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ELEVATION CERTIFICATE �' f y Dq - D/��{ <br /> � 115 OEPAPiMENTOFMOMELANDSEGURITY — � <br /> � (EOERALEM[RGENCYIAANAGLM,CNTAGENCY O(�1BN0 165C�OCOB <br /> r.�„�,��u�i�.��.ir��,�...,��<<�N��i"��� Important: Read the instructions on pages t-9. EtiP��ahon �ate .;wy 3� 20t5 <br /> SECTION A-PROPERTY INFORMATION FOR iNSURnNCE CO�.tPA��V USE <br /> A1 pm�tlmg Owner 5 Name Port of[ve�et� Policy I�u•nber <br /> A2. �wltlmg Slreei Address Ondutl�ng npl,Umt,Sude,analor HItl9 No)or a O Route aatl Boz No Com�any IJAIC NumUer <br /> 1500 Pust St <br /> Gty Everett Slate WA ZIP Code ?8203 <br /> A3 Property Descnpuon ilot and BIoU N�m6ers,Tax Parcel Num�er,Legal DestnpGen.elc) <br /> Sect.34.Tv:p 29,Rg <.t,iM ID 29043a000300100 <br /> Aq pminmg Use(e g.Res�aenbai,NoroRes�demiai,Addllion,Accesxory.etc.)Nomres�denuai.Sio�ane <br /> AS LaUluaelLongitutlC Lat <7°57'OG Bg�N Long 122°17'25 30"W Nonzonlal Dalum 1 '::.D 197% ��j N,;;) 'SP,3 <br /> �G Altach al Ieast 2 Dhotogr�phs of lne butltl�nq d tne CertiOca!e�s be�ng used to eblam Oootl�nsurance. <br /> ••7 Bcil��ng Oiagram Numbei iB <br /> AP Por a huddm9�vth a crawlspace or pnclpsure�s) A9 for a 6u�itlmg�4�Ih an altached g,ra:1� <br /> a) Square'oolage o�cravAspace or encbsure�s) nla 50 fl al SCuare�eolaqe of atlacheA garaqe r_a sa h <br /> D) Num�er of permaner.t Iloo�open�ngs in Ihe crawlspace �) N�mber ol permanenl Cood open�ngs in 11•.e altacCed garagc <br /> er enclosure�s)�ti�thin 1 O lool above ad�atent gratle n�a wdhin 1 0 foot a6ove a��acent gtatle ��a <br /> O To;al net area o�O000 epernngs�n AB b n;i s�m cl 1 ctai nel area oi P�ootl open�ngs in A9 b nla sq m <br /> d) Eng�,neeretl rood cpen�ngs� ❑ Yes G No n� [ng�neered Ilcotl cpemngs� ❑ Ycs ❑ No <br /> SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION <br /> �, �1 NPIP Commun�ty Name F.Comm�v;y Num6er 02 Ccunly Name BJ State <br /> � [vereltSJOtba S�ohomish '�'� _ _ <br /> B4 MaplPanel Number 85 Su'fiK 86 FIRM Inae:Date B7. FIRM Panel AB F�occl B9 Hase=bcd[levai�onls)�7one <br /> 53061C1010 E itlB199 EffechverRe�setlDale Zo^elsl ��O ��sebasePcoOtlep:h) <br /> a+iFi�05 ° EL 9'cet <br /> - L__--A.. _ -. _ _ _ _ - ___—_' <br /> �10 ind�wie the source ol Ihe Base Flood Eleva�wn(BfEI data or base 9ootl deplh enterea�n Item�9 <br /> ❑ �iS Pronie � FiRtd ❑ Commurnly DMermined ❑ otnenSource __ <br /> B11 ina�cale elevauon tlatum usea�or BFE in Item 09 �� NGVn 1929 ❑ NAVD 1988 ;] O'he�;5owce __ _ <br /> B 12 is Ihe bud0in�locatea�n a Coastai Barner Reso�drees System(CBRS)area or Olherwise Prolected drea�OPA�� ❑ Yrs l, No <br /> Designa�ion Dale _ ❑ CORS ❑ OPA <br /> SE�TION C-BUILUING ELFVATION INFORMATION(SURVEY REQUIRED) <br /> C' BudAvig eleva6ons are oased on ❑ Consvuctmn�ra�rngs' ❑ Ou�lainq U�aer Conslruchor.• �,� Frt���s�+ed ConsnucLo�� <br /> •A new Elr.vation Certdicale��ii 6e re0w�etl when con5lruUion ot the�wiamg�s complMe <br /> l;7 Elevaiioas-Zones A1-�130.AE,�1H,A(vnih BF�),VE,V1-V30.V(�,nth�F[).!�R AR/A,A:�(AE,r1R�A1-�30,AR:AH,AR/.10 ComplMe�Icros Ce a-�• <br /> 6elow accortl�ng Io Ihe bu�lamg tliag�am speafietl m Item A7. In Puerto RiCo only,enler meters <br /> Ren[hmark Um�ren.Snohomish Co u16'2 Ven�cdi D3tum 10 891eCi NAVDBB <br /> inamaie cicvahon dalum usea b�Ihe rlevaiions in�Iems a)Ihmugh h)below. �NGVD 1929 C7 YAVD 1988 �OthedSource _ <br /> Catum usetl 1oi bwlding eicvalions must be Ihe same as Ihat useA fo�Ihc OFE <br /> ChecF Ihe measurement used <br /> .+1 Top of bottom noor�inUud�ng 6asemeN,c�a�mspace,or enUosure 11oop 16 Ot ❑Iee1 ❑meteis <br /> hl lnn of IhC nCzl higher IloOr �ly- ❑�eel ❑meteis <br /> c� Hatinm of Ihc lov.esl homm�lal sM1uc!•ual membCf(V Zones only) nla_ ❑Iccl ❑mcters <br /> nl �tlachea qarage(top ot slab) n/i_ ❑Ice1 ❑me�r.is <br /> ��1 I.owesl elevatian ol m�ch�nery a�equ�pmenl servicing(he bwld�np ����_ (��eel ❑meters <br /> �De,cribe rype ol e�mpmenl ancf localion�n Commenis) <br /> 0 towesl adjacent 1(��nshrtl)grade ncr.t to bwlAing(L4G) _.___ ( �ICM ❑mrlr�r. <br /> q) Highest atl�acent(5mshetl)yraUe neYt lo buJAmg(HAG) ____ ❑feel ❑metcrs <br /> h)Lowesl a0�aceN yrade al lowest eleuatwn ol Aeck or slairs.indumng struciwal support nla __ ❑feel ❑meters <br /> SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION <br /> Tnis eerllf�calmn is Io be s�gned anU sealed by a land surveyor,engineer.or aich�tect aullionzetl by law lo Cetlily elevat�on — <br /> intormalion I rerUry Ihat(he�n/orma6on on(n�s CertJicate mpmsen(s my Gesf cllorts ro mlcry�et fhc dafa ava�la�le. <br /> 1 undersfand fhaf anylalse sfaferienl may he punuhable by hne o�rmpnsonmenf unde� 1B U S CoOe, Sechon 1007 <br /> 0 Check here il commenls are provitletl on back o�form Were IaUluae ana longdutle in SeU�on A piov�ded by a PLACE <br /> [,� Check here A altachmenls licensed land surveyor� � Ve, ❑ No SEAL <br /> CeniGCYs Name Mlchael Lee Sjolin lmense Number a5t 7a HERE <br /> �dle Surveyor CompanY Name Amencan Surveying 3 Engmeenn;l,L <br /> nddress 28T7 152"'Ave NE Ciry Reamond State WA ZIP Cotle 98052 <br /> SgnaNre Dale lclephone 425�8Bt-7a70 <br /> F61dA Form OB6-0�33;7112) See reverse side for cominuation Replaces all previous edilions��� <br />