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Home My WebLink AboutElevation_Certificates_oldELEVATION CERTIFICATE, page 2 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: 813 44th Street NW City State ZIP Code Company NAIC Number: Auburn WA 98001 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 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 fol lowing 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 D meters D above or ~below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ___ . ___ ~feet D meters D 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 ___ . ___ IZI feet D meters ~above or D below the HAG. E3. Attached garage (top of slab) is ___ . ___ IZI feet D meters D above or ~below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ~ feet D meters ~above or D 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? DYes D No D 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 or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments --------------------------------------------D Check here if attachments. SECTION G -COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by Jaw 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-G10. In Puerto Rico only, enter meters. Gl. D 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 Jaw to certify elevation information. (Indica te the source and date of the elevation data in the Comments area below.) G2. D 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. D Tile following information (Items G4-G10) 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: D New Construction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: ___ . __ _ G9. BFE or (in Zone AO) depth of flooding at the building site: ___ . __ _ G10. Community's design flood elevation: Local Official's Name Title Community Name Telephone Signature Date Comments Dfeet D feet D meters D meters Datum _________ _ Datum---------- D feet D meters Datum ---------- --------------------------------------------D Check here if attachments. FEMA Form 086-0-33 (Revised 7/12) 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 1205 501h ST NE City AUBURN State WA ZIP Code 98002 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 D 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. E 1. 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 __ .__ 0 feet D meters D above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet D meters D above or D 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 __ .__ D feet D meters D above or D below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters D above or D 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? 0 Yes 0 No D 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 Address City State ZIP Code Signature Date Telephone Comments D 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. D 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. D 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. D 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: D New Construction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ 0 feet D meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet 0 meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions FEMA Form 81-31, February 2006 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. 1208 50th ST NE Policy Number City AUBURN State WA ZIP Code 98002 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 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. E1. 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’s Authorized Representative’s Name Address City State ZIP Code Signature Date Telephone 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 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 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. 1208 50th ST NE Policy Number City AUBURN State WA ZIP Code 98002 Company NAIC 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, following. Lot 76 North Face 08-20-08 Lot 76 East Face 08-20-08 Building Photographs Continuation Page For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1208 50th ST NE Policy Number City AUBURN State WA ZIP Code 98002 Company NAIC 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.” Lot 76 South Face 08-20-08 Lot 76 West Face 08-20-08 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. 1209501Hst NE Policy Number City Auburn State Wa ZIP Code 98002 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 D 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 aLOMA 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. E1. 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 __ .__ D feet D meters 0 above or 0 below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet 0 meters D above or 0 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 __ .__ D feet D meters D above or 0 below the HAG. E3. Attached garage (top of slab) is __ .__ 0 feet D meters 0 above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters 0 above or D 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? 0 Yes 0 No D 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 Address City State ZIP Code Signature Date Telephone Comments D 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. 0 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. 0 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. 0 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: D New Construction 0 Substantial Improvement GB. Elevation of as-built lowest floor (including basement) of the building: __ . ___ 0 feet 0 meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet 0 meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31, February 2006 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 1213 50TH St NE City AUBURN State WA ZIP Code 98002 Company NAIC Number SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner. Comments Signature Date D 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 aLOMA 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. E 1. 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 __ .__ D feet D meters D above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet D meters D above or 0 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 __ .__ 0 feet D meters D above or D below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters D above or D 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? DYes D No D 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, 8, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments D 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 . D 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. D 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. D 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: D New Construction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ 0 feet D meters (PR) Datum __ G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ 0 feet 0 meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here if attachments FEMA Form 81-31, February 2006 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 1217 50TH St NE City AUBURN State WA ZIP Code 98002 Company NAIC Number SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner. Comments Signature Date D 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 aLOMA 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. E1. 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 __ .__ D feet D meters D above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet D meters D above or D 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 __ .__ D feet D meters D above or D below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters D above or D 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? DYes D No D 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 Address City State ZIP Code Signature Date Telephone Comments D 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. D 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. D 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. D 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: D New Construction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ 0 feet D meters (PR) Datum __ G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet D meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31, February 2006 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 1221 50TH St NE City AUBURN State WA ZIP Code 98002 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 D 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 aLOMA 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. E1 . 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 __ .__ D feet D meters D above or 0 below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet D meters D above or D 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 __ .__ D feet D meters D above or D below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ 0 feet D meters D above or D 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? DYes 0 No 0 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 Address City State ZIP Code Signature Date Telephone Comments D 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. 0 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. D 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. 0 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: D New Construction D Substantial Improvement GB. Elevation of as-built lowest floor (including basement) of the building: __ . ___ 0 feet D meters (PR) Datum __ G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet D meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31, February 2006 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 1225 SO'h ST NE City AUBURN State WA ZIP Code 98002 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 0 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 aLOMA 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. E1. 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 __ .__ 0 feet D meters D above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ 0 feet D meters D above or D 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 __ .__ D feet D meters D above or D below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ 0 feet D meters 0 above or D 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? DYes D No 0 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 Address City State ZIP Code Signature Date Telephone Comments D 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 . 0 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. 0 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. 0 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: 0 New Construction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ 0 feet 0 meters (PR) Datum __ G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet D meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here if attachments FEMA Form 81-31, February 2006 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 122950THSt NE City AUBURN State WA ZIP Code 98002 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 D 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 aLOMA 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. E1 . 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 __ .__ 0 feet 0 meters D above or 0 below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ 0 feet 0 meters 0 above or 0 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 __ .__ 0 feet D meters D above or 0 below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters 0 above or D 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? 0 Yes D No D 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, 8, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments 0 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 . 0 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. 0 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. 0 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: 0 New Construction 0 Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ 0 feet D meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ 0 feet 0 meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here if attachments FEMA Form 81-31 , February 2006 Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance C6J11pany Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1220 51'1 Place, Units 101-105 Polley Number ·· City Auburn State Washington ZIP Code 98002 Comp~nY NAJC Nurnf?er · 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 Machinery consists of hot water heater located on pad In garage. Signature Date 0 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. E1. 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 __ .__ 0 feet 0 meters 0 above or 0 below the HAG. b) Top of bottom floor (Including basement, crawl space, or enclosure) is __ .__ 0 feet 0 meters 0 above or 0 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 __ .__ 0 feet 0 meters 0 above or 0 below the HAG. E3. Attached garage (top of slab) Is --·--0 feet 0 meters 0 above or 0 below the HAG. E4. · Top of platform of machinery and/or equipment servicing the building Is --·--0 feet 0 meters 0 above or 0 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? 0 Yes 0 No 0 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 Seollons A, B, and E are oorreot to the best of my knowledge, Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments 0 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 ltem(s) and sign below. Check the measurement used in Items G8. and G9. G1. 0 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. 0 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. 0 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 G?. This permit has been Issued for: 0 New Construction 0 Substantial improvement G8. Elevation of as-built lowest floor (Including basement) of the building: --·--.0 feet 0 meters (PR) Datum __ G9. BFE or (In Zone AO) depth of flooding at the building site: · --·--0 feet 0 meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here if attachments FEMA Form 81-31, February 2006 :; . 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. 1136 51ST ST NE Policy Number City AUBURN State WA ZIP Code 98002 Company NAIC 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, following. Lot 69 East Face 11-07-07 Lot 69 North Face 11-07-07 Building Photographs Continuation Page For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1136 51ST ST NE Policy Number City AUBURN State WA ZIP Code 98002 Company NAIC 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.” Lot 69 South Face 11-07-07 Lot 69 East Face 11-07-07 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. 1140 51ST ST NE Policy Number City AUBURN State WA ZIP Code 98002 Company NAIC 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, following. Lot 68 East Face 11-07-07 Lot 68 North Face 11-07-07 Building Photographs Continuation Page For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1140 51ST ST NE Policy Number City AUBURN State WA ZIP Code 98002 Company NAIC 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.” Lot 68 South Face 11-07-07 Lot 68 West Face 11-07-07 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. 1202 51 51 STNE Policy Number City AUBURN State WA ZIP Code 98002 Company NAIC Number SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of th is Elevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner. Comments Signature Date D 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. E1 . 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 __ .__ D feet D meters D above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet D meters D above or D 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 __ .__ D feet D meters D above or D below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters D above or D 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? D Yes D No D 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 Address City State ZIP Code Signature Date Telephone Comments D 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 . D 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. D 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. D 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: D New Construction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ D feet D meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet D meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31 , February 2006 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 1206 51 '1 ST NE City AUBURN State WA ZIP Code 98002 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 0 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 aLOMA 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. E1. 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 __ .__ 0 feet 0 meters 0 above or 0 below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ 0 feet D meters 0 above or D 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 __ .__ D feet D meters 0 above or D below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ 0 feet D meters 0 above or 0 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? 0 Yes 0 No 0 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 Address City State ZIP Code Signature Date Telephone Comments D 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 . D 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. D 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. D 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: D New Construction 0 Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ D feet 0 meters (PR) Datum __ G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet 0 meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31, February 2006 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 1210 51'1 ST NE City AUBURN State WA ZIP Code 98002 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 D 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 E 1-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. E 1. 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 __ .__ D feet D meters D above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet D meters D above or D 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 __ .__ D feet D meters D above or D below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters D above or D 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? DYes D No D 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 Address City State ZIP Code Signature Date Telephone Comments D 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 . D 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. D 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. D 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: D New Construction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ 0 feet D meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet D meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31, February 2006 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 1214 51 '' ST NE City AUBURN State WA ZIP Code 98002 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 D 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. E1 . 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 __ .__ D feet D meters D above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet D meters D above or D 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 __ .__ D feet D meters D above or D below the HAG. E3. Attached garage (top of slab} is __ .__ D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters D above or D 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? DYes D No D 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 Address City State ZIP Code Signature Date Telephone Comments D 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 . D 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. D 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. D 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: D New Construction D Substantial Improvement GB. Elevation of as-built lowest floor (including basement) of the building: __ . ___ D feet D meters (PR) Datum __ G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet D meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31, February 2006 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 1218 51 '1 ST NE City AUBURN State WA ZIP Code 98002 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 D 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 aLOMA 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. E1 . 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 __ .__ D feet D meters D above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet D meters D above or D 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 __ .__ D feet 0 meters D above or D below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters D above or D 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? DYes D No D 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, 8, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments D 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. D 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. D 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. D 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: D New Construction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ D feet D meters (PR) Datum __ G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet D meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31 , February 2006 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 1222 5151 ST NE City AUBURN State WA ZIP Code 98002 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 0 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 aLOMA 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. E1 . 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 __ .__ 0 feet 0 meters 0 above or 0 below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ 0 feet 0 meters 0 above or D 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 __ .__ 0 feet D meters D above or D below the HAG. E3. Attached garage (top of slab) is __ .__ 0 feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters D above or D 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? DYes 0 No 0 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, 8, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments D 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. 0 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. 0 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. D 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: D New Construction 0 Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ 0 feet D meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet 0 meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31, February 2006 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 1226 51 '1 ST NE City AUBURN State WA ZIP Code 98002 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 0 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 aLOMA 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. E1. 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 __ .__ 0 feet 0 meters 0 above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ 0 feet D meters D above or D 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 __ .__ 0 feet 0 meters D above or 0 below the HAG. E3. Attached garage (top of slab) is __ .__ 0 feet 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ 0 feet 0 meters 0 above or 0 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? DYes 0 No 0 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 Address City State ZIP Code Signature Date Telephone Comments 0 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. D 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. 0 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. 0 The following infonmation (Items G4.-G9.) is provided for community floodplain management purposes. G4. Permit Number G5. Date Penmit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: D New Construction 0 Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ 0 feet D meters (PR) Datum __ G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ 0 feet 0 meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here if attachments FEMA Form 81-31, February 2006 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. 123051rHst NE Policy Number City AUBURN State WA ZIP Code 98002 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 D 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 aLOMA 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. E1 . 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 __ .__ D feet D meters D above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet D meters D above or D 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 __ .__ D feet D meters D above or D below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters D above or D 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? D Yes D No D 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 Address City State ZIP Code Signature Date Telephone Comments D 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 . D 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. D 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. D 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: D New Construction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ D feet D meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet D meters (PR) Datum Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31 , February 2006 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 1234 5151 ST NE City AUBURN State WA ZIP Code 98002 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 D 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 aLOMA 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. E1. 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 __ .__ D feet 0 meters D above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet 0 meters D above or D 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 __ .__ D feet D meters D above or D below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters D above or D 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? DYes D No D 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 Address City State ZIP Code Signature Date Telephone Comments 0 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. D 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. D 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. D 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: D New Construction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ 0 feet D meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet D meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions 0• 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. 1205 52"d Place NE, Units 101-105 Polley Number City Auburn State Washin·gton ZIP Code 98002 Company NAIC Number SECTION D ·SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) Insurance agenl/company, and (3) building owner. Comments Machinery consists of hot water h~ater located on pad In garage. Signature Date D Check here If attachments SECTIQN 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 aLOMA 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. E1. 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 __ .__ D feet D meters D above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) Is--·--D feet D meters D above or 0 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 -. _.__ D feet D meters D above or D below the HAG. E3. Attached garage (top of slab} Is --·--D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building Is __ . __ D feet D meters D above or D 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? D Yes D No D 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, 8, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments D 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 GB. and G9. G1. D 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. D 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. D 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: D New Construction D Substantial improvement G8. Elevation of as-built lowest floor (Including basement) of the building: __ . __ .D feet D meters (PR) Datum __ G9. BFE or (In Zone AO) depth of flooding at the building site: __ .__ D feet D meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions \ ' \ I I t' ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No 3067-0077 Expires May 31, 1993 ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to 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 or LOMR). Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE BUILDINq OWNER:9 NA1.E .. ""· ~. ~+~~~\ t-POLICY NUMBER /) tJt l_;,n.A .; , STREET ADDRESS (lnJ.u8ing A~t., LJnit.'Suite and/,or B!~· rmber) OR ~.O.~OUTE AND BOX NUMRR \ COMPANY NAIC NUMBER ?-?D~ . · b~..\o·£-\.r:A.~ l.2 ~c/~J cJ rJ:...c- OTHER DESCRIPTION (Lot and Slock Numbers, etc.) \ I.L ,· · . · :2.0 2-1 D't;=··-Cf o;-8 CITY A \· · . , , .. , · . 1 s_TATE 7jY'<q~· lA \f' , • . : .. i ,, w A--ZIP CODE Cf((oa J- Provide the following f;om the proper FIRM (S~e Instructions): ,•, .:,0 ~ • .'1' .. · 1. COMMUNITY·:NJ,Jfv1B,EI;l1, " . : ;g, ~,A.N~![ll.UMBllilH' 3. SUFFIX 4. DATE OF FIRM INDEX 5. FIRM ZONE 6. BASE FLOOD ELEVATION ,,-3007; OtEL D >~(2-t:t 1 I ct()"f A-r-1-(In AO Zones, use depth) ~7 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): '0 NGVD '29 D Other (describe 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: I I I I I I. U feet NGVD (or other FIRM datum-see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level _J_ . 2(a). FIRM Zones A 1-A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram Is at an elevation of I I I 1'[1.1) feet NGVD (or other FIRM datum-see Section 8, 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 I.U 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 W. U feet above D or below D (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 W .U feet above D or below D (check 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? D Yes No D Unknown 3. Indicate the elevation datum system used in determining the above· reference level elevations:R NGVD '29 D Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on the FIRM {see Section 8, Item 7], 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: D Yes ~No (See Instructions on Page 4) 5. The reference level elevation is based on: P? actual construction D construction drawings . (NOTE: Use of construction drawings is only valid if 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: I I I tf1?1.12J feet NGVD (or other FIRM datum-see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If 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 floodplain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is: I I I 10fi.U feet NGVD (or other FIRM datum-see Section B, Item 7). 2. Date of the start of construction or substantial improvement _________ _ FEMA Form 81-31, MAY 90 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION 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 3611 'I' Street NE Space #170 City Auburn State WA ZIP Code 98002 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 This building is a mobile home on a concrete slap. The building owner leases the space occupied by the mobile home. There is a 42'X12' concrete slab on the south side of the building and is used as a combination carport and patio. There is a 8.0'X25.6' wooden deck on the north side of the building. 7.0'X9.5' metal shed on a concrete slab in the back yard. . JiJw4 r;tJ ~ /6-/3 -2oiO D 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 aLOMA 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. E 1. 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 __ .__ D feet D meters D above or D below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is __ .__ D feet D meters D above or D below th e 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 __ .__ D feet D meters D above or D below the HAG. E3. Attached garage (top of slab) is --·--D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters D above or D 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? D Yes D No D 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, 8, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments D 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. D 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. D 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. D 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: D New Construction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ .__ D feet D meters (PR) Datum __ G9. BFE or (in Zone AO) depth of flooding at the building site: G1 0. Community's design flood elevation Local Official's Name Community Name Signature Comments Title D feet D meters (PR) Datum __ D feet D meters (PR) Datum __ Telephone Date --------------------------------------------0 Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Slreet Address (including ApL Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 3611 I STREET, NE, SPACE 180 City AUBURN State WA ZIP Code 98002 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 ELEVATIONS IN SECTION CARE BASED ON CITY OF AUBURN BM #OC-1, ELEVATION 49.96 FEET, DATUM NGVD 29. MACHINERY: FURNACE IS AT LOCATED ON THE FINISH FLOOR ELEVATION OF 53.8 FEET, DATUM NGVD 29. ~:ff~ Signature Date 2/11115 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. E1. 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 --·--0 feet 0 meters 0 above or 0 below the HAG. b) Top of bottom floor (including basement. crawlspace, or enclosure) is --·--0 feet 0 meters 0 above or 0 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 --·--0 feet 0 meters 0 above or 0 below the HAG. E3. Attached garage (top of slab) is --·--0 feet 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is --·--0 feet 0 meters 0 above or 0 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? 0 Yes 0 No 0 Unknown. The local official must certify thls 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 B FE) 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 State ZIP Code Signature Date Telephone Comments -------------------------------------------'0 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-G10. In Puerto Rico only, enter meters. G1. 0 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. 0 A community offi,cial completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO. G3. 0 The following information (Items G4-G1 0) 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: 0 New Construction 0 Substantial Improvement G8. Elevation of a::rbuilt lowest floor (including basement) of the building: __ __ 0 feet G9. BFE or (in Zone AO) depth of flooding at the building site: --·--0 feet 0 meters 0 meters G1 Q_ Community's design flood elevation: D feet D meters Local Official's Name Title Community Name Telephone Signature Date Comments Datum Datum Datum -------------------------------------------0 Check here if attachments_ FEMA Form 086-0-33 (7/12) Replaces all previous editions. IMPORT Afn: In these spaces, copy the corresponding infonnation from Section A. For Insurance Company Use: BUil<QING 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 agenUcompany, and (3) building owner. COMMENTS I I Check here if attachmen SECTION E ·BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items E1. through E4. If the Elevation Certificate is intended for use as supporting information for aLOMA or LOMR-F, Section C must be completed. . E 1. Building Diagram Number __ (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photogra,Ph.) E2. The top of the bottom floor (including basement or enclosure) of the building is I_U ft.(m) l_l_lin.(cm) l_l above or l_l belo~ (check one) the highest adjacent grade. (Use natural grade, if available.) E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is l_l_l ft.(m) l_l_lin.(cm) above the highest adjacent grade. Complete Items C3.h and C3.i on front of form. E4. For 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? I I Yes I I No I I 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, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, 8, C, and E are correct to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHON.E COMMENTS 1_1 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. G 1. !_I The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. !_I A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or ZoneAO. G3.1_1 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 beeri issued for: l_l New Construction !_I Substantial Improvement GB. Elevation of as-built lowest floor (including basement) of the building Is: . _ft.(m)Datum: ____ _ G9. BFE or (in Zone AO) depth of flooding at the building site is: . _ft.(m)Datum: ____ _ LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS I Check here if attachments 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 4904 L COURT NE City AUBURN State WA ZIP Code 98002 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) bui lding owner. Comments Signature Date D 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 aLOMA 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. E1 . 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 __ .__ D feet D meters D above or 0 below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet D meters D above or D 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 __ .__ D feet D meters D above or D below the HAG. E3. Attached garage (top of slab) is __ .__ 0 feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters D above or D 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? D Yes D No D Unknown. Th e 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 Address City State ZIP Code Signature Date Telephone Comments D 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. D 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. D 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. 0 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: D New Construction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ 0 feet D meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet D meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31, February 2006 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 4908 L COURT NE City AUBURN State WA ZIP Code 98002 Company NAIC Number SECTION D ·SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certifi cate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments Signature Date D 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 th e 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. E1. 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 fl oor (including basement, crawl space, or enclosure) is __ .__ D feet D meters D above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet D meters D above or D 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 __ .__ D feet D meters D above or D below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters D above or D 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? D Yes D No D 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 Address City State ZIP Code Signature Date Telephone Comments D 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. D 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 . D G3. D A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO. 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: D New Construction D Substantial Improvement G8. Elevation of as-built lowest fl oor (including basement) of the building: __ . ___ D feet D meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the bui lding site: __ .__ D feet D meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31 , February 2006 Replaces all previous ed itions 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 4909 L COURT NE City AUBURN State WA ZIP Code 98002 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 0 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. E1 . 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 __ .__ 0 feet 0 meters 0 above or 0 below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ 0 feet 0 meters 0 above or 0 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 __ .__ 0 feet D meters 0 above or 0 below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ 0 feet D meters D above or 0 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? DYes 0 No 0 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 Address City State ZIP Code Signature Date Telephone Comments 0 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 . D 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. 0 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. 0 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: 0 New Construction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ 0 feet 0 meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ 0 feet 0 meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here if attachments FEMA Form 81-31 , February 2006 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 4912 L COURT NE City AUBURN State WA ZIP Code 98002 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 0 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 aLOMA 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. E1 . 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 __ .__ 0 feet 0 meters 0 above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ 0 feet 0 meters 0 above or D 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 __ .__ D feet 0 meters 0 above or D below the HAG. E3. Attached garage (top of slab) is __ .__ D feet 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ 0 feet 0 meters 0 above or D 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? 0 Yes D No 0 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 Address City State ZIP Code Signature Date Telephone Comments 0 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. 0 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.) G2.0 G3.0 A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO. 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: 0 New Construction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ 0 feet 0 meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ 0 feet D meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here if attachments FEMA Form 81-31, February 2006 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 4913 L COURT NE City AUBURN State WA ZIP Code 98002 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 D 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 aLOMA 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. E1 . 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 __ .__ D feet D meters D above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet D meters D above or D 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 __ .__ D feet 0 meters 0 above or D below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ 0 feet D meters D above or 0 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? D Yes 0 No D 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 Address City State ZIP Code Signature Date Telephone Comments D 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 th e applicable item(s) and sign below. Check the measurement used in Items G8. and G9. G1 .0 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. D G3. D A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO. 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: D New Construction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ D feet D meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet D meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31, February 2006 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 4916 L COURT NE City AUBURN State WA ZIP Code 98002 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 D 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 aLOMA 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. E1 . 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 fioor (including basement, crawl space, or enclosure) is __ .__ D feet D meters 0 above or D below the HAG. b) Top of bottom fioor (including basement, crawl space, or enclosure) is __ .__ D feet D meters D above or D 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 __ .__ 0 feet D meters 0 above or 0 below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ 0 feet 0 meters 0 above or D below the HAG. E5. Zone AO only: If no fiood depth number is available, is the top of the bottom fioor elevated in accordance with the community's floodplain management ordinance? 0 Yes D No 0 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 Address City State ZIP Code Signature Date Telephone Comments 0 Check here if attachments SECTION G-COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's fioodplain 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 . D 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 . D 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. D The following information (Items G4.-G9.) is provided for community fioodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: 0 New Construction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ D feet 0 meters (PR) Datum G9. BFE or (in Zone AO) depth of fiooding at the building site: __ .__ D feet D meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here if attachments FEMA Form 81-31, February 2006 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 4917 L COURT NE City AUBURN State WA ZIP Code 98002 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 0 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 aLOMA 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. E1 . 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 __ .__ D feet D meters 0 above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet 0 meters D above or D 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 __ .__ D feet 0 meters 0 above or 0 below the HAG. E3. Attached garage (top of slab) is __ .__ 0 feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet 0 meters D above or D 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? DYes 0 No D 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 Address City State ZIP Code Signature Date Telephone Comments 0 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. 0 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. 0 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. D 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: D New Construction 0 Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ 0 feet 0 meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ 0 feet 0 meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here if attachments FEMA Form 81-31 , February 2006 Replaces all previous editions IMPORT ANT: 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 4920 L COURT NE City AUBURN State WA ZIP Code 98002 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 D 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. E1 . 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 __ .__ D feet D meters D above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet D meters D above or D 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 __ .__ D feet D meters D above or D below the HAG. E3. Attached garage (top of slab) is __ .__ D feet D meters D above or D below the HAG. E4 . Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters D above or D 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? D Yes D No D 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, 8, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments D 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. D 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.) G2.0 G3.0 A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO. 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: D New Constru ction D Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ D feet D meters (PR) Datum __ G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet 0 meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous ed itions 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 4921 L COURT NE City AUBURN State WA ZIP Code 98002 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 D 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 aLOMA 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. E1 . 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 __ .__ D feet D meters D above or D below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __ .__ D feet D meters D above or D 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 __ .__ D feet D meters D above or D below the HAG. E3. Attached garage (top of slab} is __ .__ D feet D meters D above or D below the HAG. E4. Top of platfonm of machinery and/or equipment servicing the building is __ . __ D feet D meters D above or D 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? DYes D No D 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, 8, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments D 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. D The infonmation 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 infonmation. (Indicate the source and date of the elevation data in the Comments area below.) G2. D 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. D 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 penmit has been issued for: D New Construction D Substantial improvement G8. Elevation of as-built lowest floor (including basement) of the building: __ . ___ 0 feet D meters (PR) Datum __ G9. BFE or (in Zone AO) depth of flooding at the building site: __ .__ D feet D meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31, February 2006 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. Polley Number 51.12 'L' Place NE, Units 101-105 City Auburn State Washington ZIP Code 98002 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 Machinery consists of hot water heater located on pad In garage. Signature Date D 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 aLOMA 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. E1. 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 __ . __ . D feet D meters D above or D below the HAG. b) Top of bottom floor (Including basement, crawl space, or enclosure) Is __ .__ 0 feet 0 meters 0 above or D below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided In Section A Items 8 and/or 9 (se~age 8 of Instructions), the next higher floor (elevation C2.b In the diagrams) of the building Is __ .__ 0 feet D meters 0 above or 0 below the HAG. E3. Attached garage (top of slab) Is --·--D feet D meters D above or D below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __ . __ D feet D meters D above or D 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? D Yes D No 0 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, 8, and£ are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments D 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 GB. and G9, G1. 0 The information in Section C was tal<en 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. D 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. D 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: D New Construction D Substantial improvement G8. Elevation of as-built lowest floor (Including basement) of the building: __ . __ .D feet D meters (PR) Datum __ G9. BFE or (In Zone AO) depth of flooding at the building site: __ .__ D feet D meters (PR) Datum __ Local Official's Name Title Community Name Telephone Signature Date Comments D Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, andjor Bldg. No.) or P.O. Route and Box No. Policy Number: 1101 Outlet Collection Wav City State ZIP Code Company NAIC Number: Auburn WA 98001 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 A5. Coordinates derived from RTK observations using the WSRN RTK Network corrections. C2.e The equipr c'lnt dc1scribed is a power cabinet on the Southwest side of the building. Signature 7 Y = / k ' ~--<!J ~-Date 01 /07/2014 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. E1. 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 b) Top of bottom floor (including basement. crawlspace, or enclosure) is 0 feet 0 meters 0 feet 0 meters 0 above or 0 below the HAG. 0 above or 0 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 ftoor (elevation C2.b in the diagrams) of the building is ___ . ___ 0 feet 0 meters 0 above or 0 below the HAG. E3. Attached garage (top of slab) is ___ . ___ 0 feet 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is 0 feet 0 meters 0 above or 0 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? 0 Yes 0 No 0 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 or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments --------------------------------------------0 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-G10. In Puerto Rico only, enter meters. G1 . 0 Th e 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 . 0 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. 0 Th e following information (Items G4-G10) 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: 0 New Construction 0 Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building: ___ . __ _ G9. BFE or (in Zone AO) depth of flooding at the building site: ___ . __ _ G10.Community's design flood elevation: Local Official's Name Title Community Name Telephone Signature Date Comments 0 feet 0 meters 0 feet 0 meters 0 feet 0 meters Datum---------- Datum---------- Datum---------- --------------------------------------------0 Check here if attachments. FEMA Form 086-0-33 (Revised 7/12) Replaces all previous editions.