The URL can be used to link to this page

Home My WebLink About22045 Creekside CtDEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency ELEVATION CERTIFICATE IMPORTANT: FOLLOW THE INSTRUCTIONS ON PAGES 9-16 OMB Control Number. 1660-0008 E xp i ration : 11/3012018 opy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agenticompany, and (3) building owner. SECTION A -PROPERTY INFORMATION FORM INSURANCE COMPANY USE Al. Building Owner's Name MO-YUN LEI FONG AND THEODORE FONG Policy Number: A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC 22045 CREEKSIDE COURT Number. City CUPERTINO State CA Zip Code 95014 A3, Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) APN: 326-39-041, LOT 54, TRACT NO. 3442, BOOK 165 OF MAPS, PAGE 30 AND 31 A4, Building Use (e,g., Residential, Non -Residential, Addition, Accessory, etc.) A5. Latitude/Longitude: Lat. 37.32828 Long.-122.06007 Horizontal Datum: C NAD 1927 G NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 8 AS. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage. a) Square footage of crawlspace or enclosure(s) 683 sq ft a) Square footage of attached garage 449 sq ft b) Number of permanent flood openings in the . 13 b) Number of permanent flood openings crawlspace or enclosure(s) within 1.0 foot in the attached garage within 1.0 foot NIA above adjacent grade above adjacent grade C) Total net area of flood openings in A8.b 1.092 sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? (- Yes (a No d) Engineered flood openings? (_ Yes G No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2, County Name B3. State CITY OF CUPERTINO 060339 SANTA CLARA CA B4. Map/Panel Number B5. Suffix FIRM Index Date 87. FIRM Panel Effective/ B8. Flood Zone(s) B9. Base Flood Elevation(s) 06085CO208H/020B 186. H Revised Date AE (Zone AO, use base flood MAY 18, 2009 MAY 18, 2009 depth 278.8 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: C FIS Profile (i FIRM C Community Determined C Other/Source: B11. Indicate elevation datum used for BFE in Item B9: C NGVD 1929 6- NAVD 1988 C Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ( Yes (i No Designation Date: C CBRS (' OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ( Construction Drawings' ( Building Under Construction" (: Finished Construction C2. Elevations - Zones Al - A30, AE, AH, A (with BFE), VE, V1 - V30, V (with BFE), AR, AR/A, AR/AE, AR/Al - A30, AR/AH, AR/AO. Complete Items C2.a -h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters. A new Elevation Certificate will be required when construction of the building is complete. Benchmark Utilized: SCVWD, BM400, Stevens Creek Blvd., Cupertino Vertical Datum: 305.52 Indicate elevation datum used for the elevations in items a) through h) below. (- NGVD 1929 (i NAVD 1988 i 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) 278 - 32 tre feet meters b) Top of the nerd higher floor 281 - 11 (? feet ( meters c) Bottom of the lowest horizontal structural member (V Zones only) NIA - t: feet ( meters d) Attached garage (top of slab) 279 - 44 (mfeet (� meters e) Lowest elevation of machinery or equipment servicing the building 279 47 re feet meters (Describe type of equipment and location in Comments) (� f) Lowest adjacent (finished) grade next to building (LAG) 279 - 05 to feet r meters g) Highest adjacent (finished) grade next to building (HAG) 280 - 93 (: feet ( meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 278 - 45 feet meters FEMA Form 088-0-33 (7/15) Replaces all previous editions. Page 3 of 15 22045 CREEKSIDL COURT ELEVATION CERTIFICATE CUPERTINO OMB Control Number. 1660-0008 Expiration: 11/30/2018 CA 95014 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. I certify that the information on this Certificate represents my best efforts to interpret the data available. f understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. Were latitude and longitude in Section A ® Check here if attachments. provided by a licensed land surveyor? LAN D (' Yes r No Certifier's Name License Number YI-RAN WU 8235 ` Title Company Name LAND SURVEYOR WEC AND ASSOCIATES, INC. J P. Address City State 794306 ip Code * L. 8235 2625 MIDDLEFIELD RD 658 PALO ALTO CA Si re Date Telephonet7F CA4� 1/312020 +1 (650) 823-6466 ko py b h sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. m is (including type of equipment and location, per C2(e), if applicable)" e elevation of the crawl space underneath the house is 278.32'. The crawl space area is fully vented per FEMA criteria. Pre-FRIM building, addition is not substantial improvements. /IiI ), 111 — (D , � - W" l 3 2ozo Si ature Date SECTIO E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For nes and A (without BFE), complete Items E1 -ES, If the Certificate is intended to support a LOMA or LOMR-F request, complete iSedonr-9, B,and C. For Items E1 -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, (-feet (-meters ❑ above or ❑ below the HAG. or enclosure) is b) Top of bottom floor (including basement, crawlspace, C feet r meters ❑ above or ❑ below the LAG. or enclosure) is 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 neid 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 C meters above or ❑ below the HAG. E4. Top of platform of machinery and /or equipment -feet ( meters above or below the HAG. servicing the building is 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? C Yes C No C 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: MO-YUN LEI FONG AND THEODORE FONG Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Page 4 of 15 OMB Control Number. 1660-OOOS Expiration: 11 /30/2018 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.) A community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) or Zone G2. 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 G7. This permit has been issued for: (" New Construction C Substantial Improvement G8. Elevation of as -built lowest floor (including basement) (feet (meters Datum of the building: G9. BFE or (in Zone AO) depth of flooding at the building (� feet (meters Datum site: G10. Community's design flood elevation: r feet C meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Page 5 of 15 BUILDING PHOTOGRAPHS See instructions for Item A6 OMB Control Number: 01 Expiration: 1113012018 08 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. 22045 CREEKSIDE COURT Policy Number: City CUPERTINO State CA Zip Code Company NAIC 95014 Number 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. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Page 6 of 15 BUILDING PHOTOGRAPHS Continuation Page OMB Control Number: 1660-0008 Expiration: 1113012018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FORM INSURANCE COMPANY USE Building Street Address (including Apt., Unit,Suite, and/or Bldg. No.) or P.O.Route and Box No. Policy Number: 22045 CREEKSIDE COURT City State Zip Code Company NAIC Number: CUPERTINO CA 95014 If submitting more photographs than will fit on the preceding page, affix the additionat 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. FEMA Form 086-0-33 (7115) Replaces all previous editions. Page 7 of 15