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IMPORTANT: In these spaces. copy the corresponding Infonnatlon from Section A Buitding S~I Acldt9S$ (includC'!9 foP!., Unit, Suite, and/or Bldg. No.) or P.O. Roule end Box No. ~O~ l -tr, ;)-1-. City Y hI \ \ 'S Slate "FL ZIP Code .;t1lNCNiJri1bSt. SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICAnON (CONTINUED) Copy both side. of this Elsvallon Certificate for (1) oommunlty omelet, (2) Insul'8flClt agent/company. and (a) building owner. Commenl$ Cc? Gt;:; shot 0(\ \-or of' -Foote..r Signalul'll ~ ~ Dele q , d9 ~ 0 0 Check h if attachments SECTION E . BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1-El>. If the Certlllc8te 18 intended to support s. LOMA or LOMR.F request, complete Sections A. B, and C. For Items E1-E4, use natural grade, tfavallable. Check the measuntment used. In Puerto Rico only, enter meters. E1. Prollide elevation Informatioll for the following and check the appropriate boxes 10 ilhow whether the elevallon 1$ aboll6 or below the highest adja<:ent grade (HAG)...,o Itle lowest adjacent grade (LAG}. a) Top of botlom floor (ineludlng basement, craw/space, or encfolJure) is _' _ 0 !'eet 0 melers 0 above or 8 below tl1e HAG, b) Top of boUom lIoor (including basement, as..,! space, or- enclOSUre);5 _' _ 0 feel 0 metef$ 0 above or bEtlow the LAG. E2. For Building Diagrams 6-8 wilh permanent flood openings provided In SecliQn.A Items 8 iml!or 9 (see ~e e of Instructions), Ihe nelft higher floor (el8vallon C2.b in thedlsomms) of the building is _. _0 feel U malers U above or U below the HAG, E3. Attached garage (top of slab) is _' _ 0 feel: 0 ~ers 0 above or 0 below Ihe HAG, E4. Top of platrorm of machinery and/or equipment servicing the bulJdJng Is _' _ 0 f~t 0 metelS 0 sbove or 0 below the HAG. E5. Zonlil AO only: II no flood depth number Is available, Is \he lop of tha bottom .oor elevated in accoroance with \he community's floodplain managel11(lnt ordinance? 0 Yes 0 No 0 Unknown. The locel officlal mUst eertHy thIs Informatlo!'l in Section G. . 'i/ SECTION F . PROPERTY OWNER (OR OWNER'S REPRESENTA.TIVE) CERTiFICATION The properly owner or owner's authorized represenlative wtIo completes Sections A. B, anp E for Zone A (without a FEMA-ill&ued or community-Issued BFE) or Zone 1\0 must sign here, The staffilmf3l1ls in Sections A, 8, and E a... co/78et to 'he best of my kllC1Wledge. Property Owner's or Owner's Authorized Representative's Name I\ddress City ~ Slale ZIP Code Signatln Date Telephone Ccmments SECTION G . COMMUNITY INFORMAnON (OPTIONAL) The local official who Is authorized by law or ordlnal'lQe to administer \he community'8 floodplain management ordinance can complete Sections A, B, C (or El. and G of tl1ls Elellalion Certlllcata. Complete the applicable Ilam(s) and sign OOlow. Check the measurement used in Items G8. and G9. Gl. 0 The information in Sec;lion C was laken from other documentalltrl that has been signed and sealed by a licensed surveyor, engineer. or arctlilect who is authorized by law to certify ele\l8t1on illformation. (Indicate 1I1e sotJrC8 and date of the elevation data in the Comment8 area below.) G2. 0 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. 0 The following information (Items G4.-G9.) Is provided for community floodplain management purposes. o Check here If attachmeplS G4. Permll Number G5. Dale Permit Issued G6. Date Certillcate Of Compliance/Occupancy Issued G7. This permit ha6 been issued for: 0 New Construction 0 SlJbstanCial Improvement G8. Elevstlon of as-builllowe&t floGr ((neluding bt!1sement) Qf tlle buDding: G9. BFE or (in 20ne AO) deptll 01 IloodilJg at the building site: o feet 0 mel8rs (PR) 'Datum o feel 0 meters (PR) Datum Local Official's Nama Tifl., Telephone Communlly Name Slgnalure DIM Commenls o Check here If attachmenls FEMA Form 81-31, February 2006 Replaces all previous edltJons