2531 GRAND AVE 2016-01-01 MF Import

RCW 64.55 MULTI-FAMILY CERTIFICATION WORKSHEET CITY OF EVERETT PERMIT SERVICES 3200 Cedar Street, Everett, WA 9d201 425-257-8810 - FAX 425-257-8857 - �+n�v.everettwa.o� REHABILITATIVE CONSTRUCTION, NEW CONSTRUCTION, RECORDED COVENANT OR CONVERSION CHECK ONE � BOX Property Namu �❑ ❑ Z53/ �rv�p'� ilvc F✓.�c� 9KLol (�I.J 1306'(�db Address Building tJum6er Permit Number REHABILITATIVE CONSTRUCTION equal to or less than 5% or less of current assessed market improvement value af specified building" 'NOTE: Applicanl to provide entire cost of rehabilitalive consiruclion to the building enclosure for a multiunit residential building or mixed use projecl per RCW 64.55.010, which may exceed the valuation tor building permit. (AJ ENCLOSURE P.EHAB COST (8J MULTIPLY (A) BY 100 (C) ASSESSED BUILDING VALUE (0) DIVIDE (B) by (C) _% ��LSG G Z,SDDoo I38. S�� /. S� /e NEW CONSTRUCTION OR REHABILITATIVE CONSTRUCTION equal to more than 5% of currsnt assessed market improvement value of specified building* 'NOTE: Per RCW 6?.55.010, RCW 64.55.020 and RCW 64.55.060 Each building enclosure design documenl is lo be stamped and signed by a Washinglon State archiiecl. The documents should also contain a stamped signed stalemenl by the same architect that "the undersigned has provided building enclosure documents lhal in my professional judgment are appropriate to satisfy the requiremenls or RCW 64.55.005 lhrough 64.55.090". Final inspection or 'Certificate of Occupancy' cannot be issued by the builtling department prior lo receipt of a signed letter from an independent inspector certitying thal the building enclosure has been inspected during the course of construction and has been construc;ed in substantial compliance with the building enclosure design documents. RECORDED COVENANT OF SALE from Snohomish County` 'NOTE: Sale Prohibition Covenanl per RCW 64.55.010 Submit site plan with location of building, permit with description of work and certified copy of recorded covenant from the real property records o( Snohomish Counfy, Washington for specified building. ❑ ICONVERSION lo condominium* 'NOTE: permits may be required by the City of Everett per ih� results of the independent inspection report. Undersigned will comply wilh ownrr independent inspection alternative per RCW 64.55.090 and RCW 64.34.400(2). Signature of Owner or Authorized Agent Printed name of O�vner or Authorized Agent Phone # Date Printed name of Business chklst-ncn� cuin and cundo (rcv d/23/08) Address Cily POK OPFICB USI; O\i.Y Zip Code