Flood Control - Elevation Certificate - 773 S Island Glenn Way - Mace River Ranch Sub No 01 - 4/26/2017U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
ELEVATION CERTIFICATE
ImPaltant: Follow the instructions on pages 1-9.
Copy all pages of this Elevation Cedificate and all attachments for (1) community omdal. 121 Inearam—
OMB No. 1660-0008
Expiration Date: November 30, 2018
anA (i\A��iLi:n
SECTION A- PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
Al. Building Owners Name
Policy Number:
Evergreen Construction LLC
A2. Building Street Address (including Apt., Unit, Suite, antl/or Bldg. No.) or P.O. Route end
Box No.
Company NAIC Number:
773 S. Island Glenn Way
City State ZIP Code
Eagle Idaho 83616
A3, Property Deauip8on (Lal antl Bloch Numbere, Tax Parcel Number, Legal Deacnption, etc.)
Lot 10 Block 2 Mace River Ranch Subdivision No. 1, Parcel 85421200420
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude, Lat. N43°41'76.291" Long. WI 16'21'32.192" Horizontal Datum: ❑ NAD 1927 NAD 1983
A6. Attach at least 2 photographs of the building If the Certificate Is being used to obtain flood insurance.
AT Building Diagram Number 2A
A8. For a building with a crawlspace or enclosuni
a) Square rootage of crawlspace or enclosure(s) 3,175 sq It
b) Number ofpemnament flood openings inihe crawlspace or enclosure(s) within 1.0 foot above adjacentgrade 0
c) Total net area of flood openings in A8.b 0 sq in
d) Engineered flood openings? ❑ Yes ❑x No
Ag. Fora building with an attached garage:
a) Square footage of attached garage 962 sq it
b) Number of permanent food openings in the attached garage within 1.0 foot above adjacent grade 0
C) Total net area of flood openings in A9.b 0 so In
d) Engineered flood openings? ❑ Yes ❑x No
SECTION B -FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name 8 Community Number
B2. County Name
B3. State
City of Eagle, 160003
Ade County
Idaho
B4. Map/Panel
Number
B5. Suffix
B6. FIRM Index
Date
B7. FIRM Panel
88. Flood Zones)
B9. Base Flood Elevation(s)
Effective/
Revised Date
/Zone AO, use Base
ood Depth)
18000 7 001 53
H
10/02/2003
02/199/2003
X (Shaded)
2554.0
810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9'.
❑ FIS Profile ❑ FIRM ❑ Community Determined ❑x Other/Source: LOMR-F 14-10-0537A
811. Indicate elevation datum used for BFE in Item 89: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source:
B12. Is the building located In a Coastal Barter Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No
Designation Date: ❑ CBRS ❑ OPA
FEMA Form 086-0-33 (7115) Replaces all previous editions. Form Page 1 of 6
ELEVATION CERTIFICATE
OMB No. 16603008
Expiration Date u....e...ti, on oma
IMPORTANT: In these spaces, copy the comesponding Information from Section A.
FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, all/or Bldg. No.) or P.O. Route and Box No.
Policy Number.
T73 S. Island Glenn Way
Stell ZIP Cade
Company NAIC Number
EaY
egk Idaho 83616
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based on: ❑ Construction Drawings- ❑ Building Under Construction' ❑x Finished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations - Zones Ai -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, ARAE, AR/A1-A30, ARIAH, AR/AO.
Complete Items C2.0 -h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized: IDTD PID AJ3346 Vertical Dstum: NAVD 88
Indicate elevation datum used for the ekvatiorro in items a) through h) below.
❑ NGVD 1929 M NAVD 1988 ❑ tOher/Source:
Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a) Top of bottom floor (including basement, crawispace, or enclosure floor) 2555.4 ❑x feet N meters
b) Top of the next higher floor 2558.S ❑X feet ❑ meters
C) Bottom of the lowest horizontal structural member (V Zones only) n/a. 0 feet ❑ meters
d) Attached garage (top of slab) 2557.8 9 feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 2557.7 Nx feet ❑ meters
(Describe type of equipment and locefion in Comments)
0 Lowest adjacent (finished) grade next to building (LAG) 2557.6 0 feet ❑ meters
III Highest adjacent (finished) grade next to building (HAG) 2558.3 ❑x feet ❑ maters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including 2558.1 feet ❑ maters
structural support
SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by dew to oenify elevation information.
1 certify that the information on this Cedficafe represents my beat efforts to interpret the data available. I understand that any false
statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001,
Were latitude and longitude in Section A provided by a licensed land surveyor? Z Yes ❑ No ❑ Check here if attachments.
Certifiels Name License Number
Michael Byrne 11334
E
Title
PLS
I
4
Company Name
JUB Engineers, Inc.
IL
Addren
250 S. Beachwood Ave., Suite 201
.L._ rE of 5
y�ElS.
StZIP Code
Some Idaho 83709ate
Signaturo //,rn Date Telephone
04262017 (208) 376-7330
Copy all pages of Elevation Certificate and as attachments for (1) community oMdal, (2) insumnce agent/company, and (3) building owner.
Comments (including type of equipment and location, per C2(e), If applicable)
A5, Eaatmost comwr
C2e, Crawl Exhaust 8 Gas Fire Pit on Pato. AC Pad = 2557.9. Garage Mechanical Pad 2558.4.
C2h, Front Porch Column
FEMA Form 086-033 (7115) Replaces es previous addions, Form Page 2 of 6
ELEVATION CERTIFICATE
OMB No. 1660-0008
Fmbarinn Date: ldc ,mtnr an 9018
IMPORTANT: In these spaces, copy the corresponding Information from Section A.
FOR INSURANCE COMPANY USE
Building Street Address (Including Apt, Ung, Suite, and/or Bldg. No.) or P.O. Route and Buz No.
Policy Number.
773 S. Island Glenn Way
City Stele ZIP Code
Company NAIC Number
Eagle Idaho 83616
SECTION E -BUILDING ELEVATION INFORMATION (SURVEY NOT REOUIREDI
FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones AO and A (without SFE), complete Items EI -E5. If the Certificate Is Intended to support a LOMA or LOMR-F request,
complete Sections A, Band C. For Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only,
enter meters.
El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below
the highest adjacent grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement,
crawlepace, or endosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
b) Top of bottom floor (including basement,
crawtspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG.
E2, For Building Diagrams 6-9 with permanent flood openings provided in Section A items B and/or 9 fees pages 1-2 of Instructions),
the next higher floor (elevation C2.1b in
the diagrams) of the building is ❑ feet ❑ meters ❑ above or E] below the HAG.
E3. Attached garage (top of slab) Is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment
servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
ES. Zone AO only: If no good depth number Is available, is the top of the bottom floor elevated in accordance with the communitys
floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A. B, and E for Zone A (without a FEMA -issued or
community-i1med BFE) or Zone AO must sign here. The statements in Sections A. B, and E are correct to the beat of my knowledge.
Property Owner or lTwnefs Authorized Representative's Name
Address City State ZIP Cade
Signature Oats Telephone
Comments
❑ Check here if attachments.
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6
ELEVATION CERTIFICATE
OMB No. 1660-0008
Fmlmlinn nal-: ms amher 9n 1919
IMPORTANT: In these spaces, copy the corresponding Information from Section A.
FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number
773 S. Island Glenn Way
City State ZIP Code
Company NAIC Number
Eagle Idaho 83616
SECTION G —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 applicable item(e) and sign below. Check the measurement
used in Nems G8 -G70. In Puerto Rico only, enter meters.
GI. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,
engineer, or architect who is authorized by law to certify elevaban information. (Indicate the source and date of the elevation
date in the Comments area below.)
Gp ❑ 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. ❑ The following information (Items G4—G10) Is provided for community floodplain management purposes.
G4. Permit Number
G5. Dose Permit Issued
G8. Date CMificeb of
Comptianca/O=pency Issued
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as-buiit lowest floor (including basement)
of the building: ❑ fest ❑ meters Datum
Gg. BFE or (In Zone AO) depth of flooding at the building site: ❑ seat ❑ melena Datum
G10. Community's design flood elevation ❑ feet ❑ meters Datum
Local Offiolal'e Neme Title
Community Name Telephone
Signature Date
Comments (including type of equipment and location, per C2(e), if applicable)
Check here If adachments.
FEMA Form 086.0-33 (7/15) Replaces all previous editions. Farm Page 4 of 6
BUILDING PHOTOGRAPHS OMS No. 1860-0008
ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30 2018
IMPORTANT:In these spaces, copy the corresponding informetion from Section A.
FOR INSURANCE COMPANY USE
Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Sox No.
Policy Number:
773 S. Island Glenn Way
Cay State ZIP Code
Company NAIC Number
Eagle Idaho Weis
If using the Elevation Certificates to obtain NFIP flood Insurance, of at least 2 building photographs below according to the
instructions for Item A8. Identify all Photographs with date taken; "Front Vie W' and "Rear View; and, if required, "Right Side View" and
left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or
vents, as indicated in Section AS. If submitting more photographs than will ft on this page, use the Continuation Page.
c
r
roman
Photo One Caption 4/28/17 Frant View
a
.µ,
_ PMbTxa
Photo Twp Caption 4126117 Rght Slde View
FEMA Form 086-0.33 (7/15) Replaces all previous editions. Form Page 5 of 6
BUILDING PHOTOGRAPHS OMB No. 16660668
ELEVATION CERTIFICATE Continuation Pace FvnLntinn nme. ru,,.,. t, en 201e
IMPORTANT: In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
Building Street Address (Including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number:
773 S. Island Glenn Way
Cdy State ZIP Code
Company NAIC Number
Eagle Idaho 83618
If whonitang more photographs than wig fit on the preceding page, affix the additional photographs below. Identify all photographs
with: date taken; "Front Via W' and "Rear View': and, If required, "Right Side VIeW' and "Left Side View" When applicable,
photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section AS
7
—%,.
Photo One CWon 428/17 Left Side View
rnomra
Photo TWo Caption 4126/17 Two RearViews
FEMA Form 0864.33 (7115) Replaces all previous editions. Form Page 6 of 6