FLOOD ZONE- 5410 & 5412 W Kedge Ave - Plan

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ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON INSTRUCTION CITY OF SANTA ANA Planning and Building Agency Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURAN"""4kFE 5410 W Kedge Avenue, Unit #2 Polic Nu a F, f� PERMIT ISSUAN City: Santa Ana State: CA ZIP Code: 92704 Company NAIC Number: SECTION E — BUILDING MEASUREMENT INFORMATION (SURVEY NOT: FOR ZONE AO, ZONE AR/AO, AND ZONE A (WITHOUT BFE) Date: For Zones AO, AR/AO, and A (without BFE), complete Items E1—E5. For Items E1—E4, use natural grade, i intended to support a Letter of Map Change request, complete Sections A, B, and C. Check the measurement used. In Puerto Rico only, enter meters. Building measurements are based on: ® Construction Drawings* ❑ Building Under Construction* ❑ Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. E1. Provide measurements (C.2.a in applicable Building Diagram) for the following and check the appropriate boxes to show whether the measurement is above or below the natural HAG and the LAG. a) Top of bottom floor (including basement, crawlspace, or enclosure) is: 0.51 ® feet ❑ meters ® above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is: 1.37 ® 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 (C2.b in applicable Building Diagram) of the building is: N/A ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is: N/A ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is: N/A ❑ 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 AUTHORIZED REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge ❑ Check here if attachments and describe in the Comments area. Property Owner or Owner's Authorized Representative Name: Truong Son Nguyen Address: 5410 W Kedge Avenue City: Santa Ana State: CA ZIP Code: 92704 Telephone: Ext.: Email: Signature: Date: Comments: =E FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (8/23) Form Page 4 of 8