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i �-- --- -- - - -- -- -- - - -� <br /> � RCW 64.55 MULTI-FAMILY CERTIFICATION WORKSHEET <br /> I �\���� CITY OF EVERETT PERMIT SERVICES <br /> ,.�,. <br /> i l"100 Ccd.+r StreeL Fverett.WA 9020t <br /> I425�257�Bf310-FAX 425-257-0057-www_evereNwa_r;J <br /> REHAB�TIVE CONSTRUCTION, NEW CONSTRUCTION, RECORDED COVENANT OR CONVERSION <br /> IooHE�` T�'Y-k-AJ�-�LP � I �- �S ��, �As� Hsa� �- t, . D Q �3or-c23,6 <br /> IBO% PropeAY IJame Addiess F3��.Id�ng Number Permit Numbe� <br /> � I� REHABILITATIVE CONSTRUCTION cqual to or less than 5% or less of current assessed <br /> i market improvement value of specified building' I <br /> 'NOTE Apphcanl to prowde enGre cost of rehab�6tative construction to the butlding endosure for a multicnit <br /> j residen!ial build�ng or mixed use pro�ect per RCW 64 55 010,wh�th may exceed the valuation for building permit I <br /> I (AJ CNCLOSURC Rf.HAA COST (B)61ULTIPLY(A)OV 100 (C7 ASSCSSCD DUILDING VALUf. (D)DIVIDL (0)by(C) _ % <br /> I ' <br /> I <br /> I ❑ NEW CONSTRUCTION OR REHABILITATIVE CONSTRUCTION equal to more than 5% of <br /> � current assessed market improvement value of specified building' <br /> I 'NOTE Per RCW 64 55 010, RCW 64 55 020 anA RCW 64 55 060 <br /> Each bwlding enclosure design document�s to be stamped and signed by a Wash�ngton State archdect The <br /> Idocumenls shoultl afso contain a slamped signed stalement by the same archltect that'the undersiyned has <br /> prowded bwlding enclosure dotumenls that in my protessronal�udgment are appropnate lo sat�sfy the reqwrements <br /> i or RCW 64 55 005 through 64 55 090'. <br /> i <br /> � Final inspection or �Cert�hcate ot Occupancy' cannot be issued by the budding tlepartment pnor lo receipt of a <br /> ' signed letter (rom an mdependent mspector certdying thal the bwlding enclosure has been inspected dunng the <br /> Icourse of construct�on and has been constructed in su6stantial comphance w�th the budding enclosure design <br /> documents <br /> � ------------_ - — _ —� <br /> I ❑ RECORDED CGVENANT OF SALE from Snohomish County' <br /> � 'N07[ Sale ProhibAion Covenant per RCW 64 55 O70 <br /> Su6mit stle plan �nnlh localion of building. permit with descripLon of work and certdied copy of rn.corded cov:�nant <br /> from the real property records ol Snohomish County, Washmgton lor speafied buddmg <br /> � ❑ CONVERSION to condominium' <br /> I 'NOTE permits may be requved by Ihc Cdy ol Everett per the results of Ihe mdependent inspedion report <br /> � Undersigned v�nll comply with owner independent mspecbon atternative per RCW 64 55 090 and RCW 64 34 400(2) <br /> S�ynatwc ol Ownur oi AuUioiited Agenl Pnnled name ol Owne� or Au�honted Agent Phonc M Datc <br /> � <br /> IPrinted name ol�usmess Address Ciry Iip Code <br /> 2 <br /> chAly!�nr��com anJ cnnJu Ircc 7;I J� F�IR��Illl'I�. l�til[ ONI.1' <br />