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14110 „ <br /> III <br /> 3 <br /> '- RCW 64.55 BUILDING ENVELOPE SUBMITTAL WORT SHEET <br /> �,4wifa4 <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200:CedarStre Everel WA 0820.1 „ : <br /> 425-257-8810 email:everetteps@everettwa.ggv website:www.everettwagov/permit <br /> REHABILITATIVE CONSTRUCTION, NEW CONSTRUCTION, RECORDED COVENANT OR CONVERSION <br /> CHECK <br /> ONE : /100771vbv�i nag er 'Poi ..g.. /IG L /L_._ m <br /> Box Property Name Address <br /> Address Buiiding Number u Permit Minter <br /> it 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 (8)MULTIPLY(A)BY 100 I()ASSESSED BUILDING VALUE (D)DIVIDE(B)by(C) =% <br /> t/24132//Z51/1044, 20 = ,q9 <br /> I <br /> 0 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 WasharWton.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 /> . <br /> ❑ NH ATTED',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 unitrf building. <br /> Sighhture cif d n er'or Authorized Agent Printed nanie of,Ow ner or At:Aborized Agent 14idne Da <br /> ZAP V' R aY,R— /i(J G. M8 !`...D__P le69/„t � ,062 <br /> Printed name of Business Address City Zip Code <br /> SIGNATURE REQUIRED FOR EACH BUILDING PERMIT APPLICATION <br />