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RCW 64.55 BUILDING ENVELOPE SUBMITTAL WORKSHEET <br />C TY:QF EVERETT PERMIT SERVICES. <br />,EVERETT 3200 Cedar Stroet, Everett, WA M01 <br />W 1 S H r NGTO H l'hone:425-257-881a} etnall. eyeretteos%Severetiwa oov Webslte: WrrxLVy#veL,-ftW&.jqv ermlt' <br />(REHABILITATIVE CONSTRUCt.10k N WCCNSTRUCTION, RECORDED COWNANT OR.CONVER I td <br />ON <br />BOX property Name Address Building Number permit Number <br />REHA.BILiTATIVE 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 costof rehabilitative construction to the building enclosure fora multiunit residential <br />building or mixed usg'projei:tt per RCW 64,55,bio, which may exceed the valuation for building permit.; <br />(AJ ENCI t7SURi REh{AS COSfi (sl MULCIpLy (A) BY l0ii (C) ASSESSED BUii p1NG1ti tiE (ol iliviRE (sf b (� °fin <br />,,.., .A... <br />t j l <br />} S 7a11 <br />000, <br />Cl NEW CO NSTtlCTtC;U aR C2EHAB1LtTATCVE-CONSTRUCTION equal to more than 594 of current assessed <br />market impro ernent value of specified building* <br />#.Nolrt�: PerACW 644.55:0.0j RCW 605.0210 d RCW 64.55.tI O <br />i Each bonding enclosure design docwmentls 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 enclo..sure <br />documents that in my professional judgment ar. <br />ei appropriate to "satisfy the requirements or RCW 64,55:065 through <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 Snoltr><rnish'County (Sale Prohibition Cavenaht} 64.55 ci10 <br />Submit site plan' with location of building; permit with descriptivn.of'work and certified ccapy Of recorded covenant from'th+x <br />real property records of.Snohomish, County; Washington forspecifled building. <br />❑ TOWNHOUSES ON. SING PLATTED I.OTS,(9nitLot Subdivision) <br />Can submit for building,pernnit while concurrently seeking to obtain snit lot subdivision for each towahome., 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 tccupancy will not be issued without apprs�ved subdivision, '7he applicant accepts tiie'rlsk irrvalUed <br />to obtain a single platted"lo iaxemptionAo RCW64.55 for each unit of building; <br />Signature of Owner or Authorized Agent Printed name of Owner or Authorized Agent Phone;# <br />�.s�vsrtc�f� <br />Printed, name of Business Address City zip Code ff <br />SICGN`Ai7 RE UIREQ FOR EACH gUIL1 1i<iG PER'M1rAPPL1G it Af <br />�J3 <br />