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Home My WebLink AboutBLD2001-00609 Flood Certificate ELEVATION CERTIFICATE O.M.B.No3067-0011 Exp'rei hluy 31, 1993 FEDERAL EMERGENCY MANAGEMENT AGENCYNA ATTENTION: Use of this certificate does not proviide a wavONAL OODhefloUdANtCa PROGRAM purchase requirement. This form is used provide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate,and/or to support a request for a Letter of Map Amendment or Revision(LOMA ort OMR). Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION BUILDING OWNERS NAME FOR INSURANCE COMPANY USE J�,UIl] e It, (,ifr11IIE3hlnan POLICY NUMBER STREET ADDRESS(Including Apt.,Unit,Suite and/or Bldg,Number)OR P.O.ROUTE AND BOX NUMBER N o. 13 V b0 COMPANY NAIC NUMBER OTHER DESCRIPTION( and BlockNumbers, 2T L v Lot 4 , Ludlow eac1acts 1 CITY Port Ludlow STATE WA ZIP CODE 98365 SECTION B FLOOD INSURANCE RATE MAP(FIRM)INFORMATION Provide the following from the proper FIRM(See Instructions): 1.COMMUNITY NUMBER 2.PANEL NUMBER 3.SUFFIX 4.DATE OF FIRM INDEX 5.FIRM ZONE 6.BASE FLOOD ELEVATION S 4 Q / _ f - p 2. (in AO Zones,use depth) 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ®NGVD '29 ❑Otherr((desc ibe on back) 8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate the community's BFE:L_1__LI LJ,Li feet NGVD (or other FIRM datum—see Section B, Item 7) SECTION C: BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions,Indicata the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level 2(a). FIRM Zones Al-A30,AE,AH, and A(with BFE). The top of the reference level floor from the selected diagram is at an elevation of L L_ jJo . 7J feet NGVD (or other FIRM datum—see Section B, Item 7). (b). FIRM Zones V1-V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of I I I I I.LJ feet NGVD(or other FIRM datum—see Section B, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is LIJ,Li feet above❑ or below❑ (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is I I I.LJ feet above or below El(check r-- one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? LI Yes Li No I__i Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: Li Other under Comments on Page 2). (NOTE: If the elevation datum used In measuring the elevations is different29 than that used on(describe the FIRM [see Section B, Item 7.1, then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: X Yes ❑No (See Instructions on Page g 4) S g l_ Co NA nA e,._,-ram 5. The reference level elevation is based on: actual construction L construction drawings (NOTE: Use of construction drawings is only valid'f the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post-construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is:Ll 1 I iI?I,�oj feet NGVD (or other FIRM datum see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. It the community official responsible for verifying building elevations specifies that the reference level Indicated in Section C, Item 1 is not the "lowest floor"as defined in the community's floodplaln management ordinance, the elevation of the building's"lowest floor" as defined by the ordinance is: L I I I I I.L feet NGVD (or other FIRM datum—see Section B, Item 7). 2. Date of the start of construction or substantial improvement FEMA Form 81-31r MAY 90 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION • SEC770N E. 'CERTIFICATION rills certification is to be signed by a land surveyor, engineer,or architect who is authorized by state or local law to certify elevation Into, nation when the elevation information for Zones A1—A30,AE,AH,A(with BFE),V1—V30,VE,and V(with BFE)is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A(without a FEMA or community Issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8- Distinguishing Features—If the certifier Is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use,wall openings, or unfinished area Feature(s), then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFI A'S NAME LICENSE NUMBER(or Affix Seal) inLE U 2 / COMPANY NAME �' G- Qy ADDRESS TO Iw ti S a ti L 4Ja ---�_3 C. C. Qer /�ITY (�/ _-S1iy_��____ //--15-- STATE ZIP SIGNATURE �.___._ ONE 3 g 5— S 9 c. g DATE PHONE Copies should be made of this Certificate for: 1)community official, 2) Insurance agent/company, and 3) building owner. COMMENTS: C. I S SNow#.l -_ __-- ,.1...l.0 Lq 1 II 1!drf IIhglUllq. - ___ �'O ...►. . � .• WAS .`�` c — A. /d_1e}'' O T 0 II------------- _. � fi — --- 11111L1:9:91S.Tec :7',‘...Ai: ON SLAB WITH ; EXPIRES 1/17/96 •,'PILES, BASEMENT ' ''.q,nulnl;nnRllnlllpll/lulllllnl III n1;11.1.';,OR COLUMNS A V ZONES ZONES A A [III ZONES V ZONES ZONES Ts REFERENCE -'1-�\ • LEVEL I►1 %I G �J REFERENCE ',' 'I' F�O LEVEL } REFERENC E� ELEVATION ~_ LEVEL BASE '.r::•.', •:A:1i.Y., ,(:' ADJACENT :',:t REFERENCE BASE FLOOD REFERENCE ADJACENT GRADE LEVEL ELEVAT1O FIOG EELEVATIONI LEVEL GRADE N '. ADJACENT` RRRIII///��` ....L..•.., 7f1111::{•: GRADE �. The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measurers at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2