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IMPORT ANT: In these spaces, copy the corre.pondlng Infonnatlon from Section A. Buifdlng S~f AddnJSs (il1Cludf'!9 (\pI., Unit. Suite, andlor Bldg. No.) or P.O. Roule and Box No. ~ O?J 1 lP-tr.:)T. City y hi \\ <::. Slate k ZIP Code SECTION 0 . SURVEYOR, ENGINEER, OR ARCHITECT CEATIFICAnON (CONTINUED) ;~prl~J"IQe~anll Usa: ;~lf/!;'ylilll~ : A{CN.Yri1bei: . Copy both side. of this Elsllatkm Certlfk:ate for (1) community ofllclel, (2jinS\lfWI cot agentlcompany, and (3) building owner. Comments C:J a.;; shot Ol" h>p or -Pootev-- Signature ~ K Dete q ~ d9.- 0 0 Check h if attllchmenls SECTION E . BUILDING ELEVA.TION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONe A (WITHOUT BFE) For Zonas AO and A (without BFE), complete Items E1-E5. If the Cerll\l(1ele Is ir\tended to support a LOMA or LOMR.F request, complete Sections A. B, and C. For Items E1-E4. use natural grade, ifavaltable. Check ltIe messurement used. 'n Puerto Rico only. enter meters. E1. Provide elevallon Information for the following and check tile appropl1Bte box" to show whether the elevation Is above or below the hlghest adjacen t grade (HAG) and Ihe lowast adjacEmt grade (LAG). a) Top of botlom lIoor (including basement, aaw/SpMClt. or endolJure)is__ _ 0 lbel 0 meters 0 above or B belowlhe HAG, b) Top of botlom floor (includlno basement, aawl spaoe, or encloaure) is _' _ 0 feet 0 metel'$ 0 above or bEtIow the LAG. E2. For Building Diagram; 6-8 with permanentll00d openings provided In SectiQn..A Items 8 iJl1lIor 9 (8ee e!$Ic 8 of Instructions), the next higher floor (elevatIon C2.b in /hedisgmms) of the bllildlng is _' _0 feel U meters U above or U below the HAG, E3. Allached garage (lop of slab) is _' _ 0 feel: 0 ~rs 0 above or 0 below the HAG, E4. Top of platform 01 machinery and/or l!Kjulpment servicing the bulJdJng Is _' _ 0 f.el 0 meters 0 sbove or 0 below Ihe HAG. E5. Zon. AO only; If no flood depth numberls avaUable. Is /he top of the bottom toor elevated In accoroan<:e with \he cammun!1y's floodplain management ordinance? 0 Yes 0 No 0 Unknown. The Io<:el ol'Iiclal milst certll'y this fnformallon in Section G. ./ SECTION F. PROPERTY OWNER (OR OWNER'S REPRE8ENTATNE) CERTIFICATION The properly owner or owner's authorized representative wlto completes Sections A. B. aII,!:I E for Zone A (without a F EMA-lll8Ue<l or community-issued a FE) or Zone "'0 mllst sign here. The stattml811ts fn SBCtlons A. B, and E a... corPBcf to the best of my knt:1Wledge. Property Owner's or Owner's A"thorized Represenlative's Name ' Mdres$ City il S/ate ZIP Code Signalure Date Telephone Comments SECTION G . COMMUNITY INFORMATION (OPTIONAL) The local ofliolal who 18 authoriz:ed by law or ordinance to administer the communlly's floodplain management ordinance can complete Sections A, B. C (or E), and G of ttis Elevalion Cer1lftcatl!. Complete the appllcabJe itam(s) and sign bellow. Check the measurement used in ltema G8. and G9. G 1. 0 The informs/Ion in Seclion C was laken from other documentation 11\et has been elgned and sealed by a licensed surveyor, engineer, or arct\i\ect who is 8uthorized by lew to certify 618\1811on infonnation. (lndlcatalhe source and date of the elevation data in the Comments area below.) G2. 0 A community official completed Section E fix a building located In Zone A (wilhoul a FEMA-issued or community-issued BFE) or Zone AO, G3. 0 The following [nformatlon (Itams G4.-G9.) Is provide<! for community fIOQdplaln management purposes. G4. Permll Number G5. Date Permit Issued G6. Date Certificate Of CompllanceJOocupancy Issued o Check hMe If attachme~ G7. ThIs permit has been i$"ued for: 0 New Conslructlon 0 SUbstanCial Improvement G6. Elevation of as-built 1D'lMlSt floor ((ncluding besement) of the buDding; G9. BFE or (in 20ne AO) depUI of flooding at the buildIng slle: o feet 0 meters (FOR) 'Datum o feet 0 melera (PR) Delum Local Official's Nama TiDe Communlly Name Telephone SIgnature Date COnYnenls o CtIeck here If attachments FEMA Form 81-31 , February 2006 Replaces all previous editions