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Home My WebLink About932200801 - 840 BECKETT POINT RD - FLOOD or, (A - i'--� ORIGINAL Il Engineers • Land Surveyors • Planners NORTHWESTERN TERRITORIES, INC. 717 SOUTH PEABODY STREET Construction Coordination • Materials Testing PORT ANGELES, WASHINGTON 98362 • Phone (360)452-8491 • Fax (360)452-8498 1-800-654-5545 E-Mail: info @nti4u.com Ni.'! www.nti4u.com JUL 222009 TO: Jefferson County DATE: July 21 , 2009 Building Dept. (DCD) ATTN: Michael Hoskins 621 Sheridan St. SUBJECT: Permit No. BLD09-00110 Port Townsend, WA 98368 WE ARE TRANSMITTING: • One Original Elevation Certificate. REMARKS: • Please contact us at the information above with questions or comments. These are: For your use. Sent via: US Mail Signed Tami Brothers, Office Manager U.S. 6I ARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency Expires March 31,2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name Diane Lux Policy Number A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number 840 Beckett Point Road City Port Townsend State WA ZIP Code 98368-5717 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) A Lots 2 Beckett Point West Beach,Beckett Point Fisherman's Club Assessor's Plat,Gov. Lot 1,Sec 23,T3ON, R2W,WM. A L A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential A5. Latitude/Longitude:Lat.48 04 35.9 Long. 122 53 29.1 Horizontal Datum: ❑ NAD 1927 ® NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 8 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 610 sq ft a) Square footage of attached garage sq ft b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade 16 within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b 1024 sq in c) Total net area of flood openings in A9.b sq in d) Engineered flood openings? Z Yes ❑ No d) Engineered flood openings? LI Yes ❑ No SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION B1. NFIP Community Name&Community Number B2.County Name B3.State Jefferson Co.530069 Unincorporated area WA B4. Map/Panel Number B5.Suffix B6. FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone 530069 0135 B Date Effective/Revised Date Zone(s) AO,use base flood depth) July 19, 1982 Al 9.0 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other(Describe) B11. Indicate elevation datum used for BFE in Item B9: ® NGVD 1929 ❑ NAVD 1988 LI Other(Describe) B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes ® No Designation Date ❑ CBRS ❑ OPA SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations-Zones Al-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 Items C2.a-h below according to the building diagram specified in Item A7. Use the same datum as the BFE. JUL . 2 L�� Benchmark Utilized GP16101-2Vertical Datum NAVD 1988 Conversion/Comments NAVD 1988-3.51'=NGVD 1929 Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor)11.81 ®feet ❑meters(Puerto Rico only) b) Top of the next higher floor . ❑feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) . ❑feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) . ❑feet ❑ meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building . ❑feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) . ❑feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) . ❑feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including . ❑feet ❑meters(Puerto Rico only) structural support SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION ,,s' This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation � ' information. I certify that the information on this Certificate represents my best efforts to interpret the data available. '0 co WAak 4 \_ I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. .,7 ❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a v► licensed land surveyor? ® Yes ❑ No Certifier's Name Thomas D.Roorda License Number 36825 Title Principal Surveyor Company Name Northwestern Territories Inc.(NTI) ,, 36825 1� � �,,..p Address 717 South Peab y City Port Angeles State WA ZIP Code 98362 I% AZ LAS' i Signature Date July 20,2009 Telephone (360)452-8491 t`SBPIREB Y FEMA Form 81- 1, Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use: Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number 840 Beckett Point Road City Port TownsendState WA ZIP Code 98368-5717 Company NAIC Number SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments Signature Date 7/20/09 ❑ Check here if attachments SECTION E IL,'ING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A, B, and C. For Items E1-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or❑ below the HAG. E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A,B,and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Thomas D.Roorda-Northwestern Territories Inc Address 717 South Peabody City Port Angeles State WA ZIP Code 98362 Signature Date 7/20/09 Telephone (360)452-8491 Comments ❑Check here if attachment, SECTION G-COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8 and G9. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.❑ The following information(Items G4-G9)is provided for community floodplain management purposes. G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: ❑New Construction ❑Substantial Improvement G8. Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑ meters(PR)Datum G9. BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR)Datum G10.Community's design flood elevation ❑feet ❑meters(PR)Datum Local Official's Name Title '„ ' _ 2 2 2009 Community Name Telephone Signature Date Comments ❑Check here if attachment: FEMA Form 81-31, Mar 09 Replaces all previous editions Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number 840 Beckett Point Road City Port Townsend State WA ZIP Code 98368-5717 Company MC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the reverse. JUL 2 2 2009 SEE ATTACHED ,. . 400040' 1 44011/16b "11101:agek. -Is. iss. -,....., •••. '1111111*- ',a* •11101, ,,,,.. lir*" ,', *0.• ... - 7----- , t _ - , •. ,..,. ........„..,,,_%mor ...a."........... .""t. ----7:,, •ft!•42%.*?*****4.4..*Ft4,...., ,,,,,_•'' '-':-::•-t- :',::.: . ,'':,'i* 44, . • F-. ...„.„,,..1, ..4..,„,•,44.4„.*.,,,^ ,,, ,,,*,,,,,.•.;.,- . :,;,-,,;..-7,.:::••7„.:",:—,, . ' • . ' ''.t, ,!' 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' ' I. ,,,, .. . . ,,.,,,,,,• ,,,,,,,,,,, ,„._„,,,,.- , .,;*,..,..,_ f 1, l :',;',. -,"...';','_ , „' ...,, , 41111,01tk, ' ' : t, 3 ., ,,..... , _ „ , ",, I . . ... ., ,. . ..,...... . .,,, ,,..., , , ., .. , ,... ..s _ __ , ,_ ., ... , , .. _...,,,... ,,_.....„,_ . ,,,. .,, ,,, .....,„,„„„,. , .,_. , ,... ... .,.......,. . .. . ... ..,, _., , . . .. . .,.... , ...,,, . ,... ... ... ..._ . . „. ,__.„... . ... ... ,,,:,..,,,, ..,,.. .. ,_ . -7.-.'17 .:'---,-, -'' -. , ,-; i . ,:y 7 10. _ r x ... ...�,:. x l • t; t'.9 24 " �,. a ' ._ _-. z 3 ar f' t 1 - ..a. ft .... a r. 4 In IN* 31 I ' .. 411Pr---dor , .11, ,, ,,,...'i} ,,,, i, r , , ... 11,4'.-. :: ,., .- -a - , ., / 1 f _ � I i 1 1 .iw s t°' .r A i, a « I `� Y 1e , U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency Expires March 31,2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION #1 oral#si a e mpa`riir,Use Al. Building Owner's Name Diane Lux $; o it; , , A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. 1r,vi. a e a, f 840 Beckett Point Road s City Port Townsend State WA ZIP Code 98368-5717 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Lots 2 Beckett Point West Beach,Beckett Point Fisherman's Club Assessor's Plat,Gov.Lot 1,Sec 23,T3ON,R2W,WM. oRIGINAL A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential A5. Latitude/Longitude:Lat.48 04 35.9 Long. 122 53 29.1 Horizontal Datum: ❑ NAD 1927 ® NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 8 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 610 sq ft a) Square footage of attached garage sq ft b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade 16 within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b 1024 sq in c) Total net area of flood openings in A9.b sq in d) Engineered flood openings? ® Yes ❑ No d) Engineered flood openings? ❑ Yes ❑ No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name&Community Number B2.County Name B3.State Jefferson Co.530069 Unincorporated area WA B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood B9. Base Flood Elevation(s)(Zone 530069 0135 B Date Effective/Revised Date Zone(s) AO,use base flood depth) July 19,1982 Al 9.0 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. El FIS Profile ® FIRM ❑ Community Determined ❑ Other(Describe) B11. Indicate elevation datum used for BFE in Item B9: ® NGVD 1929 ❑ NAVD 1988 El Other(Describe) B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes ® No Designation Date ❑ CBRS ❑ OPA SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction" ® Finished Construction "A new Elevation Certificate will be required when construction of the building is complete. -= C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/Al-A30,AR/AH,AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized GP16101-2Vertical Datum NAVD 1988 JUL 2 2 2009 Conversion/Comments NAVD 1988-3.51'=NGVD 1929 Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor)11.81 ®feet ❑meters(Puerto Rico only) b) Top of the next higher floor . ❑feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) . ❑feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) . ❑feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building . ❑feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) . El feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) ❑feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including 0 feet ❑meters(Puerto Rico only) structural support SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION 0 This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation /, U. : information. /certify that the information on this Certificate represents my best efforts to interpret the data available. C7 •p= a►�g,- A. I I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. 1 ''�P.147\\,`O gh El Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a a� licensed land surveyor? ® Yes ❑ No Certifier's Name Thomas D.Roorda License Number 36825 Title Principal Surveyor Company Name Northwestern Territories Inc.(NTI) j825 ,.Address 717 South Peab y City Port Angeles State WA ZIP Code 98362 66 t�ii Signature Date July 20,2009 Telephone (360)452-8491 IEPIi3E5 FEMA Form 8l- ' Ma'r 09 See reverse side for continuatio.. Replaces all previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use: Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. ^;Pohcy Number 840 Beckett Point Road City Port TownsendState WA ZIP Code 98368-5717 Company°NAIC Number F SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for(1)community official, (2)insurance agent/company,and(3)building owner. Comments Signature Date 7/20/09 ❑ Check here if attachments SECTION E IL ING ELEVATION INFORMATION(SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items E1-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or❑below the HAG. E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A,B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Thomas D.Roorda-Northwestem Territories Inc Address 717 South Peabody City Port Angeles State WA ZIP Code 98362 Signature Date 7/20/09 Telephone (360)452-8491 Comments ❑Check here if attachments SECTION G -COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8 and G9. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2.❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.,1 The following information(Items G4-G9)is provided for community floodplain management purposes. G4. ermit Number G5. Date P rmit Iss ed G6. Date Certificate Of Comp iance/Occupancy Issued WO- Co O 417..-1I2Op 7/1,2a vo? G7. This permit has been issued for: ❑ New Construction ❑Substantial Improvement G8. Elevation of as-built lowest floor(including basement)of the building: I . ❑feet ❑meters(PR)Datum G9. BFE or(in Zone AO)depth of flooding at the building site: 9 . G feet ❑meters(PR)Datum G10.Community's design flood elevation ❑feet ❑meters(PR)Datum Local Official's Name L . `(�� Title , �t : i tv v N li(.:es 2 2 2�2009 Community Name Telephone ter` `y 17;19 -Litt "-C-% ::: ' - Date ( LQ ents ❑Check here if attachment; FEMA Form 81-31, Mar 09 Replaces all previous editions Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number 840 Beckett Point Road City Port Townsend State WA ZIP Code 98368-5717 Company NAIC Number If using the Elevation Certificate t g to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the reverse. ,'UL 2 2 2099 SEE ATTACHED .,.. • ..,_ ,. ,, .., '. 4.,-2.-',','0.• '-', 4 ,„-- -,ve- --- -... _.,,, ----- ,:•,.:-.:,.7.,.- .-.:_ Tyfe: :-... ...,. ,,,:s., ... .-, -......... -... ... ... ,q..:- ,...-..r5,- - ,..--zr"..".- - .-1... — -von, ...e'r",•--;, - ',tt- '7-:-_. .. _ ..,.,04it.14.z.."-`7'-'' '7-,:'f-. 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