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. � ! <br /> RCW 64.55 MULTI-FAMILY CERTIFICATION WORKSHEET <br /> CITY OF EVFRETT HERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857-www everettwa.or9 <br /> VALUATION MAl(IMUM, RECORDED SALE PROHIBITION, CONVERSION,OR FULL COMPLIANCE <br /> �YYt�IS�*.�+' �L 1 30 . Sin.c7 • 1(i07c� 'OSq <br /> CHECK �v��+ wa_qa��-.--- . . . 38 ----�---�- ------� <br /> oNE C(,i1'1d.0(�1�f�1O�17S--------- -------�-- -� -�� BuildingNumber PermitNumher <br /> BOX Property Name Address <br /> ❑ VALUATION of 5'/a or less of current assessed value (per building permit application) <br /> ' Per RCW 64.55.020 (1);reler to Everett Municipal Code for all other perrnit requirements. <br /> Calculate percenlage ol valu:.tion divided by current assessed value (structure only�. <br /> MULTIPLY CONT9ACT P910E OF WORK BY 100 DIVIOE BY ASSESSED VALUE RESUITING PERCENTAGE <br /> ❑ RECORDED Snohomish County Sale Prohibit(on Covenenant for minimum 5 years <br /> ' Per RCW 64.55.010(10);refer to Everelt Municipal Code 1or all other permil requiremenls. <br /> Submit covenant recorded in the real property records ot Snohomish County,Washington, in satislaction of the <br /> requirements ot RCW 64.55.010 through 64.55.090. The covenant identilies the sole owner ol the property <br /> described on Ezhibit A (the"Property). Unlil termination o( the covenant, no dwelling unit in or un the Property <br /> may be sold as a condominium unit except for sales listed In RCW 64.34.400(2). <br /> ❑ CONVERSION to condominium (owner inspection alternalive) <br /> ' No permit requirr,d per RCW 64.55.09u and RCW 64.34.400(2);reler lo Everett Municipal Code lor all other <br /> permit requiremenis. <br /> SignaWre of Owner or Aulhorized Agent Printed name of Owner or Authorizad Agent Phonelt Date <br /> -----.. __.__. .-------- <br /> -- -- --- '--- --' _ . <br /> . . _ .__ _.._ _. -. <br /> __. ..._ _ __--- - - Cit Zip Co e <br /> Printed name ol Business Address Y <br /> FULL COMPLIANCE with RCW 64.55.005 through 64.55.090 <br /> Ail build�ng enclosure design documents to be stamped and signed by a Washington State Archilect or <br /> Engineer, including modifications to the documents that become addenda or change orders to alter Ihose <br /> documents, per RCW 64.55.010 (11). 6uilding enclosur� design documents ara to contain a stamped <br /> statemenl by the architect or engineer that"lhe undersigned has provided building enclosure documents thal in <br /> my professional judgment are anpropria�e to sa�isly the requiremen�s or RCW 64.55.005 Ihrough 64.55.090", <br /> per RCW 64.55.020. <br /> � Final inspection or Certilicate ol Occ�pancy will not be issued without a signed letter Irom an independent <br /> I inspector certitying that the building enclosure has been inspected during the course of construction and has <br /> been constructed in substantial compliance with the building enclosure design documenls, per RCW 64.55.060. <br /> FOR OfFICE USE ONLV <br /> Updated 10�03,07 <br /> ------ -- --- -- � ����� <br />