HomeMy WebLinkAboutMiscellaneous Construction Specification 2001-10-22
OCT.23.01 9:11AM;
TO'541 .sea?
PAGE 2/4
P. eec'004
o & ASSOCIATES; 541 688 8087;
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-:;:;., ~.. . Foundation' ~ngineering!Inc.
/.. "'I!!!F' ' Pmfriuional Ge01uhnicClZS/!rvrus '.
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.D~arMr. Beecroft . '. , " 'b~ -uJL
. Atyeur'raqtJest, we hav.a,Completed the co~stN.ctiCJll observalioni:!nd conslJlttllion dur1ng
, earthwork, for',resil:!enttal lots withi,n .the Levi .Landing :... 2'" Addilion .de~elOpmeni in
Springfield, Oregol'!. This I~er summarizes our ob~ervatloos during the earthwork.
CIiOI Beecroft
E(;R and Assocfates
, 25358 Prairie RO,ad
Eugene, Oregon 97402
octOber 22, 2001
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L.evi landing":" 2nd Addition ,
Earthwork for Re~idential Lot Cons~ructlDn '
, Sprlllllfleld,.Oregon
Prolect 20:111155
9ACKG~OUND
.. ,Foundation Englneerlng.lne. (FEI) cenGlucted a.geotechnicallnvastlgetlort'of tile ~Ite and' ,
presented our findings in a letter re'port dated Aug~st 3'1, 2000. levi landing' 2"" AdditIon
includes 'Lots 34 #1rough 11 ~ and' is located north cif Thurston Road. G.el'eral'
~commendations for site preparatlori and fill placeF]'1ent and compaction were includ~ In
the ,report. FEI, was , retalne~ '~ E,<3R and Associates (the civil designer) to prriVlde
geote!:hnical engineering consultation durtng.the eartllworll, FEI Testing and IIJ'pection,
Inc, was also retained by EG~ and Associates ,to conduct, field and materials testing
servi~es; ,
lABORATORY AND FIEL:D TeSTING
.~
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Laboretoiy end field testing assoclafed wilhthe lot fiUs was compieled by FEI Testing
'and Inspection, Inc. The 'laboratory wortc:inc:luded moiSture-denslly curves for the
" materials fron:l'the cut areas Utal-were used as fill. On-slte'borrow soils used in the site, ' '
grading typically ,lncluded'~111 to sandy. sill '!3ar-run gravels excavated from trenches
were a1So'u~e~ ,I" site grading, Several moisture density. relationships for the on-site ~ilt
were conducted as the eartl1worll progressed. Moisture dlilnsity testing on the'sllt solis
sUj;Jgests . the maximum dry, density ranges from 91.5 pcf ,at an 'optlmum moisture
, i:ontent of 22:S% to.96.1 pet at an optimum moisture ~ntent of 2<1,3%. Several check
poin13 ,were also conduc:lsd, with result within this range. .
,FI~Id' denstly testing wes cqnducted on Individual lifts of fill and the preparell subgrade
dl:!t1ng:rough site grading:' '
.,. . .' '.
.. , ,I'onland " co".ili. ' .
820 NW C",!,,,U Avenue. Corvalli.. Orogon 97330-4.117 ".8u,. (341) 757.764S',F.. (5'41) 7.n.76S0
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PAGE 3/4
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C~STRUCT10N OBSERVAnoNS"
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, Fill-Placement and Com.qac6on, , ,
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.' ,The ea:isting ground sUlfacB wM Prep~d by strippIng U,e siJrlicial, Organics fa a deprh' of
:t2 to ,4 ind1es and placing ,the stripp!ngs in the back, !3f the lets. :We indicated Ihe~ this
" wou~, be ,adequate for sl~ppfng' in areaS of d"eeperfills (>2'feet). However, 'so",!! roots
, i'E!malned .In !he ,exposed '~ubgrade due ,10 the, on:h~/'ds !hat p,eviol,Js~ occupledlhe sitE!. '
Therefore'!WEl,recommended a'dditional stripping la areas'6f shallower fills. The subgracie
: was, prepared by ripping Ilia soli to a dspt/J at 1:12 inches. and (:OIT!pacting 'the surra,ce., ,
,Field density testing In sill/eral, 'areas indicated' that InlUal compaction efforts weR:! not
adeqL!ate. ,These areas were typically,reworked by ripping tlie surface, again, mCliSti.i~
, ,conditIOning the so~ and recompad!ng Wfth',severaf passeS 'of a pad foot roller, The
: ,: prepai'ed ,!Jubgrade,was then either r.etesled' or evaluated by proof, roiling WitH it ,Ioa'ded
' 1~ cubiC yard dump truck, '. ' , "
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Periodic': ,field' density tes1jng. Pi'oOt-rolllng, arid ,: 'obserVation of fill plaee";Emt ~hd
,compaction methOds, we~ C9ndudec{' throughout site', grading. .. We previded'
reClimmendations regarding moistUre c;ondiljoning of the fill and remove.! of organic
materia! throLjghout ,fill, PlacemiJnt. 'Our- observations 'and: mcommendatlons ,were,
summariZed in, a ~erie~ of field noles as Ihe worl(,prog~Sed, ' Lol tills were q:lnslrucfed'
, lI3ing on-site soils plaf:ed, and compadedin ;t121ncli (loose) lifts. ' Rlls were Compacted
wilfi multiple passes of El pad foot roner. Periodic field density lasllnQ and proof'ro!11ng
uslr,ga,loaded dump lruck were conduCted o!'lllle compileted fill. Areas that d~not '
, initially ,meet the spedlied' c;ompaction were, searffied,aridJor, moisture conc;lilioned and '
, " " reccimpacted. '
A ti~1 revlew:ofsile condiliqns and flelddenSlly teatS at t!:le finish grade of the lots Were:
conducted on Odoller 15:2001:' We not~d In ,,$ev.eral areas that'flnal,lot'greding re!l~1Is
in 'a tow area n~r the middle er front of th'e lot. We airtfdpate thai the Predomlmitely silly
sorb used dufing the site work WIll be moisture sen,sillve and wiH soften wltl'l 'axP.Osure, 10
wet weathen::ondltlaos. 'Themfore, 1ne fill will havs'tc'be, evaluated at Ille time of
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foundatiOn constNdionto' delert:nine the Im~ct of wet" weather CQndltlo!1S and
appropriate mitigation measures.' ,
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CONCLUSIONS' , "
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" We 'hll'ie Cl?nc/uded, based on the ~Its 01 our cpnstructi.m observations and the' ~eld
;and laboi'atory\esllng conduded" tl)af thefiJ1,intended, to slipport h,ouse' founda~ons
, meets the requil'l1ments ofUBC Appendix 33, Sectlo", 3313.' TherefOR:!, the 1019 ',are ,
approved fcir,~identia' con,~ction provided that any sofl.or dJstu~,materfals at the '
surface are' remo~ prior to 'fooling construction: This lipproval presumes :~at" '
foundation constliJctfon on lh'ese JOts'WiIl be COrripleted'prior to lIVet weellher. The surface "
of the'liIl Will likely' ioften 'When' Wet and eh,o\lJd be 're-:eVal!lat9c:l )lTIinedlately prior to
eon'structlon fo~ foundallon cOnstrUCtion, delayed beYcr1d-the end of this fall, "
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F1mI1'!e2ll~'D!I~
EGR and Aaod;l~. Im:::.
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8087 OCT.23.01 9:12AM; PAGE 4/4
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: ;:;:::" .' ,', '1;he Jmpact of: W!!t weathllr conditions Is likely to vary, with beanon ,and prppcis~'
' , C9ns'lnJi:t!onteehniques,' Thai'efore, IndMdtial IbIS wI/I ;',eed to be evaluated at ~li!tl~ of ' '
"fou~allon' construdion.. :The en-sIte, fill materials, are mOistu~, ~ensitiv8., Therefore,
I'BW9rking these rnaterlal$ dUrlng wet ~atoor, conditions will' net be.practical. ,In addlllon.
:fol!n.datlon: p~j)!1ratfon wor:j( ~y requfrjl spec/'" measurllsdunng, wer.wea/her to
minimize disltJrban,ce 10 the compacted ii,n materials. " , ' '
, II has: been ''8 plea::lure ,aSsIsting Yell' wlth,tn'i&' PhB~' of y~r projeCt~, Pfea::le doun'ot,
, hesila,ta' local/If you haye any quelillons cri; we Can be of fyrther assIstance.
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FOUNDAli'ONENGINEERING. INC. ", '
'7ft! f11~,L '
,Mel Mccraclien. P.E.
ProjeCt ,Engineer ,
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Branch Engineering. Inc.
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31 0 5th Street
Springfield, Oregon 97477
(541) 746.0637
Fex (541) 746.0389
STATEMENT REGARDING BASE FLOOD ELEV AnON DATA
FOR LEVI LANDING 2ND ADDITION
December 13, 2001
Branch No, 01-186
SCAi'n~E[)
The original phase of Levi Landing was platted and recorded in the area of late 1997/early 1998.
All flood zone data and project filling were based on FEMA maps that were dated May 2, 1994. In
June of 1999 updated FEMA maps were issued that reflect closely the 100-year Flood Zone
Boundary shown on the 1994 maps but have some significant differences with regards to the 100-
year Flood Contours.
Levi Landing 2"" Addition as filed in September of200 1 is a later phase of the original Levi Landing
subdivision, The 1 OO-year Flood Zone boundary and Base Flood Contours that are shown on the 2m!
Addition reflect the information from the 1994 FEMA Floodway Map 4155910044.
Data as shown on the attached Elevation Certificates is based on the June 2, 1999 FIRM except as
otherwise noted.
LOT 49
Lot 49 is shown on the plat QfLevi Landing 2m! Addition as being in Zone X. However, by scaling
and overlaying the 1999 FIRM with tax maps and subdivision plat, it appears that Lot 49 lies (;
partially in Zone AE and partially in Zone X. ('
-.l
The interpolated Base Flood Elevation in the area of Lot 49 as per the 1994 Floodway Map and'as -C..
shown on the plat of Levi Landing 2m! Addition is approximately 512,6. Due to changes in location
of Base Flood Contours on the 1999 FIRM, the same area now has a Base Flood Elevation of
approximately 514.1 (1.5 feet higher than the 1994 information). If one were to use the 1994
Floodway information, all elevations taken forLot49 would be above Base Flood Elevation (5 12.6),
LOT 91
Lot 91 is clearly shown on the plat of Levi Landing 2nd Addition as being in Zone X. Scaling and
overlays of the 1999 FIRM agree with this, No BaSe Flood Elevations are designated for this zone.
~
'\
Rex A. Betz, PLS
Survey Manager
REGISTERED
PROFESSIONAL
LANj) SURVEYOR
./&-1X?d. ~'
OREGON .
JULY 20, 1993
~, - Rf-XA BE172/filoJ
/'
TRANSPORTATION SURVEYING
/
"'- CIVIL
STRUCTURAL
,
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AOERAL EMERGENCY MANAGEMENT .rACY
~ NATIONAL FLOOD INSURANCE PROG.
ELEVATION CERTIFICATE
Q,M,8, No. 3067..Q077
Expires July 31, 2002
Important: Read the instructions on pa~. 7.
SECTION A. PROPERTY OWNER INFORMATION
. 8UILOING OWNER'S NAME '\. . "711 _
\"-.~ ^ ,v,. ~ " \M '^~
8UI~N~ STREET ADDRESS (Indudlng~, UniL Suile, and/or 8ldg. No,) OR P,O, ROUTE AND 80X NO,
I L( ,v117<.e..<. 1--'4,<: $ _ _ .. _._
CITYSonv- Ael~ ~IAIt;OR..
PROPER'fY DESCR';';!,TION (Lol and 810ck Numbers, Tax Parcel ~egal C~_;"';'n. etc.)
sJotJls~e,lg.. Rl~i~~~l, ~o~s1.:~.~,l~~: ~Ury. ete. t~ J~~ !!:4t:nf~;~};t'H I
- 1?""':d'k'l1!!"-\
LATITUDElLDNGITUOE (OPTIONAl) HORIZONTAL DATUM: SOURCE: U GPS (Type)'
( 1I#'.#If -1#1.11#" or 11#,II##1II1') U NAO 1927 U NAO 1983 U USGS Quad Map
f For Insurance ~pany Use:
Policy Number
- .. -.
f l.OlIlpany Ml(,; Numb~r
ZIP COOE
C? 7477
en",..~ 'Iv.", let loot;
~rf~ ~.~~~~~
UOther: ...................._1J
SECTION B. FLOOO INSURANCE RATE MAP (FIRM) INFORMATION
MUNITY NAME & COMMUNIlY NUM8ER
S ('. 41551-
I 84. MAP ANO PANEL 65. SUFFIX '86, FIRM INDEX tlf. ..;;....; ;;;,;_ ' tie. ~lOOO 89. BASE FLOOO ElEVATlON(S)
NUM8ER F' ,DATE EFFECTIVEiREVISEDDATE ZONE(S) (ZoneAO, use depth oftloodlng)
410~<::lc..'10 Tf.-.:,l,I'11'1 Z t; ~e-j;,-:2P\-te X
B10. Indicate the source of the Base Rood Elevation (BFE) data or base fIood,depth ef!lered in B9..! ' ~e ~ tHt4c.-t............rt-
UFISProfile ~IRM . UCommunilyDetermined ',UEllllerfS aiDe): A.,.J;/J '\10/ 1-=17.001
B11. Indicate the elevation datum used for the BFE in B9: ~GVD 1929 U NAVD 1988 ,U Other (Desaibe):. ' '
B 12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Prolected Area (OPA)?, U Yes ~o
Designation Date:
82. COUNTY NAME
COLt....
53. STATE
. ()
SECTION C. BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C 1. Building elevations are based on: UConstruction Drawings' ~ijding Under Construclion' UFinished Construction .
. 'A new Elevation Certificate )l!ill be required when construction of the building Is complete.
. Building Diagram Number.l::L. (Select the building diagram most similar to the building for which this certificate is being completed. see
pages 6 and 7. If no diagram aa:urately represents the building, provide a sketch or photograph.)
C3.Elevations - Zones A1-A3D, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR. ARiA. ARlAE, ARiA1.A30, ARiAH, ARiAO
Complete Items C3a-i below according to the building diagram specified in Item C2. Slate the datum used. If the datum is different from
the datum used for the BFE in Section B, convert the datum to that used for the 8FE. Shaw field measurements and datum conversion
calculation. Use the space provided or the Comments area of Section 0 or Sedion G, as appropriate, to document the datum conversion.
Datum ~ )f,., V 00 Z ~ Conversion/Comments '
Elevation reference mark used>:K ~ e.e Q.e"ev<:'~oes the elevation reference mark used a~pear on the, FIR~::J._'_Yes "h4No
~)TOPOfbOItOmfloorOnclud,"gbaSementorenclOSUre) 1=) 12'2fl.~ -:' REGI:OIt:tit:O --.'
O"b) Top of next higherfloor.c; 11f.3.... fl.(r7t) ~ PROFESSIONAL
~; ~~:d;~~:~~;~;: (;~~:f~~:r OM. 0=1 mpmhpr p' 7MO. OQly; 5 I 3' : s. ~~(~ i ~ I.A~D SUR,,:!';
~) Lowest elevation of machinery andlor equipment jig ':;; I f~ 0. !'~
servicing the building 5 I "T. _ ft.(Jl\)' ~ g OREGON
0/1) Lowest adjacent grade (lAG) ,&)/2... Oft.("" ~~ JULY20.,1993
ff.9)Highestadjacentgrade(HAG) .. E/.3...Lfl.(I!.) f' , REX~ETZ ,/
rn" h) No, of permanent openings (flood vents) within 1 ft. above aOJacent grade / ():l /
0/;) Total area of all permanent openings (Boodvenls) in C3h /, I W sq. In.;,,,. _.., ['1,2' Qc;:> 12/~I/C>f
SECTION 0 . SURVEYOR, ENGINEER. OR AR"M' J 1:1.. CERTIRCA TION
This certification is to be signed and sealed by a land surveyor, engineer, or archiled authorized by law to certify elevation information.
I cenify that the information in Sections A, 8, and C on this certificate represents my best effons to interpret the data ava17able.
I understand that any false statement may be puniShable bv fine or imprisonment unde,-~8 U.S. Code. Section 1001.
CERTIFIER'S NAME 'TJ ,.,.., + ll(;I:NSE NUMSER,--,S 2
1<:::'= \C 'PI e... 7__ _ t-'L &0 (0
41E ~ COMPANY ,'iMlt:'T) (,
,){.AVVC'1.M.ti.lA.aS<EV-. 1?rUI1l:. 1 a5i~~YI~~'.:u:c..
"DRESS 310 F\~ ~ -,.,....+ cns "."';"'e;,hdd STATEO~ ZIP coo 71f77
SIGNATURE , -. -, TE'f \ Z-OC! \ TELEPHONf S" I _ OG,.
~ \ FEMA Form 81.31, AUG 99 -SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS
IMPORTANT: In these spaces, copy theeesPOnding information f'om Section A. _
BUILDING STREET ADDRE,Si> (Including Api.. UA Suile, andlor 81dg, ;";0,; c;;:;: ~,O, ROUTE AND BOX NO,
(r? (~ -".4 AA n <; e <;. \r-'4 5: S
CITY 5 (' (./ . STATf /J L'P i:uof I Company NAIC Number
rr"""",:fl e~ (}J, Cf71.ft'
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For Insurance Company Use:
Policy Number
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
3M~W~~L'P'.M~-e\d B",,,,,r/(.,, U&vk. ~(';'''j ~ c~~~(;J <;1uuve ~'-+ ~~p
--=fi/P J; ~v h ~+ -H.!'2 \'v\,iJr'OI'",t- oJ (ij~""t-. ,....,...iu....... ~~ <::'nlA~ u~~+{'-DYl\e" c.tf2
-1Ll+t-- ~\I.-.:.......~-I-?V'_ 1'II,:,vl';''; 6"" AaVA.-nv.-d' .S-/'2.hl {':h., l1"fu...... CiAArl
~-bA -1-2> g[1",..r6-n"", 5/~ II A){,vn'2t:; LU4<; (.I~,(4"> RSI<; c.f~lcv<<~<;:;,.
.ojt,:~ ~e.e. c.tt"~~~t~v>\G%t AG~~ (\)eceMb,..-I'~Lt.ool I!1'Checkhereifattachments,
SECTION E. BUILDINC:i 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 E3. If the Bevation Certificate is intended for use a; supporting
infonnation for a LOMA or LOMR-F, Section C must be compteted. ' ,
E 1. Building Diagram Number ~ (Select the building' ol3gram most sinular to the bwlding tor which this ~ ~~-;~ is being completed-
see pages 6 and.7. ,If no diagram accUrately represents the buil~ing, provide a sketch or ~:,~;~~.~ph.) .
E2.- The~ top of the tiOtlorii floor Qncluding basement or endosure) of the building is LU ll.(m) LUin.(an) U above or,' U below "
(check one) the highest adjacent grade. ' ' '
E3, For Zone AO only:, If no flood depth numlllir is available, is the top of the bollom floor elevated in a~.~~...:ewith the community's '
floodplain nianaqement ordina,\ce? t!1 Yes' II No I I uriknOwn.,The local oflicial must certifylhis infu...~~~.. in Section G:::.,
, l;ECTION F . PROPERTYOWNERToR OWNER'S REPRESENTATIVE) cEimACATION : I
The property owner or owner's authori,zed representative who completes Sections A, B, and E tor Zone A (Without a 'FEMA-issued or
community.issued BFE) or Zone AO musl sig,; here.
SEGiiUN D. SURVEYOR, ENGINEER, OR ARCHITECT CERTIACATION (CONTINUED)
.
PROPERTY OWNER'S OR OWNER'S AlffiiORIZEO REPRESENTAnvt2-;; MMC
DAli:
:; lA're ' ZIP CODE
TELEPHONE .
elli
ADORESS
SIGNATURE
COMMENTS
1-1 Check here if attachments ,
SECTIONG. 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 appliclble tlem(s) and sign below.
G 1, U 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 slate or local law to certiiy elevation information. (Indicate the source and date of the
elevation data in the Comments area below,)
G2, U 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, U The following information (Items G4-G9) is provided for community floodplain management purposes,
I G4, PERMIT NUMBER I' G5. DATE PERMIT ISSUEO I G6, DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY
, ' ISSUE~
G7, This'permit has been Issued for:' U New Construction U Substantial Improvement
G8, Elevation of as.built lowest floor Qndudlng basement) of the building is:
G9, BFE or (In Zone AO) depth offloodin~ ..t.~~~uildingsite is:
LOCAL OFFICIAL'S NAME
. _ll.(m) Datum:
. _ It.(m) Datum: .
TIT1.E
COMMUNt',y N"Mc
SIGNA'iuKC
COMMEN Ii;
TELEPHONE
DATE
,-
1-1 Check here if a1l8c.hmeiits
REPLACES ALL PREVIOUS EDITIONS
~
~C~A.a t:,..,..rn A.1_':l.1 Aile:; ~Q
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FEDERAL EMERGENCY MANAGEJl. AGENcy
NATIONAL FLOOD INSURANCE FROGRAM
ELEVATION CERTIFICATE
O.M.B. No. 3067-0077
Expires July 31, 2002
.-
Important Read the instructions on pages 1 .7.
SECTION A. PROPERTY OWNER INFORMATION For Insu",nee Company Use:
BUILDING OWNER'S NAME I Policy Number
BUILDING STREET ADDRESS (Including AJll,. Unit, Suite. and/or Bldg. No.) ui< ;:;.u, i<CV -;-;; AAU SOX NO. I Company NAJC,Number,
to (jp I U .01 "'<-<".C. ~<:<< <;; _.
CITY :. -, ~IA'IE ZIP CODE
'50'("~~ Fel.:;( DR... C? 71.17"7
PROPER'I"Y DES'CR TION (Leland 810eX Numbers. Tax Parcel NUmb~ Legal 0escripil0ii; etc.)
___...I...at ql J ev.i la",df"'~ 'Z.....d A-kft:.JJ[;'YI "U.1c~I7.-ol-34-~t ~Tfu,.lct1'oc::::
BUILD~ USE.(e.goo R~id.ential. NOIl-re.idenlial.Addition, Aa:essol)', etc. Use Comments ll1ea!SSaly.)
~r:'<;ld~1'lIitl.\ ._,__, __.__ . "'_ _ ~
LA TITUDElLONGITUOE (OPTIONAL) HORIZONTAL uA, VM; "uu'<l.c; W \JP::. (I ype)'
( ".".- ...-, "coo~::, ~"= .."..."'~=,: u_.:
I B1. NFIPC'If'1, MUNITY NAME'& COMMUNITYNUM~_ I ~COUNTY NAME.. .1.','-, B3.STATE 12.... ".,.~
(l,,+,~ r.T 5..D-r""-,,,...&:.k1. L\.l55'2.2:..LL..a.., e ell ~"'S"'1.:. ,I ' '6, " "< J
I 84. MAP ANO PANEL J B5. su"FFiX- ~6. ARM INDEX B7. ARM PANEl. . sa. FLOoO 89. BASE FLOOD ELEVATION(S)
NUMBER F ,DATE EFFECT1VEIREVISEDDATE ZONE(S) ',: .(ZoneAO......depthotlloodlng)
4ID~~(?.IIG, " ':Ti- 11<1 <;',: -- ~e. k:"2~~"X'
Bl0. Indicate the source of the BaseAood 8evation(8FE) data or base flood depth ~;~~_InB9.;,:,., ,'~e~ fkt4<:r!.......
UFISFrofile I!;l!FIRM' -', UCoinmunilyDetermined '..USlherlB! "'l1le):",' --J.s..\,::,J 1lo, I~; 7i?tJl
Bll. Indicate the elevation datum used for the BFE in B9: WGVD 1929 U NAVD 1988, U Other (Oesaibe):_., " '
B12. Is the building located in a eoastai Barrier Resources System (CBRS) area or Otherwise Protecled Area (OPA)?, U Yes ~No
Designation Date:_
SECTION C. BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: UConstruction Drawings. ~g Under ConstnJction. UFinished Construction "
. A new Elevation Certificate ~ be required when construction of the bwlclll9 is complete.
,L. Building Diagram Number.1:::L (Select the building diagram most similar to the building for whic.i this certificate is being completed _ .ee
pages 6 and 7. If no diagram aa:urately represents the building, provide a sketch or photograph.)
C3.Elevations - Zones A l-AJO, AE, AH, A (with BFE), \IE. Vl-V30, V (with BFE). AR. ARIA, ARlAE.. ARIA l-AJO, ARlAH, ARlAO
Complete Items C3a-j below aCCOrding to the building di;>gram specified in Item C2. Slate th~ datum u.ed. If the datum is different from .
the datum used for the BFE in Section B convert the datum to that used for the BFE. ShOw field measurements and datum conversion
calculation. Use the space provided or the Comments area of Section D 'or Section G. as appropriate, to document the datum conversion.
Datum ~ It- V D'Z~ ConversiOn/Comments
Elevation reference mark used~ 5: e.e Q ~ Ie oK/!.Does the elevation reference mark used appear on the FIR~l..l I Yes mNo
~) Top of bottom f100c (,"duding basement or endosure) ;:; 1.,g..2 fl.(lll):" REGISTERED '
<Yb) Top of next higher floor L; 1'f:.3....fl.(~ ~ PROFESSIONAL
~ ~~:~~~"~;~;~ ~;~~:i~~~~)"",""'~1 mpmhor r' 'MO. o"~'1 ,&:) I ~ : ~ ~(;;;; j i ~D SURVEYOR
~) Lowest elevation of mac.iinery andlor equipment ,I 8 ~.;' f~ S7. ~
servicing the building , 5 J 'T . _ fl.(nfT f ~ OREGON
0/1) Lowe.t adjacent grade (lAG) ,~I 2...a fl.(~ % ~ JULY 20. ,1993
G",p) Highest adjacent grade (HAG) '...5 I.~. -L fl.(Ift) r " REX~ETZ "
IB"~) No. of pennanent openings (flOOd vents) within 1 fl. above aOJacent grade / {) _:!! "I 1 ,
tYll Total area of al/ pennanent openings (flood vents) in C3h I, 1 W sq. In. {ecr.-aIl) [,(2. Gc;:, l.erg/lel
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFlCA TI\Ji~
This certification is to be signed and sealed by a land surveyor, engineer, or archilect authorized by law to certify elevation information.
I certify that the infonnalion in Sections A, 8, and C on this cerlificale represents my be$ efforts /0 intelpret the dala ava/7able.
I understand that any false statement may be Dimishable by fine Dr imprisonment under 18 U.S. Cede. Sec/ion 100t.
CERTIFIER'S NAME .-.--., ~ + ,UCEHSE NUMBE~ <' '7
"K:'r= Ie'"': op<;.... ,7_ . ;;) rJpO r"
-F.E, S .. -. COMPANY NAM!:'D I = .. '..,..,.,
. LA VOl! C.vL M..",^,? c c:e y- .. ,..' 'P.rc..I-1~l.rt ~"'e; ih ~Y" Ikc .....w,. t" ...' .
- AlJORESS 3\ 0 n' f-tt, ~" -:....t Cf~ ('..;..,,,,, H c::.ld sTATEO ~ ZIP coo'q 7/f 7 7 ';.
SIGNATURE../7 )~ ,- 9AJ.cf, TELEPHONijr, )
f'&~ a. /:t:A _ ',Joe... \'":3, 2.00 \ l S'-II 71/./".,- ()(~-:J... '7,;c
-,
-.,
.'
'. .
IMPORT ANT: In these spaces, copy the correspondin9 infonnation from SeCtion A-
BUILDING STREET AOORE,SS (Including ApL, Upil,.Suile, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.
(",(",""1 t..J. ^~ I'l<"p <, 11-'4'< S
CITY 5r("~A~(d - ,-' STAiJR 'q7~~~
For Insurance Company Use:
POlley Numller
Company NAIC Number
I
.j
-J
SECTION D. SURVEYOR, ENGINEER, OR ARCHITI::C'I Cl:j{IIACATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official. (2) insurance agent/company. and (3) bwlding owner.
~~~ & )p~,,",~.fW.\d 1=?,,,,,,),,' .v{,C.tJ?eI';'1 ~ d..,,~~(~J "1ua".e. <1<-+":~
....:fi;t.n, ,I;, r..A.... b ,..-\. -\'i_'~ IN\,iA~D\''''+- AI (l"".../'" ....:h,......... ~ oe::,/)",--tt., uJ<!o:.i-'f'.A'f\\<!
---'U~ ~~.:L.<~-t<:,,"'. L.(,1I1";""~ <'?..... r:;;/"V"4-tcv..-JSJ'2._hl (','k, V'--b,....... /l
~,~ -b p;;1~w, ~/3, II Vl.VD'2"'i WC,<:LtV...(4o;, ~~~4.~~
~~ ~~ c..th~."t.eJ ~t~~~-t ~ieJ \i1e,el-o'l~"'~Ltcol _Checkhereifattachmen~
SECTION E. BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO and :7.oNE A (WITHOUT BFE) 1
For Zone AO and Zone A (without BFE), complete 'items Ell1uOugh E3. If the Elevation Cerlifh;ate is intellded";' use ~ SlJppottfng
information for a LOMA or LOMR-F Sed/on C must be completed. ' .
El. 8unding Diagram Number ~ (Select the bwlding diagram most similar to the building fat whicI1 this - ;Jc.;" is be~ compleied .:.
see pages 6 and 7. ,If no diagram accUrately represents the builcfmg. provide a sketch or photDgraph.) :"
E2.' The top of the bottom floor Cmduding basement or imcIOSiJre) oi the building is '. L.LJ ft.{m) LLJin.{an) 'U above Or . LI below
(check oriel the highest adjai:e~t grad~. ' ,.' ,
E3. For Zone AO only:, If no flood depth number is available. is the toP. ~f the bottom floor elevated in _..;..,..:e with the community's '
flood'plain nianaqement ordinartce? L I Yes 'L I No 1__1 UnknoWI1. -The local ofliciaI must ~ this ~,;_.._a~.. in sedio1i G:' :: ,
, ' SECTION F. PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFlCATION -,
The property owner or owne(s authorjzed representative who completes Sections A. B. and E fat Zone A (without a FEMA-issued or '
community-issued 8FE) or Zone AO must sign here. '
. - .--.
(;111
STAn: ' ZIP cOOE
1
J
J
J
. U Check here if atlachmen
PROPERTY OWNER'S OR OWNER'S AUTMORIZED REPRESENTAllVE-S NlWc
AOORESS
SIGNATURE
DAlE
TELEPHONE
COMMENTS
SECTlOIl-G. COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community'S floodplain management oromance can complete
Sedions A, B. C (or E), and G of this 8evation Certificate: complete the apprlC3ble ttem(s) and sign below. '
Gl, U The information in Section C was taken from other documentation that has been signed,and embossed by a licensed surveyor,
engineer, or architedwho is authorized by state or lacallaw to certify elevation information. (Indicate the source and date of the
elevatioli data in the Comments area below,)
G2. LJ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued 8FE) or
Zone AO. '
G3. U The folloWing information (Items G4-G9) is provided fer community floodplain management purposes.
I G4. PERMIT NUMBER I'GS. DATE PERMIT ISSUED I Go. UA1ECERTIFlCATEOFCOMPUANCElOCCUPANCY
, ISSUED
G7. This'pimilit has been issued for: U New Construction U Substantiallmprovemern
Ga. Elevation of as-built lowest floor Oncluding basement) efthe buHding is:
G9. BFE or On Zone AO) depth of flooding ~ttl1~ illiilding sne is:
LOCAL OFFICIAL'S NAME " "...',..
. _ ft.{m) Datum:
. _ fl(m) Oatum:
TI,Lf
COMMUNITY NAME
SIGNATURE
TELEPHONE
DAre
, COMMENTS
LJ Check here if <itiachmel