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RCW 64.55 BUILDING ENVELOPE SUBMITTAL WORKSHEET <br /> ,111111/N,PicP.-ea <br /> --, CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar Street,Everett,WA 98201 <br /> 425-257-8810 email:everetteps{a�everettwa.gov website:www.everettwa.govlpermit <br /> REHABILITATIVELI�ICONSTRUCTION, NEW CONSTRUCTION, RECORDED COVENANT OR CONVERSION <br /> CHI/��L�L co '3-., l(� 1 5i J v <br /> ONEECK �70L'f� <br /> BOX Property Name Address Building Number Permit Number <br /> X REHABILITATIVE CONSTRUCTION equal to or less than 5% or less of current assessed <br /> market improvement value of specified building* <br /> *NOTE: Applicant to provide entire cost of rehabilitative construction to the building enclosure for a multiunit <br /> residential building or mixed use project per RCW 64.55.010,which may exceed the valuation for building permit. <br /> (A)ENCLOSURE REHAB COST'(B)MULTIPLY(A)BY 100 (C)ASSESSED BUILDING VALUE ' (D)DIVIDE(B)by(C) =% <br /> 41 41-r.0 coo ,2 Ooo coo 4,2 Zloe) coo 6� <br /> I I 1 <br /> ❑ NEW CONSTRUCTION OR REHABILITATIVE CONSTRUCTION equal to more than 5% of <br /> current assessed market improvement value of specified building* <br /> *NOTE: Per RCW 64.55.010,RCW 64.55.020,and RCW 64.55.060 <br /> Each building enclosure design document is to be stamped and signed by a Washington State architect. The <br /> documents should also contain a stamped signed statement by the same architect that"the undersigned has <br /> provided building enclosure documents that in my professional judgment are appropriate to satisfy the requirements <br /> or RCW 64.55.005 through 64.55.090". <br /> Final inspection or 'Certificate of Occupancy' cannot be issued by the building department prior to receipt of a <br /> signed letter from an independent inspector certifying that the building enclosure has been inspected during the <br /> course of construction and has been constructed in substantial compliance with the building enclosure design <br /> documents. <br /> ❑ RECORDED COVENANT OF SALE from Snohomish County (Sale Prohibition Covenant)64.55.010 <br /> Submit site plan with location of building, permit with description of work and certified copy of recorded covenant <br /> from the real property records of Snohomish County,Washington for specified building. <br /> ❑ TOWNHOUSES ON SINGLE PLATTED LOTS (Unit Lot Subdivision) <br /> Can submit for building permit while concurrently seeking to obtain unit lot subdivision for each townhome. This <br /> exemption is an alternate to providing building enclosure design documents for the townhome building, if the unit lot <br /> subdivision is not approved. Certificate of Occupancy will not be issued without approved subdivision. The <br /> applic- accep the risk involved to obtain a single platted lot exemption to RCW 64.55 for each unit of building. <br /> 15110/1 <br /> Signature . • - .r Auth ized Agent Printed name of Owner or Authorized Agent Phone# Dat <br /> Scg, 510\ <br /> Printed name of Business Address City Zip Code <br /> SIGNATURE REQUIRED FOR EACH BUILDING PERMIT APPLICATION <br />