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ERTIFICATIONSECTION F C
SIGI'IATURE
Coplos shoutd bs mado ol lttls
COMMENTS:
certlllcate lqr; l) contnrunllY olllclel' 21
Land $u
Loop
lnsuronce 0genUcalnPony' aod 3) bull<llrtg owll€f
ALNstosEFPRO
OREGON
(},l fll E5.
Pl€a15, OR COtUata{swmtoaloa6cr.€tlr6LA9 v
Y
EON€S
A roN€s to.{esIONESzo,tES
-rc-
ar ooo
t.av^Ih
,toooIrtv^l0a
Tlro diagrams abovo illuslrato lhe Polnls at whlclt tlto slovallons
Etovations lor allA Zonos should bo firqacufod al th€ toP ol lho
Elovatlons lor all V Zones should lro mdasured al lho bottom ol
slpuld bg moasurod ln A Zones and V Zonos
tglgreoco levolllgor'
thg lowesl horlrontal slruclural mentbor'
Pago 2
NAME
THE NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
PURPOSE OF THE ELEVATION CERTIFICATE
Ihe Elnvalion Corlilicale ls an lmporlanl admlnlslrallve lool ol lhe Nallonat Flood lnsuranco program (NFlp).
As parl ol lho aoreonretrl lor maklng tlood lnsuranco availabfe ln e communlly. lhe NFIP roqrrlros lhs eommunily lo adopl a llorrlplairrnrntraqctrtettl ordinance. conlahtlng corlaln mlnlmu-rn r6q,lromdnls lnlonded lii teducs tUurd nooa bssos. ono .such requiremanl is l6arlho eorrrrrrunily "oblairt lho elevalion ol lhe Jowesl lloor (including basemenrl of
"tt
ne,, end subsfanrfaly improved slruclure.s, arr6 mai^t;r,a record ol all sttch hrforrnallon.', fhe Elevallon cedili&te ts oni wa/foia'communlty ro --pi1*irrr tiris iequirement. -
I he Elevalion Cerlificaie is al:g.requhed loOroperly rale posl-FlflM slruclures, whbh aro buildings conslrucle6 aler putrlication of t6ef-roorl lrtsttranee Ralo [,lal,^lIllMl. for.lloodlnsuraioo t'r FinM iorreJ ai-aso; iE. iO Ag:A Gii, Bass Ftood Eleririons IBFE,sf ],y I Y?0, VE, and V (wilh BfE's). in addillon. lhe Elevation Certllieate ls also needed loi pre-ftnU structures being rated under post.t-tr u
llood irrsrtrarrce rules.
tlso ol lhis cerlilicale does nol ln any way aller.lhe llood hrsurance purchase requiremenl. Tte Elevalion Cerlilicate is only usar! to ,)ro!.i, I
irr161611i611 necessary lo ensure.eompllahce wlfi Cpdlcebld dhrinunlty lloodplain managemenl ordinances. to determine tlre pr.,grni 1.,',,
irtstrtance prentium rale. and/oi lo supporl a rcquosl lor a Leller ol Map Ametrdmonl or lievlsion (LOMA or LOMR). onty a I.OMA ort.oMll lrom lhe Federal Emergency M'anagemdnl Agency (FEMA) carr amendlho FlnM and renrbve the Federal iequirement lor a
londino lnslilulion lo tequire lhe puichase ol llood lnJurancd. Notd tlral lhe lendlnE lnslllutlon may slitl requlre ltood insurance.
I his eerlilic-ale ls orrly used lo cerlily lhe elevalion ol llrc relerence level ol a building ll a non residenlial building is baing llooctprooferl.
thnn a Flootlprooling Cerlilicale musl be compleled lrr addition lo cerlltying llre buit<ii1g's elevalion. Floodproolini ol a reiidorrtial llritrtir,,r
<loos nol eller a comnturrlly'slloodplaln tnaflebemetrl olevatlOn lOquheirre-nts or aflec,lihe lnsuranco ratlng unless"lhe community has 1x,,,,
issred arr exception by FEMA ro ailow lloodprooled tdsldenilalbaiemenls.
INSTRUGTIONS FOH COMPLETING THE ELEVATION CERTIFICATE
I lte Elevalion Corlificale is to be.completed by a land surveyor, englneer. or archilecl who lg aulhorizelby state or local law lo cerli{yolevallon lnlormallon when lhe elevaliorr lnlormatlon lor Zones Al-igo, nf. AH, A (wtlh BFE's). vt-v30. vE, and V (with BFE's) isreqtllred. .Cornmunlly ofllc,lals wtro 6rc euthbtlt0d Fy loCal law ot odlnanca lo p'rovl'de ltoodfraiir management intormation may atsornnrplele lhls lorm. For Zones Ao gnd.A (wllhout bfE's1, a bulldrrg olllclal, e ptopedy or-lr. o, an owner's representative miy alsoprovlrle lhe lnlormalion on lhls eerlificalion.
SECtloN A Property hrtormatlon
I ho Elevalion Corlilicale ldenllllel lho bullding, lls owtr* and hs locallon. Provlde ihe building owner's name(s), the buitrlirrg's comptotn
slroel addross, and lol and block number. ll lhe properly eddress ls a rural roul6 or PO box nilmber, provide a legal descripiion or annblxovialerl localion desoiplion basod on distanta irorn a mlerence polnl.
SECtloN B Flood lnsurdtrce Hate l,lap lnlormatton
ht order.lo ptoperly complele lhe Elevation Cerllflc.rle. lt ls nec$sery lo locale lhe bullding orr lhe appropriate FIRM, and record theappropriale lnlormatlon. ro oblaln e FlnM, conlect ilo oommldlty o? cail l-g0()-933.lg63:
Ilre Elevalion Cerlilicale may be compleled based on eilher llre FlnM lh etfec-t at the time ol the.cerlllication or lhe FIRM in ellecl wlrerreonslnlclion ol lhe building was slarled.
llern-c I - 5. Uslng lhe FIRM lndex erd.lhe appopriate FlflM panel lor lhe comrnunity, recond lhe ommunlty number. panel (or page)ttumber, strlfix, and Index.dale..-From lhe approprlale f[lM panel. locale lhe propsty and.record lhe zone i.u ttle eCe 1or riooo o-eprrl
rrunrber) al lhe bulldlng slle. BFE's are sho',,ritt dn a FIHM toi Zon6s Al-430, ne. nUivl-V30. arrd VE: nooO Oeprrr nr.U"rs are showrrlor Zone AO-
llern 7. tlecord lhe verllcaldalum cyslertr-lo.s,trhfi lho elovelloru oh he appllcable FIIIM ero mloronced. Ths datum ls specilied ln rtreuppor righl comer ol the title blo* dl ft€ FIHM.
llem 6- ln A or V Zones where. BFE? ete nolptovlded on lhe FIHM, lhe communily may haw establish€d BFE's based on data from ottrn,
sourc?s. Fot subdlvlslorc etrd olh0td€t€loptldnl0reet6r lhdil 60,1013 or 5 ecros, 6statillshmentol BFEI ls reqrfJ Ui communitylloodplaln managoment ordlndme. wtron llilc lc ilr6 cace, omplolo itrlo ttem.
Pago 3
SECIION C tlulldiog Elevallott lnlortt 'l
rrerr 2. Dcpcrrtring on ilre propony locarion.s FrflM Zons, comprore lrenr ?a, 2b,2c,or 2d' uso rrro lelororrco lov'rl slrowtt itt llr{r
.rl4rro|,iarc buirtlrng <rragram as ttre pornt qlfnr*;;;ionll nr iirqnlin u,J ,lidgrinion ttre lmck-ol llro ccrlilrcalo' lo( all A Zortos' llru
uruvaliorr slrourr, l,o nrcasured at u,u top of urs roilliil&'liroifl"bi. Foi uir v /&,os, tlro olevatim glpukl lnt rrtoasurotl al llto lplt.rtt ,l
llro lowost lronronlalsructural monrbsi ol Ure leriilffil;fflr;;' 'le|*rlns oi ulo'arions h ltoms 2a atxl 2b slrorrll bo lo llro noa{csl
ru,rrr or a roor. or alornarivory, untoss prolrltiled di;i.r.Uffi qroln,in"iii,p iiiq*n.€ lbvstolovation n,y u'i 'rouoded dowrr ltt llto
;r;;;;i wtrolo lool ('roundlnil up" h-prohlbltedt:
luern 2(a). Fo( suuctures locarod h FIRM Zonos Rt.lso. AE, AH, 1d A (with BFE''), rocord lho slovaliOn (to lllo noarosl lcntlr ol a loou
"ili,"-r'"rl.r ri,ulr*r ioortnoO as Uniitglgn* lovelin tlro agrlice!ilo diagram'
Ircrn 2(b). For.srruclures tocar€d ln FIRM zonus Vtryao. ve, soo v it ,',,
?ff ll;;ffi,$]i[fiigtp;ltlJ51;,ili:""
or a roorl or rrrt)
i-li"ri"i ri,u to*esr trorizooiJirruirrral mornbor ot the llapr UentiliEii 9t
rre'r 2(c). For srrucrures located in FIRM Zons A (wirlput EF.E's), rscord llte lroiglrl (to lln 0.oa,gsl leolh ol a lootl ol lho lop ol tln llool
irrdicared as lrro reroro^oo rovor (trorn rrro appricario;i6ii"i a6re or dif;i-i,i'iiigitptr'adlac€nl grade irrxttediatoly ooxl lo llr'ttuildirtg'
Irem 2(d). For struduros lr"4uq h rq r!!rysno, uy, Flay w'l.!! s[row.ItE baqe llood cepul Fo1 losalio0s in FIRM Zono AO rocord llto
rreisrrr (ro rho noarosr runiii "r'il*i;iilre i"p riuiriii*;'ia.;r,rrri'en .silru ruiriftn"u irvei ttrom urs applicalrlo diasratr) arrove or Dolow
rtro trisrresr adiaconr srado trnnndiaiuy nort t', d;ili,,od. t;i p6r,i Fini,i[^;ii,Jir,ss,-[ta mmmunlty s'lloot{ilairr managelnerrl otdinartce
rcq,i,esrr,a.h.srurruiirai*;A;iui.iir"Ebli&t';iF,rrprii$b'd;iiili'iRM: Foi-ttrosotewrjornmunitisswltorollrisbasollood
<r,,la,rance.
tlenr3.Rocorrlt]revorticaldaturnsyslomusodini<lentityingtlrereJglonqo]ov9lo|ev4ions|orfl!lruildings.l||ltgdalulttuserlirtlttuirsutittg
lrru urovario^s is <rlroreriiliii'il;i;*n*on uie riBil. irr'edtonvert uro eriviiiliG h ltoms Zad lo ilro dalunt use<l ort llu FIBM' atttl sl*.,w
ii,r "o,r*r.i"tl equalion uncler tlrc Coatmenls sqclion <llt Pago 2'
Irerrr 4. lrilicats it lho slova6on roleienco mark usod alpearo on llro FIBM. Rolsronoe madrs pllrgr 0Bll llpsq sltowtt ott llre l-lllM ttray lrt:
rrscd lo( clcvation dete,,nfuralions. lrr aroas orlrori"ucfiid-oiourxJ subsirtc,,"e, ll," fltogl recenlly arliusled telerunce trratk elcva]ioils llltrsl
Lro usod lor telerence level elevalion dtlletntinatiqrts'
ltc|n 5. lnrjicats il tltq rsloroncq lovel used ln making.ilrc gl€vation mge$urelrrenl ls basod oo equal conslruLlio'l or cottsttucliott drawirtgs
(jo.srrucrion drawings sl,oul( 6nty us usod ll ureil;ndiiir"di.-not y'oti,uvo ii,g iorerirnco lgyel tloor ln pla@, irt wlridr caso llro l-lr:vuli.rt
cr:rriric.r. w1l onry rrs valiri 16r tlr6 building ourirp-uro-;uriu "l corisiir"rilir.'i pdiAilrrhon Flcvition certilicato wlllbo trcedcd urrcc
corrslruclion is comPlete. . '
Irern 6. Record ttre etovation moasuremeol ol lhs lowegt grado a-djaconl.tollru brlllrg.llilhs noaresl le0tll ola lool)' Atljaccrrl grado is
dulirrcd as tlre etevalion ol ltro grourxt, sioe"a[..-piu;.16.fi ;rrp6d, or baserncrrt enlryway inurodialely lroxl lo llr, slrucluro l lris
,rqasu,erne.r srrourd b, r;ffiffi;esiiorrur or ii.iiil uiir certiiicaie is hring uso<l tupupinrl a rcqusst lor a l'oMA/LoMR
SEcTtoN O CommunllY lnlormatlon
con|t)lctioil ol tlris sc.clion may lro roqulrod try tlm comrtunity in orrlor tq msel tho mlnlmqm lloodplain rnarlaoollle'll requircntettls ol llro
NFIPI O0rerwiso, complotion b, Uris s'ection is nol requirod'
ltorn l. Tlre community,s lloodplaln managornoiri ordioancs roqukos- olovation ol llre hqil4ing'e 'hwest lloof irbovo lhs BFE' For llre vasl
rrrajoriry ol Sultling rvp.".'irre-rLrorenco teiol ad rr,e b*;rl irobr wiu bo tl,o sanre. ll llto ooivnurilly doterrlilrtes llrat lltcro is a
clis&epancy. record tlte elovalion ol tho lowosl lloor.
Itenl 2. Entsr dale. Theso lorrns aro deliood try local ordinaocs'
SEcnoN E Csrllllcatlon
conrplclo as irxjicated. Tho Elovation cortilkxro may only.bosignor! lry a lanrl survoyor, onginoor. or arclrilocl wlro is aulltorlrod by slato
or locallaw lo corrity ururii[ninioi*arion wt,en uBlruri'uJ,r tirtirn,ai6n lor zoncs At-nro' ae. All, A (witlr BFE's), vl'v30. vE. arxl V
(wirrr BFE.s) is requirod.'flffi;it;iridars wt;;l;'i,G;;.diil r""qgyb, oiotnanoo g-qgvi.ro lloixlplaio mana0"rrro'rl irtlotrttariort
rrray iilso s(;fl tlils oe,rirication.' in ttie case of z"no-i-eo oJe irniir,orr gng's), a bulldlng omba. a PfoPo,ly owrlet, or an owrr{'('s
r r:pio ser rlativo may slgn tl ris csrtilirztion.
c€ni,icarion ls normally to tho lnformatlon p(ovidod ln sodhns F md 9.. ll ttlo cerulior ls unaPlg,to corllfy to llro solocdbn ol rolorooco lovol
diasraor 6, 7 or 8 lsecrion c-, ri"m ir. 9 e.. rru""uro';idtt6iri l,t6bi+FsUn;irucrton or u.iuing uso hlorrnalloo ooodod to dolorrrtirto
rrro Disrrnsursrring reatur;1ii.'ir,ii "iiruirir
rnrirflti rti Fiirriiitii ilu@ ftonr ttro cortifrcallort un,Jor conmrcrtls ort Pag, 2' Tlto
;il;;r,,,1*irstf forlie Roloronco lovolnrusl stlll bo sntorod ln Soctlon C' ltem l'
Page 4
t
INSTRUCTIONS
I lre lollowirrg
llrn rliaqrarrrs
enrrrplole llto
llotE: l, all A Zones, lhe rolorenco lcvcl lr lhe lop ol lhe lowcr( too;; ln v zonat lhe rcletenec lcvcl !r lhc bollom ol lhe lowosl horlronlel
strrretrrrat momtror (rae dlegrem on prgc Zt. agiifr tio"'fj ii.. fo tfic Flood lnstlranc,c Menuel lor lnrlnrcllon on lowcsl lloor dellnlllon'
DIAGNAM NUMBEN I DIAGNAM NUMBEN 2
ALL SINGLE ANO MULIIpLE FLOOn BUIDINGS (OrllEn nl^N
spur tEvEt!, lrlcLuoolcl IIANUFACTnED (MoBlLE'
llouslNc ANo lllcll tllsE BultDlNGs, EnllEn oEr^cllED on
nO$, TYPE (E.G.,'foWilllOUSES, ETC.I; wlfll on ffIlloUT
AITACIIED GANAGE.
Dlsllnguhhlng lcrlurc - lho firsl lloor rrbasonronl (inrJrrlirt(l an
undorgrourxl gerago'f ls bo.kn grorrrl hvel (oradol on all sir'fcs'
trar{n 'l rnns(r s.n
ALL srlrclE Atlo MutilpLE Froott ButlblNcs (otllEH
ilr^il sPLrr tEvELr, tNctuDtNc uANUrActUnEu luouttellrousrNc ANrr l[cil nrsE ButtDll.ics. EtT]Gn bEt^ctlEo oR
now IYPE (E.c.. towNlloUSE, EtC.l: Wlil On WflIOUI
ArrAcIED cAnAcE.
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DIAGNAM NUMBEN 3
AI.L SPLIT LEVEL BUILOINGS, ETNIER DETACIIED ON NOW
ryPE (E.G., rowNilousEs, ETc.r: Wlfll on Wffllout
ATTACIIEO GANAGE
Dlsllnguhhlng fcelurc - tho krwor level ls rrol bblorv grornd level (giadet on
allsHos'. Ihls lrrtudos 'walkd,l- btsornonls, wlwo il leasl ono slde h al or
ntnve grade.
tflGil€fi n o(rr3 lfixcn nOOllS0r^xn 0r^fin
onAoE
CrlAD€
trf't'Gtl t EVEL
fit€nrrEor^rE
T E\IEI
tolifEn tcv€L
G.IAOE
tt
DIAGNAil NUilBEN 4
ALT SFLIT I.EVET BUITDINGS, ETN|EN DETACIIED ON NOW
wPE (E.G.. IOWNIIOUSES, Erc-r; wml on wmlour
AITACIIED GANAGE.
Dkllngulstrlng fc.lrrtc - nrc lffi€t l€vol (orlnlottrxxfialo hvoll is bc&rw
grormd level (grade) on aisUc'.
l0G|Gnnoons lllctrcnftOOtlS
, flF^lrn (rr^fln
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G'IADE
G;IADC
'Ut*r iln Nalonal W htc_r,draot rr60fiil8 dgkderfuiarilar edhstrua ffill.e7e.etlrntilElkbtowgrwndtevel(gadol on all sUeslgalasldetud tbasimenewntttltitOA7m/rrrrbusd lorfivlngp,porl4 ot $ enolb,7etqp,
r+or*sho1t, elc.
Page 5
l)lrllngulshlng fcrkrre - Iho lirsl ltm ls aot bolow grotlrrl lovol (gradol on
n/r sirlas'. Ihis hrkrdos lflrlkirr{' hasornonls. wlmre al loasl ono srjo ls al o
nlmvo 6rado (Nol llkrrlralodf
(ror
rnst rt.oon on^o€
IilG|l[n rto(xs
{rr ANn
rl'rsr no(rr
tt^sctf,t|r tirr,Lo$l(itli|f[rrflou]r, GAMGFI
ttoorl
UTPCN IEVCT
I{I€NUEOIAT€
IEVIEL
I(,.I,ENLCVEt
(rwof noorl',
a
o6/q vrrl rcq
I c0ed
F)nn,tns otlt ot tt,p.,elpe 'lpe,6
;r;e,lol e.l sl p/lct eil,erop) eq udl 'reu, ue epetln esetl p te'ilpv lt 'st/D,/t
'o\etxe
uo seilot pootl
xt,t!,so,pttl to,t,,t,.rtpnh aqte ni vbpib ,r'1, teqr-;;iii n neb,r,e fl.lj,iclotd pn,ieslao e lq pquotd eo lew,oileqntot
.t1ant1ettn11y .op,o o^ni-iiiT:i,il'i,riti'iiiri i'rdi,rfii e,, 1o wotiort W t1i1" wsora'e eela lo tool eteibs tue^e to1 tpry ennhs
ot,o rsoot ," p eore tou retot e tlrtn lntnbet en sauiiio oiio uniwu.a uevr' 'Nsql$ lnnl s1 toop lse,,ot eqt
^'oQq
eue etil ll "'
.lt4e epeetnl ,gutple cnr,os lot, s1 pososcu| os eete uv 'uonPpttnq lxtllnddns
to 1rrtpltrtg at11 1o trotltod pa',,^ep otlt ot eaeupp a,pirii*rltt^-'selry aolpeq pn1e1 qlpeds nptn esdqla ot uo"ciltst'ox Ptte
rt'rsop tatlt tqnoxtt pepuoti,t'i,i i;; di;ti e p ioOli, p.,it*-it eq p idiiet*en4 ue tou ile t'.il silea e'e s11en te*teYeotq PlpS "
.ore dottl!'ot| ,eaen6 .?rtJp ue selo .sosadnxl ault n nl pesn s! notl otlt tlBnorl ue,"e lueu,eseq e po'cplcu@ sl seQ's ile
tn (npnfi) paol p,,nn,a ^ii si r"iit*ti i;e6eter,o ea,ensb'r,,,i'uoltrr,l,6iser) ysp s.uetbt,1 druetnsu! pootJ PuolteN eqt )efltn
Y:]I'V
srroor j
r USSWNN wvu9vlo
r:rArr,cNilrrrrll
stlooU
'(o;rlssmued 3t 0t,tttoont pesq one^ottrc',(ppnnl n lton
0)lll?l froo^^urxlo) ttotnn pooy lo rr\oll otll ol uollfn'lsqo ort rptl,r'Un<lo St
,ooll pot?^ole orll r^qeq Dere etf'seuol ne ,oJ ' !',nltej 6u11t1n0ttPc16
I
lANv ,ll
|r;nr9tr I
'la^ol o1ral.lo,
lANv ,,tulrl9lll
'uoolJ O:llv^fl;l
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o-l:,e vruv gNl)luvd lnotlll^ uo tllli^'sl-lvi^
uvliU;sHnnroc'irsoa'sufld No o:llvllll s;lnorl
liiio-ot l, druntcvlnHvw gNlonlcNl'sDNlollnB -l-1v
s ul8nnN nvu9vlo
UOOl.l I srn,
, fY/s
lmto
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tAwr'
sll(nl,llarrill
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(rilrslHlJNn NV TAOeV Oflf,nt lsNoc sgNlolln6 -11V
I U:lEvlnN
ltArr,3l.rtrrJril
)roor{ tsul,(It lYAl l,
1t^, r,rrrrulJru
v iilY nlqo lSNt
ucro! Lsln,ollv^llt
slloot,
lArN rlurrrDt
'e6?rol3 Frotttutl ,o
s ulov{ntl y{v
orlYA:'1J'UoolJ
'B11VilllLriiUOlnotlllA'tSNltuvdYrUV
^^o1JC sl lrollNOorlv^Jl''sulld'slsodlsuvrlNnn-roc's
11V'soNldlln0eNlonlcNl3vJnNvl{ofunl(rrteonl
tr)olt lstlrJ' (,1wArl,
'tlolllullep ,lool,
lsa^ ol uo uoltrn,tsr,l ,o, lunrrr$l rf,lrrrnsul - u erll ot ,!l1r-?11::l: clue0v '(7 o6ed rro ttrorBelp oes) roqrueru le-tnlsnrls lBltro'l'orf
"r. ^'-';l;;;i;l;;;; ,,,.,ro( ,tI qt ti^at c:ruo _ 3,ir'I"i,:nz;;iffirr GJxoi o,ii ro do1 br1| s; 1er rare;ar et;i 'setro2 v fle Ul :arorl
's30rP,rrqxnN
posopue
posop4,F
pol"^nlo aqoq "ell,ootls!
's1-lvM
s;tt{oll
I)Nlyuvd lnotlllii^o-l:!6 vSUV
'su3ld No
gNlonlcNl'SgNlOllno -llv
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