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40 2005 .... c04__ <br /> IN RCW 6435 BUILDING ENVELOPE SUBMiTTAL WORKSHEET <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar Street,Everett,WA 98201 <br /> WASH'CNOTON Phone:425-257-8810 email:everetteast" everettwa,oav webste:www.everettwwa.00v/permit <br /> REHABILITATIVE CONSTRUCTION,NEW CONSTRUCTION, RECORDED COVENANT OR CONVERSION <br /> CHECK + , gluts24 Um* iet. Pri.astweitii1401 _51005- 001_Property Name 111 Address Building Number Permit Number <br /> tsk REHABILITATIVE 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 cost of rehabilitative construction to the building enclosure for a multiunit residential <br /> 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 (C)ASSESSED BUILDING VALUE (0)DIVIDE($)by(C) =% <br /> I to,I. It'll i%0.000.00 k Till 000 cz 952.5.20 <br /> . i • . <br /> 0 NEW CONSTRUCTION OR REHABILITATIVE CONSTRUCTION equal to more than 5%of current assessed <br /> 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 documents <br /> should also contain a stamped signed statement by the same architect that"the undersigned has provided building enclosure <br /> documents that in my professional judgment are appropriate to satisfy the requirements or RCW 64.55.005 through. <br /> 64.55.090". <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 /> I 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 from the <br /> real property records of Snohomish County,Washington for specified building. <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 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 Occupancy will not be issued without approved subdivision. The applicant accepts the risk involved <br /> to obtain a single platted lot exemption to RCW 64.55 for each unit of building. <br /> „,(W6r. Ska ValtAkterekt 4.2-513Wir12. S '210**24)2C4 <br /> Signature of Owner or Authorized Agent Printed name of Owner or Authorized Agent Phone# Date <br /> V.040 , SAChri. -- _,312.-101.0St SO-) goerett uYA qtabq <br /> Printed name of Business Address City Zip Code <br /> r W - ar '' )0r4,, <br /> SIGNATURE REQUIRED FOR EACH BUILDING PERMIT APPLICATION <br />