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929 CARY RD - ELEVATION CERTIFICATE - FINALU.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program Al. Building Owner's Name Tom Strickland ELEVATION CERTIFICATE Important: Read the instructions on pages 1-8. SECTION A - PROPERTY INFORMATION OMB No. 1660-0008 Exoires February 28. 2009 T--IKV(L- For Insurance Company Use: Policy Number A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. tf �mpany NAIC Number 929 Cary Road City Edmonds State WA ZIP Code 98020 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Parcels A through G of survey recorded AFN 200002115003, Records of Snohomish County OFF( ppM,�, 9 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Res ��CF6ko DS CT8. A5. Latitude/Longitude: Lat. 47-49-14.71 N Long. 122-22-27.61 W 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 3 A8. For a building with a crawl space or enclosure(s), provide A9. For a building with an attached garage, provide: a) Square footage of crawl space or enclosure(s) 2,160 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 0 walls within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b 0 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 Edmonds, City of 530163 Snohomish I WA B4. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone Date Effective/Revised Date Zone(s) AO, use base flood depth) 1306 E Nov. 8, 1999 Nov. 8, 1999 A 12.5 feet 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) Simplified Method Bl l . Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 ® NAVD 1988 ❑ 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, 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. Benchmark Utilized See Comments Vertical Datum NAVD 88 Conversion/Comments a) Top of bottom floor (including basement, crawl space, or enclosure floor)_ b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment in Comments) f) Lowest adjacent (finished) grade (LAG) g) Highest adjacent (finished) grade (HAG) Check the measurement used. 18.80 ® feet ❑ meters (Puerto Rico only) ❑ feet ❑ meters (Puerto Rico only) ❑ feet ❑ meters (Puerto Rico only) ❑ feet ❑ meters (Puerto Rico only) ❑ feet ❑ meters (Puerto Rico only) 18.65 ® feet ❑ meters (Puerto Rico only) 21.30 ® feet ❑ meters (Puerto Rico only) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (p Eq.) /140 , 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. l 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 Seth D. O'Hare, PLS License Number 38985 Title Professional Land 4u4eyor Company Name Duane Hartman and Associates Address (16R8 Wovnle)Redond Rd. #B-107 City Woodinville State WA ZIP Code 98072 10/23/2006 Telephone 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 929 Cary Road City Edmonds State WA ZIP Code 98020 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 Reference Mark 175 from FIRM Map is several miles and almost 400 vertical feet from the site. The benchmark used for this certification is Washington Department of Transportation monument ID 190 with a designation of "Edmonds". 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 El-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 page 8 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 Authorized Representative's Name Seth D. O'Hare, PLS Address 928 W di it edmond Road #13-107 City Woodinville State WA ZIP Code 98072 Signature Date LIP Telephone 425-483-5355 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 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 t _�,•i�, G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Da 011 Local Official's Name Title •.'® Community Name Telephone Signature Date A + Comments I899�NZ3��.• KILFIRES Building Photographs See Instructions for Item A6. For Insurance 1 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 929 Cary Road City Edmonds State wA ZIP Code 98020 Company NAIC 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. FRONT LEFT Building Photographs Continuation Page Forinsurancel Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 929 Cary Road City Edmonds State wA ZIP Code 98020 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." RIGHT BACK All pictures taken 10/19/2006