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RCW 64.55 BUILDING ENVELOPE SUBMITTAL WORKSHEET <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar Street, Everett, WA 98201 <br />425-257-8810 email. everettepgdeverpttwagp website: www.everettwa.aov/permit <br />REHABILITATIVE CONSTRUCTION, NEW CONSTRUCTION, RECORDED COVENANT OR CONVERSION <br />ONE <br />KOZ on Broadway 1020 North Broadway 1020 B1804-011 <br />@Permit <br />BOX <br />Property Name Address Building Number Number <br />❑ <br />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-i(S) MULTIPLY (A) BY 10o (C) ASSESSED BUILDING VALUE ; (D) DIVIDE <br />i <br />I <br />® <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 />❑ <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 />❑ <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 />applicant a epts the risk involved to obtain a single platted lot exemption to RCW 64.55 for each unit of building. <br />*T- <br />L_ Jason Andersen 11/04/2019 <br />_206.422.2990 <br />Signature of O er or Authorized Agent M Printed name of Owner or Authorized Agent Phone # Date <br />K_OZ Development 1830 Bickford Ave Snohomish 98290 <br />Printed name of Business Address 4 City Zip Code <br />SIGNATURE REQUIRED FOR EACH BUILDING PERMIT APPLICATION <br />