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112 <br /> f RCW 64.51kUeL ING ENVELOPE SUBP AL WORKSHEET <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar Street,Everett,WA 98201 <br /> WASHINGTON Phone:425-257-8810 email:everetteps(Weverettwa.aav website:www.everettwa.aov/permit <br /> REHABILITATIVE CONSTRUCTION, NEW CONSTRUCTION, RECORDED COVENANT OR CONVERSION <br /> CHECK I ^ .[� St Q�. 1.1 17 t 7J riF,.'+' St; ^ .t_-['i- 1,Q �ii)'CJ 1' o(]S 'f / i <br /> ONE 1 OLY�C 1 ! I� i Wt� �0 J <br /> BOX Property Name ✓ Address Building Number Permit Number a f).,,,,,, <br /> XREHABILITATIVE CONSTRUCTION equal to or less than 5%or less of current assessed market i,6,, f' <br /> improvement value of specified building* it' r9 '� <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 (D)DIVIDE(B)by(C) =% <br /> ' S`"I, Ypp 3;NSC/ au° 51, 0Sbi000 5, 303 _ . , 7, <br /> i I <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 /> El 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 /> c <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 ob • a singl I t lot exemption to RCW 64.55 for each unit of building. <br /> ' \ I <br /> / .D? 7-,y � trnc\r0 L.)6:zo (43c) 438-- 1 .so OG'(SIao . <br /> Signature of Owner or Authorized Agent Printed name of Owner or Authorized Agent Phone# Date <br /> �fc o x0`� \HOC c;u i L,LL \ aslS Ev Cf2El1 �ir'. 44ti,c�Ilec . �)ijA. OalS <br /> Printed name of Business Address , City r Zip Code <br /> SIGNATURE REQUIRED FOR EACH BUILDING PERMIT APPLICATION <br />