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Building Heialit Handout-Page 3 of -1 <br /> City of E vf:reita WA <br /> Base Elevation Survey <br /> (For Surveyor Use Only 1F a survey is required.instructions:Complete this form to determine the average base <br /> elevation of the proposed footprint or to locate the highest point of the sidewalk, whichever applies. This farm is to <br /> be submitted with the building permit application.Include these calculations on the site plan and building plans. <br /> During framing,the Height Survey form will be required for the framing inspection. Contact the Planning <br /> Department at 425.257.8731 if the structure does not meet the height limit.) <br /> Date of Survey: 10- -15 Z1 PERMIT# <br /> Property Location Surveyed: 2-3/5 <br /> (address and/or parcel#) <br /> Description of Bench Mark: Focgld-7cl &104f- cY74- 5W <br /> s <br /> Bench Mark Elevation: le <br /> BOX 1 BOX 2 <br /> A <br /> B= `,Y 3Z Highest point of the <br /> C= ?T,30 sidewalk EL <br /> D=/CO./0 <br /> A+B+C+D= 39T VC? j 4 62— Average Base Elevation *Submit a map showing <br /> the location of the highest <br /> +Maximum Height of Z (feet) point of the sidewalk <br /> _ /Z7(Z Maximum Elevation Allowed abutting the property. <br /> Check: <br /> BOX 1I, 1)grA-,J-1 certify that I measured the grade at the <br /> midpoints of the proposed structure at theXundisturbed ground elevations/❑approved <br /> topography elevations for the property above. <br /> BOX 2 ❑ I, , certify that I measured the highest point <br /> of the sidewalk r the property abov . <br /> Signature of Surveyor <br /> Company Ia9°Gi OG C 9'3 sgy-�e5,2174- g�N. <br /> Q' o <br /> Address RO, 13oX /.3 6/7 °x <br /> iii/� G'1'-��/E' , v✓s� �'�D 8� ;ap �' a� <br /> GIsTER�� <br /> Phone/Email �� ' �o���->b S�O9��I <br />