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CITY OF SANTA ANA <br />ELEVATION CERTIFICATE Planning and Building Agency <br />IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 <br />Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: <br />FOR <br />INSURAN E COMPANY U <br />E <br />Policy <br />Nam: PERMIT ISSUAN <br />602 S Genoa Drive <br />City: Santa Ana State: CA ZIP Code: 92704 <br />Company <br />NAIC Number: <br />SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQU <br />RMer ID: <br />D <br />_ate: <br />C1. Building elevations are based on: ® Construction Drawings* ❑ Building Under Construction* nished Construction <br />*A new Elevation Certificate will be required when construction of the building is complete. <br />C2. Elevations — Zones Al—A30, AE, AH, AO, A (with BFE), VE, V1—V30, V (with BFE), AR, AR/A, AR/AE, AR/A1—A30, AR/AH, AR/AO, <br />A99. Complete Items C2.a—h below according to the Building Diagram specified in Item A7. In Puerto Rico only, enter meters. <br />Benchmark Utilized: SA-223-70 Vertical Datum: 56.212 <br />Indicate elevation datum used for the elevations in items a) through h) below. <br />❑ NGVD 1929 ® NAVD 1988 ❑ Other: <br />Datum used for building elevations must be the same as that used for the BFE. Conversion factor used? ❑ Yes ® No <br />If Yes, describe the source of the conversion factor in the Section D Comments area. <br />Check the measurement used: <br />a) Top of bottom floor (including basement, crawlspace, or enclosure floor): 59.70 ® feet ❑ meters <br />b) Top of the next higher floor (see Instructions): ❑ feet ❑ meters <br />c) Bottom of the lowest horizontal structural member (see Instructions): ❑ feet ❑ meters <br />d) Attached garage (top of slab): ❑ feet ❑ meters <br />e) Lowest elevation of Machinery and Equipment (M&E) servicing the building <br />(describe type of M&E and location in Section D Comments area): ❑ feet ❑ meters <br />f) Lowest Adjacent Grade (LAG) next to building: ❑ Natural ❑ Finished ❑ feet ❑ meters <br />g) Highest Adjacent Grade (HAG) next to building: ❑ Natural ❑ Finished ❑ feet ❑ meters <br />h) Finished LAG at lowest elevation of attached deck or stairs, including structural <br />support: ❑ feet ❑ meters <br />SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION <br />This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by state law to certify elevation <br />information. I certify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any <br />false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. <br />Were latitude and longitude in Section A provided by a licensed land surveyor? ® Yes ❑ No <br />❑ Check here if attachments and describe in the Comments area. <br />Certifier's Name: Ron Miedema License Number:4653 <br />Title: Land Surveyor <br />�\-AND0 <br />Company Name: RdM Surveying J RON 1� <br />Address: 23016 Lake Forest Drive #409 MIEDEMA <br />No. 4653 <br />City: Laguna Hills State: CA ZIP Code: 92653 * EXP. 9/30/25 ,k <br />ST�TFOF <br />CA1-�FC��\P <br />Ron M l ed e m a <br />Signature: Date: 07/22/2024 <br />- <br />Telephone: (949) 858-2924 Ext.: Email: rdmsurveying@cox.net Place Seal Here <br />Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. <br />Comments (including source of conversion factor in C2; type of equipment and location per C2.e; and description of any attachments): <br />FEMA cert is for the proposed additional dwelling unit at 602 S Genoa Drive only <br />d <br />FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 3 of 19 <br />