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Home My WebLink AboutFEMA License 1985-12-18 r-- - . .'- ELEVATION CERTIFICATt: FEDERAL. EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM 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, andlor 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. O.M.B. NO. 3067-0077 Expire> May 31, 1996 SECTION A PROPERTV INFORMATION FOR INSURANCE COMPANY USE POLlCY NUMBER eUILOING OWNER'S NAME Terrv & Pam Matthews STREET ADDRESS (Including Apt.. Unit, Suile and/or Bldg. Number) OR P.O. AOUTE AND BOX NU,..,SER 2573 Grand Vista Drive OTHER DESCRIPTION (Lot and Block Numbers, etc.) I COMPANY NAIC NUMBER CITY 50rinofield STATE Oreoon SECTION 8 FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): . . ZIP COOE q7477 1. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATE OF FIRM INDEX 5. FIRM ZONE-' 6. BASE FLOOD ELEVATION (in AO Zones, use depth) 415591 0370 c Dee 18, 1985 A6 449.0 7. Indicate the elevation datum system u~ed on the FIRM for 8ase Flood Elevations (BFE): ~ NGVD '29 I I 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 '. 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--L . . 2{a). FIRM Zones Al-A30, AE, AH, and A (with BFE). The,tqp'oft~e reference levertloor from the selected diagrnmis-at'an.elevation" lot i j 41'S?'~llIJeetNGvu.ior_uiherBBM-datSiii~see:section B, Item 7). .".". n,' (b). FIRM Zones VI-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 L:..J.:..J feet above 0 or b~low n (check one) the highest grade adjacent to the building. ,- , (d). FIRM Zone AD. The floor used as the reference level from the selected diagram is W.U feet above I I or below 0 (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) eievated in accordance with the community's floodplain management ordinance? I I Ves I I No; I Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: LX! NGVD '29 0 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 B, 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: 0 Ves [K] No (See Instructions on Page 4) 5~The-reference'level'elevation'is'bas-ed on: xJ actualCo'i1Structio.j' i construction drawings , . .. L(N0TE.~Use.of.construcllon'drawlngs'ls.onlyvalld'lf the'bulldlng does not yet have the relerence level lIoor In place, In which case this certificate will only be valid for the building during the course of construction. A post-construction Elevation Certilicate will be required once construction is complete.) 6~tj'~:~levation_OfJhe;/OWest.grade.immediateIY adj"c.ent,toJhe.building.is:.LL'41'5\I.~..feet.NGVD (or other FIRM datum-~' Section B, Item 7). ' SECTION D COMMUNITV INFORMATION I. 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.U feet NGVD (or other FIRM datum-see Section B, Item 7). 2. Date of the start of construction or substantial improvement FEMA Fo,," 81.31, MAY 93 REPlACES All PREVIOUS EDITIONS SEE REVERSE SIDE FOR CON11NUA TlON c . SECTION E CERTIFICATION . This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al-A30, AE, AH, A (with BFE),Vl-V30.VE, and V (with BFE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AD and A (without a FEMA or community issued BFE). a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8 - Distinguishing Features-If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size. location of servicing equipment, area use, wall openings. or unfinished area Feature(s), then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. I certify that the information in Sections Band C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. 'Code. Section 1001. Jonathan A. Oakes CERTIFIER'S NAME Survev Proiect Erainpp.r TITLE p n Rn~ 7~J7 :\~l{M . M( I < #2105 LICENSE NUMBER (or Affix Seal) Pn~np F(1ninpprinn r... c:.'f.r.y~~1in~L Inr COMPANY NAME F llnpnp CITY STATE o 7u1'\7-"A 1 <:7 ZIP n...""",...n SIGNATURE 1 /0 /o~ OATE (~ul\uR~-u~n~ PHONE Copies should be made of this Certificate for: 1) community official. 2) Insurance agent/company, and 3) bulfdlng owner. COMMENTS: 4 ON SLAB WITH BASEMENT ON PILES, PIERS. OR COLUMNS . A ZONES V ZONES A lID'"__ ZONES . FeAsE FLOOD ELEVATION ; I , ~w ~~t ;"""';E~' ~%I r"'''ENCEI ~ t:~ ~ LEVEL I:&' t\"f~.~ ,~t ,'~';:;~f;:,;;;~""f:i'f A ZONES I BASE A.OOO ELEVATION I"""N~E LEVEL ~, v aONES , IREFE~ENCEI lEVEL I ~I ~ .~ , I lQ~il~iJ$j;~J'~:l~;:;;f -L BASE A.OOO ~ The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zon~.s should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2