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11111 • <br /> 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:everetteps(@,everettvva.qov website: www.everettwa.qov/permit <br /> REHABILITATIVE CONSTRUCTION, NEW CONSTRUCTION, RECORDED COVENANT OR CONVERSION <br /> CHECK 4 <br /> ONE IVO-4 la) hAvnio-r-rs Jai 6. ylp.f...t tie-\how Dv G <br /> BOX Property Name Address Building Number Permit Number <br /> El 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 /> X1 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 /> El 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 /> 0 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 accepts the risk involved to obtain a single platted lot exemption to RCW 64.55 for each unit of building. <br /> ign ture of Owner or Authorized Agent <br /> eW...1 . TOM NEAUBAUER 425-452-4042 <br /> Printed name of Owner or Authorized Agent Phone# 12/21/2018 <br /> Date <br /> HEARTLAND CONSTRUCTION, LLC 10900 NE 8TH ST, SUITE 1200 BELLEVUE 98004 <br /> Printed name of Business Address City Zip Code <br /> SIGNATURE REQUIRED FOR EACH BUILDING PERMIT APPLICATION <br />