HomeMy WebLinkAbout1725 River Run StreetU.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30, 2022
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 agent/company, and (3) building owner,
SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name Policy Number:
Gregory Price
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number:
1725 River Run Street
City State ZIP Code
Central Point Oregon 97502
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
372W03BB-3605; Lot 119, The North Village at Twin Creeks, Phase V
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) residential
A5. Latitude/Longitude: Lat. 42.387177 N Long. 122.933900 W Horizontal Datum: ❑ NAD 1927 ❑x 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) 1470 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 13
c) Total net area of flood openings in A8.b 1729 sq in
d) Engineered flood openings? ❑ Yes ❑x No
A9. For a building with an attached garage:
a) Square footage of attached garage 837 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 0 sq in
d) Engineered flood openings? ❑ Yes ❑x No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number j B2. County Name B3. State
City of Central Point 410092 I Jackson 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 1238.4
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9:
❑x FIS Profile ❑ FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No
Designation Date: ❑ CBRS ❑ OPA
FEMA Form 086-0-33 (12/19) 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:
1725 River Run Street
City State ZIP Code
Company NAIL Number
Central Point Oregon 97502
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. 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, V1—V30, V (with BFE), AR, AR/A, AR/AE,
AR/A1—A30, AR/AH, 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 0 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)
1237.E ❑x feet ❑ meters
b) Top of the next higher floor
1240.3 0 feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only)
N/A ❑ feet ❑ meters
d) Attached garage (top of slab)
1240.0 0 feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building
(DesCube type of equipment and location in Comments) _
1240.3 x❑ feet ❑ meters
f) Lowest adjacent (finished) grade next to building (LAG)
1238.3 x❑ feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG)
1239.8 x0 feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
structural support
1240.2 ❑x feet ❑ meters
SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.
l certify that the information on this Certificate represents my best efforfs to interpret the data available. 1 understand that any false
statement may be punishable by fine or imprisonment under 18 U. S. Cade, Section 1001.
Were latitude and longitude in Section A provided by a licensed land surveyor? El Yes ❑ No
❑ Check here if attachments.
Certiflees Name License Number
Fred A Frantz
50077
REGISTERED
Tide
PR❑FESSI❑NAL
Surveyor
LAND SURVEY❑R
Company Name
Terrasurvey Inc
Address
❑ R E G brq
JULY 12, 2005
274 Fourth Street
FRED A. FRANTZ
City State ZIP Code
No. 50077
Ashland Oregon 97520
Renewal 12-21-21
Signatur Date Telephone
Ext.
03-11-2020 (541) 428-6774
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments (including type of equipment and location, per C2(e), if applicable)
C2e is a 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:
1725 River Run Street
City 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 E1—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 El 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. Form Page 3 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:
1725 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.
G1. ❑ 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. ® The following information (Items G4—G10) is provided for community floodplain management purposes.
G4. Permit Number G5. Date Permit Issued G6. Date Certificate of
Compliance/Occupancy Issued
175-19-000308-DWL 09/11 /2019 T.B.D.
G7. This permit has been issued for: ® New Construction ❑ Substantial Improvement
G8 Elevation of as -built lowest floor (including basement)
of the building: ® feet ❑ meters Datum NAVD 88
G9. BFE or (in Zone AO) depth of flooding at the building site:
G10. Community's design flood elevation:
Local Official's Name
Justin Gindlesperger, CFM
Community Name
City of Central Point
Signature
,.-- -= _
g type of equipment and
1238.4 ® feet ❑ meters Datum NAVD 88
1239.4
® feet ❑ meters Datum NAVD 88
Title
Community Planner II
Telephone
541.664.3321, ext 245
Date
04/29/2020
C2(e), if applicable)
The structure complies with the requirements of CPMC 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:
1725 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.
Photo One
I Photo One Caption FRONT 03-11-2020
Photo Two
Photo Two Caption BACK 03-11-2020
Clear Photo One
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:
1725 River Run Street
City State ZIP Code Company NAIC Number
Central Point 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.
� f
i
Photo Three
Photo Three Caption NORTH SIDE 03-11-2020 Clear Photo Three
Photo Four Caption SOUTH SIDE 03-11-2020
Photo Four
Clear Photo Four
FEMA Form 086-0-33 (12/19)
Replaces all previous editions.
Form Page 6 of 6