7825 LARIMER RD 2018-01-02 MF Import

OMIT 026-11-00026 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM POST COI:STRUCTION ELEVATION CERTIFICATE/FLOODPROOFING CERTIFICATE COMMUNITY NUMBER 53O1G4 INSTRUCTIONS The registered professional engineer, architect, surveyor or community permit official completes Section I below. Section P may be completed by any of the professionals listed at the beginning of Section II, or by a similarly qualified local permit official. Print or t rpe the information on this form. This form is to be used for new (POST -FIRM) construction and for substantial Improvements to existing structures In Zones AT-A3O, AH and VT-V3O and existing (PRE -FIRM) buildings to be rated under POST -FIRM rules and rates. SECTION I (TO BE COMPLETED BY COMMUNITY PERMIT OFFICIAL) ROPERTY ADORLSS (or lot and block numbers it address is unavailable) 7825 Lowell—Larimer Rd. iA MAP PANEL ON WHICH PROPEfliY IS LOCATED FIA MAP ZONE IN WHICH PROPERTY IS LOCATED O0O2A B 'A M4P EFFECTIVE DATE BASE FLOOD ELEVATION AT THE PROPOSED SITE 4/3/78 18 (City of Everett Datum is 117.07) _ TART OF CONSTRUCTION DATE Nam' and Title PHONE (with Area Code) 7/86 Lawrence N. Callahan, Buiiding Official (206) 259-8745 UORESS O Cedar_ EvEret A- 98201 j 2 Signa ure _ (Date) SECTION II INSTRUCTIONS Complete only the Elevation Certification unless the building has been floodproofed at least to the base flood elevation. If floodproofinq is used, complete only the Floodproofing Certification. The Elevation Certification may be completed L-y a registered professional engineer, archilect, or surveyor. The Floodproofing Certification may only be completed by a registered professional engineer or archilect. ELEVATION CERTIFICATION I certify that the building at the properly location described above has the lowest floor at an elevation of feet, NGVD (mean sea level). FLOODPROOFING CERTIFICATION I certify to the best of my knowledge, Information, and belief, that the structure is designed so that the structure is watertight to an elevation of _____ feet NGVD (mean sea level), with walls substantially impermeable to the passage of water and structural components having the capability of resisting hydrostatic and hydrodynamic loads and effects of buoyancy that would be caused by the flood depths, pressures, velocities, Impact and uplift forces assorialed with the base flood. In the event of flooding, will this degree of floodproofing be achieved with human Intervention?* _ Will the structure be occupied as a residence? If the answer to both questions is Yes, the floodproofing cannot be credited for rating purposes and the elevation certification ;oust be completed instead_. *Floodproofed with human intervention rneans that water will enter the structure when floods up to the base flood level occur, unless measures are taken prior to the flood to prevent entry of water (e.g. bolting metal shields over doors and windows). fiTIFIER S NAME AFFIX SEAL OR WRITE PROFESSIONAL LICENSE NO. BELOW: LE DRESS (Signature) (Date) The Insurance agent attaches the second copy of the completed form to the Rood Insurance policy applicall;n for new (POST -FIRM) construction or substantial Improvements. Be sure that the second copy is cerlined. INSURANCE AGENTS MAY ORDrR THIS FORM 117