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• mai 1112 RCW 64.55 BUILDING ENVELOPE SUBMITTAL WORKSHEET CITY OF EVERETT PERMIT SERVICES RET T 3200 Cedar Street,Everett,WA 98201 ! website:www everettwa gov/permit VASHINGION Phone:425-257-8810 email:evere evere o'pOV iBiLITATIVE CONSTRUCTION,NEW CONSTRUCTION,RECORDED COVENANT OR CONVERSION PA-P- C OeNi Wilk Zit I _,..�..._. Permit Number Property Name Address Building Number e REHABILITATIVE CONSTRUCTION equal to or less than 5%or less of current assessed market improvement value of specified building* *NOTE: Applicant to provide entire cost of rehabilitative construction to the building enclosure for amultiunit residential building or mixed use project per RCW 64.55.010,which may exceed the valuation for building permit. (A)ENCLOSURE REHAB COST (Et)MULTIPLY(A)BY 100 1 (C)ASSESSED Bt1iL01NG VALUE I (D)DiVIDE(B)by 2-111505 -- 2 i 4-5'j 5 1 Zit 5e i gs ' 3 NEW CONSTRUCTION OR REHABILITATIVE CONSTRUCTION equal to more than 5%of current assessed market improvement value of specified building* *NOTE: Per RCW 64.55.010,RCW 64.55.020 and RCW 64.55.060 Each building enclosure design document is to be stampedsaee architectnd signedthat Ny a the undersigned has provided The buiidingencIosure should also contain a stamped signed statement by documents that in my professional judgment are appropriate to satisfy the requirements or RCW 64.55.005 through 6455.090". Finalm inspection independent or'Certificate inspector of Occupancy' cannot building enclosure has been inspected during the course of construction be issued by the building department prior to receipt of a signed letter from an independent certifying that and has been constructed in substantial compliance with the building enclosure design documents. ❑ RECORDED COVENANT OF SALE from Snohomish County(Sale Prohibition Covenant)64.55.010 Submit site plan with location of building,permit with description of work and certified copy of recorded covenant from the real property records of Snohomish County,Washington for specified building. ❑ TOWNHOUSES ON SINGLE PLAITED LOTS(Unit Lot Subdivision) Can submit for building permit while concurrently seeking to obtain unit lot subdivision for each townhome. This exemption is an alternate to providing building enclosure design documents for the applicant accepts the risk involved uilding,if the unit lot subdivision is not approved. Certificate of Occupancy will not be issued without approved subdivision ob ain a ' platted lot exemption to RCW 64.55 for each unit of building L ��, ,o z-55 -7 7 7- ' 1 7 0 - M T�^'�`!�--..,_ y....�. .,_w �. Date Sign re w or horized Agent Printed name of Owner or Authorized Agent Phone f Printed name of Business Address City Zip Code SIGNATURE RE UIRED FOR EACH BUILDING PERMIT APPLICATION