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111.1111 RCW 64.55 BUILDING ENVELOPE SUBMITTAL WORKSHEET <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar Street,Everett,WA 98201 <br /> WASHINGTON Phone:425-257-8810 email:everetteps(Ieverettwa.gov website:www.everettwa.gov/permit <br /> REHABILITATIVE CONSTRUCTION,NEW CONSTRUCTION,RECORDED COVENANT OR CONVERSION <br /> CHECK <br /> owe (0:0 <br /> I..-.._...._LGk_i A -7...__ ............._...._._...._. <br /> BOX Property Name Address Building Number Permit Number <br /> 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 /> • <br /> (A)ENCLOSURE REHAB COST 1 (B)MULTIPLY(A)BY 100 (C)ASSESS.• BUI DING V LUE (DJ DIVIDE(B)by(C) =% <br /> S•+oCo ;,�. roJ .l re 3. cr%� . <br /> 0/30oo / 3ar --NCO . . . :".' <br /> . <br /> ff ^ <br /> • <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 /> ❑ 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 /> 0 obtain a sin platted lot exemption to RCW 64.55 for ea unit of building. <br /> aw6e r€ice.... _ (, c-)35"3:!s.3'2_ 3/2/._._. <br /> a ure of Ow r uthorized Agent_ Printed name of Owner or Authorized Agent Phone# Date <br /> Qom(.. ' 'Cro F_I Pa L Z�.l c-. LZ 1� t ST, SA- E-f ea-ZIT 1i A- �. 43 <br /> s <br /> Printed name of Business Address City Zip Code <br /> SIGNATURE REQUIRED FOR EACH BUILDING PERMIT APPLICATION <br />