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• • <br /> .... <br /> LI RCW 64.55 BUILDING ENVELOPE SUBMITTAL WORKSHEET <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT 3200 Cedar Street,Everett,WA 98201 <br /> ' WASHING TON Phone:425-257-8810 email:everette s cbeverettwa. ov website:www.everettwa.gbviriermit <br /> REHABILITATIVE CONSTRUCTION,NEW CONSTRUCTION,RECORDED COVENANT OR CONVERSION <br /> CHECK Seek-11 .Z.4.- i2Ote .5 •,,trt-rt St- SLo I-4 • :°)(4—07 S <br /> uox 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 (8)MULTIPLY(A)BY 100 ICJ/5.55E55ED BUILDING VALUE i DJ DIVIDE(3)by(C) •.% <br /> -- <br /> h i CI , CO Alle?,600,ct, 2, 64 4 c)coo I a 0 <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 /> CI 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 /> 0 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 /> 4.4.0. <br /> - art daledA-Sdii,r „.Y4 , ,Lia-f-e-.44,‘ 4.''' /42614q-ezcz til21,1& <br /> p Ignature of Owner or Authorized Agent Printed name of Owner or Authorized Agent Phone# Date : <br /> ri .th.tr5itkt._koo. _.rin_4-te_ 5'114 Ac h it.--txt..,.. .-tbcks-isutilit _IAA- 61.,a9:70_,_._ <br /> Printed name of Business Address City Zip Code <br /> SIGNATURE REQUIRED FOR EACH BUILDING PERMIT APPLICATION <br /> , <br />