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RCW 64.55 BUILDING ENVELOPE SUBMI AL WORKSHEET <br /> CITY OF EVERETT PERMIT SERVICES <br /> E V E R E T T 3200 Cedar Street,Everett,WA 98201 <br /> WASHINGTON Phone:425-257-8810 email:PermitServices@everettwo.go w site:www.everettwo.aov/permit <br /> REHABILITATIVE CONSTRUCTION, NEW CONSTRUCTION,RECORDED COVENANT OR CONVERSION <br /> CHECK <br /> ONE (�'( ® ! `►' til�G.r r/��V/�� V/� '"1� �G�'�i©� �V C7 <br /> BOx Property Name Address Building Number Permit Number <br /> 1� 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 /> s11411-70 1,Lin,00c> ;5r501 ,40 O 1 .1�6 "'u <br /> ❑ NEW CONSTRUCTION OR REHABILITATIVE CONSTRUCTION equal tom re 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 and riigned 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 depa tment 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 Prohibitio Covenant)64.55.010 <br /> Submit site plan with location of building, permit with description of work and certifi d 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 /> $av <br /> it for building r "t while concurrently seeking to obtain unit lot subdivision for each townhome. This exemption <br /> mate to prov" ilding enclosure design documents for the townhome building,if the unit lot subdivision is not <br /> . Certificat c cy will not be issued without approved subdivision. The applicant accepts the risk involved <br /> a single p t ptio�RCW 64.55 for each unit of building. <br /> pp� 'l•Signatuer or Authorized A Printed name of Owner or Authorized Agent Ph ne# Date <br /> it <br /> .•a Gdp �a�i� <br /> Printed name of Bunn Address City Zip Code <br /> SIGNATURE REQUIRED FOR EACH BUILDING PERM/ APPLICATION <br />