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11030 EVERGREEN WAY REC BLDG 2017-07-14
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11030 EVERGREEN WAY REC BLDG 2017-07-14
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Last modified
7/14/2017 7:42:08 AM
Creation date
12/5/2016 2:26:03 PM
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Address Document
Street Name
EVERGREEN WAY
Street Number
11030
Unit
REC BLDG
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� <br />� <br />RCW 64.55 MULTI-FAMILY CERTIFICATION WORKSHEET <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar Street, Everett, WA 98201 � 1312-6(�(�l�p�l�� <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.orq <br />8 r'3 t Z-G f f 12�c <br />REHABILITATIVE CONSTRUCTION, NEW CC)P�STRUCTION, RECORDED COVEf�ANT OR COt�VERSiON <br />CNECK CAMELOT APARTMENTS 11030 EVERGREEN WAY, EVERETT WA 98204 A, B, C� jZ�C <br />ONE: _. . _. _ _. _ __ . _. ........._ ... _.. <br />BOX Property Name Address Building Number Permit Number <br />� REHABILITATIVE CONSTRUCTION equai tb or less than 5% or less of current assessed <br />market impravement value of specified building* <br />'NOTE: Applicant to provide entire cost of rehabilitative construction to the building enclosure for a multiunit <br />residential building or mixed use project per RCW 64.55.010, which may exceed the valuation for building permit. <br />_. ._ _ _ _ _ _ _. _ . . __ . ... . .. <br />.. . . ..:... . ,_.... . <br />(A) ENCLOSURE REHAB COST (B) MULTIPLY (A) BY 100 (C) ASSESSED BUILDING VALUE (D) DIVIDE (B) by (C) —%o <br />$845,000 , $84,500,000 $21,950,000 <br />4.18% <br />❑ NEW CONSTRUCTION �R REHABILiTATlVE CONSTRUCTION equal �€� more than 5% of <br />current assessed markefi improvement value of specified building* <br />*NOTE: Per RCW 64.55.010, RCW 64.55.020 and RCW 64.55.060 <br />Each building enciosure design document is to be stamped and signed by a Washington State architect. The <br />documents should also contain a stamped signed statement by the same architect that "the undersigned has <br />provided building enclosure documents that in my professional judgment are appropriate to satisfy the requirements <br />or RCW 64.55.005 through 64.55.090". <br />Final inspection or `Certificate of Occupancy' cannot be issued by the building department prior to receipt of a <br />signed letter from an independent inspector certifying that the building enclosure has been inspected during the <br />course of construction and has been constructed in substantial compliance with the building enclosure design <br />documents. <br />❑ � RECORDED COVENANT (JF SALE from Snohomish County* <br />"NOTE: Sale Prohibition Covenant per RCW 64.55.010 <br />Submit site plan with location of building, permit with description of work and certified copy of recorded covenant <br />from the real property records of Snohomish County, Washington for specified building. <br />❑ I CONVERSION to condominium* <br />�NOTE: permits may be required by the City of Everett per the results of the independent inspection report. <br />Undersigned will comply with owner independent inspection alternative per RCW 64.55.090 and RCW 64.34.400(2). <br />. . ... .... . ..� .. :. .. . .. _... _,.. .. .... .. ..... . .... .. ... .... . . . _ . _. _�.._ _ . . ..... v.. ..._...,�_.._. <br />Signature of Owner or Authorized Agent Printed name of Owner or Authorized Agent Phone # Date <br />.. ,�.. _......._ <br />Printed name of Business <br />_ _. ,. . , _.. <br />Address City <br />Zip Code <br />� �.-r <br />chklst-new com and condo (rev 7/] 3) FOR OFFICE USE ONLY j l <br />i <br />
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