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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,Everett,WA 98201 <br /> WASHINGTON Phone:425-257-8810 email:PermitSerwces@everettwo.aov we Site:www.everettwa.aov/permit <br /> REHABILITATIVE CONSTRUCTION, NEW CONSTRUCTION, RECORDED COVENANT OR ONVERSION <br /> Y�/� /.� 2 I Y <br /> CHECK - <br /> ONE IIIIr „® MI ( 1 f /� �Y v��vYV �IA + Af J <br /> BOX Property Name Address Building Number Permit Number <br /> PC 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 (8)MULTIPLY(A)BY 100 (C)ASSESSED BUILDING VALUE (D)DIVIDE(B)by(C) =% <br /> O <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 WasIningtin State architect.The documents <br /> should also contain a stamped signed statement by the same architect that"the andsigned has provided building enclosure <br /> documents that in my professional judgment are appropriate to satisfy the requiremis or RCW 64.55.005 through <br /> 64.55.090". <br /> Final inspection or 'Certificate of Occupancy' cannot be issued by the building depaitment 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 certified 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 /> Can bmit for building ile concurrently seeking to obtain unit lot subdivision for each townhome. This exemption <br /> is mate to provi u g enclosure design documents for the townhome building, if the unit lot subdivision is not <br /> a v d. Certificate f y will not be issued without approved subdivision. The applicant accepts the risk involved <br /> b in a single pi lion to R W 64.55 for each unit of building. <br /> Sig natJFe Owner or Aut rize A n Printed name of Owner or Authorized Agent Ph ne# Date <br /> �fus-�,rg m�11� � �ro�Printed nameiness Address City Zip Code <br /> SIGNATURE REQUIRED FOR EACH BUILDING PERMIT APPLICATION <br />