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<br /> RC ' 64.55 _, UILDr G E 'VELOPE SU ATTAL ':.ORKSHEET
<br /> ' . CITY OF EVERETT PER IT SERVICES
<br /> VAN)Cedar Slrer,r,Everett,WA 98201
<br /> 425-257-8810 email:eyeredtQps(alpvorgityva.q_Qv website:w_of&x_v_crattwAsioylgunig
<br /> REHABILITATIVE CONSTRUCTION, NEW CONSTRUCTION, RECORDED COVENANT OR CONVERSION
<br /> CHECK \3 \ , (I)(i.
<br /> BOX Property Name Address Building Number Permit Number
<br /> Li REHABILITATIVE CONSTRUCTION equal to or less than 5% or less of current assessed
<br /> market improvement value of specified build mg
<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 /> jAIENCLOSUREREHAB COST (81 Mt II_TIPl.Y(A)BY 100 (C)ASSESSED BUILDING VALUE (D)DIVIDE(B)by(C) =%
<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 /> )1 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 budding enclosure documents that in my professional judgment are appropriate to satisfy the requirements
<br /> 1 or ROW 84,55.005 through 64,55.090",
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<br /> Final inspection or 'Certificate of Occupancy cannot be issued by the building department prior to receipt of a
<br /> %.1 signed letter from an independent inspector certifying that the building enclosure has been inspected during the
<br /> 0 course of construction and has been constructed in substantial compliance with the building enclosure design
<br /> documents.
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<br /> D 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 arid certified copy of recorded covenant
<br /> 1 from the real property records of Snohomish County,Washington for specified building.
<br /> f4 Esi TOWNHOUSES ON SINGLE PLATTED LOTS (Unit Lot subdivision)
<br /> 4 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 /> 1,',,,, _ applicant accepts the risk involved to obtain a single platted lot exemption to RCW 64,55 for each unit of building,
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<br /> Si{SnakfennrAhorizolt Agent Pr intwl rlarne,of Owner or Autbortyald Agent Home.# Date
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<br /> Printed name of Business Addre,ss Coy Zip Code
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<br /> SIONA TURF.REQUIRED FOR EACH BUILDING PERMIT APPLICATION
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