA)? [ yes @ No
[_] cBRs u oPA
81.b. NFIP Communlly ldsntificailon Number; 53009s
87. FIRM Panel Effoctlvo/Rovlsed Date: 09124 I 2O21
83. StatsWA
81.a. NFIP Community Name: KITTITAS COUNTY
84. Map/Panet No.: 53037C1064 Bf, Sufftx; D
Yes No
82. County Name: KITTITAS
88. FIRM lndex Daio: 0512412021
88. Flood Zone(e)l AE
B1S, ls the looaled soaward of lhe Llmlt of Modsrate Wavo Aclion
812. ls the bulldlng located in a Coastel Ba
Doslgnallon Dale:
FEMA Form FF-206-FY-22-152 (formerly 086-0.93) (10/22)Page 2 ol 19
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCT|ONS oN PAGES S.lg
Rulldlng strset Address {lnc{udlng Apl., unlt, sulle, and/or Bldg. No.}or p.o. Roule and Box No.:
2911 Dapple Gray Way
Clty: Ellens_9_rJlg_ Stare: -WA ZIP Oods: 98926
FOR INSURANCE COMPANY USE
Policy Number;
Company NAIO Number:
C1. Bullding olovations aro bascd on: ff Conslrucllon Drawings' n Building Under Conslruclion" E Finlshed Corrslrucllon'A n€w Elevstlon Cerlificale wlll be roqulrod whan conslruction of lhe bulldlng ls complelo,
(wilh BFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AFVA1-A3O, AR/AH,
lndlcate elevation datum used for lhs elevallon$ ln llems a) through h) bclow.fl NGVD 1e2s El NAVD 1SSS I other:
Datum used for building elevallons tnusl tre lhe same ss lhat used for the BFE. Conversion lactor used?
lf Yes, describe lhe sourco of lhe convorslon lactor in lhe section D commenls area,
a) Top of bottom floor (includlng bassm€nl, crawlspace, or enclosure 0oor);
b) Top of lho noxt hlgher floor (See lnstruclions):
c) Bottom of the lowssl horizonlol skucturel rnomhor (see lnohucllons):
d) Atteched garege (top of slab);
e) Lowesl elevatlon of Machlnery and Equlpment {M&E) serviclng tho bulldlng
(describe type of M&E and locallon ln Secllon D Commonls ar6a);
f) Lowest Ar{acenl Grado (LAG) next to building; f] Naturat [] fmlsneO
g) Hlgh€st AdJacent Grade {HAG} next io buitdtng: I Natural E] ftnistreO
h) Finlshed LAG al lowest olovatlon of afiached deck or slairs, lncludlng slruclural
eupport:
@ foot fl meters
[ff leel I meters
^l
//l [_J foot fJ meiers
nRtno,
ing rneters,
N,
1,588.00
1,588.00
C2. Elsvallons - Zones A1-A30. n E, AH, AO, A
A99, Complete llems C2.a-h below accord lo tho Bulldlng Dlagram specified in ltem AZ. ln puodo Rlco only, enler
Benchmark Utllizod; Cenler of S 27, T '18 R 18 E VerllcalDatum: NAVD 19BB
1,582:90 flfeetImeters
1 ,599.10
1,586.70
I Yes EJ No
Clteck the meaeuremenl used:
fi teet I meters
I laet I meters
fl feel fl meters
p leet I meters
'{v.l*M/k
werc latilude and longltude ln section A provlded by a llcensed land surveyor? fi yes I No
[JCheck here lf sllachmenls and describe ln the Gommenls area,
copy all pages of this Elovatlon certilicato and all altauhmonts for (1) community ofliclal,
Tille: Professlonal Land $urveyor
Company Name: Western Paclflc Engineerlng & Survoy , lno.
Commenls olvzilype Bqulpmonl dnd locallon per
of ths hoat pump raised
anduz,ei desoripllon
Slale: WA ZtpCode: 98837
sourco of conv6rslon taolor ln o{ any atlachmenls):
Heat Purnp pad was measured at the top with the bottom an additlonalelght lnchss wllh legs
cerllficalionThls lois be sealedand laslgned nd aor rchltoctbyenglnaer,6UrVOyOr,aulhorlzed slate lolawby elovalloncedify
lnformallon that lhe lnlarmallon lltlsoncsrftly Cotilflcals besl toellodsrepresenlsmy Iha avallable,dalalnlarprol undersland thal anyslalemenlfalsobeorlinemaypunlshableunderu.s,1B Secllon 1001byimprisonmentCoda,
(2) lnsuranco agenUcompany, and (3) bullding ownar
Addrsss: 1224 S, Pioneer Way
Cortifle/s Name; Rlck Skinnor Llconse Number:436't9
Emall: rsklnfier@wpo765.1023 Exl.:
City: Moses
Slgnalure:
Telephono:,:::;,444-
FEMA Form FF-20B"FY-22-152 (formerly 0S6"0-33) (10/22)Page 3 oI 19
ELEVATION CERTIFICATE
IMPORTANTI MUST FOLLOW THE INSTRUCTIONS oN PAGE$ 9.I9
Bullding Streel Addross (tncludhrg Apt., Untt, $ulte, and/or Btdg.
Clty:Ellonsburg
No.) or F.O. Roule and Box No.:
2911 Gray Way
Slate: WA ZIP Code: 98926
FOR INSURANCE COMPANY USE
Policy Numbor: ___..,,,_
Company NA|O Number;
Bullding measuromonls are based on: I' l Construcllon Drawings' fJ Building llnder Construclion' f] Flnished ConstruclionrA new Elevallon Ce{iflcale will be required whsn construcllon of lhe b;lldlng ie comptete
E1' Provide mea$uretn€nls (C,Z,a ln appticablo Building Dlagram) for the followlng and chock tho approprlats Soxes to ehow whether lhemeasuremenl ls above {)r below the nalurol HAG and ihe LAc,
crawlspece, or enclosure) is: fJ feet lf melers I abovo or I below lhe LAG,
E2. For Building Diagrants 6-0 wlth pormanent flood openlngs providod ln Sectlon A ltems 8 and/or g (eee pages 1-2 of lnslruclons), lhenoxl higher lloor {C2.b tn appllcable
[_J leet f] metars I abovo or I betow the HAG.
E5. Zons AO only: lf no llood deplh number ls avallable, is lhe iop of tho botlom floor elevalsd ln accordance wi(h lhe communll/s
floodplaln msnagomonl ordlnanoe? [-l Yes l-l tlo I Unknown The local oIfictal musl cerilgr thls lnformatlon in Section G.
For Zones andAFYAO,AO,A (wilhout llems ForE1-E5,El!6ms usc nalur6tBFE),completo 1*E4,av€rfllable.thegrada,Gerllficate lstolntendcdSUgofLellerpportChangeMapSecllonsandGheckc.complelerequesl,A,B,moasurom6ntlhe u$ed.ln RicoPuorto nly,meters.enler
Buildlng Dlagram) of lhe bulldlng ls:
a) Top of bollom lloor (lncludlng basemenl,
crawlspace, or enciosuro) is:.
b) Top of botlom floor (induding basemonl,
fl feol fl maters I above or [_J betow the HAG,
I feel I meters I above or f] bolow the HAG.
E3. Allached garago (top of slab) is:
E4. Top of plalform of machlnery and/or equipmont
sorvlclng lhe buildlng ls:I feot I meters I above or [] botow the HAG.
completes Saclione A, B, ond E for Zone rd (without BFE) or Zone AO musl
lo lhe best ol my knowledge
l] Check here lf al,tachmenls and dsscribo in the Commenls area.
Properly Owner or Owne/s Aulhorized Repreoentativs Name: Scot{ Hgnson
Moses Lake
Ext.
Clty:Stale: WA Zp Code: gBB37
The property ownor or ownor's aulhorizod representalive who
s'gn here. Ihe slalemonls in Secllons /, B, and E ara corroct
Commenls;
Emall: shenson@wp6lnc,not
Arldressr 1224 8. Pioneer Way
Telephone: {509) 765-1 023
Slgnature:Dsto: (,/tt
FEMA Forrn F F -206-F Y -22-1 52 (fonnerty 080-0-g g) ( 1 0/22)Page 4 of ',l9
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.1S
Building Street Address (including Apt.. Unil, Suite, and/or Bldg. No.) or P.O. Route and Box No.
2911 Dapple Gray Way
City:Ellensbu Srare; WA Zlp Code: 98926
FOR INSURANCE COMPANY USE
Policy Number:
Company NAIC Number:
sEcTtoN G - GOMMUNTTY TNFORMATTON (RECOMMENDEO FOR COMMUN|TY OFF|C|AL COMPLETTON)
E and H.
The local official who is authorized by law or ordinance lo adminisler the communily'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. f] fne 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. (lndicate the source and date of the
elevation data in the Comments area below.)
[-l R Ocat official completed Section E lor a building located in Zone A (wilhout a BFE), Zone AO, or Zone AR/AO, or when item
E5 is completed for a building located in Zone AO.
G2.a
G2.b.
G3,
G4.
G5.
G7,
G8.
G9.a.
G9.b.
G10.a.
G10.b.
E I tocat official completed Section H for insurance purposes.
ff tn tre Comments area of Section G, the local official describes specific correclions to lhe information in Sections A, B,
El fne following informalion (ltems G5-G1 1) is provided for communiry floodplain management purposes.
Permit Number; FD-22-00015 G6. Date Permil lssued 0310212022
Dale Cerlilicate of Compliance/Occupancy tssued: 0811812023
This permit has been issued for: E ru"w Construclion I Substantial lmprovement
Elevation ol as-built lowest floor (including basement) of thebuilding: 1,588.00 [ feet I meters Darum: NAVD 1988
Elevalion of boltom of as-built lowest horizontal structural
member:f, feet I meters
I meters
Datum
BFE (or depth in Zone AO) of flooding at the building site 1,585.90 E feet Darum: NAVD 1988
Community's minimum elevation (or depth in Zone AO)
requirement for lhe lowesl floor or lowest horizontal slructural
member:1,586.90 I reet I meters Datum; NAVD 1988
G11. Variance issued? ! Ves [J f.lo lf yes, attach documentalion and describe in the Comments area,
The local official who provides information in Section G must sign here. I have completed the inlormation in Seclion G and cerlify that it is
conect lo fAe 0est of my knowledge. lf applicable, I have also provided specilic correclions in the Comments area of this section.
Local Official's 11srng; Samintha Cox Title:Water Resources Specialist
NFIP Community Name: Kittitas County
Telephone: (509) 962'7523
Address:411 N. Ruby St.. Suite 1
Exl.: Email:publicworks@co. kittitas.wa. us
City;Ellensburg State: WA Ztp Code: 98926
Signature:Oate: 08/18/2023
Commenls (Lncludtng lype of equipment and location, per C2.e; description of eny attachments; and conections to specitic 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-tg
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.0. Route and Box No.
2911 Dapple Gray Way
City:Ellensburg State: WA Ztp Code: 98926
FOR INSURANCE COMPANY USE
Policy Number:
Company NAIC Number:
SECTION H - BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES
(suRvEY NOT REQUTRED) (FOR TNSURANCE PURPOSES ONLn
The property owner, owner's aulhorized represenlative, or local floodplain managemenl official may complete Seclion 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 fool (nearest tenth o{ a meler in Puerto Rico). Reference the Foundation Type Dtagrams (at the end of Section H
lnstructions) and the appropriate Building Diagrams (at lhe end of Section I lnstructions) to compleae thr secfion.
H'l . Provide the heighl 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 crawlspaces or enclosure floors) is;
1.30 S feet I meters @ above the LAG
b) For Building Dlagrams 2A,28'4, and 6-9, Top of next
higher floor (i.e., the floor above basement, crawlspace, or
enclosure floor) is:
NJ lft n feet I meters I above the LAG
H2. ls all Machinery and Equipment servicing the building (as listed in ltem H2 instructions) elevated to or above the floor indicated by lhe
H2 arrow (shown in the Foundation Type Diagrams at end of Section H instructions) for the appropriate Building Diagram?
I Yes E tto
sEcTroN r- PRoPERTY OWNER (OR OWNER'S AUTHORTZED REPRESENTATTVEI CERT|F|CAT|ON
The property owner or owner's authorized representative who cornpletes Sections A, B, and H must sign here. The statements rn Sections
A, Q, anl H are correct to the bcsl of my knowledge. Noto: lf the local floodplain management official completed Section H, they should
indicale in ltem G2.b and sign Section G.
I Check here if attachments are provided (including required photos) and describe each altachment in the Comments area.
Property Owner or Owner's Authorized Representative Name
Address:
City:State:_ ZIP Gode:
Signature:
Telephone
Date:
Ext.: Email:
Commenls
FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10122')Page 6 of 19
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE TNSTRUCTTONS ON pAGEs s-l9
BUILDING PHOTOGRAPHS
See lnslrucllons tor ltem 46.
FOR INSURANCE COMPANY USE
Policy Number: .-.
Company NAIC Number:
Bullding strool Address (lndudlng Apt., unit, suite, and/or Bldg. No,) or p.o. Route and Box No.:
2911 Dapple Gray Way
Cily; Ellensburg State: WA Ztp Code: 9gg26
and when posslble four photographs
lownhouses/rowhouses). ldenllfy ell
lnsertlnslruclbns:atbelow twoleael each side lheofshowing (forbullding bemayexample,onlyloablefronltakebackandofpiclureswiihdalelhelakenphotographsanduRear"Fronl View,View,Slde"Lofl View.Side Vlew,or musl'Rlghl lheshow Whenloundallon.Pholographs llood areopenings atlnclude oneleaslpresenl,
ofpholograph flood orclose.up represenlatlve v9nlB,lndlcaledas Secllonsin A8openlngs erd 49.
Pholo One
Clear Pholo OnoPhoto Ono Gapllon: Front Vlew
Photo Two
Oear Pholo TwoPhoto Two Captlon: Slde Vlew
FEMA Form FF-206-FY-22-152 (formerly 0S6,0-99) (l}t?,2l Page 7 of lg
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIoNS oN PAGES 9-I9
BUILDING PHOTOGRAPHS
Conlinuation Page
FOR INSUMNCE COMPANY USE
Policy Number: _
Company NAIC Number: _
Bulldlng street Address (lnctudlng Apt., Unil, suits, and/or Bldg. No.) or p.o. Route and Box No.:
2911 Dapple Gray Way
below' ldentifu all photographs with lhe date laken and 'Fronl Vlew," ,,Rear Viow,, "Rlght gide
openlngs are presonl, lnclude al leasl one close-up photograph of representallve floodipenings or
AS.
Clly:Ellensburg Slale: WA Ztp Code: 98926
lnserl lhe lhhd and fourlh photographs
View,'or *Lefl Slde View.'When llood
venls, as lndicaled ln Ssctlons AB and
Pholo Three
Claar Photo ThreePholo Three Captlon: Back View
Photo Four
Clcar Pholo FourPhoto FourCaptlon: Slde Vlew
FEMA Form FF-20$FY-22-152 (formedy 086.0-9A) (10/22)Page 8 of 19
U.S. DEPARTMENT OF HOMELAND SECURITY
Fedoral Emergency Management Agency
National Flood lnsurance Program
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES e{9
all of thls Elevation Certifioate and all attachments for nsurance
OMB Control No. i66&0008
Expl atlon Date: 00/30/2028
and owner.
FOR INSURANGE COMPANY USE
A1. Building Owner's Name: SSHI LLC Polioy Number: _
Company NAIC Number;A2. Bultdlng Street Address (lncludlng Apt., Unlt, Sulte, and/or Bldg. No.) or P.O. Route and Box
No':2995 Daoole Grav Wav
City: Ellensburg ,,.. State: ...WA- _ZlPCode: 98926
A3. Property Descdplion (o,9., Lot and Block Numbers or Legal Descrlptlon) and/or Tax Parcel Number:
Division 7 Lot 13, 962129
A4. Bulldlng Use (e.9., Resldentlal, Non-Resldenllal, Addillon, Accessory, elc,): Residentlal
A5. Latitude/Longllude:Lat. N47"01'23.69' Long.W120"34'44,64" Horizontal Dalum:ENAD 1e27 ENAD 1ee3 fl WGS 84
46. Attach al leasl lwo and when possible four clear photographs (one for eadr side) of the buildlng (see Fonn pagos 7 and 8).
A7. Building Diagram Number: 19
AB. For a bulldlng wlth a crawlspace or enolosuro(s):
a) Square footage of crawlspace or enclosure(s): il I t4- sq.ft.
b) ls lhere at least one permanent llood opening on two different sides of eaoh enclosed area? f] Yes f] No E N/A
c) Enler number of permanenl flood openings in the orawlspace or enclosure(s) wi{hin 1,0 foot above adjacent grade;
Non-engineered llood openings /y,/f Engineered llood openingsi ,i/ /lL
d) Total net open area of non+ngineered flood openlngs in A8.c: j//tF sC.ln.
e) Total rated area of engineer€d flood openlngs ln A8.c {attach documentatlon - see lnstructlons):
f) Sum of AB.d and A8.e rated area (lf applicable - see lnshuctions): A./ ,,,rt* sq. ft.
,P /tt*--.--...---.7--
A9. For a building with an attaohed garage:
a) Square foolage of attaohed garage:604.00 sq. ft.
b) ls lhere at least one permanent flood openlng on two different sides of the attached garage? ! Yes I No I N/A
c) Enler number of permanenl flood openings in the attached garage wilhin 1.0 foot abpve adjacent grade:
Non-engineered flood openings; // /.,4* Engineered flood openings, /Ul'?
d) Total net open area of non-snglneered flood openings in A9.c _&.f tj* -sC,tn.
e) Total rated area of engineered flood oponings in A9.c (attach documontation - see lnstruclions):I /* sq.ft.
f) Sum of A9.d and AO,e raled area (if applicable - see lnshuclions):s9.fi.
81,a. NFIP Community Name:KITTITAS COUNTY 81.b. NFIP Communlty ldentilication Number: 630095
82, County Name:KITTITAS 83, $tato: WA 84. Map/PanelNo.: 53037C1064 85. Suffir D
86. FIRM lndex Dale: 0912412021 87. FIRM Panel Effeotive/Revised Dale: 0912412021
88. Flood Zone(s): AE 89. Base Flood Elevatlon(s) (BFE) (Zone AO, use Base Flood Depth): 1584.8
lndioate the source of the BFE data or Base Flood Depth entered in ltem B9;
E FIS fJ FIRM E Communlty Oelermlned flOther:
lndlcate elevation datum used for BFE in ltem Bg: I NGVD 1929 EJNAVD 19Bg fJ Olher/Source:
Is lhe building located in a Coastal Barrier Resources System (CBRS) erea or Othefflse Protected Area (OPAp I Yes [] No
Designalion Date:flcBRs [oPA
ls the bullding located seaward of the Limit of Moderate Wave Acllon Yes lTl No
sq, ft.
B10.
811.
812.
813.
FEMA Form FF-20A-FY-22-152 (formerly 080-0-33) (10/22)Page 2 of 19
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW TIIE INSTRUCTIONS ON PAGES 9"I9
FOR INSURANCE COMPANY USEBuilding StreetAddress (lncluding Apt,, Unit, Suite, andlor Bldg. No.) or p.O. Route and Box No.:
Ciiy:Ellensburo
2905 Daoole Grav Wav
Slate: WA Ztp Goder 98926
Policy Number: _
Company NAIC Number:
C1. Building elevations aro based on; I Constructlon Drawinger I Building Under Construcllon* [ Finished Conslruolion*A new Elevetlon Cedlficate wlll be required when oonstruotion of lhe bullding ls complete.
C2. Elevalions - Zones A1*A30, AE, AH, AO, A (wilh BFE), VE, V1*V30, V (wtth BFE), AR, AR/A, AR/AE, AFyAI-A90, AR/AH, AR/AO,
A99. Complele ltems C2,a-h below according to the Building Diagram spocified ln ltem A7. ln Puerto Rico only, enler meters.
lndlcate elevallon datum used for the elevalions in itoms a) through h) below.
fl NGVD 192e E NAVD leBB ! other:
Datum used for bullding elevaliona must be lhe same as thal used for the BFE. Conversion factor used?
lf Yes, describe the souroe of the conversion factor in the Seotlon D Comments area.
a) Top of boltom lloor (including basement, crawlspace, or enclosure floor):
b) Top of the next higher floor (eee lnstructions):
c) Bottom of the lowesl horizontal struotural member (see lnslrucllons):
d) Atlachod garage (top ofslab)t
e) Lowest elevation of Machlnery and Equlpment (M&E) servicing lhe bullding
(desoribe type of M&E and location in $ection D Comments area):
Q Lowest AdJacenl Grade (LAG) next to buildlng; I Naturat fu f inirn.O
g) Hlghesl Adjacent Grade (HAG)next to building: I Natural I finrcneO
h) Flnlshed LAG at lowest elevalion of attached deck or s{airs, lncluding skuclural
supporl:
1,587.10 [] feet I meters
1,586^10 $ feot I melers
Benchmark Ulllizedl Center of S 27 TlBN
^. -N 'r* [ feet I merars
. .1,587,40
fti/1,
luih
1,587.40
fl Yes E No
Check lhe measurement used;p feet I melers
I feet f] meters
il feet I meters
@ feet I metere
1,587.19 fi feet fl melers
R 18 E VertioalDatum: NAVD 1988
oz
This certilicetion is to be signed and sealed by a land surveyor, engineer, or srchilecl authorized
lnformatlon, I ceftlfy lhat the lntormation on thls Ceftlflcate represenls my best elforts to lnteryret
false sfalement may be puntshable by line or imprisonment under 18 u.8. code, seclion 10a1.
Were latltude and longllude ln Seclion A provided by a lioensed land surveyor? [ yes ff No
I Check here if altachments and doscrlbe in the Gommenls ar€a.
Certlfie/s Name: Rlok Sklnner License Number:43619
Copy all pages of this Elevatton Cedificate and all attachments fot (1) community oflicial, (2) lnsurance agenVcompany, and (3) building ownor.
Tiile: Professlonal Land Surveyor
Company Name: Western Paclflc Enolneerino & Survov , lnc.
attachmenls):
city:Moses State: WA ZlPCode; 98837
Comments (includlng source of conversion factor ln C2; type of equipment and locallon per C2.e; and description of any
Heat Pump pad was measured at the top with the bottom of the heat pump raised an addillonal elght inches with legs
by stale law to certlfy elevalion
lhe data avallable. I undersland that any
Address: 1224 S. Ploneer Way
Signature:
Tolephone;765-1023 Ex[: .- Email:
FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10122',Page 3 of 19
ELEVATION CERTIFIGATE
IMPORTANT; MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.19
FOR INEUMNGE COMPANY USEBuildlng Street Address (lncludlng Apt., Unit, Suite, andior Bldg. No,) or P.O. Route and Box No.:
_. 2905 Dapple Gray Way
City:Ellensburs Slale: WA ZP Code: 98926
Company NAIC Number:
Policy Number:
For Zones AO, ARfAO, and A (wllhout BFE), complele ltems E1-E6. For ltems E1-E4, use na{ural grade, if available, lf the Ceriifioate is
lntended lo support a Letler of Map Change request, complele Sections A, B, and C. Gheck the measuremenl used. ln Puerto Rico only,
enter meters,
Building measurements are based on: I Conelructlon Drawings* [ auitOing Under Construction* @ Flnlshed Construclion
*A new ElevaUon Cediflcate will be requlred when construction of the building is complete.
E1. Provide measurements (C.2.a in applicable Bullding Diagram) for the following and oheok the appropriate boxes to show whether the
measurement ls above or below the natural HAG and lhe LAG.
F2. For Bulldlng Dlagrams 6-9 wlth permanent flood openings provlded ln Sectlon A l(ems 8 and/or g (see pages 1-2 of lnslruotions), the
E3. Altachedgarase(lopof slab) is: l] feet f] meters I aboveor I belowtheHAG,
E4. Top of platfotm of machlnery and/orequipment
seruioing the building ls: f] feet f] meters I above or I below the HAG,
E5. Zone AO only: lf no flood depth number is avallable, is the lop of lhe boltom Roor elevated ln accordance with ihe community's
lloodplaln management ordinance? [ Yes fl No E Unknown The local offlclal musl certlry ftis lnformallon ln Sectlon G.
a) Top of bot{om floor (including basoment,
crawlspace, or enclosure) is:
b) Top of botlom floor (including basement,
crawlspace, or enclosure) is:
I feet f] meters I above or fl below the HAG.
I feet I motors I above or f] below the LAG.
next higher floor {C2.b ln appllcable
Building Diagram) of the building is:I feet I meters fl above or ! below (he HAG.
The property owner or owner's aulhorized represenlalive who compleles Sections A, B, and E for Zone A (without BFE) or Zone AO must
sign here. Ihe statemenls in Seclions 4 B, and E are corrcct lo the bost of my knowledge
fl Check here if attachments and describe in the Comments area.
Property Owner or Owne/s Authorized Represenlalive Name: Scott Henson
Date:4,1q,/n"*7
Comments:
Email: shenson@wPelnc.net
City:Moses Lake
Address: 1224 S, Ploneer Way
Signature:
State: WA ZIP Code: 98837
Telephone: (509) 765'1023 Ext:
FEMA Form FFA08-FY-22-152 fformerly 0864-33) (10/22)Page 4 of 19
EI.EVATION C ERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19
Building street Address (including Apt., unit, suite, andior Bldg. No.i or P,O. Route and Box No,:
2905 DaPPle Gray Way
City:Ellensbu State: . WA ztP CoOe: 98926
FOR INSURANCE COMPANY USE
Policy Number._-__-
Company NAIC Number:
SE CTION G COMMU Ntw IN FORMA TI ON (RECOMMEN DED FOR COMMUN tw OFFI CIAL coMPLETION)
The local ofiicial who is Euthorized by law or ordinance to administer the community's floodplain management ordinance can complete
Secfion A-9, C, E. G, or H of this El6vation Certificate. Complete the applicable item{s) and sign below when:
G1. D fne information in Section C was taken from other documenlation lhat has been signed and sealed by a licensed surveyor,
engineer, or archilect who is aulhorized by state law to cerlify elevalion information. (lndicate the source and date of the
ele-valion data in the Comments area below.)
G2.a. ! A local officiat comptered Section E for a building located in Zone A (withoul a BFE), Zone AO, or Zone AR/AO, or when item
E5 is completed foi a building located in Zone AO'
G2.b. K A local official completed Section H for insurance purposes.
GB. f] tn tne Commenls area of Seclion G, the local official deseribes specific correclions to the information in Sections A, B, E and H
G4, E Tn"followinginlormation(ltenrsGS-G11)isprovidedforcommunityfloodplainmanagementpurposes'
G5. Permit Number:FD-22-00018 G6. Date Permit lssued:o310212022
G7. Date Ce(ificate of Compliance/Occupancy lssued:
GB. This permit has been issued for: E t,tew Construction I Substantiat lmprovement
G9'a. 6;sv61;on of as-built lowest floor (including basement) of the
building:1,587.40 B leet n meters Datum: NAVD 1988
G9.b. E1ev31ion of boltom of as-built lowesl horizontal struclural
member:ry- tn flfeet I meters Datum:
G10.a. BFE (or depth in Zone AO) of flooding at the building sile:
G 10'b' g6lnnlenity's minimum elevation {or depth in Zone A0)
requirement for the lowest floor or lowest horizontal slructural
member;
1 584.80 E feet I meters Datum: NAVD 1988
1,585.80 B feet n melers Datum: NAVD 1988
G11. Variance issued? fl Yes E tto lf yes, attach documentation and describe in lhe Comments area.
The local oflrciat who provldes informalion in section G must sign here- I have, comple-t?d t!P_if9r^3!on^in Seclion G.and celtily that it is
;;;r;;t t; ti;E;iiior ki iniiltii6l6. i iipiii"iore-,i nive atso phvided speciric coriections in the comments area or this sedion.
Local Official's 11srng; Sam€ntha Cox Title Water Resources SPecialist
NFIP CommunilY Name:Kittitas Countv
Telephone: (509) 962-7523 Ext.:Email:Pub licworks@co. kiltitas,wa.us
Address:411 N, Ruby Street, Suite 1
CitY:Ellensburg State: WA ZIP Code: 98926
-
Signature:oarc:0912812023
Commenls
Sections A.
of eguipment and location, per CZ.e; descriplion ol any attachments; and corrections lo specilic informalion in
):
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
FOR IN$URANCE COMPANY USEBuilding street Address (including Apt., Unit, suite, and/or Bldg. No.) or p.o. Route and Box No.:
City Ellensburq State: WA ZIP Code: 98926
2905 Dapple Grav way
Company NAIC Number: _
Policy Number:
INFORMATIONNsEcTroHBUILDING'S TFIRS HEFLOOR TIGH ALLFOR ZONE s
NOTRVEY R(su RANCENSU oPURPOSES N(FOREQUTRED)L Y)
The Propeny owner. owner's authorized represenlalive, or local floodplain management official may comp,ete Section H for all flood zoneslo delermine the building's {irst lloor height for insurance purposes, Sections A, B, and I must also 6e completed. Enter heights to lhe
f:j::l.1i1t!,oj_a foot (nearest tenlh of a meter in Puerto.Rico) , Refere-nce the Foundation Type Dtagratms (at the ena irseclion l,hstructions) and ,he aPpropriate Building Diagrams (at the end of Secfion t Instructioni)'to cortplete tllrs iec-iion. - ------
H1. Provide the height of the top of the floor (as indicaled in Foundalion Type Diagrams) above the Lowesl Adjacent Grade (LAG):
H2' 19^all Machinery qnd qqlflgll,:911",-1gll,e building (as.listed in ltem. H2 instructions) elevated to or above the ftoor indicated by lheH2 arrow {shown in the Foundation Type Diagrams ai end of Section H instrucrions) tol tne appiop-rilte euitdi;ig Eii[r;;? -'"-
flYes E wo
a) For Bulldlng Dlagrams 1A, 18, 3, and S-9, Top of boltom
lloor (include above-grade floors only for buildinqs with
subgrade crawlspaces or enclosure iloors) is:
1.30 E feet I meters fi above the LAG
b) For Building Diagrams 2A,28,4, and 6-9. Top of next
higher floor (i.e.,.the floor above basement, crawlspace, or
enclosure floor) is:
D feet l] meters il above the LAG
SEGTION I- PROPERTY OWNER (OR OWNER'S AUTHORIZED REPRESENTA TlvE) cERT|FtcATtoN
The property owner or owner's authorized representa
A, B, and H are correct to the besl of mv knowledae
indicate in ltem G2.b and sign Seclion G.
tive who compleles sections A, B, and H must sign here. rhe sfalemenls ln seclions
Note: lf the local floodplain managemenl official completed section H, they should
f Checf here if attachments are provided (including required pholos) and describe each atlachment in the Comments area.
Property Owner or Owner's Authorized Represenlative Name
Address:
City:State ZIP Code:
Signalure:
Telephone:
Date:
Ext.Email:
Comments:
FEMA Form FF-2O6-FY-22-152 (formerty 086-0-33) l1\tz7)Page 6 of 19
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9"19
BUILDING PHOTOGRAPHS
See lnstructions for ltem 46.
FOR INSURANGE COMPANY USE
Policy Number;
Company NAIC Number:
Bulldlng Slreet Addreos (includlng Apt., Unit, Sulte, and/or Bldg. No.) or P.O. Route and Box No.
lnslruclions: lnsert below at leasl two 6nd when possible four photographs showing each side of ihe bullding (for example, may only be
able lo take itont and back piotures of lownhouses/rowhouses). ldentlfy all pholographs wlth the date taken and "Front MeW" ;Reai Vlew,'
"Right Side View,'or "Left Side View." Photographs must show lhe foundalion. When flood openings are presenl, include at leasl one
close-up photograph ol representalivo flood oponings or veqts, as indicaled in Seotions AB and Ag.
Gity:Ellensburg
2905 Dapple Gray Way
Slale: WA ZIP Code: 9B926
Photo Ono Caption: Front View
Pholo Two
.cte.iiP..txPhoto Two Caption: Side View
FEMA Form FF-206-FYA?-152 (formedy 080-0-33) (10i22)Page 7 of 19
ELEVATION CERTIFICATE
IMPORTANT; MUST FOLLOWTITE INSTRUCT|ON$ ON PAGES 9..t9
BUILDING PHOTOGRAPHS
Continuation Page
FOR IN8URANCE COMPANY USE
Policy Number: _
Company NAIG Number;
Bullding StreetAddress (including Apt.. Unil Sulte, and/or Bldg. No.) or P.O. Route and Box No.:
lnserl lhe lhird and fourth photographs below. ldenlify all pholographs with lhe dale taken and "Front Vlew,'' "Rear Visw," 'Right Side
View," or "Left Side View." When flood openings are presenl, lnclude at leaet one close-up pho{ograph of representative flood openings or
vents, ae indicated in Seclions A8 and A9.
City; Ellensburg - _ State: WA ZIP Code: 98920
2905 Dapple GrayWay
Pholo Three
Pholo Three Caption: Back View
Photo Four
::.,;1. ..
Pholo Four Gaption; Side Vlew
FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22)Page B of 1€
320 Mt
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 rnap 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:
o Whether a property is in or out of the SFHA as shown on the curent Flood Insurance
Rate Map (FIRM), including the following information:the FIRM zone and base flood
elevation or depth, if available; the Community Number, PanelNumber and Suffix;the
date of the FIRMS's Index;the elevation datum.
o Whether a property is in the floodway.
o Known flood problems that are not shown on the FIRM, such as dam failure inundation
areas or drainage problems.
o The depth of expected flooding (not available in all areas).
o Other flood relatedhazards, such as information relating to ice jams or erosion.
o Historical flood information and photos.
o Information about areas that should be protected, such as wetlands or critical habitat.
. Handouts on the National Flood Insurance Program.
o Copies of completed elevation certificates.
If you would like to make an inquiry, please call 509-962-7523. kll us the parcel number or
street address. There is no chargefor this service.
Much of this information is also available on our COMPAS online mapping service at
http://eis.co.kittitas.wa.us/compas/default.aspx and at FEMA s Mapping Service Center
https://msc.fema.sov
Visit the Kittitas County Floodplain Management webpage (www.co.kittitas.wa.us/public-
works/flood) for:
o more information on flooding in Kittitas County;
o directions on how to use COMPAS to determine if a property is in the floodplain; and
o to conduct an online Elevation Certificate Search (many of county's elevation certificates
are available online).
411 N Ruby St, Suite 1
Ellensburg WA9B926
T:509.962.7523
F:509.962.7663
320 Mr
One page log
Mt5
Historical
Flood lnfo
Mt 7
Natural
Floodplain
FunctionAddressTypeDatePanel ZoneJurisdication Parcel No.
Mt2
Floodway
Ml L lns
/ FIRM
7/L8/2o23 Call
tl23/2023 Call
2/912023 Call
2/Ls/2023 Call
3/L/2023 Call
3/24/2023 Call
90 Heron Dr Kittitas Countv
2912 Roan Dr Kittitas County
3004 Roan Dr Kittitas County
901 Kiias Elk Trail Kittitas County
2912 Roan Dr Kittitas County
816 Lincoln Ave South Cle Elum
470764
951575
961579
645334
951575
950508
0654D AE X
1064D AE X
1064D AE/X X
0666D AE X
1064D AE X
0679D AE/X X
X
X
X
X
X
3/2712023 Call/ Email
4/L2/2O23 Call
s/4/2023 Call
s/Lo/2023 Call
170 Meadow Park Dr Kittitas Cou
2906 N. Pioneer Rd Kittitas County
230 Swallow Ln Kittitas County
781Wapiti Dr Kittitas County
667734
52733
131334
160534
0631D AE X
X1070D X
0554D AE x
0554D AE X
X
X
X
5/26/2023
slLs/2o23 Call 2631Millstone Ellens
5/18/2023 Ca Email 3870 Reecer Creek Rd Kittitas Cou
Call/ Email 670 Quail Run Ln Kittitas County
s/30/2023 Call 1001 Sanders Rd Kittitas County
6/!/2023 Call/ Email 21 Sun lsland Dr Kittitas County
6/t/2023 Call/ Email 911 Kiias Elk Trail Kittitas Countv
6/212023 Call 3001 Dapple Gray Way Kittitas Countv
949755
866233
10605
946233
511834
32s334
962122
1070D X
1O7OD AE
1260D AE
X
X
X
1070D AO X
0531D AE X
0656D AE X
1054D AE X
X
X
X
X
X
X
X
6/712023 Call
6/L2/2023 Call
7/5/2023 Call
7/612023 Call
7/!3/2023
541 Heron Dr Kittitas Cou
160 Mowich Ln Kittitas Count.v
301 McElroy Rd Kittitas County
370734
770534
5to734
961576
557435
894635
645334
280734
063234
L7540
0654D AE X
X0654D AE
0654D AE X
I054D AEIX X
0393D AE X
1033D AE X
0556D AE X
0654D AE X
0656D AE X
1234D AE/X X
X
X
X
X
X
X
2916 Roan Dr Kittitas County
Call 301 Boondogle Rd Kittitas Count-v
7/2612023 Call/ Email 10780 N Thorp Hwy Thorp
8/812023 Call 901 Kiias Elk Trail Kittitas Countv
8/1412023 Call/ Email 91 Black Bear Dr Kittitas Countv
8/2L12023 Call 1260 Pebble Beach Dr Kittitas Countv
8/22/2023 Call 2234 Woodhouse Lp Kittitas County
8/2s/2023 Call
9/712023 Call
9/Lt12023 Call
9lLs/2023 Email
9/20/2023 Call/ Email
Number 6 Rd Kittitas
1010 Brown Rd Kittitas County
2815 Dapple Gray Way Kittitas County
583 Heron Dr Kittitas County
583 Heron Dr Kittitas County
L2309 t292D AIAE/X X
178233 t277D AE X
961597 1064D X X
350734 0654D AE X
350734 0654D AE X
X
X
X
X
9/2612023 Call/ Email 501 Penny Ln Kittitas County 954225 L26OD AE X
X X
.4, a. -" --"!. ..
.-KITTITAS COUNTY
FLOOD CONTROL ZONE DISTRICT
(Owner First> <Owner Last))
<Mailing Address>
<City>, <State> <Zip>
October 2,2023
Regarding Parcel # <All Parcel #s>
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 Nifio is expected to continue through lhe 2023-2024 winter, bringing warmer than normal
temperatures and higher precipitation, You have received this letter because vour propertv listed above is in
an area that has flooded several times. Here are some things you can do to reduce your flood risk:
Contdct 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
ln 2023 Kittitas County completed a flood hazard assessment along an 11-mile Yakima River
reach starting at the Easton Diversion Dam down to the l-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-
worksff lood/reports.aspx
Prepore for flooding:
r Know how to shut off the electricity and gas to your house when a flood comes.
o Make a list of emergency numbers and identify a safe place to go.
r Make a household inventory, especially of basement contents.
o Put insurance policies, valuable papers, medicine, etc., in a safe place.
o Collect and put cleaning supplies, camera, waterproof boots, etc., in a handy place.
r 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 meosuresi
o 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
Ellensburg, WA98926
T:509.962.7523
F:509.962.7663
Flood Control Zone District
Page 2
r Consider elevating your house above flood levels.
o 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.
o lnstall a floor drain plug, standpipe, overhead sewer, or sewer backup valve to prevent sewer backup
flooding.
e More information can be found at the FEMA's Homeowner's Guide to Retrofitting, Six Woys to
Protect Your Home from Flooding (FEMA P-312).
o 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 finoncial assistance options:
o Grant funding may be available for home elevation, home relocation, or property acquisition -
contact Flood Control District staff for more information.
o 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 llood insuronce:
o Homeowner's insurance policies do not cover damage from floods. However, because our
community participates in the National Flood lnsurance 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.
o lf your home is not within the 100-year floodplain, you may qualify for a lower-cost Preferred Risk
Policy.
o 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.
e Don'twaitforthe nextflood to buy insurance protection. ln most cases, there is a 30-daywaiting
period before National Flood lnsurance Program coverage takes effect.
o Contact your insurance agent for more information on rates and coverage.
For more information on flooding within Kittitas County, visit the County's Flood lnformation Website at
www.co.kittitas.wa.us/public-works/flood. Please contact us at 509-962 -7523 if you have questions.
Sincerely,
q><
Samantha Cox, CFM
Water Resources Specialist
CRS Activity 510
Annual Progress Report on lmplementation of Credited Plan
Which Plan is this for (use separate templates for each credited Plan):
X FlooOplain Management Plan (Hazard Mitigation Plan)
! Repetitive Loss Area Analysis
I flooOplain Species Plan
! Substantial Damage Plan
Name of Community: Kittitas County
Date this Annual Progress Report was prepared (not the date of adoption of the creditedPlan): October 04,2023
Name of Plan: Kittitas County Multi-Jurisdictional Hazard Mitigation Plan
Date of Adoption of Plan: September 3, 2019
5 Year CRS Expiration Date: 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: publicworks@co.kittitas.wa.us. The plan is also available for
download through our website httos://www co kittitas.wa. u s/oub I ic-works/haza rd -
mitioation-ola n/default.aspx
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 lnitiatives 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 u nincorporated Kittitas County Mitigation I nitiatives.
4. Discuss why any objectives were not reached or why implementation is behind
schedule:
lmplementation 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. This update will consider new information that is
available (i.e., a regional air quality initiative in response to wildfire smoke, a
Community Wildlife Protection Plan amendment, and the Easton Reach Flood
Hazard Study). Additionallv, we have reached out to the City of Kittitas, who did not
participate in the 2019 update, to encourage this localjurisdiction to participate in the
2024 updale.
Kittitas County
Hazard Mitigation Plan
2023 Annual Report (October 1,2022 - September 30, 2023)
Kittitas County
q.l
r
lt
'ChmdrffimBEtd
fiCl
Hghrrrtr
Channel Migration Risk Hazards, Easton Reach Floodplain
County-Wide Mitigation Initiatives 20L9 Kittitas County Hazard Mitigation plan
2023 Annual Progress Report (October I,2O22 - September 30,20231
StatusDescriptionNo.
CW-1 High
CW-2 Medium
Continue to maintain a countywide hazard mitigation plan website to house the plan and
plan updates, in order to provide the public an opportunity to monitor plan
implementation and progress. Each planning partner may support the initiative by
including an initiative in its action plan and creating a web link to the website. Updates
will occur annually, or more often as appropriate.
Leverage public outreach partnering capabilities to inform and educate the public about
hazard mitigation and preparedness.
ongoing Activity. The Hazard Mitigation Plan webpage has been updated with the 2019
adopted plan and annual reports.
Ongoing Activity. The Flood Control Zone District targets outreach annually to areas with
high flood risk. Kittitas Fire Adapted communities coalition has a landowner outreach
program and landowners can receive a personalized fire plan through this program.
Public Outreach to update the Hazard Mitigation Plan has been initiated.
This element would be better supported by convening annual steering committee
meetings and should be addressed during HMP update process.
Progress made. The Flood Control Zone District has installed a total of5 stream gages
with real-time data. The number of stream gages installed and maintained has increased
since the last reporting period. Additionally, the Easton Reach Flood Hazard Assessment
was completed during the reporting period.
Kittitas county provides coordination and technical assistance as requested but does not
currently have the capacity to provide cost vs. benefit analysis for grant-eligible projects.
Progress made. Kittitas County entered into a Purchase and Sale Agreement to purchase
a flood risk property and willtake ownership on October 4, 2023. This acquisition will
result in the removal of 3 floodway structures.
Kittitas County has not maintained a steering committee but will address this deficit
duringthe 2O24Hazard Mitigation Plan Update.
Progress made. Two Capital lmprovement Plans, Kittitas County's Road G-year plan and
the Flood Control Zone District 6-year plan includes projects that address needs identified
in the Hazard Mitigation Plan.
CW-3 High
CW-4 High
CW-5 High
CW-6 High
CW-7 High
cW-8 High
inate all mitigation planni ng and project efforts, including grant application support,
to maximize all resources available to the planning partnership, with the County
mentoring qther jurisdictions with less grant application experience.
Support the collection ofimproved data (hydrologic, geologic, topographic, volcanic,
historical, etc.) to better assess risks and vulnerabilities.
Provide coordination and technical assistance in grant application preparation that
includes assistance in cost vs. benefit analysis for grant-eligible projects.
Where appropriate, support retrofitting, purchase, or relocation of structures or
infrastructure located in hazard-prone areas to protect structures/infrastructure from
future damage, with repetitive loss and severe repetitive loss properties as priority when
applicable.
Continue to maintain the steering committee as a viable committee to monitor the
progress ofthe hazard mitigation plan, provide technical assistance to planning partners
and oversee the update ofthe plan as necessary.
lntegrate mitigation plan requirements and actions into other appropriate planning
mechanisms such as comprehensive plans and capital improvement plans.
County-Wide Page 1of 2
County-Wide Mitigation Initiatives 2019 Kittitas County Hazard Mitigation plan
2023 Annual Progress Report (October I,2022 - September 30, 2023)
StatusNo. Priority Description
CW-g High
CW-10 High
CW-11 Medium
CW-12 Medium
Support mitigation projects that will result in protection of public or private property
from natural hazards.
Develop a system and designate responsible parties for capturing damage data after
hazard events, to assist with capturing Public and lndividual Assistance expenditures and
to catalogue damages for use in developing future projects including. This data will assist
with Benefi t/Cost Analysis.
With Kittitas County as lead, to provide guidance to other jurisdictions, evaluate the
benefits of other jurisdictions joining the NFIP Community Rating System.
Evaluate Countywide criticalfacilities list and GIS layer and update as appropriate, to
Progress made. significant Flood control Zone District accomplishments during the
reporting period include: funding support for the city of Ellensburg-led Reecer creek
floodplain and levee project; completion of designs to siphon the Ellensburg Water
company canal at whiskey Creek, cooperation with the palomino subdivision to provide
technical assistance regarding the elevation of new homes, and continued
implementation of the Yakima River Corridor plan.
Following every declared emergency event, public works reports all damages to Kittitas
county Emergency Management capturing necessary data used for determining public
and private FEMA assistance program efforts. During the reporting period, staff
requested Ecology and Region 10 staff to offer the FEMA substantial Damage Response
trai ning.
Kittitas County did not provide this guidance in 2022.
No action - the Risk geodatabase developed for the current hazard mitigation plan is still
continue the risk assessment in this to date
CW-13 Medium lncrease stakeholder and public participation in the Kittitas county Hazard Mitigation pla n Progress made. The Hazard Mitigation plan update has been initiated, and outreach
rocess,
CW-14 Medium Prioritize Kittitas County's list of potential acquisitions of flood-prone properties.
CW-15 High
To more accurately show flood risks, develop maps that show alluvial fans, channel
zones, and areas of cross-basin flow transfers
CW-16 High
lmprove public health responses to hazard events. For example, testing drinking water for
contamination after flood events or distributing masks and closing outdoor events when
arr quality declines due to wildfire.
efforts commenced at the 2023 Kittitas Co Fair
Progress made. The Easton Reach Technical Assessment will be used to inform this
prioritization. The FCZD has purchased those properties prioritized by past technical
assessment and planning for in the Jeffries Levee to canyon reach ofthe yakima River
Progress made. updated alluvial fan flood mapping has been submitted for Reecer Creek
and Mercer and Whiskey Creeks.
On-going Activity. In the reporting period, there were not local flooding or wildfire
events that required this type of response.
County-Wide Page2of 2
Kittitas County Mitigation Initiatives 2019 Kittitas County Hazard Mitigation plan
2023 Annual Progress Report (October 1,2O22 - September 30 2023)
DescriptionPrio StatusNo
KC - 1 High Maintain the Kittitas County Flood Control Zone District (FCZD)Progress made. The FCZD continues to make progress implementing the Capital
Enhance the flood warning system on major rivers and streams within Kittitas County
including strengthening the computer interface and upgrading and increasing the num
m
Flood Control Zone District has installed a total of5 stream gages
The number of stream gages installed and maintained has
lm
Progress made. The
ber with reaFtime data.KC - 2 Medium
KC - 6 High
of weather stations.
KC - 3 High Continue participation and improve rating in the Community Rating System
KC-4
Where appropriate, support retrofitting, purchase, or relocation ofstructures in
Medium hazardprone areas to protect them from future damage, with priority for properties
exposed to repetitive losses.
KC - 5 High
Adopt appropriate regulatory standards that will reduce the risk to natural hazards
through updates to existing code affecting critical areas regulations, flood hazard
regulations, shoreline regulations, and to the county's growth management
comprehensive plan
Annually disseminate a floodplain information brochure to all floodplain area or flood risk Flood info
increased by 3 during the reporting period.
Ongoi ng Program. ln 2019 Kittitas County retained its Class G rating, which reduces
residents flood insurance premiums by 2oo/o.
Progress made. Kittitas County entered into a purchase and Sale Agreement to
purchase a flood risk property and will take ownership on October 4, 2023. This
acquisition will result in the removal of 3 floodway structures. FCZD staff presented a
buyout program option to the Elk Meadows HOA leadership, concerning properties
accessed by the McElroy Road bridge. The HOA chose instead to upgrade the bridge.
The Flood control zone District annually sends letters to landowners in repetitive loss
areas.
No change. On August 17 , 2O2I Kittitas County updated its Flood Damage prevention
ordinance to meet current state and federal requirements and enhanced requirements
for Community Rating System participation.
rmation brochures are available at County offices but were not mailed during
KC - 7 Medium
KC - 8 Medium Replace undersized bridges and culverts throughout Kittitas County
Retrofit, rehabilitate or replace vulnerable road facilities, bridges and infrastructure
throughout Kittitas County
Continue to maintain compliance and good standing under the National Flood lnsurance
Program.
the riod.
Progress made. Federal Highways completed construction for the Dickie creek bridge.
Kittitas county constructed the Kittitas county vantage Highway over Cascade Canal
Bridge lmprovement and Manastash Road Bank stabilization projects. The Elk Meadows
HOA is working on a design proposal for the McElroy Road Bridge.
Progress made. Federal Highways completed construction for the Dickie creek bridge
and Kittitas County constructed the Kittitas County Vantage Highway over Cascade
Canal Bridge lmprovement project during the reporting period.
Progress made. Kittitas County is working to address issues identified by FEMA and
Washington State during its Community Assistance Visit.
households.
KC - 9 High
Kittitas County Page 1 of4
Kittitas County Mitigation Initiatives 2019 Kittitas County Hazard Mitigation plan
2023 Annual Progress Report (Octobet L,ZO2Z - September 30 2023)
StatusNo.
KC - 10 Medium Update the Kittitas County Comprehensive Flood Management plan
Progress made. Kittitas county completed the Easton Reach flood hazard technical
assessment and the results will inform the update to the flood hazard section ofthe
Hazard Mitigation Plan.
Progress made. The Flood control zone District annually sends letters to landowners in
repetitive loss areas and conducts site visits upon request to advised on structure
elevation options. The FCZD 6-year work plan has schedule a Repetitive Loss Area
analysis to occur in 2027.
Progress made. The Flood Control District has installed 5 gages, including 3 north of
Ellensburg, l west of Ellensburg, and one on the NF Teanaway River. These gages will
form the initial elements of an early flood warning system for the Ellensburg area.
KC - 11-Medium
KC - 12 Medium
KC - 13 Medium
KC - 14 High
KC - 15 High
KC - 16 High
Where feasible, seek to elevate at-risk structures within the floodplain to an adequate
freeboard that is commensurate with the flood risk. The measure of feasibility will be
willing participation by the property owner and the cost-effectiveness of the project.
Upgrade or install stream gauges on rivers and streams with a flow greater than 20 cubic
feet per second.
Conduct a study of all County-owned facilities to determine their vulnerability to natural
hazards. Conduct a seismic retrofit or other mitigation to identified vulnerable structures.No action at this time.
Begin a public outreach effort to educate landowners about Firewise and Fire Adapted
Communities programs, defensible space around structures, non-combustible building
materials, fuel reduction and other wildfire prevention tactics. Place information boards
in key areas ofthe County.
Perform fuel reduction projects in high wildfire risk areas and areas with identified need
throughout Kittitas County.
Enhance the subdivision code and building code to include updated fire code
Progress made. Kittitas Fire Adapted Communities conducts outreach for these topics.
Progress made. The Kittitas County Conservation District, along with the Washington
State Department of Natural Resources and local fire districts was awarded $11.17
million in funding from the USDA community wildfire Defense Grant for fuels reduction
work.
KC - 17 Hieh
KC - 18 Medium
KC - 19 High
rements.
Continue to improve and preserve fire apparatus access throughout the County, including
access through private gates
ldentifiT seiche hazard areas and adopt higher regulatory standards to protect structures
within the identified areas.
Continue to adopt land use policies that prohibit the placement of habitable structures in
high risk landslide and avalanche areas.
Kittitas County updated the building code to meet state requirements.
Progress made. Private bridges are required to meet the 75,000-pound load limit
required in fire code adoption. All gated accesses must be approved by the Fire Marshal
and comply with minimum width and emergency opening device requirements.
No action at this time
No action at this time
Kittitas County Page 2 ol 4
Kittitas County Mitigation Initiatives 2019 Kittitas County Hazard Mitigation plan
2023 Annual Progress Report (October L,2022 - September 30 2023)
StatusNo. Priority Descri
KC - 20 Medium
KC - 21 High
KC - 22 High
KC - 23 High
KC- 24 High
KC - 25 High
KC - 26 High
KC
Strengthen/harden critical road facilities from the impacts of all hazards for which they
have exposure and vulnerability.
Proactively manage hazardous tree removal from public areas, and educate private
property owners about management oftheir own trees
lntegrate the hazard mitigation plan into future updates ofthe Kittitas County
Comprehensive PIan.
Continue to support the implementation, monitoring, maintenance and updating of this
plan.
lntegrate goals, objectives and initiatives of the Kittitas County Hazard Mitigation plan
into existing County regulations and programs where appropriate
Maintain an active public outreach strategy using available multiple media to inform the
public how to personally prepare for and mitigate the hazards of concern.
27 Low Support detailed ash fall studies.
KC - 28 Medium ldentii/ and create new impounded water sources
KC - 29 Medium Educate the public on drought resistance and encourage the use ofwater saving
landscaping, irrigation methods and farming practices.
No action at this time.
Ongoing activity. The Kittitas County Road Maintenance department removes
hazardous trees threatening county rights ofway as part ofthe annual maintenance
program. DangertreesareremovedfollowingsignificantwindeventsintheCounty.
Progress Made. The 2024 Hazard Mitigation Plan update has been initiated and is
being coordinated with Kittitas Countv planning staff.
Progress made. Kittitas County has provided annual reports since 2020.
Progress made through regular work programs.
Progress made through regular work programs.
No action at this time
Progr€ss made. This activity is being advanced through the yakima Basin lntegrated
Plan and the Kittitas Reclamation District has been investigating potential new
impounded water sources.
Progress made. This activity is being advanced through the yakima Basin lntegrated
Plan. The Heritage Garden Program, which provides technical assistance through the
conservation District to encourage the use of native plans and water-efficient irrigation,
expanded into Kittitas County during the reporting period. The Kittitas County
conservation District provides technical assistance and helps leverage state and federal
funding to improve on farm practices.
UsethebestavailabledataandsciencetocontinuallyupdatetheCountyriskassessment Progressmade.TheFloodControl ZoneDistrictCompletedtheEastonReachFlood
as new information becomes available (hydrologic, geologic, topographic, etc.) Hazard Technical Assessment.
Kittitas County Page 3 of 4
Kittitas County Mitigation Initiatives 2019 Kittitas County Hazard Mitigation plan
2023 Annual Progress Report (October 1,,2O22 - September 30 2023)
StatusNo. Priority Description
KC - 30 Medium lmprove irrigation conveyance systems to reduce water loss through earthen canals and
ditches.
KC - 31 High Enhance the existing dam failure early warning system
KC - 32 Medium Set the course for sustained operations of critical county functions by the development of
a continuity of operations plan and/or a post-disaster recovery plan.
Continue to support through active participation the "county-wide" initiatives identified
in Volume 1 of the Kittitas County Hazard Mitigation Plan.
Progress made. This activity is being advanced through the yakima Basin lntegrated
Plan and the Kittitas Reclamation District has been actively implementing water
conservation projects along their distribution system.
Progress made.The Bureau of Reclamation maintains a phone tree and practices it
everyyear. Countyresidentscansignuptobenotifiedaboutemergenciesatlocations
they identify through their account.
Progress made. work at home orders associated with coVlD-19 necessitated policies
and procedures for telework for continuity of operations.
Progress made / ongoing activity.
Progress made / ongoing activity. Kittitas County public Works participates in NOAA
weather briefings year-round as issued from the regional office in pendleton, OR.
Advancing storm fronts are monitored and NOAA data is used to schedule
supplemental maintenance crews.
KC - 33 High
KC - 34 High Consider participation in the National Weather Service "Storm Ready'' program
Kittitas County Page 4 of 4