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HomeMy WebLinkAboutFEMA PAPERWORK - INCLUDES COMPLETED ELEVATION CERTIFICATES IN THE BACK�cnxry FILE lgND Stiff , FEMA copy SCANNED St . "ciecountv NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE F.11011 INSTRUCTIONS NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE PAPERWORK REDUCTION ACT NOTICE Public reporting burden for the Elevation Certificate is estimated to average 3.5 hours per response. Burden means the time, effort, or financial resources expended by persons to generate, maintain, retain, disclose, or provide information to the Federal Emergency Management Agency (FEMA). You are not required to respond to the collection of information unless a valid OMB control number is displayed in the upper right corner of the form. You may send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: U.S. Department of Homeland Security, Federal Emergency Management Agency, Mitigation Division, 500 C Street SW, Washington DC 20472, Paperwork Reduction Project (1660-0008). NOTE: Do not send your completed form to this address. To obtain or retain benefits under the National Flood Insurance Program (NFIP), you must respond to this collection of information. PURPOSE OF THE ELEVATION CERTIFICATE The Elevation Certificate is an important administrative tool of the National Flood Insurance Program (NFIP). It is to be used to provide elevation information necessary to ensure compliance with community floodplain management ordinances, to determine the proper insurance premium rate, and to support a request for a Letter of Map Amendment (LOMA) or Letter of Map Revision based on fill (LOMR-F). The Elevation Certificate is required in order to properly rate post -FIRM buildings, which are buildings constructed after publication of the Flood Insurance Rate Map (FIRM), located in flood insurance Zones Al-A30, AE, AH, A (with BFE), VE, VI-V30, V (with BFE), AR, AR/A, AR/AE, AR/Al-A30, AR/AH, and AR/AO. The Elevation Certificate is not required for pre -FIRM buildings unless the building is being rated under the optional post -FIRM flood insurance rules. As part of the agreement for making flood insurance available in a community, the NFIP requires the community to adopt a floodplain management ordinance that specifies minimum requirements for reducing flood losses. One such requirement is for the community to obtain the elevation of the lowest floor (including basement) of all new and substantially improved buildings, and maintain a record of such information. The Elevation Certificate provides a way for a community to document compliance with the community's floodplain management ordinance. Use of this certificate does not provide a waiver of the flood insurance purchase requirement. Only a LOMA or LOMR-F from the Federal Emergency Management Agency (FEMA) can amend the FIRM and remove the Federal mandate for a lending institution to require the purchase of flood insurance. However, the lending institution has the option of requiring flood insurance even if a LOMA/LOMR-F has been issued by FEMA. The Elevation Certificate may be used to support a LOMA or LOMR-F request. Lowest floor and lowest adjacent grade elevations certified by a surveyor or engineer will be required if the certificate is used to support a LOMA or LOMR-F request. A LOMA or LOMR-F request must be submitted with either a completed FEMA MT-EZ or MT -I package, whichever is appropriate. This certificate is used only to certify building elevations. A separate certificate is required for floodproofing. Under the NFIP, non-residential buildings can be floodproofed up to or above the Base Flood Elevation (BFE). A floodproofed building is a building that has been designed and constructed to be watertight (substantially impermeable to floodwaters) below the BFE. Floodproofing of residential buildings is not permitted under the NFIP unless FEMA has granted the community an exception for residential floodproofed basements. The community must adopt standards for design and construction of floodproofed basements before FEMA will grant a basement exception. For both floodproofed non- residential buildings and residential floodproofed basements in communities that have been granted an exception by FEMA, a floodprooftng certificate is required. Additional guidance can be found in the FEMA Floodplain Management Bulletin about using the Elevation Certificate, available on FEMA's website at www.fema.gov/fima/fombut.shtm. Click on "FEMA 467-1 Elevation Certificate Cover and Bulletin." U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program City ELEVATION CERTIFICATE Important: Read the instructions on pages 1-8. A- PROPERTY INFORMATION Bldg. No.) or P.O. Route and Box OMB No. 1660-0008 Expires February 28. 2009• - r�N� I`7 eoc_Ann oiocq rv� n i� rarcei numger, cegai_uescn�noni elm I�j 2 IV Slp� L-i''7l Jl 7( )�iJ.C.fr :J A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) (x- !CA Q•li' nL— A5. LafitudelLongitude: Lat. Long. Horizontal Datum: .❑ NAD 1927 ❑ NAD1983- A6..Attach -at least photographs of the building if the Cergficate..is being used to obtain flood insurance. A7. Building Diagram Number — As. For a building with a crawl space or enclosure(s)rprovide: A9. For a building with an attached' garage, provide: a) Square footage of crawl, space or enclosure(s) sq ft a) Square footage of attached garage sq It b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings In the attached garage, enclosure(s) walls within 1.0 fool above adjacent grade walls within 1.0 foot above adjacent grade c) Totelnetareaof tigod.openings in AB.b sqin c) Total net area of flood openings in A9.b sq In B- 111 \ �O� t I Dat ER dive/Revised Date Zone(s) AD, use base good de fpth) N L��1�Gicag B10. Indicate the source ofr a Base Flood Elevation (BFE) dataror base fiood depth,ente d i Item B9. - ❑ FIS Profile IRM ❑ Community Determined ❑ Other (Describe). B11. Indicate elevation datum used for BFE In Item 139: NGVD 1929 ❑ NAVDd988 ❑ Other (Describe) B12. 1s the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)7 ❑ Yes No Designation Date ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction' ❑ Finished Construction •A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations -Zones Al-A30, AE, AH, A.(with BFE), VE, V1430, V (with BFE), AR, ARIA, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item A7. BenchmarkUtilized= Vertical Datum ' Check the measurement used.' a) Top of bottom floor (including basement, crawl space, or enclosure floor).. _ ❑ feel ❑ meters (Puerto Rico only) b) Top'of the next, tierfloor • -' _❑ feet •_.,. ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) _❑ feel. ❑ 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 _ ❑ metes (Puerto Rico only) (Describe type.of equipment in Comments) _- 1) Lowest adjacent (finished) grade (LAG) _❑ feel ❑ meters (Puerto Rico only) g)- Highest adjacent (finished) grade (HAG) _❑ feet ❑ meters (Puerto Rim only) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is tobe signed and sealed by land surveyor, engineer• or architect authorized by law to certify elei information. I certify that the information 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. ❑ Check here if comments are provided on back of form. Certifier's Name License Number = company Name Address City State ZIP Code Signature Dale Telephone PLACE SEAL HERE fEMA Form 81-31, February 2006 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 - City - State - ZIP Code 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 _ 1 Signature Date " ❑Check here If attachments SECTION E - BUILDING ELEVATION INFORMATION,(SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E7-E5. If the Certificate Is Intended to support a LOMA or LOMR-F request, complete Sections A. B, and C. For Items El-E4, use natural grade,.if available. Check the measurement used. In Puerto Rico only, enter meters. Et. 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"Qnduding basement, crawl space, or enclosure) is _ ❑ feel ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is _ ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided inSecltori Items B and/or 9 (see pa9�a 8 of Instructions), the next higher floor . • (elevation C2.b in the diagrams)of the building is _ [:]feet meters- ❑above or LI 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 floodptain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must ceriity this information in Section G. The property owner or owner's authorized representative whocompletesSections A, B. and E for Zone A (without a FEIr1A-issued or community -issued BFE) - or Zone AO must sign here. The statements fnSecticns A, B, and -E. are correct to the best of my knowledge. Property Owners or Owner's Authorized Representative's Name Address City State ZIP Code Comments G- Date Telephone The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B. G (ore), and G of this Elevation Certificate. Complete the applicable Items) and sign below. Check the measurement used in Items G8. and Ga. 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 providedfor community floodplain management purposes. .. ... - 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 Local Official's Name Title Community Name Telephone ❑ Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions Building Photographs See Instructions for Item A6. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or State 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, following. Building Photographs Continuation Pane For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number City State ZIP Code company NAIL Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." INSTRUCTIONS FOR COMPLETING THE ELEVATION CERTIFICATE The Elevation Certificate is to be completed by a'land surveyor, engineer, or architect who is authorized by law to certify elevation information when elevation information is required for Zones Al-A30, AE, AH, A (with BFE), VE, V 1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, or AR/AO. Community officials who are authorized by law or ordinance to provide floodplain management information may also complete this form. For Zones AO and A (without BFE), a community official, a property owner, or an owner's representative may provide information on this certificate, unless the elevations are intended for use in supporting a request for a LOMA or LOMR-F. Certified elevations must be included if the purpose of completing the Elevation Certificate is to obtain a LOMA or LOMR-F. The property owner, the owner's representative, or local official who is authorized by law to administer the community floodplainbrdinance can complete Section A and Section B. The partially completed form can then be given to the land surveyor, engineer, or architect to complete Section C. The land surveyor, engineer, or architect should verify the information provided by the property owner or owner's representative to ensure that this certificate is complete. In Puerto Rico only, elevations for building information and flood hazard information may be entered in meters SECTION A — PROPERTY INFORMATION Items Al: A4. This section identifies the building, its location, and its owner. Enter the name(s) of the building owner(s), the building's complete street address, and the lot and block numbers. If the building's address is different from the owner's address, enter the address of the building being certified. If the address is a rural route or a Post Office box number, enter the lot and block numbers, the tax parcel number, the legal description, or an abbreviated location description based on distance and direction from a fixed point of reference. For the purposes of this certificate, "building" means both a building and a manufactured (mobile) home. A map may be attached to this certificate to show the location of the building on the property. A tax map, FIRM, or detailed community map is appropriate. If no map is available, provide a sketch of the property location, and the location of the building on the property. Include appropriate landmarks such as nearby roads; intersections, and bodies of water. For building use, indicate whether the building is residential, non-residential, an addition to an existing residential or non-residential building, an accessory building (e.g., garage), or other type of structure. Use the Comments area of the appropriate section if needed, or attach additional comments. Item A5. Provide latitude and longitude coordinates for the center of the front of the building. Use either decimal degrees (e.g., 39.5043°,-110.75851) or degrees, minutes, seconds (e.g., 39' 30' 15.5", -110' 45' 30.7") format. If decimal degrees are used, provide coordinates to at least 4 decimal places or better. When using degrees, minutes, seconds, provide seconds to at least 1 decimal place or better. The latitude and longitude coordinates must be accurate within 66 feet. If the Elevation Certificate is being certified by other than a licensed surveyor, engineer, or architect, this information is not required. Provide the type of datum used to obtain the latitude and longitude. FEMA prefers the use of NAD 1983. Item A6. If the Elevation Certificate is being used to obtain flood insurance through the NFIP, the certifier must provide at least two photographs showing the front and rear of the building taken within 90 days from the date of certification. The photographs must be taken with views confirming the building description and diagram number provided in Section A. If the building has split-level or multi -level areas, provide at least two additional photographs showing side views of the building. All photographs must be in color and measure at least 3"x3". Digital photographs are acceptable. Item A7. Select the diagram on pages 7-8 that best represents the building. Then enter the diagram number and use the diagram to identify and determine the appropriate elevations requested in Items C2.a-g. If you are unsure of the correct diagram, select the diagram that most closely resembles the building being certified. Item A8.a Provide the square footage of the crawl space or enclosure(s) below the lowest elevated floor of an elevated building with or without permanent flood openings. Take the measurement from the outside of the crawl space or enclosure(s). Examples of elevated buildings constructed with crawl space and enclosure(s) are shown in Diagrams 6-8 on page 8. Diagram 2 or 4 should be used for a building constructed with a crawl space floor that is below the exterior grade on all sides. Items A8.b-c Enter in Item A8.b the number of permanent flood openings in the crawl space or enclosure(s) walls that are no higher than 1.0 foot above the adjacent grade. Estimate the total net area of all such permanent flood openings in square inches, excluding any bars, louvers, or other covers of the permanent flood openings, and enter the total in Item A8.c. If the net Instructions —Page I area cannot be reasonably estimated, provide the size of the flood openings without consideration of any covers and indicate in the Comments area the type of cover that exists in the flood openings. If the crawl space or enclosure(s) walls have no permanent openings within 1.0 foot above adjacent grade, enter "0" (zero) in Items A8.b-c. Item A9.a Provide the square footage of the attached garage with or without permanent flood openings, Take the measurement from the outside of the garage. Items A9.b-c Enter in Item A9.b the number of permanent flood openings in the attached garage that are no higher than 1.0 foot above the adjacent grade. This includes any openings that are in the.garage door that are no higher than 1.0 foot above the adjacent grade. Estimate the total net area of all such permanent flood openings in square inches and enter the total in Item A9.c.- If the -garage has no permanent flood openings within 1.0 foot "above adjacent grade, enter "0" (zero) in Items A9.b-c. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Complete the Elevation Certificate on the basis of the FIRM in effect at the time of the certification. The information for Section B is obtained by reviewing the FIRM panel that includes the building's location. Information about the current FIRM is available from the Federal Emergency Management Agency (FEMA) by calling 1-800-358-9616. If a Letter of Map Amendment (LOMA) or Letter of Map Revision (LOMR-F) has been issued by FEMA, please provide the letter date and case number in the Comments area of Section D or Section G, as appropriate. For a building in an area that has been annexed by one community but is shown on another community's FIRM, enter the community name and 6-digit number of the annexing community in Item B 1, the name of the new county in Item 132, and the FIRM index date for the annexing community in Item 136. Enter information from the actual FIRM panel that shows the building location, even if it is the FIRM for the previous jurisdiction, in Items 134, 135, 137, B8, and 139. Item B1. NFIP Community Name & Community Number. Enter the complete name of the community in which the building is located and the associated 6-digit community number. For a newly incorporated community, use the name and 6-digit number of the new community. Under the NFIP, a "community" is any State or area or political subdivision thereof, or any Indian tribe or authorized native organization, that has authority to adopt and enforce floodplain management regulations for the areas within its jurisdiction. To determine the current community number, see the NFIP Community Status Book, available on FEMA's web site at htto://www.fema.gov/fema/csb.shtm, or call 1-800-358-9616. Item B2. County Name. Enter the name of the county or counties in which the community is located. For an unincorporated area of a county, enter "unincorporated area." For an independent city, enter "independent city." Item B3. State. Enter the 2-letter state abbreviation (for example, VA, TX, CA). Items B4: B5. Map/Panel Number and Suffix. Enter the 10-character "Map Number" or "Community Panel Number" shown on the FIRM where the building or manufactured (mobile) home is located. For maps in a county -wide format, the sixth character of the "Map Number" is the letter "C" followed by a four -digit map number. For maps not in a county -wide format, enter the "Community Panel Number" shown on the FIRM. Item B6. FIRM Index Date. Enter the effective date or the map revised date shown on the FIRM Index. Item B7. FIRM Panel Effective/Revised Date. Enter the map effective date or the map revised date shown on the FIRM panel. This will be the latest of all dates shown on the map. The current FIRM panel effective date can be determined by calling 1-800-358-9616. Item B8. Flood Zone(s). Enter the flood zone, or flood zones, in which the building is located. All flood zones containing the letter "A" or "V" are considered Special Flood Hazard Areas. The flood zones are A, AE, Al-A30, V, VE, V 1-V30, AH, AO, AR, AR/A, AR/AE, AR/Al-A30, AR/AH, and AR/AO. Each flood zone is defined in the legend of the FIRM panel on which it appears. Instructions — Page 2 Item B9. Base Flood Elevation(s). Using the appropriate Flood Insurance Study (FIS) Profile, Floodway Data Table, or FIRM panel, locate the property and enter the BFE (or base flood depth) of the building site. If the building is located in more than one flood zone in Item B8, list all appropriate BFEs in Item B9. BFEs are shown on a FIRM or FIS Profile for Zones A1- A30, AE, Ali, VI-V30, VE, AR, AR/A, AR/AE, AR/A1-A30, AR/AH, and AR/AO; flood depth numbers are shown for Zone AO. Use the AR BFE if the building is located in any of Zones AR/A, AR/AE, AR/Al-A30, AR/AH, or AR/AO. In A or V zones where BFEs are not provided on the FIRM, BFEs may be available from another source. For example, the community may have established BFEs or obtained BFE data from other sources for the building site. For subdivisions and other developments of more than 50 lots or 5 acres, establishment of BFEs is required by the community's floodplain management ordinance. If a BFE is obtained from another source, enter the BFE in Item B9. In an A Zone where BFEs are not available, complete Section E and enter N/A for Section B, Item B9. Enter the BFE to the nearest tenth of a foot (nearest tenth of a meter, in Puerto Rico). Item B10. Indicate the source of the BFE that you entered in Item B9. If the BFE is from a source other than FIS Profile, FIRM, or community, describe the source of the BFE. Item B1I. Indicate the elevation datum to which the elevations on the applicable FIRM are referenced as shown on the map legend. The vertical datum is shown in the Map Legend and/or the Notes to Users on the FIRM. Item B12. Indicate whether the building is located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA). (OPAs are portions of coastal barriers that are owned by Federal, State, or local governments or by certain non- profit organizations and used primarily for natural resources protection.) Federal flood insurance is prohibited in designated CBRS areas or OPAs for buildings or manufactured (mobile) homes built or substantially improved after the date of the CBRS or OPA designation. For the first CBRS designations, that date is October 1, 1983. An information sheet explaining CBRS areas and OPAs may be obtained on FEMA's web site at http://www.fema.gov/ffiln/fmc cbrs.shtm. SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Gomplete Section C if the building is located in any of Zones Al-A30, AE, AH, A (with BFE), VE, V 1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A I-A30, AR/AH, or AR/AO, or if this certificate is being used to support a request for a LOMA or LOMR-F. If the building is located in Zone AO or Zone A (without BFE), complete Section E instead. To ensure that all required elevations are obtained, it may be necessary to enter the building (for instance, if the building has a basement.or sunken living room, split-level construction, or machinery and equipment). Surveyors may not be able to gain access to some crawl spaces to shoot the elevation of the crawl space floor. If access to the crawl space is limited or cannot be gained, follow one of these procedures. • Use a yardstick or tape measure to measure the height from the floor of the crawl space to the "next higher floor," and then subtract the crawl space height from the elevation of the "next higher floor." If there is no access to the crawl space, use the exterior grade next to the structure to measure the height of the crawl space to the "next higher floor." • Contact the local floodplain administrator of the community in which the building is located. The community may have documentation of the elevation of the crawl space floor as part of the permit issued for the building. • If the property owner has documentation or knows the height of the crawl space floor to the next higher floor, try to verify this by looking inside the crawl space through any openings or vents. In all three cases, provide the elevation in the Comments area of Section D on the back of the form and a brief description of how the elevation was obtained. Item Cl. Indicate whether the elevations to be entered in this section are based on construction drawings, a building under construction, or finished construction. For either of the first two choices, a post -construction Elevation Certificate will be required when construction is complete. If the building is under construction, include only those elevations that can be . surveyed in Items C2.a-g. Use the Comments area of Section D to provide elevations obtained from the construction plans or drawings. Select "Finished Construction" only when all machinery and/or equipment such as furnaces, hot water heaters, heat pumps, air conditioners, and elevators and their associated equipment have been installed and the grading around the building is completed. Item C2. A field survey is required for Items C2.a-g. Provide the benchmark utilized, the vertical datum for that benchmark, and any datum conversion necessary. Most control networks will assign a unique identifier for each benchmark. For example, the National Geodetic Survey uses the Permanent Identifier (PID). For the benchmark utilized, provide the PID or other Instructions — Page 3 unique identifier assigned by the maintainer of the benchmark. Also provide the vertical datum for the benchmark elevation. Show the conversion from the field survey datum used if it differs from the datum used for the BFE entered in Item 139 and indicate the conversion software used. All elevations for the certificate, including the elevations for Items C2.a-g, must be referenced to the datum on which the BFE is based. Show the datum conversion, if applicable, in this section or in the Comments area of Section D. For property experiencing ground subsidence, the most recent reference mark elevations must be used for determining building elevations. However, when subsidence is involved, the BFE should not be adjusted. Enter elevations in Items C2.a-g to the nearest tenth of a foot (nearest tenth of a meter, in Puerto Rico). Items C2.a-d Enter the building elevations (excluding the attached garage) indicated by the selected building diagram (Item A7.) in Items C2.a-c. If there is an attached garage, enter the elevation for top of attached garage slab in Item C2.d. (Because elevation for top of attached garage slab is self-explanatory, attached garages are not illustrated in the diagrams..)- If the building is located in a V zone on the FIRM, complete Item C2.c. If the flood zone cannot be determined, enter elevations for all of Items C2.a-g. For buildings in A zones, elevations a, b, d, and a should be measured at the top of the floor. For buildings in V zones, elevation c must be measured at the bottom of the lowest horizontal structural member of the floor (see drawing below). For buildings elevated on a crawl space, Diagram 8, enter the elevation of the top of the crawl space floor in Item C2.a, whether or not the crawl space has permanent flood openings (flood vents). If any item does not apply to the building, enter "NIA"for not applicable. BUILDING ON BUILDING WITH BUILDING ON PILES, SLAB BASEMENT PIERS, OR COLUMNS ZONES VZONES ./i' C2.a AZONES VZONES - AZONES 1 C2.a C2.c BASE FLOOD .. ELEVATION C2.0 BASE FLOOn'..`: ELEVATION: -;DENT ADJACENT ' :. :'::':•.: GRADE �} GRADE Item C2.e Enter the lowest platform elevation of at least one of the following machinery and equipment items: elevators and their associated equipment, furnaces, hot water heaters, heat pumps, and air conditioners in an attached garage or enclosure or on an open utility platform that provides utility services for the building. Note that elevations for these specific machinery and equipment items are required in order to rate the building for flood insurance. Local floodplain management officials are required to ensure that all machinery and equipment servicing the building are protected from flooding. Thus, local officials may require that elevation information for all machinery and equipment, including ductwork, be documented on the Elevation Certificate. If the machinery and/or equipment is mounted to a wall, pile, etc., enter the platform elevation of the machinery and/or equipment. Indicate machinery/equipment type in the Comments area of Section D or Section G, as appropriate. If this item does not apply to the building, enter "NIA"for not applicable. Items C2.f g Adjacent grade is defined as the elevation of the ground, sidewalk, patio slab, or deck support immediately next to the building. If the certificate is to be used to support a request for a LOMA or LOMR-F, provide in the Comments area the lowest adjacent grade elevation measured at the deck support or stairs if that elevation is lower than the building's lowest adjacent grade. For Zone AO, use the natural grade elevation, if available. This measurement must be to the nearest tenth of a foot (nearest tenth of a meter, in Puerto Rico) if this certificate is being used to support a request for a LOMA or LOMR-F. SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION Complete as indicated. This section of the Elevation Certificate may be signed by only a land surveyor, engineer, or architect who is authorized by law to certify elevation information. Place your license number, your seal (as allowed by the State licensing board), your signature, and the date in the box in Section D. You are certifying that the information on this certificate represents your best efforts to interpret the data available and that you understand that any false statement may be punishable Instructions — Page 4 by fine or imprisonment under 18 U.S. Code, Section 1001. Use the Comments area of Section D, on the back of the certificate, to provide datum, elevation, or other relevant information not specified on the front. SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO & ZONE A (WITHOUT BFE) Complete Section E if the building is located in Zone AO or Zone A (without BFE). Otherwise, complete Section C instead. Explain in the Section F Comments area if the measurement provided under Items El.- E4. is based on the "natural grade." Items El.a and b Enter in Item El.a the height to the nearest tenth of a foot (tenth of a meter in Puerto Rico) of the top of the bottom floor (as indicated in the applicable diagram) above or below the highest adjacent grade (HAG). Enter in -Item El.b the height to the nearest tenth of a foot (tenth of a meter in Puerto Rico) of the top of the bottom floor (as indicated in the applicable diagram) above or below the lowest adjacent grade (LAG). For buildings in Zone AO, the community's floodplain management ordinance requires the lowest floor of the building be elevated above the highest adjacent grade at least as high as the depth number on the FIRM. Buildings in Zone A (without BFE) may qualify for a lower insurance rate if an engineered BFE is developed at the site. Item E2. For Building Diagrams 6-8 with permanent flood openings (see page 8), enter the height to the nearest tenth of a foot (tenth of a meter in Puerto Rico) of the next higher floor or elevated floor (as indicated in the applicable diagram) above or below the highest adjacent grade (HAG). Item E3. Enter the height to the nearest tenth of a foot (tenth of a meter in Puerto Rico), in relation to the highest adjacent grade next to the building, for the top of attached garage slab. (Because elevation for top of attached garage slab is self- explanatory, attached garages are not illustrated in the diagrams.) If this item does not apply to the building, enter "N/A" for not applicable. Item E4. Enter the height to the nearest tenth of a foot (tenth of a meter in Puerto Rico), in relation to the highest adjacent grade next to the building, of the platform elevation that supports the machinery and/or equipment servicing the building. Indicate machinery/equipment type in the Comments area of Section F. If this item does not apply to the building, enter "N/A" for not applicable. Item E5. For those communities where this base flood depth is not available, the community will need to determine whether the top of the bottom floor is elevated in accordance with the community's floodplain management ordinance. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION Complete as indicated. This section is provided for certification of measurements taken by a property owner or property owner's representative when responding to Sections A, B, and E. The address entered in this section must be the actual mailing address of the property owner or property owner's representative who provided the information on the certificate. SECTION G - COMMUNITY INFORMATION (OPTIONAL) Complete as indicated. The community 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. Section C may be filled in by the local official as provided in the instructions below for Item GI. If the authorized community official completes Sections C, E, or G, complete the appropriate item(s) and sign this section. Check Item Gl. if Section C is completed with elevation data from other documentation, including elevations obtained from the Community Rating System Elevation Software, 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 of the elevation data and the date obtained in the Comments area of Section G. If you are both a community official and a licensed land surveyor, engineer, or architect authorized by law to certify elevation information, and you performed the actual survey for a building in Zones A1- A30, AE, AH, A (with BFE), VE, VI-V30, V (with BFE), AR, AR/A, AR/Al-A30, AR/AE, AR/AH, or AR/AO, you must also complete Section D. Check Item G2. if information is entered in Section E by the community for a building in Zone A (without a FEMA-issued or community -issued BFE) or Zone AO. instructions — Page 5 Check Item G3. if the information in Items G4: G9. has been completed for community floodplain management purposes to document the as -built lowest floor elevation of the building. Section C of the Elevation Certificate records the elevation of various building components but does not determine the lowest floor of the building or whether the building, as constructed, complies with the community's floodplain management ordinance. This must be done by the community. Items G4.-G9. provide a way to document these determinations. Item G4. Permit Number. Enter the permit number or other identifier to key the Elevation Certificate to the permit issued for the building. Item G5. Date Permit Issued. Enter the date the permit was issued for the building. Item G6.-Date Certificate of Compliance/Occupancy Issued. Enter the date that the Certificate of Compliance or Occupancy or similar written official documentation of as -built lowest floor elevation was issued by the community as evidence that all work authorized by the floodplain development permit has been completed in accordance with the community's floodplain management laws or ordinances. Item G7. New Construction or Substantial Improvement. Check the applicable box. "Substantial Improvement" means any reconstruction, rehabilitation, addition, or other improvement of a building, the cost of which equals or exceeds 50 percent of the market value of the building before the start of construction of the improvement. The term includes buildings that have incurred substantial damage, regardless of the actual repair work performed. Item G8. As -built lowest floor elevation. Enter the elevation of the lowest floor (including basement) when the construction of the building is completed and a final inspection has been made to confirm that the building is built in accordance with the permit, the approved plans, and the community's floodplain management laws or ordinances. Indicate the elevation datum used. Item G9. BFE. Using the appropriate FIRM panel, FIS Profile, or other data source, locate the property and enter the BFE (or base flood depth) of the building site. Indicate the elevation datum used. Enter your name, title, and telephone number, and the name of the community. Sign and enter the date in the appropriate blanks. Instructions - Page 6 BUILDING DIAGRAMS The following eight diagrams illustrate various types of buildings. Compare the features of the building being certified with the features shown in the diagrams and select the diagram most applicable. Enter the diagram number in Item A7., the square footage of crawl space or enclosure(s) and the area of flood openings in square inches in Items Ag.a-c, the square footage of attached garage and the area of flood openings in square inches in Items A9.a-c, and the elevations in Items C2.a-g. In A zones, the floor elevation is taken at the top finished surface of the floor indicated; in V zones, the floor elevation is taken at the bottom of the lowest horizontal structural member (see drawing in instructions for Section C). DIAGRAM 1 All slab -on -grade single- and multiple -floor buildings (other than split-level) and high-rise buildings, either detached or row type (e.g., townhouses); with or without attached garage: Distinguishing Feature - The bottom floor is at or show ground level (grade) on at least one side. SC2.b C2.a NEXT HIGHER FLOOR GRADE BOTTOM FLOOR DIAGRAM 3 All split-level buildings that are slab -on -grade, either detached or row type (e.g., townhouses); with or without attached garage. Distinguishing Feature -The bottom floor (excluding garage) is at or above ground level (grade) on atleast one side.- C2.a C2.b HIGHER FLOORS NEXT HIGHER SBADE BOTTOM FLOOR LOOR ........... ...... ...... ... .. Q!T All single- and multiple -floor buildings with basement (other than split-level) and high-rise buildings with basement, either detached or row type (e.g., Distinguishing Feature -The bottom Poor (basement or underground garage) is below ground level (grade) on all sides. Buildings constructed above crawl spaces that are below grade on all sides should also use this diagram.* C2.a NEXT HIGHER FLOOR BOTTOM FLOOR (BASEMENT) C2.b DIAGRAM 4 All split-level buildings (other than slab -on -grade), either detached or row type (e.g., townhouses); with or without attached garage. Distinguishing Feature -The bottom floor (basement or underground garage) is below ground level (grade) on all sides. Buildings constructed above crawl spaces that are below grade on all sides should also use this diagram. C C2.a 2.b HIGHER Lee GRADE FLOORS NEXT HIGHER BOTTOM FLOOR FLOOR BASEMENT) existing grade) A floor that is below ground level (grade) on all sides is considered a basement even if the floor is used for living purposes, or as an office, garage, workshop, etc. Instructions - Page 7 DIAGRAM 5 All buildings elevated on piers, posts, piles, columns, or parallel shear walls. No obstructions below the elevated floor. Distinguishing Feature - For all zones, the area belowthe elevated floor is open, with no obstruction to flow of flood waters (open lattice work and/or readily removable insect screening is permissible). C2.b 8C2.a\ NEXTHIGHERFLOOR ELEVATED FLOOR GRADE i C2.f-g(determriedby existing grade) C2.0 (For V zones only) DIAGRAM 7 All buildings elevated on full -story foundation walls with a partially or fully enclosed area below the elevated floor. This includes walkout levels, where at least one side is at or above grade. The principal use of this building is located in the elevated floors of the building. Distinguishing Feature - For all zones, the area below the elevated floor is enclosed, either partially or fully. In A Zones, the partially or fully enclosed area below the elevated floor is with or without openings" present in the walls of the enclosure. Indicate Information about enclosure size and openings in Section A - Property Information. C2.a C2.b BNEXT HIGHER FLOOR GRADE C2f WALKOUT LEVEL C2.g (ENCLOSURE) y , A8.b-c .. AB.a.. OPENINGS" DIAGRAM 6 All buildings elevated on piers, posts, piles, columns, or parallel shear walls with full or partial enclosure below the elevated floor. Distinguishing Feature - For all zones, the area below the elevated floor is enclosed, either partially or fully. In A Zones, the partially or fully enclosed area below the elevated floor is with or without openings- present in the walls of the enclosure. Indicate information about enclosure size and openings in Section A - Property Information. i NEXT HIGHER i FLOOR C2.a C2.b ELEVATED FLOOR A8.a-c NENCGRADE OSUR Determine enclosure size & openings, if any. 1;2.f tg existing grade) C2.0 (For V zones only) DIAGRAM 8 All buildings elevated on a crawl space with the floor of the crawl space at or above grade on at least one side, with or without an attached garage. Dlsdnguishing Feature- For all zones, the area below the first floor is enclosed by solid or paNal perimeter walls. In all A zones, the crawl space is with or without openings- present In the walls of the crawl space. Indicate information about crawl space size and openings in Section A - Property Information. i I I C2.a i i C2.b GRADE NEXT HIGHER C2.f FLOOR C2.g CRAWL SPACE AS.b-c OPENINGS' ** An "opening" is defined as a permanent opening in a wall that allows for the free passage of water automatically in both directions without human intervention. Under the NFIP, a minimum of two openings is required for enclosures or crawl spaces with a total net area of not less than one square inch for every square foot of area enclosed. Each opening must be on different sides of the enclosed area. If a building has more than one enclosed area, each area must have openings on exterior walls to allow floodwater to directly enter. The bottom of the openings must be no higher than one foot above the grade underneath the flood vents. Alternatively, you may submit a certification by a registered professional engineer or architect that the design will allow for the automatic equalization of hydrostatic flood forces on exterior walls. A window, a door, or a garage door is not considered an opening. Instructions - Page 8 U.S. DEPARTMEKT�OF HOMELANkSECU4 � ELEVATION CERTIFICCAATRE Febtvary 28.20D9 Federal Emergent-y Managaiberi lAgbn . B National Flood Insurance Program Important: Read the )nstrUatiOns On pS_.. �I- TOP UY' r; Z -SEC-qoN A - PROPERTY INFORMATION For l"rf5ulance,Qom . Use- Poncy Number Al. Building Owners Name '- / Z '•.TWlfr E L Coro n NAM Number A2. Building Stree AddmE Cncludfng L: Unit, Suite, and/or Bldg, No.) or P.O Route and Box No. Company Z I ZIP Code State Ofy 51 »S 9- rj B.�A �f� LO A3 Property on on (Lm and Block. Num'r Tax Par»I NN ber, Legal De cxiption. pq. Building Use (e.g.. Residential. Non -Residential. addition. Aarssory. etc.) S F�t/l/f1i- A -A. Latituderlongitude: Lat J 7 7 $,599 N Long go. 7 2 3 4S Horizontal D'�fum:" NAD 1927 �+] NAC' 198:. Ab AttaCh at roast�otogmph• of the building if the Certificate isbeing used to obtain flood insurance. _ •' +^ A7 Building Diagram Number M. For a building with an attached garage, Provide: r AB For a budding with a cawl spars or enclosure(s), provide: LO so it a) Square footage of crawl spate or enaos�e(s) A s4 ff a) Square foomge of Irttarlled garage Ill No. of pennanard flood openings vt the trawl space or b) No. of nW 1. erd flood above adjaingscent n the attached ge anGosumis) walls within 1.0 foot aboveadjacerrl grade walls had am 1.0 tool above iMs i nt 9retle e) Total net area of flood openings in AB.b sq in _ 7e�1 reel area of flood openings in Ag.b _ sq in SECTION B - FLOOD INSURANCE RATE MAP (FIRM) MFORMATION 61. NFlP Commumity Name S Community Nur�Eer f32 Courth' Pia a State r /�A 4Cn -r LU B4..Map1Panel Number r r BB. Suffix B6. FIRM Index . Bi. FIRM Panel B8 Flood Ba Base Flood Buvation(s) (ZoneDale AD. use base flood deem) G Eti'ecnvetRevsed Date Zones) % 170283�7�/ Z _ on B10. Indicate the source of the Base Flood tevation (et-wt) data or case moo" oapa i r,„vac' „• —•• — ❑ FIS profile ® fIRM ❑ CommunityrrvDDerlem(D rined ❑ Ogler escribe) BII. Indicate elevation datum used for BRE in heLC' m Bil: NGVD 1929 ❑ NAVD 1988 ❑Other (Describe) 512. Is the br ilding lo�ated in a Coastal Bartigr Rss esourSystem (CBRS) area or Oftmifte Protected Area (OPA)? ❑'Yes ❑ No Designation Date /V // CBRS DPA Cl Binding eevedons are based on: -A new Elevation C MMoale will be CZ. Elevations-Zonee-At�30, AE, A below according to the building die Benchmark Ubllzed Tliz Comreroion/Commems ❑ Consirumon Drawings- ❑ Building Under ConE ruction' ®Flnishad Canstn+rSon wired when cortslrudion df'trle building is wrtlPlele. A (wtth BPE), vE, vl-V80. V (with BFE), AR. ARIA, ARIAE, AR/A1•A90, ARIAK ARIAC, Camp� home �.a-y am spaofiad in Item A7 Nq y /t 9g6 i ;� Ver11®I D,man l 7 IrR 1 U. mmsuem M u—d a) Top of bosom floor (indudhlg basemen, rrdwl space, or enrJtuure door) 0 m feet ❑ meters (Puerto Rico only) b) Top of the next higher floor —� feat El feet (Pta.Rionly) c) Bottom of the lowest horizontal strucbaal member (V Zones only) . fit ❑meters (Pue. rto Remm only) d) Attaohed garage (top of slab) '�' ynJ 43et ❑meters (Puerto Rico only) e) Lowest elevation or machinery or equipment servicing the. building Ale_ t feel ❑ meters (Purest° Rloo only) (Describe type of equipment in Comments) f) Lowest adjacent (finished) grade (LAG) _�' '�®®'feet ❑ meters (Puerto Phoo only) g) Highest adjacent (finish ad) grade (HAG) v" feet ❑ meters (Puerto Rip only) . • SECTION D- SURVEYOR, ENGINEER, OR. ARCHRBCT CERTIFICATION This certification is 10 be signed and sealed by a land surveyor, engineer• or architect aumonzeo coy law ro mmy:ere.ow„ information I certify that the information on this Certificate represents my best efforts to interpret the data avdilable I dderstand that any talse srarement may be punishable by fine or imprisonment under 18 U. S Cade Section 1001. 0 Check here it comments are provided on back of form J �(e Cenffiers Name Umnse Number Name . �•-�� <nb Ct Ic.✓O SJQU�Iid�s n Form 81-31. February reverae side for continuation L: ccJse�r���65d. 1 COP Replaces ell previous edition IMPORTANT: In these spaces., copy 1;- zwresponding information from Section A. . - For Insurance Building Street Address (including Apt., Unit, >, and/or Bldg. No.) or P.O. Route and Box No. Policy Numbe Chy SECTION O - SURVEYOR, ENGINEERr OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUeompany, and (3) building owner. SECTIDN E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AD AND ZONE A (WITHOUT BFE) For Zones AO and A (wfhoul BFE), complete Items El-E5. If the Certificate Is intended to support a LOMA or LOMR-F request, complete Sections A. B. and C. For Items E1-E4, use natural grade, if available. Check the measurement used. In Puerto Rice only, enter meters. Et. 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 El below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is _ ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Secti¢n ,A Items 6 and/or 9 (see e 8 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is _ ❑ feet L meters Ela 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 low] official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owners authorized representative who completes Sections A, B; and E for Zone A (without a. FEMA-issued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are conact to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State Signature Date Telephone Comments ❑ Check hem if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the communityjs floodplain management ordinance can complete SI and G of this Elevation Certificate. Complete the applicable hem(s) and sign below. Chetic the measurement used in Items G6: 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. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement GB. Elevation of as -built lowest floor (including basement) of the building: G9. BFE or (in Zone AO) depth of flooding at the building site: Local Official's Name Title Communitg Name Telephone v Sinnature '. Date ❑ feel ❑ meters (PP,) ❑ feel ❑ meters (PR) FFMA Form 81-31. February 2D06 Replaces all previous editions Building Photographs See Instructions for Item A6. : MiMME I 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, following. U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency/ National Flood Insurance Program OAl. bNlplmg VWrRrS rvarne .'. • A2. Buildin t Addmss (I in! 2 q }.% e Cry tLtVA I ILAV L;r- < I lr-K EA I C Important Read the instructions on 18 .SECTION A - PROPERTY INFORMATION Unit, Suite, and/or Bldg. No,) or P.0 Route and Box No. !a'f53 Expires February 28. 20D9 For Z BY Use A4. Building Use (e.g.. Residential, Non -Residential, Addition, Accessory. etc.) .J-h G •� �.C. r--r / I7 L.-. As. Latftude/Longitude: Lai. Long Horizontal Datum: ❑ NAD 1927 ❑NAD 1983 As - Attach al least 2 photograph_ of the buildinp if the -Certificate is being used to obtain food Insurance. A7 Building Diagram Number AR For a building with a awl space or enclosure(s), provide: A9. For a building with an medtled garage, provide: crawl a) Square footage of crawl space or endosurels) sq It Square footage of attached garage sq I"ra b) No. of permanent flood o ni in the trawl space or b) No. of pemgment floodppentngs it,, the attached garage endosure(s) walls within rit7�ve &I nt grade walls wihin 1.0 fool above adjacent grade c) Total net area of flood o n9 B.0 n c) Total net arse of flood gpenin9s in Ag.b sq m 61. NFlP Communm�Name a Community Numb;( B2 Cou- - /Zit Z83 li��l S% LJ4 Co �� La ..' CoJ��y State E(..Oi�/v�/ _ B4. MaptPanel Number B5. Suffix B6. FIRM Index B7. FIRM Panel Date 68 Flood Zones) B9. Base Flood Elevation(s) (Zone AO. use base flood depth) 2n2.85 03// G Date NW ,/99 2 E ctive/Revised /VOO. 9 Z .116 `1, O B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 89 ❑ FIS Profile ❑ FIRM ❑ Community.Deternined ❑ Other (Describe) B11. Indicate elevafion datum used for BFE in Item B9: �[4GVD 1929 ❑ NAVE)1988 Elrib Other (Desce) B12. Is the building lasted in a Coastal Banner Resources System (CBRS) area or Otherwise Protected Area (OPA)? Q•Yes ❑ No Designation Date ❑ CBRS ❑ OPA Cl Building elevations are based on: ❑ Construction Drawings' 15 Building Under Construction- ❑ Finished Construction `A near Elevation Gedifica[e will tee required when eonstruotion orthe bus ing is mmplate. C2. BJ tIon5 —Zones Al-A30, AE, AH, A (wbh BFE), VE. V'-V3p. V (with BFE), AR, AMA, AR/AE, AR/A'M1-A,O. AR/AH, AR/A0, Complete Item. C-2.a-9 below according 10 the building diagram cps d iTn hem A7 Benchmark Utilized ZL3D L i% Vadinl D^'•^^ Check the maasuremerd used a) Top of bottom floor (including basement, crawl space, or enclosure floor) O ® feet ❑ meters (Puerto Rico only) b) Top of the next higher floor _Z. �V�J._—❑ feel feel ❑ meters (Puerto Rico only) ❑ meters (Puerto Rim only) c) Bottom of the lowest horizontal structural member (V Zones only) feet ❑ ureters (Puerto Rim only) d) e) Attached garage (lop of slab) Lowest elevation of machinery or equipment se�rvf/ep ng the building rr❑✓�, .�,. = -A test ❑ meters (Puerto Rice only) f) (Describe type of equipment in Comments) Lowest adjacent (finished) grade (LAG) © feet ❑ meters (Puerto Pico only) g) Highest adjacem (finished) grade (HAG) . O © feet ❑ meters (Puerto Pico only) SECTION D - SURVEYOR, ENGINEER. OR ARCHrTECT CERTIFICATION This certification is 10 be signed and sealed by a land surveyor, engineer, or architect autnonzeo oy law to Gentry ele information I certi¢y that the int011722601? on this Certificate represents mr, best efforts to interpre! the data available I understand thal any talse statement may be punishable by fine or imprisonment under 18 U.S Code Section 7007 D Check here if comments are provided on back of forth .0 2005 -Y �(e rose Number S - 2 S,,,,mverae side for c minuation P.eplaces ell previous editions IMPORTANT: In these spaces, copy. or Section A. � � . I For Insurance City u....._ - .�,q J �=Aco 7LD ;QA 3y956" SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) building owner. GA SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items Et -ES. rf 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. Cherie the measurement used. In Puerto Rico ordy, enter meters. . Et. Provide elevation information for the following and check the.appropnate 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, crawl:space, or enclosure) is _ El feet ❑ meters ❑ above or ❑ below the HAG. m b) Top of bottom floor (including baseent, crawl space, or enclosure) is - _ ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Secd9rL A Items 8 and/or 9 (see pale 8 of Instructions), the next higher floor (elevation C2.b irtthe diagrams) of the building is _ ❑ feet Li meters ❑above or Li below the HAG. E3. Attached'gamge (top of slab) is ' . _ ❑ feet ❑ meters ❑ above: or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servldng'the building is _ ❑ feet ❑ meters ❑ above or ❑,be)ow 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 communitys floodplain management ordinance? E] Yes E] No El Unknown. The local official must oe" this i1.nformation in Se1.ction G. - - N/� SECTION F - PROPERTY OWNER IOR 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 Address City Signature Date Telephone Comments ZIP Code 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 flem(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 byiaw to certify elevation infomration. (Indicate the source and date of the elevation date 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 G4A9' .) is provided for community floodplain management purposes. G4. Permit Number I G5. Dale Permit Issued G7. This per it has been issued for: ❑ New Construction ❑ Substantial Improvement GB. 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 she: ❑ feet ❑ meters (PR) Datum Local Official's Name Title Community Name Telephone ❑ Cheo(Chem If attachments I`EMA Form g1-21, rebrunry 2DOG Replaces all previous editions