2007-0551 Sundquist Elevation CertZot�`� -056
M. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc-)
As5Essoe1s •P,aece-L- 00. 2'7o432oa3aafocb
A4. Building Use (e-g-, Residential, Non -Residential, Addition, Accessory, etc.) RESt 00tJ QAL
A5. Latitude/Longitude: Lat. 7" 47' 05,0'r Long. 122Q 19 ` 59.S' r Horizontal Datum: ❑ NAD 1927 v 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
A8. For a building with a crawl space or encosure(s), provide: 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 ft
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 foot above adjacent grade walls within 1.0 foot above adjacent grade
c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number B2. County Name B3. State
� VVASfA 1 N &T-otJ
B4. Map/Panel Number
B5. Suffix
B6. FIRM Index
87, FIRM Panel
B8- Flood
B9. Base Flood Elevation(s) (Zone
5,b0AG 1361�5
E
Date
Effecti e/R vised Date
iI
Zone(s)
AO, use base flood depth)
'Z82150
11g (999
g 199g
A
Bi 0.
B11.
B12.
Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile ❑ FIRM 0 Community Determined ❑ Other (Describe)
Indicate elevation datum used for BFE in Item B9: R NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe)
Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)?
Designation Date ❑ CBRS ❑ OPA
❑ Yes ® No
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, AL, AH, A (with BFE), VE, V1430, V (with BFE), AR, ARIA, ARIAE, AR/A1-A30, ARIAH, ARIAO. Complete Items C2.a-g
below according to the building diagram specified in Item A7.
Benchmark Utilized MUNUMENI tP 11,=T 2 &f-h 1_7&, l
Vertical Datum N61rrD [929
Conversion/Comments B tyGN hACL
{1r -
o 7-/S(991 E
0_t�(.28P�K-
Check the measurement used.
a) Top of bottom floor (including basement, crawl space, or enclosure
floor) 24 } I
30d
feet
N feet
❑ meters (Puerto Rico only° ,
❑ ry F rz
b) Top of the next higher floor
c) Bottom of the lowest horizontal structural member (V Zones only)
._Id
_❑ feet
meters (Puerto Rico on y
❑ meters (Puerto Rico on MAY
Ivlr 2007
d) Attached garage (top of slab)
294g n feet
El meters (Puerto Rico only) a 4IS
e) Lowest elevation of machinery or equipment servicing the building
_❑ feet
❑ meters (Puerto Rico onfyU1LB1G Up�Tl1h1=N7
I)I
(Describe type of equipment in Comments)
f) Lowest adjacent (finished) grade (LAG)
29D_ .Cd ❑ feet
Sr OF F..PARTME
DMONDS
❑ meters (Puerto Rico only)
g) Highest adjacent (finished) grade (HAG)
3aD 'Go feet
meters (Puerto Rico only)
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation,
information. I certify that the information on this Certificate represents my best efforts to interpret the data available.
i understand That any false statement may be punishable by fine or imprisonment under 78 U.S. Code, Section 100 i.`-� T
❑ Check here if comments are provided on back of form.
Jr--FT:'ZE`F -TV-P—LBEZ
33 AaE, L0.41200
Si
FEMA Form 81-31, February 0115
'1
License Number
'�_iyuEr LAKJD ASSnC., 0-16-
Company Name
L.\COs SWOOD 1�4 C}a02)6
City State ZIP Code
Daate_'' Telephone
I4" - �v�r9
L&-to
IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use:
Building Street Ad re s (inGudin Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number
23�75 7 IkV r`SU E
City State ZIP Code Company NAIC Number
t7_70MOOD!S: WA
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agentfcompany, and (3) building owner.
Comments
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 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, crawl space, or enclosure) is _ ❑ feet ❑ 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 in Section A Items 8 and/or 9 (see a e 8 of Instructions), the next higher floor
(elevation C2.1b in the diagrams) of the building is E]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 owners authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community -issued BFE)
or Zone AO must sign here. The statements in Sections A, B. and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address C�i�x State ZIP Code
V.o . Box L?'M40eD WA 204
Sign.'re �,_'11J/i2�i 5� 17 -42T &76 -27/{ --
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. ❑ The following information (Items G4.-G9.) is provided for community floodplain management purposes.
G4_ Permit Number G5. Date Permit Issued I G9. 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
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑ Check here if attachments
FEMA Form 81-31, February 2006 Replaces all previous editions