Laserfiche WebLink
RCW 64.55 MULTI-FAMILY CERTIFICATION WORKSHEET <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar Street, Everett, WA 98201 � �'312-��,��D7l�� <br />425-257-8810 — FAX 425-257-8857 — wv✓w.everettv,+a.orq <br />B r3cZ—G �I �� <br />REHABILITATIVE CONSTRUCTlON, f�EW CQP�STRUCTION, RECORDED COVEhEANT �R CONVERSiON <br />CHECK CAMELOT APARTMENTS 11030 EVERGREEN WAY, EVERETT WA 98204 A, B, C� f��� <br />ONE__.. _. _. . ._,.. _ _ __ _ _ _ . ..,,... <br />BOX Property Name Address Building Number Permit Number <br />� REHABILITAT(VE CONSTRUCTION equal fib or less than 5% or less af current assessed <br />market improvement ualue of specified builciing* <br />"NOTE: Applicant to provide entire cost of rehabilitative construction to the building enclosure for a muitiunit <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 (BJ MULTIPLY (A) BY 100 (C) ASSESSED BUILDING VALUE (D)„DIVIDE (B) by (C) _% <br />$845,000 $84,500,000 $21,950,000 4.18% <br />❑ NEW C�NSTRUCTfON �R REHABILiTA71VE CONSTRUCTION equai #o more than 5% of <br />current assessed 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 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 buiiding 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 />❑ IRECORDED COVENANT QF 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 />❑ ICONVERSf�N 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 />..... .,_ . _ ... _.. .. . . _.__. ._.._ . ... ... . .... . ... ... .. . .. _..._ . . _ . ..... . � ... .. . ......... _.,..._ _... . <br />Signature of Owner or Authorized Agent Printed name of Owner or Authorized Agent Phone # Date <br />, _�.� .... ..... . .. . ..... ........ . .. . . .. <br />Printed name of Business Address <br />_ _ __ _ _ __ <br />2/ <br />chklst-new com and condo (rev 7/l3) <br />City <br />FOR OFFICE USE ONLY <br />Zip Code <br />