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( <br /> RCW 64.55 MULTI-FAMILY CERTIFICATION WORKSHEET <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> 425�257�8810-FAX 425-257-8857-4vWw everettwa.ora <br /> VALUATION MAXIMUM, RECORDFD SALE PROHIBITION, CONVERSION,OH FULL COMPLIANCE <br /> �►�n.�s�.t '�+� i �-,o ,.L `s' �� n -^yy^ �,o�0�-054 <br /> CMECK 1_ G�JIJI.��T.�_WA_�VZ�.'_' JJ <br /> ONE CQI'IO.vm�/�1V/ns'----..._-�--�- -- . _ . . . _ - _._ '---- -' --'----'---- <br /> BOX Property Name Address Building Number Permit Number <br /> ❑ VALUA710N ot 5%or less ot current assessed value (per building permit application) <br /> ' Per RCW 64.55.020 (1); reler to Eveiett Municipal Code for ail other permit requiremenis. <br /> Calculate percentage o1 valuation divided by currenl assessed value(structure only). <br /> MULTIPLY CONTRACT PRICE OF WORK BY 100 DIVIDE BY.4SSESSED VALUE RESULTING PcRCENTAGE <br /> ❑ RECORDED Snohomish County Sale Prohibition Covenenant for minimum 5 years <br /> ' Per RCW 64.55.010(10);refer lo Everett Municipal Code for all other permit requiremenls. <br /> Submit covenant recorded in Ihe real property records ol Snohomish County, Washington, in satisfaction ol the <br /> requirements ol RCW 64.55.010 thro�gh 64.55.090. The covenant identifies the sole owner ol the property <br /> described on Exhibit A (the "Property). Until termination ol the covenant, no dwefling unit in or on the Property <br /> may be so�d as a condominium unit except for sales listed in RCW 64.34.400(2). <br /> ❑ CONVERSION to condominium (owner inspection alternative) <br /> ' No permit required per RCW 64.55.090 and RCW 64.34.400(2);refer to Everett Municipal Code lor all other <br /> permit requiremen�s. <br /> Signalurn ol Owner or Authorized Agent Primed name ol Owner or Aulhorized Ayenl Phone# Date <br /> � - -- - -. ._.-- -- - -�---- - ----- ... _ <br /> . . _.. .. -- --. ....__.. <br /> ...___._.. - -----.._ _.. . ... --- � <br /> Printed name ol Business Address Ciry Zip Code <br /> FULL COMPLIANCE with RCW b4.55.005 through 64.55.090 <br /> All building enclosure design documents to be stamped and signed by a Washington State Archilect or <br /> Engineei, including moditications to t'ne documents lhat become addenda or change orders lo alter Ihose <br /> documenis, per RCW 64.55.010 (11). Building enclosure design documents are to contain a stamped <br /> statement by Ihe architect or engineer that "the undersigned has provided building enclosure documenls that in <br /> my prolessional judgment are appropriate to satisfy the requirements or RCW 64.55.005 Ihrough 64.55.090", <br /> per RCW 64.55.020. <br /> Final inspection or Ceni�icate of Occupancy will not be issued wilhout a signed letter irom an independenl <br /> inspector certitying lhal the building enclosure has been inspected during the course of constr�ction and has <br /> been constructed in substantial compliance with the building enclosure design documents, per RCW 64.55.060. <br /> Updated 10'07'07 FOR OFPICE USE ONLY <br /> ----------- , �)�4�� <br /> � <br />