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Home My WebLink About10336 Vicksburg Dr - CorrectedCity Hall 10300 Torre Avenue Cupertino, CA 95014-3255 PH: (408) 777-3354 FX: (408) 777-3333 C U P E RT I N O PUBLIC WORKS DEPARTMENT MEMO OF REVIEW FOR CORRECTNESS AND COMPLETION In accordance with this community's participation in the National Flood Insurance Program's Community Rating System, all FEMA Elevation Certificates must be correct and complete. The attached Certificate has some incorrect items which are noted here. SEC77ONA -PROPERTY INFORMATION I For Insurance Company Use: I s r.W w. A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number 1033(a VIC)CS g✓te(r 1,�?/10r CC ✓PCRI,No State C,d ZIP Code 9501y A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) A5. Latitude/Longitude: Lat. Long. Horizontal Datum: ❑ NAD 1927 ❑ 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 A8. For a building with a crawl space or enclosure(s), provide A9. For a building with an attached garage, provide: a) Square footage of crawl space or enclosures) sq it a) Square footage of attached garage sq ft b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage enclosure(s) walls within 1.0 foot above adjacent grade walls within 1.0 foot above adjacent grade _ c) Total net ara of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bl. NFIP Community Name & Community Number B2. County Name B3. State B4. Map/Pauel Number Suffix B5. Sux B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) B9. Base Flood Elevation(s) (Zone AO, ovakO2.09 # Date Effective/Revised Date use base flood depth) B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ❑ FIRM ❑ Community Determined ❑ Other (Describe) Bit. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑Yes ❑No Designation Date ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations arebased on: ❑ Construction Drawings* ❑ Building Under Construction* ❑ Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations— Zones Al-A30, AE, Ali, A (with BFE), VE, V 1-V30, V (with BFE), AR, AR/A, AR/AE, AR/AI-A30, AR/AH, AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item A7. Benchmark Utilized Vertical Datum Conversion/Comments COMMENTS: I. z of Review: 2 /2 01 Iq Community Official: CA Z, certificates shall be maintained by the community and copies with the attached memo made available upon request. U.S. Dl! r AR�WENT OF HOMELAND SECURITY Federal Emergency Management Agency NatioSSal Flood Insurance Program 21 ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. OMB No. 1660-0008 Expires March 31, 2012 SECTION A - PROPERTY INFORMATION I For Insurance Company Use: I and/or Bldg. No.) or P.O. Route and Box No. A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Est pEdT 1 AL_ A5. Latftude/Longitude: Lat.a .y'Long. I2-2 oo/S3'� Horizontal Datum: ❑ NAD 1927 ❑ NAD 1983 K/pt As. Attach at least 2 photographs of the building If the Certificate is being used to obtain flood insurance. AT Building Diagram Number 113 LFy FLOO rL) A8. For a building with a crawispace or enc osure(s): A9. For a building with an attached garage: a) Square footage of crawispace or enclosure(s) —WA sq ft a) Square footage of attached garage sq ft b) No. of permanent flood openings in the crawispace or - b) No. of permanent flood openings in the atta ed garage enclosure(s) within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b N " sq in c) Total net area of flood openings In A9.b � sq in d) Engineered flood openings? ❑ Yes ,R No /^ d) Engineered flood openings? ❑ Yes No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION St. NFIP Community Name & Community Number B2. County Name 83. State 0L0D339 CA. )GOKSC D*?0q H Date j Effective/Revised Date j Zone(s) B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile Aj FIRM ❑ Community Determined ❑ Other (Describe) _ B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 is NAVD 1988 ❑ Other (Describe) B,r Is the building located In a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1 Designation Date _ ❑ CBRS ❑ OPA AO, use base flood 1 _ ❑ Yes Nr No SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction` 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, V1430, V (with BFE), AR, ARIA, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized 1LA�' Vertical Datum Z. OO -7. SS Conversion/Comments_ ELiEgAi Ifonj SHL)UJAi IS KGfD19L9; 2.75 r WA S A OLM ila ACH IC\& NAVD 1998 Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 2 111 . i;S IS feet ❑ meters (Puerto Rico only) b) Top of the next higher floor W! 7A ❑feet ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) n/ 1 A ❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) W / A ❑ feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building$Q_ I� feet ❑ meters (Puerto Rico only) (Describe type of equipment and location in Comments) 5C-E SeL, D 0 Lowest adjacent (finished) grade next to building (LAG) 21 D.,8 6 IN feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) 211 . 1< N feet ❑ meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including 22100 .F F, (&.feet ❑ meters (Puerto Rico only) structural support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification Is to be signed and sealed by a land surveyor, engineer, or arcnaect autnonzea Dy law to cenrty eievanon information. I certify that the information on this CartKcale represents my best efforts to interpret the data avefiable.l I AND understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ❑ ��0 k Check here if comments are provided on back of forth. Were latitude and longitude in Section A provided by a t� 6f�R s1E. licensed land surveyor? M Yes ❑ No QO Certifiers Name License Number v `DtJtki2 DoD(rte f,,1�D ASSOGtATES, Sil2VKYtIL�ly EV.4b130-1 ...a....... )/ �-.�C]-7—WII .--- r ------- L]'.)U 412 —`�Z-t7. Form BV31. Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. I For Insurance Company Use: or 7 ZIP Code SECTION D -SURVEYOR. ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/oompany, and (3) building owner. Comments C Zee Ifd�f�lACNI/�1CiL�02 CQL1►PKIPnIi �A)R Ca�i i]I i rOC-ftS -CferJ�(�f��e RS-11£ATL=kS EXIST DU i 511)E T44C HONIE; THE w TE(Z a HOVSF HFATe2 A96 w h CILDSE-T ►rJ THE W0dSE AT f11Air( fL0011- here / 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 E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B. and C. For Items E7-E4, use natural grade, if available. Check the measurement used. in Puerto Rico only, enter meters. El. 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 8-9 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 lop 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 Owners or Owner's Authorized Representative's Name I ass I _ City _ , , - _ State Signature Date Telephone ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) rho 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 items) and sign below. Check the measurement used in Items G8 and G9. 31. ❑ 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.) 32. ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) or Zone AO. 33. ❑ The following Information (Items G4-G9) is provided for community floodplain management purposes. G5. Date Persil Issued 37. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement 38. Elevation of as -built lowest floor (including basement) of the building: _ _ ❑ feet ❑ meters (PR) Datum 39. BFE or (in Zone AO) depth of flooding at the building she: ❑ feet ❑ meters (PR) Datum T 310. Community's design flood elevation ❑ feet ❑ meters (PR) Datum Local Officlal's Name Title Community Name Telephone Date Issued Check here 'd attachments 81-31, Mar 09 Replaces all previous editions Building Photographs See Instructions for Item A6. Bldg. No.) or Code If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two 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." If submitting more photographs than will fit on this following. F20r1 i /DF' H0OSE %/IE3 uiITH 6rA2� ACGt -CAk-PORT olnl 1)4E RiiSHL u w !� "now MAW EvI+RAPLE An(D PA-rio VIEu7 f Ai FRDrl of HoOSE aNcll< Of= ND�SE V I EW UL LS 3295 20652 Chaparral Circle Penn Valley, Ca. 95M Telephone Srp r. 23, Zo i 2IE ; Ems(, CE27. loss,,. VIGIcsC3eRlY D,ti t �UlSe4� L, C>✓(2T, PE IL YDv2 CALL_ �� c�oSc� - F>+At-\)) 4:�� NEL.P LDu-) / M t i VV A l �IE.A, - LL_7� L. WORKS DEpPARTMENT SEP 29 2011