1401 MERRILL CREEK PKY #3 2025-04-07

RCW 64.55 BUILDING ENVELOPE SUBMI AL WORKSHEET CITY OF EVERETT PERMIT SERVICES E V E R E T T 3200 Cedar Street,Everett,WA 98201 WASHINGTON Phone:425-257-8810 email:Permit5ervices@everettwo.gov we site:www.everettwo.gov/permit: REHABILITATIVE CONSTRUCTION,NEW CONSTRUCTION, RECORDED COVENANT*OROINVERSION A y>�COEK hsi rt - n � ! ll�rjf��C. EJon bbIWA-� �(/'�� ©�BOX Property Namee Address Budding NumbPermit Number REHABILITATIVE CONSTRUCTION equal to or less than 5%or less of current assessed market improvement value of specified building* *NOTE: Applicant to provide entire cost of rehabilitative construction to the building enclosure for a multiunit residential building or mixed use project per RCW 64.55.010,which may exceed the valuation for building permit. (A)ENCLOSURE REHAB COST (B)MULTIPLY(A)BY 100 (C)ASSESSED BUILDING VALUE (A)DIVIDE(B)by(C) =% ®1110*0 `71 VO831Dr`." j ,?A0),0 ❑ NEW CONSTRUCTION OR REHABILITATIVE CONSTRUCTION equal tom re than 5%of current assessed market improvement value of specified building* *NOTE: Per RCW 64.55.010, RCW 64.55.020 and RCW 64.55.060 Each building enclosure design document is to be stamped and signed by a Washington State architect.The documents should also contain a stamped signed statement by the same architect that"the undersigned has provided building enclosure documents that in my professional judgment are appropriate to satisfy the requireME nts or RCW 64.55.005 through 64.55.090". Final inspection or'Certificate of Occupancy' cannot be issued by the building depa tment prior to receipt of a signed letter from an independent inspector certifying that the building enclosure has been inspected during the course of construction and has been constructed in substantial compliance with the building enclosure design documents. ❑ RECORDED COVENANT OF SALE from Snohomish County(Sale Prohibitio i Covenant)64.55.010 Submit site plan with location of building, permit with description of work and certified copy of recorded covenant from the real property records of Snohomish County,Washington for specified building. ❑ TOWNHOUSES ON SINGLE PLATTED LOTS(Unit Lot Subdivision) Ca submit for building r 't while concurrently seeking to obtain unit lot subdivision for each townhome. This exemption is Iternate to provi I ing enclosure design documents for the townhome t uilding,if the unit lot subdivision is not ed. Certificate ncy will not be issued without approved subdivision. The applicant accepts the risk involved ain a single pl t ion to R W 64.55 for each unit of building. Signatur of w r A on ed Printed name of Owner or Au orized Agent Phone# Date &�Vft-v* 4 — Printed name of Buz C Address City Zip Code SIGNATURE REQUIRED FOR EACH BUILDING PERM/ APPLICATION