Fema Form 086-0-33 - Elevation Certificate - U.s. Department Of Homeland Security (Page 11 of 15) in pdf

Instructions for Completing

OMB Control Number: 1660-0008

the Elevation Certificate (Continued)

Expiration: 11/30/2018

Item C2.e Enter the lowest platform elevation of at least 1 of the following machinery and equipment items: elevators and their associated

equipment, furnaces, hot water heaters, heat pumps, and air conditioners in an attached garage or enclosure or on an open utility platform

that provides utility services for the building. Note that elevations for these specific machinery and equipment items are required in order to

rate the building for flood insurance. Local floodplain management officials are required to ensure that all machinery and equipment

servicing the building are protected from flooding. Thus, local officials may require that elevation information for all machinery and

equipment, including ductwork, be documented on the Elevation Certificate. If the machinery and/or equipment is mounted to a wall, pile,

etc., enter the platform elevation of the machinery and/or equipment. Indicate machinery/equipment type and its general location, e.g., on

floor inside garage or on platform affixed to exterior wall, in the Comments area of Section D or Section G, as appropriate. If this item does

not apply to the building, enter "N/A" for not applicable.

Items C2.f-g Enter the elevation of the ground, sidewalk, or patio slab immediately next to the building. For Zone AO, use the natural

grade elevation, if available. This measurement must be to the nearest tenth of a foot (nearest tenth of a meter, in Puerto Rico) if this

certificate is being used to support a request for a LOMA or LOMR-F.

Item C2.h Enter the lowest grade elevation at the deck support or stairs. For Zone AO, use the natural grade elevation, if available. This

measurement must be to the nearest tenth of a foot (nearest tenth of a meter, in Puerto Rico) if this certificate is being used to support a

request for a LOMA or LOMR-F.

SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION

Complete as indicated. This section of the Elevation Certificate may be signed by only a land surveyor, engineer, or architect who is

authorized by law to certify elevation information. Place your license number, your seal (as allowed by the State licensing board), your

signature, and the date in the box in Section D. You are certifying that the information on this certificate represents your best efforts to

interpret the data available and that you understand that any false statement may be punishable by fine or imprisonment under 18 U.S.

Code, Section 1001. Use the Comments area of Section D to provide datum, elevation, openings, or other relevant information not

specified elsewhere on the certificate.

SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)

Complete Section E if the building is located in Zone AO or Zone A (without BFE). Otherwise, complete Section C instead. Explain in the

Section F Comments area if the measurement provided under Items E1-E4 is based on the "natural grade."

Items E1.a and b Enter in Item E1.a the height to the nearest tenth of a foot (tenth of a meter in Puerto Rico) of the top of the bottom

floor (as indicated in the applicable diagram) above or below the highest adjacent grade (HAG). Enter in Item E1.b the height to the

nearest tenth of a foot (tenth of a meter in Puerto Rico) of the top of the bottom floor (as indicated in the applicable diagram) above or

below the lowest adjacent grade (LAG). For buildings in Zone AO, the community's floodplain management ordinance requires the lowest

floor of the building be elevated above the highest adjacent grade at least as high as the depth number on the FIRM. Buildings in Zone A

(without BFE) may qualify for a lower insurance rate if an engineered BFE is developed at the site.

Item E2. For Building Diagrams 6-9 with permanent flood openings (see pages 14-15), enter the height to the nearest tenth of a foot

(tenth of a meter in Puerto Rico) of the next higher floor or elevated floor (as indicated in the applicable diagram) above or below the

highest adjacent grade (HAG).

Item E3. Enter the height to the nearest tenth of a foot (tenth of a meter in Puerto Rico), in relation to the highest adjacent grade next to

the building, for the top of attached garage slab. (Because elevation for top of attached garage slab is self-explanatory, attached garages

are not illustrated in the diagrams.) If this item does not apply to the building, enter "N/A" for not applicable.

Item E4. Enter the height to the nearest tenth of a foot (tenth of a meter in Puerto Rico), in relation to the highest adjacent grade next to

the building, of the platform elevation that supports the machinery and/or equipment servicing the building. Indicate machinery/equipment

type in the Comments area of Section F. If this item does not apply to the building, enter "N/A" for not applicable.

Item E5. For those communities where this base flood depth is not available, the community will need to determine whether the top of the

bottom floor is elevated in accordance with the community's floodplain management ordinance.

SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION

Complete as indicated. This section is provided for certification of measurements taken by a property owner or property owner's

representative when responding to Sections A, B, and E. The address entered in this section must be the actual mailing address of the

property owner or property owner's representative who provided the information on the certificate.

SECTION G - COMMUNITY INFORMATION (OPTIONAL)

Complete as indicated. The community 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. Section C may be filled in by the local

official as provided in the instructions below for Item G1. If the authorized community official completes Sections C, E, or G, complete the

appropriate item(s) and sign this section.

Check Item G1 if Section C is completed with elevation data 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 of the elevation data and the

date obtained in the Comments area of Section G. If you are both a community official and a licensed land surveyor, engineer, or

architect authorized by law to certify elevation information, and you performed the actual survey for a building in Zones A1-A30, AE, AH,

A (with BFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/A1-A30, AR/AE, AR/AH, or AR/AO, you must also complete Section D.

Check Item G2 if information is entered in Section E by the community for a building in Zone A (without a FEMA-issued or community-

issued BFE) or Zone AO.

Check Item G3 if the information in Items G4-G10 has been completed for community floodplain management purposes to document the

as-built lowest floor elevation of the building. Section C of the Elevation Certificate records the elevation of various building components

but does not determine the lowest floor of the building or whether the building, as constructed, complies with the community's floodplain

management ordinance. This must be done by the community. Items G4-G10 provide a way to document these determinations.

FEMA Form 086-0-33 (7/15)

Replaces all previous editions.

Page 11 of 15

Fema Form 086-0-33 - Elevation Certificate - U.s. Department Of Homeland Security Page 11

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