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f <br /> RCW 64.55 BUILDING ENVELOPE SUBMITTAL WORKSHEET <br /> CITY dF EVERETT PERMIT SERVICES <br /> 3200 Cedar Street;Everett,WA 98201 <br /> f WASHINO-rGN Phone-,425-2$1-8810 cmdll:r_vefeltm.5Logg. w , v webslte,wwrv.r'veretrwtr; av errfrrt <br /> REHABILITATIVE CONSTRUCTION,NEW CONSTRUCTION,RECORDED COVENANT OR CONVERSION <br /> caccx - _ <br /> ONE C P%. <br /> BOX Property Name Address' Building Nurnber ParrrFit Numbers mm <br /> �. REHI4BI�,ITATI1fE CONSTRUCTION equal to or less than 5.%or less of current assessed market <br /> Improvement valtie of specified building* <br /> .*NOTE; jAppiicafit:to provide entire.cost of rehabilitative construction to the bull <br /> dirrg enclosure for 2 multiunit residential <br /> Wildina:or.mixed use project per RCW 64.55,010,wklch'may exceed the valuation for building"permit. <br /> .._ �. :... ...w,.:.:..� 4 . <br /> (A)Gl�et a lane ctas�t.._ <br /> s. r•_. ,.._.. . B MUrTIPi.Y a 11Y14a ~r�� <br /> .._.. <br /> )., _} ` ��ASSESSED HUilt?1NG.VAI(,s t,.(nj drViE3E(ejyb`(C)f <br /> -"_ :0 - <br /> S.N TRUCTI <br /> . . QH:. <br /> RIHA..I><ITATIVE�ONS'iRUCT10N:i4"' to'rnore;tf� of curr�rit:ass�sed'..::.. <br /> m lrket'improvi-Ment'value .. specified 6u11dIr <br /> 64.55.U]0,ftt ..64 55A20 and RCW 6 SUM <br /> , <br /> 4. . ., <br /> 46 btiitding e6dosure:4esl n document is.t o be:stamped and signb igo5ae � oine la c �: cat ert5 <br />€ should also contain a stamped signed statement.isy:the same architect that"the U9,.ersigoed.h$groviiied Building enclasure <br /> doct►menis.thatin <br /> ud <br /> m profP rofessigrtalI. ment PTO appropriate to satlsfv.th.0equirements ar RCtN.6Q.sS.Q05 t rQiiglr , ' <br /> d4;5S.09o" y. . , <br /> i Final irispbotloii.or;�Cettilieat�of.Otcu arc'': earn t b <br /> Ind <br /> . ..... .. . .. .... .:... . P :_.Y. . ,..,,a eassued by the 6uildi09.dep4rtment•pnor.to;receipt.of 8:signed Fetter: .: <br /> ffbm an Independetlt inspector c rtlfying that the;bililding ericlosure has been inspected during the,course.of Carlstr'tiction <br /> aitd has baen.pan ttucted.trl sttb$tarlt[a:compliance with the bii€lding enclosure design documents, <br /> YWO 1:/F R ..,.R .Ep.C4 ENAIiI'i'.i3F S kl':i o>tt:S o o I C <br /> z. ._. _ ........ ......�. . ....... .. . A.. . t' tl._.I'I 11't,5#1 t�laRty(SaFe.Prohit�ltlorr Cdveitaiit <br /> r , <br /> Submit s . lan.:�iltlt dcatl ` of b.uildin" a it w h p.... .l.. n . B, Fm. . tt descrf tion of vrortc and.:rerdfi d� y :oT r'cord`d ra <br /> .� : P,,., P,� PY. .@ veiian 6rorn <br /> real pra records of 5iiohomish.Couri ;1Nsshiir ion fdrs clht;d btiildirt plrt <br /> .R. .pe, <br /> w. <br /> Q .H' S.P 0 1 GLE PLATTEb raTs{trlt Iot subarvision - <br /> Jr.; .permitwhileconeurrontt seukin toabtai. unit <br /> i <br /> g Y. S. . n t► _ ....bd vi�ion.fnr each.townh:oiiie;'Fti ;.r�stription:; ..=. '::. <br /> "{ fsn�+iter ate to ravjdFn bpfidin ogtire dasF, n documents fof.the lcwrliarriettiidiE,[,f„„the linit lorulduisi�ptt is nbt <br /> P.. g <br /> ,... <br /> approYsd. rt�ficate.af Occu cY wi not be 1ss ed without.approyed subdivlslon, The appt cants opts tit riskirivoW-etj <br /> 3 to otfa fa platted xomp n to ItGViI` 4:5a for ao'th unit cif tsuilpiri <br /> B;. <br /> 3lgtratu' f or nt' PrWed.naine of(hynernr Authorized.Agat ~P6ne.0~. Date;.'. <br /> Printed name of Usiness. Address City Yip Code <br /> I <br /> i <br /> &M&-r/CN <br /> SSIGNATUREREQt�lRED FaOREACH.BUltDjjdG PEl�MlT P_ <br />