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RCW 64.55 BUILDING ENVELOPE SUBMITTAL WORKSHEET <br />�,�V f E � C � � CITY OF EVERETT PERMIT SERVICES <br />G 3200 Cedar Street, Everett, WA98201 <br />wASHIwGTflN Phone:425-257-8810 email: everetteps everettwa.aov website: www.everettwa. ov ermit <br />REHABILITATIVE CONSTRUCTION, NEW CONSTRUCTION, RECORDED COVENANT OR CONVERSION <br />k <br />CHECK t'`I � ,p� ! ... _ _V � Yl <br />ONE y��{ _. <br />Bolt Property Name AddressBuilding Number Permit Number <br />REHABILITATIVE CONSTRUCTION equal to or less than 5% or less of current assessed market <br />improvement value of specified building* <br />*NOTE: Applicant to provide entire cost of rehabilitative construction to the building enclosure for a multiunit residential <br />building or mixed use project per RCW 64.55,010, which may exceed the valuation for building permit. <br />(a) rip,' .d._ U i, `�`✓,�� �, ate(C) A�55E5 BUILDING VALUE (D) olu,lo�c ( a) w (c) <br />EncLasuR REHAB COST (8) MULTIPLY (A) BY 100 r ��. . 7...: <br />69o. goo, 00 <br />❑ NEW CONSTRUCTION OR REHABILITATIVE CONSTRUCTION equal to more than 5% of current assessed <br />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 documents <br />should also contain a stamped signed statement by the same architect that "the undersigned has provided building enclosure <br />documents that in my professional judgment are appropriate to satisfy the requirements or RCW 64,55.005 through <br />64.55.090". <br />Final inspection or 'Certificate of Occupancy' cannot be issued by the building department prior to receipt of a signed letter <br />from an independent inspector certifying that the building enclosure has been inspected during the course of construction <br />and has been constructed in substantial compliance with the building enclosure design 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 from the <br />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 exemption <br />is an alternate to providing building enclosure design documents for the townhome building, if the unit lot subdivision is not <br />approved. Certificate of Occupancy will not be issued without approved subdivision. The applicant accepts the risk involved <br />to obtain a single platted lot exemption to RCW 64.55 for each unit of building. <br />.T.__ <br />S ature of weer%c�rized Agent Printed name of Owner or Authorized Agent i Date <br />pry er / �P r!r.....s> #l.P/,�_..._..1 Neff _._... <br />?+' yr'it�/4.... CityZip Code <br />Address <br />Printed name of Business <br />SIGNATURE REQUIRED FOR EACH BUILDING PERMIT APPLICATION <br />1/3 <br />