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+ i <br /> Building Height Handout-y_age-31 <br /> City of Everett,WA <br /> Base Elevation Survey <br /> (For Surveyor Use Only IF 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 form 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: o zio412ol b PERMIT# 1C12- 00 / <br /> Property Location Surveyed: t 0 1 27 7 �E Jt <br /> (address and/or parcel#) <br /> Description of Bench Mark: Mar %A-4 I f Y (,Ull1 s'dGw�1k <br /> Bench Mark Elevation: /() f 141,1W14- <br /> BOX <br /> 4JJJr" BOX 1 BOX 2 <br /> A= )0 5____ <br /> B= 1 o.. Highest point of the <br /> C= 105 sidewalk i0-0 EL <br /> D= IDS LAI <br /> A+B+C+D= 47o /4= I DS Average Base Elevation *Submit a map showing <br /> the location of the highest <br /> +Maximum Height of 2 v (feet) point of the sidewalk <br /> = 1-'y3' Maximum Elevation Allowed abutting the property. <br /> Check: <br /> BOX 1 ❑ I, Mat')V}er WW t ulje, pc , certify that I measured the grade at the <br /> midpoints of the proposed structure at the l t ndisturbed ground elevations/❑approved <br /> topography elevations for the property above. <br /> BOX 2 ❑ I, 1l ,tiec we! � pt< , certify that I measured the highest point <br /> of the sidewalk for the property aL ove. <br /> Signature of` ysr { Date <br /> Company SERA j' <br /> wnsyf -Y,. <br /> Address 1.Cc/6 5-64'11 <br /> (j-j-v►1ot4i (A/A-- SD26 �33264 <br /> o <br /> tS*Phone/Email . ► -ft w; - - • ,I (C <br /> /OVAL <br /> •-• ' <br />