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RCW 64.55 BUILDING ENVELOPE SUBMITTAL WORKSHEET <br /> CITY OF EVERETT PERMIT SERVICES <br /> E V E R E T T <br /> 3200 Cedar Street,Fvprett,WA 98201 <br /> Y4 ASH I N G 1014 Phone:42.5.257.8810 email' webi ite: <br /> REHABILITATIVE CONSTRUCTION,NEW CONSTRUCTION, RECORDED COVENANT OR CONVERSION <br /> CHECK <br /> ONF I I�t n® !' �I t f �J![K'J�. VA4 I <br /> aox Property Nam Address Budding Number Permit Number <br /> Pl REHABILITATIVE CONSTRUCTION equal to or less than 5%or less of curt ent assessed market <br /> improvement value of specified building' <br /> 'NOTE: Applicant to provide entire cost of rehabilitative construction to the building Onclosure 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 (0)MULTIPLY(A)BY 100 (C)ASSESSED BUILDING VAi UE (D)DIVIDE(0)by(C) =% <br /> -70 C L4 1 •IC, I JI l'01-44 I4� ., "lit! b I ,L4 �O <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 under igned has provided building enclosure <br /> documents that in my professional judgment are appropriate to satisfy the requireme s of RCW 64,55.005 through <br /> 64.55.090". <br /> F roil 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 inspe led during the course of construction <br /> and has been constructed in substantial compliance with the building enclosure design documents. <br /> I <br /> ❑ RECORDED COVENANT OF SALE from Snohomish County(Sale ProhibitionCovenant)64.55.010 <br /> Submit site plan with location of building,permit with description of work and certifie copy of recorded covenant from the <br /> real property records of Snohomish County.Washington foi specified building. <br /> ❑ (TOWNHOUSES ON SINGLE PLATTED LOTS (Unit Lot Subdivision) <br /> Car a nit for building p t' hile concurrently seeking to obtain unit lot suhdivisioi for each townhome. This exemption <br /> is ornate to provid b g enclosure design documents for the townhome building,if the unit lot subdivision is not <br /> p�r d. Certificate c y will not be issued without approved subdivision. he applicant accepts the risk involved <br /> tq 0 in a single pla e I on to RCW 64.55 for each unit of building <br /> I r <br /> Signals re of Owner or/Authonued A nt Prnted name of Owner or Authorised Agent Phu a Is pate <br /> �.�i/'n r '►O r� (o l� InPP1� �+ro�r^'�'`f W �ZArD <br /> Printed name of Business Address (sty lop CMIe <br /> SIGNATURE REQUIRED FOR EACH BUILDING PERMIT APPLICATION <br />