HomeMy WebLinkAboutFEMA Application 1999-6-2
ri:Ol:RAL SMERGENCY MANAGeMeNT AGENCV
NATIONAL FLOOD INSURANCE! PROGRAM
ELEVATION CERTIFICATE
Important: Reed th~ lnstruc:tioos on paqes1 f~?'
SECTION A. p PROPeRTY OWNeR INFORMATION
aUI~al~~~~~NAMa ~~~~~t-'\ ..,-, , , '" ,.., .". ..'. . ."
8UIL.DlNo lilTWT ACOMA {lns;lllClLI1S Apt., Unit. 511.1110, IncI~r Bldg NQ.1 OR P.O. ROUTE A~ eox NO,
~..,..tl 4*-....... PI.I\..=
CITY .,.' , ,.. . stAtE
v"l".aF\"'o O~.
PRUP~1"'t~Ol{l;~UN(~ a~~e:,'TU~9=N=~~DI!~eT1PtlCl1.etc)
5\.!II.DlNG US! g's" R88fliCl'ltISl. Non-:tIIrdentia~ At.:I~iij:ln, AooeISOty, tIC.U~ COtr,tnenlS aec:l!oti IfrieoeHeil')'.)
to, ~\ o"""'lfIIt- d ..,.. .'1''''''
\,A'I II' U(:l~QNlJilll,/w (OfllnlJ'll/AW HORIZON'rA'- IJArUM~" 'SOURCE: W apt (Type):
( IfiI' - If! . tII. or 1IIU#"t#f) U NAD 19;7 W NAD 1083 U VaGS Q~d Map W 0\I;Ier;
RUG 20.2002 4:2:~1
rORD NESS FASSBENDER
I' .1
1'10.932 . P .Z/3'C'l1'
O,M,B. No. 3061.0077
~ir. July 31, 2002
~
SECTION (:1. FLOOP IN8uRANCEMfEMAP (FlfWlINFORMAT10N
,... " ,,,,"'..'~I ..,. '.""'. . ""~""'''''''''~'''''"''~' .~",__,,_,,~ ..
:8' ~~~~:~NIW~i~NIT'YtfU\\4aeH I e2'1~~~YNAMi T $3 ~.tAt~,.
- 154: MAflANt.l PAN!l. I!l($. tsu;jlt", 'M. ;II\M IND!!X .. .," '&'7.P'IRiill PANel I BS.PLeCD "fl$.IWS!FLODt ~..:~"Ai"tON(S) '1'
-i-10".~:~~~., .. .... F'-/:A~~.,E~F:m~~~ClOATE.I~!(S) '.. (Zo~~~~.ptI\ofn~9) I
e. O. Indicate the OOllroe (If the SIIlO FloOQ Slayden (BFE) data or base ~O\j<l depth ontered in ae.
U FIS Profile W PIAA1 ' ~CQmrmmity Cet(tnftlood Ll Other (Oescnbe):, .
B11 Indicate the elevation <latr.lm _"forth, ElFE In B9: t2!NQVD 1929 W NAVO 1988 LJ Oiber(Oesaibe): " .
1:"2,11 the buildIng loCJat$d In 8 COlal Barrier ReflClJf'QIO System (CSRS) area arOlhelWi$e ProtectedAtea (OPA}? U Ye3 Els.J No
OIIll;naUan oat.~.
. 'eeC'i'iON(f;'euir.:cH~G IL.I!VA TlOH INFORrM TION (SURWY RL!aUlRI!tl)
01. SlJ,ldlnlllelewtl,'n..rt bflitdorn L.1C'~len'OfaWtnga. L1Bu1ldil1g U"Ider Coftltl\lCtlonlt ... ~Frnllh$d ConGtructU:M"
"A MW EIGVl!Itlon Cerllflcate wln be required when....., ...~rucUan of the bullcllllgls c:cmplete
eg. Building Oi8C1rern Number e (Salect th~ bulding dlligl'llm mest eimn" to the bwlldln; for whl~ tnla certifioafD 18 being completed - see
PI9.. Ci /lnd"l. If flO dlagl1im aCCU1'lte1y r1prHIl'ltI the bl.ii1cilns, pl'Cllldu sketch cr photogl'lllph.)
OS. Elevat1cns - Zones A 1~A!O, "Eo AH. A (with BF5), Vi!, VM/30, V (With BFr!). AR., ARIA, AAJA!, ARJA 1 ~A30. AN~. ARJAO
Complete Iterr.. 03.-1 below ICCOl'CIjng te tn. bunding dilgram stledfied in Item C2. State ti'le dt1tum used. IftM dat1.lm fa 6rent from
the datum Ilted for the BFa In I~ a, ccrwerl tne datum to ti1ahlced fen'the aFe, ShOW fitlt.I met8tJrtrnem. amd d8Mn corlvereion
caIouiation, Use the .08 provtded or t1e Comll1Gnrs al'\!l 01 Section 0 or Section 13, at approPriate, to document the ~m eonwl'Gt~Qn
~=0f1 reference m~nve .'. , ..~~ D~ th;le!/!.vation ~fe~enoe IMrie UGllKfappeeron the FIRM? - Lj Yes ~ No
o a)TClpcfbCl1tomflom:~"cflJdlnSbuemMtor$nel05I.W.) ... '!HL.,,:!..,.ft.{m) '; - ...
o b) TQP cf nut nl;hIr fIodr .,. , '!a . ~ ft.(m) ~ r.........'"RiQk,; ;;;";i., .... ~
C c) Bo1tom of lowest hottzontal structural memoOf' (V ltenea Clnt;') . ,_' Item) II' PROFESSIONAL ;.
o d) Attach~ gll1g1l1 (tep of Ilab) "$l'1. ...L tt.(m) !" i LAND SU~ :
o e)!.cwestelevatlonafmachlnery8ndlorequipment Iii .."'~ .,.. ""'''''''' ..r:I~_
eeMclng lht buiklln9 ~ \1. . ~ ft.(m) oj ,.... t-. ~
C 1) !.oweSit adjacent;md8 (LAG} ~ \ 'L. . ...2... ft.(m) .I ("" \J."~N-'-'" .. ". .."
c 9> Higl'leetl$eent grade (HAG) ~~1. ..!.. ft.(m))II1; PI!8.11~ 1_ ,
C h) No. 01 """' ,...lllll!)j'lt openings (flood vinla) wfthf'l 1 ft. above adjlilWrlt grade "1__ ... : dAM_ ~7'SCa.TON)
C 0 Totel ClrGI of &11 permanent oPEnings (nood ~tI) In '0311 .,., Iq In. (eq em) ~ '..,. ,~;;;:r:...t.F:~ . .. ..... ..N
....,,," ., , .. .... ....." .,. ....,.. 81!CT1OND ~SUR\liYO~EN'GtNE~OFfARCHfTECT OI!RTlFICATIQN ~~ ~t/i(( ~ ,"
rhiS C:lrtI~oniS to be 'iigfiedMd' llIeeifi; !:lye I8nd sUN'yor, en9inHl'! or architect auU'lotlZtd bylaW to c.rtrfy e1wattln jnfolmatlOn.'
I wtf(y tIt,f the information in 8edftm8 A. B, and C on this cei1J'ffaate feplefHJM<9 my best 1'I~1a to t J.;.ll'...-t the dafa evsl.dJ/e.
J umlfl1tlnd that Iny '.lse\ltelfunfl'll mill' be ooni'lha~ by fine Oflm~'onrmlllf tJfI(k)r is V.8. ~, SltcliM 1001
CAr\11l"jU ~"1\ . ,. . . - ;;,l"r~r l1ce.~!It~aER . -
T!1U' .,~I'\ . '\f4. . ~.m!" . _. .... . COMPANY NAMJL e"'.l ~-::.. .. ~ a," ~r.
L.~O 6\JQ.,irJlM~ ~..~'SJ*~~
F~:;aL:~~~~eReve~SE$la~~0~~;~ ::::~;:1~~IT'oN6
~
· PUG. 20, 21002 4: 22pt1 rORD NESS FASSBENDER
-IMPORTANT:'" thole $PllIClllS, eepy the COrrupondlng Information fFem Section A,. . l:gj-ili:fliriiflW-t:,QIilIl."Y'Us~, .
erJu.oul/G $1'RlifffAODREWiJJtlCruelrrt$ Ap!., ~ SlIltm, Ilndior .",g. No.1 OR pt 0 RoliTeANO fii,:')~ NQ ~I'!rr~~f' " . .
..em' tlCf-. ,,~':IiS ~~ STAr; ~PCOOE"~l "
~~IN~fiOo.J:) $. ""i'1+,,\t JJJIl..~if,r; 'i,'!"
, " .', .., ,.. . ." ,~,. ~.llIii ,....~" ,.." '^
~\o '332
P 3- 2,0'1\
It I ill ~'fl.N~..."\.~,,,
. .. . ... secnoN D . SURVEYOr;:, liNa/H'e'eR. OR ARCHITECT CERTIFICATION' {CONTIWUEO,) ..
.'.." - I.,,,.,,. _,.".,.,
Copy both aideo of this EleviIlt)cln Certlflcate for <1' community offlaa~ (2) Il'lSlJrar.oe agenUcompany, an" (3) bUichn.g owner,
COI't1MENTe .. .
'" . .. ...... ...; .... ...... ...., ....... .. ...... ...... .. ..... .. -.". ... 1..,..tC.h~t1ete!r.~ttachm.el1.~_
. 5!CTlON ~ . !UfLOf~a SliVA-nON INFORMATION (SURVey NOT REQUIfr;cO) fO.R ZONE AO and ZONe A (WITHO'UT BFE)
Fer Zone ~Q and Zona A (witho~'feFej;'QOmptete'items'~, thfCKS9h 53. . iitheSeva'ion eerdflcate l$""jntanded 10r us, &8 sUpPfiiJng ... ..... .
Infotmatlon fer a LOMA or 1.0MR~ SHtiM C mUlt be completed.
51, BuRding'Diagram Number ... (StJl'Ict the building eilSgml'i most sir:'lllar to the budeiOg fQl' Which ~I' cert11ieate rs being oompl.l~-
so. Pi1St' 6 end 7, If no diagram lCl:U'8tely repl'UHrIU the bulldrng, provide i slcsteh or photograph.)
e2 The10p ofthl ~m floer(l"Clf~buementorenC!oaure) ofth~ bUitding II LU ft.(m~ 11..JIn.(cm) L/lIlbovG I)t W b~lcw
(check Ol'le) the hIghest Ic!JIlCl!m IJT!Cft, '
53, For ZOne AQ only; If no flood depCh nllmber ta availiblCl, ialhe top Qfthe bottom 1'I0Qf' elevstea In ilJc:.;aranoe with the CiOmmlllllly's
. tloodcrl~.".lT1anagetnel'1~ Ordinen~e$.w~~ ... ~.-tU"known.: .}!'Ie IO~~..~!.':fW~t ~~.1]fY this lntc~~If1.~.Qtfi!'l ~:., ..
SECTION p. PROPERTY OWNER (OR OW'NERlS RIiiPRi:S&NTAilVE) eeR'l'IPleATrON
ThGp,opltty owner or aWner'. IUiJ',ertied rtpmaentStlve wtiO eom~letM SeCtlQ:,$ A. 'B; "and tffOr ZOMe A .cWMCUt .FEMMiilued or' ..... . '.-
ccmmunity.rssuecl SFE) or Zenia AO l'nUGt ~ htte,
PRol"efl.TY OWNSR"3 01'\ '1:;;lWN~'S A~rUb RIiFRE5IiMTA'nV~'$ NAMe
AOOftia8
'3lt11AA TjJFtg;.
,OMM!NT5
Cln .
DAiE
$TAn
ZIP CcJC~
ret,;iPHONi
aticfiON Q .COMMUNl1YiNFcmMATION(OPTIONAL)"..... f.J Ch~ ~.~l!l..~~~l!'en~
", ...". ...,~. ". "..,.......-...a..."...., ,",.. .I. ...... ,_ ,~,,,,. I"~,,..,',.__. "". ,..'.,... '~"." ,t. ...._,.... ,.~."..
Ill) Iccxil Officll' who IS authortzed by raw O'fORilMnoe 10 adminIster tile colMIIJnlry's ftOOC1plain manegement orQ'inance can COITIFtltte
eetianl A, S. C (or E), and G ofthla, ellmlUon CertIfiCate, C,omplete the appllcible item(B) and lilen below.
1 LJ The Infomlllltlon i~ $eotlcm e wee tuen tom other documentation flat h88 been signee! and embO&sed by a flCenqd flLuveyCll.
engfneer. or architect who itil a~ hy stl~e or 'CIC!llaw to ~ elfllalicn lnf~tiol'!, (Indicata the souroe and date of the
elevation data In the Oomments... below"
2.. W A communft)/ om.I oompleCed Section E for a bU<<dfng lecated In Zo/'l\t A (without a FEMA-rs.sued or communlty..lssued BFE) or
Zone AO.
3. LJ The following infonnaUon (IteJTl# f34.GG) II PfYMded for carnmunity floodpfsin ma:'la;gel'l1er'1~ pt.lfpQaefi.
... ".""If -.." L~ 01<111 """"f'tl8$ueo .. .1 f:'~"'~"""'~"""""~bU"A"OT
'. T!1rs J*I'11it has bei!l'lllnlUect fOr: U New OonstrucHOI1 U Substant>af iml2fovernent
I. El~on or n-builUQWelt flocr (lnc:fudfng bhement) Qr the bllilcfin; Is:
I. SF! or (in Zone AO) dept" of'l'lCllXffl'l9 at Ihe blilld1rlS Sl~ 18:
OeAl. Of'l"lCtAl.'Si'WJIl!
OMMUNfT'r' rwJll!
IUMrlJRe
~NlE!N1ls '.
TIM
.' _ fl(m) Datum:
_' _ fl.{m) OGtLlrn:
TelJii!p"ONfd
.......
o.A,T~
· Fcrm81.s~, AlJGW
..,...... .
1-1 Check here If IiIttachmants
~,.. ,l .
~;:", ifice'At'1"'" ~'b'~ 1'I"-i,^ ~-~I"._II{A .