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tECIEVEI <br /> 2ll 2021IC4.55 BUILDING ENVELOPE SUBMITTAL WORKSHEET <br /> E VI ") ti 'ETT <br /> CITY OF EVERETT PERMIT SERVICES <br /> ��pp 3200 Cedar Street,Everett,WA 98201 <br /> V1i•S'ri'I fir , <br /> -r IFRbe:425-257-8810 email everettepsCuieverettwa_pav website:www.everettwa.aov/permit <br /> REHABILITATIVE CONSTRUCTION,NEW.CONSTRUCTION,RECORDED COVENANT OR CONVERSION <br /> CHECK Millington at Merrill Creek 1401 Merrill Creek Parkway 14 <br /> ONE _... <br /> BOX Property Name Address Building Number Permit Number <br /> O 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 ,(B)MULTIPLY(A)BY 100 (C)ASSESSED BUILDING VALUE (D)DIVIDE(B)by(C) =% <br /> $41,253.03 $4,125,303.00 $4,663,757,90 0.88% <br /> O 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 /> I 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 /> 1 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 /> O 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 /> O 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 .' ' •le platted lot exemption to RCW 64.55 for each unit of building. <br /> ,, t Angelica Juarez 206-681-0015 10/16/2023 <br /> Signature o t <br /> n , Authorized Agent Printed name of Owner or Authorized Agent Phone# Date <br /> Polen Property Services LLC 4104 SW 327th PL Federal Way 98023. <br /> Printed name of Business Address City Zip Code <br /> SIGNATURE REQUIRED FOR EACH BUILDING PERMIT APPLICATION <br /> 1. <br />