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• • <br /> MEN <br /> 1112 <br /> RCW 64.55 BUILDING ENVELOPE SUBMITTAL WORKSHEET <br /> EV E R E T T CITY OF EVERETT PERMIT SERVICES <br /> Y 3200 Cedar Street,Everett,WA 98201 <br /> WASHINGTON Phone:425-257-8810 email:everetteps@everettwa.gov website:www.everettwa.4ov/permit <br /> REHABILITATIVE CONSTRUCTION,NEW CONSTRUCTION,RECORDED COVENANT OR CONVERSION <br /> CHECK GENERAL CAR WASH 6101 Evergreen Way, Everett WA 98203 N/A TBD <br /> ONEw_� ___„„ _ ____.M_ _... <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 /> (A)ENCLOSURE REHAB COST (IV MULTIPLY(A)BY 100 (C)ASSESSED BUILDING VALUE (D)DIVIDE(B){by(C) <br /> $42,487.00 $4 248 700 $2,980,002 1.4% <br /> ❑ 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 /> to obtain a single platted lot exemption to RCW 64.55 for each unit of building. <br /> %eCt- Travis Hendrickson (425)388-9906 9/28/2022 <br /> Signature of Owner or Authorized Agent Printed name of Owner or Authorized Agent Phone 4,.,.._ Date. <br /> Four Seasons Roofing 17903 SR 9 SE _ <br /> Snohomish 98290 <br /> _ _ Printed name of Business � � Address _ , __ , ' `____"Cityp " ___ __ __,__, -. ._ __ <br /> SIGNATURE REQUIRED FOR EACH BUILDING PERMIT APPLICATION <br />