HomeMy WebLinkAbout1617 River Run StreetU.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30, 2022 J
National Flood Insurance Program — - —
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agenttcompany, and (3) building owner.
SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owners Name Policy Number.
TWIN CREEKS DEVELOPMENT CO LLC
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number:
Box No.
1617 RIVER RUN STREET
City State ZIP Code
CENTRAL POINT Oregon 97502
`A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 123, THE NORTH VILLAGE AT TWIN CREEKS, PHASE V; 362W03BB-3654
A4. Building Use (e g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. 42.386437 N Long.-122.933912 W Horizontal Datum: ❑NAD 1927 Z NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 9
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 2607 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1-0 foot above adjacent grade 20
c) Total net area of flood openings in A8.b 2660 sq in
d) Engineered flood openings? ❑ Yes Z No
A9. For a building with an attached garage:
a) Square footage of attached garage
629 sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A9.b
d) Engineered flood openings? ❑ Yes M No
0 sq in
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number B2. County Name B3. State
CITY OF CENTRAL POINT 410092 �JACKSON I Oregon
B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s)
Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth)
Revised Date
41029C1768 F 01-19-2018 09-14-2016 AE 1238.5
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139:
21 FIS Profile ❑ FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 Z NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)7 ❑ Yes ff] No
Designation Date:
❑ CBRS ❑ OPA
FEMA Form 086-0-33 (12119) Replaces all previous editions_ Form Page 1 of 6
ELEVATION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2022
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:
1617 RIVER RUN STREET
City State ZIP Code
Company NAtC Number
CENTRAL POINT Oregon 97502
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 Al—A30, AE, AH, A (with BFE), VE, VI—V30, V (with BFE), AR, AR/A, ARIAE, AR/A1—A30, ARIAH, AR/AO-
Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized: P-549 Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a) through h) below.
❑ NGVD 1929 ❑X NAVD 1988 ❑ Other/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, crawlspace, or enclosure floor)
1238.6 ❑X feet ❑ meters
b) Top of the next higher floor 1241.3 feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only)
N/A feet ❑ meters
d) Attached garage (top of slab)
1241.0 feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building
1241.1 feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG)
1240.6 ❑X feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG)
1240.9 ❑X feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
1241.1 0 feet ❑ meters
structural support
SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
I his certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.
I certify that the information on this Certificate represents my hest 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? M Yes ❑ No
❑ Check here if attachments.
Certifier's Name License Number
f-REGISTERED
FRED A FRANTZ 50077
PR❑FESSI❑NAL
Title
LAND SURVEYOR
SURVEYOR
Company Name
TERASURVEY, INC
Address
=A.FRANTZ
274 FOURTH STREET
City State ZIP Code
ASHLAND Oregon 97520
Renewal
Signature Date Telephone
Ext.
--Z � 7—,� 11-11-2020 (541)480-6474
Copy this Elevation t e#i�i�tc and all attachments for (1) community official, (2) insurance
agent/company, and (3) building owner -
all p gee of
Comments (including type of equipment and location, per C2(e), if applicable)
C 2e) Heat pump
FEMA Form 086-0-33 (12/19) Replaces all previous editions
Form Page 2 of 6
ELEVATION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2022
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:
1617 RIVER RUN STREET
City i State ZIP Code
Company NAIC Number
CENTRAL POINT Oregon 97502
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 El—E5. If the Certificate is intended to support a LOMA or LOMR-F request,
complete Sections A, B,and C. For Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only,
enter meters.
E1. 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,
crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
b) Top of bottom floor (including basement,
crawlspace, 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 8 and/or 9 (see pages 1-2 of Instructions),
the next higher floor (elevation C2.b in
the diagrams) of the building is __. [:]feet ❑ meters ❑ above or ❑ 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.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's
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 -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.
Property Owner or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
❑ Check here if attachments.
FEMA Form 086-0-33 (12/19) Replaces all previous editions. roan rage o ui u
660-0008
ELEVATION CERTIFICATE E pir tionlDa e: November 30, 2022
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
1617 RIVER RUN STREET
City State ZIP Code Company NAIC Number
CENTRAL POINT Oregon 97502
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(s) and sign below. Check the measurement
used in Items G8—G10. In Puerto Rico only, enter meters.
G 1. ❑ 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 elevation information. (Indicate the source and date of the elevation
data in the Comments area below.)
G2 ❑ 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. x❑ The following information (Items G4-1310) is provided for community floodplain management purposes.
G4. Permit Number G5. Date Permit Issued G6. Date Certificate of
Compliance/Occupancy Issued
175-20-000163-D WL 06/23/2020 T.B.D.
G7. This permit has been issued for: x❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) 1241 3 0 feet ❑meters Datum NAVD 88
of the building: ---
G9. BFE or (in Zone AO) depth of flooding at the building site: 1238.5
G10. Community's design flood elevation:
Local Official's Name
Justin Gindlesperger, CFM
Community Name
City of Central Point
Signature ____77
and location,
1239.5
® feet ❑ meters Datum NAVD 88
x❑ feet ❑ meters Datum NAVD 88
Title
Community Planner II
541,664,3321. ext 245
11 / 17/2020
if applicable)
The structure complies with the requirements of CPIVIC 8.24 - Flood Damage Prevention.
❑ Check here if attachments.
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 4 of 6
BUILDING PHOTOGRAPHS OMB No.1660-0008
ELEVATION CERTIFICATE See Instructions for Item A6- Expiration Date: November 30, 2022
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.
1617 RIVER RUN STREET
City State ZIP Code Company NAIC Number
CENTRAL POINT Oregon 97502
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the
instructions for Item A6. Identify all photographs with date taken; "Front View" 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 A8. If submitting more photographs than will fit on this page, use the Continuation Page.
ryryqq •ssxrxit�eer "��g� yy11 5Q h S:er .... �� �.:�,i -- •-�ti1 gypyppE L. y. yay] �f #- '�•
�PA�rBi��El�4 1���! � a• :� �GC ,II l3 d i�� c�CF{/ `—w- 1�a• .
Photo One
Photo One Caption Front 11-11-2020 Clear Photo One
s
Photo Two
Photo Two Caption Back 11-11-2020 Clear Photo Two
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 5 of 6
BUILDING PHOTOGRAPHS OMB No.1660-0008
ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2022
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:
1617 RIVER RUN STREET
City
CENTRAL POINT
State ZIP Code Company NAIC Number
Oregon 97502
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs
with: date taken; "Front View" 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 A8.
Photo Three
oti.+ T1 we lam. +;— Ki—r h chic 11-11-9nin
Photo Mow
Photo Four CapVon South side 11-11-2020
FEMA Fort 086-0-33 (12119) Replaces all previous editions.
Cleo rPhoto inree
Clear Photo Four
Form Page 6 of 6