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RCW 64.55 MULTI-FAMILY CERTIFICATIUN WORKSHEET <br /> CITY OF EVERtTT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> 425-257-BBt 0-FAX 425-257-8857-lwvw everettwa om <br /> VALUATION MAXIMUM, RECORDED SALE PROHIBITION, CONVERSION,OR FULL COMPLIANCE <br /> �-�OrYlO.l Sa�,�+'IG 1 30 . S i n.c7 ��70 Q• Q f 0 <br /> CHECK E V1�J1�� <br /> ONE CpP1d.D O'II(11OfY1S----- Address � �A �82� Building N�ber Permit Number <br /> BOX Property Name <br /> ❑ vALUA710N of 5% or less of current assessed value (per building permit applicat(on) <br /> • per RCW 64.55.020(1);reler lo Everett Municipal Code lor all other permil requirements. <br /> Calculate percentage ol valualion divided by current assessed value(ctructure only). <br /> MULTIPLY CONTRACT PRICE OF WORK BY 100 DIVIDE BV ASSESSED VALUE RESULTING 'ERCENTAGE <br /> ❑ RECORDEo Snohomish County Sale Prohibit(on Covenenant for minimum 5 years <br /> ' Per RCW 64.55.010(10);refer lo Everett Municipal Code lor all other permit r�quirements. <br /> Submit covenant recorded in the real proper+y records ol Snohomish County, Wash'ngton, In satislaction ol the <br /> requirements of RCW 64.55.010 ihrough 64.55.090. The covenant identilies Ihe sole awner ol ihe property <br /> described on Ezhibit A (the "Property). Until lermination of lhe covenant, no dwelling unit in or on Ihe Properly <br /> may be sold as a condominium unit ezcept for sales listed in RCW 64.34.400(2). <br /> ❑ CONVERSION to condominium (owner inspectfon alternative) <br /> ' No permit required per RCW 64.55.090 and RCW 64.34.400(2); reler to Everett Municipal Code for all olher <br /> permit requiremen�s. <br /> -- - ------ ------------ - <br /> _ - -- <br /> Signawre of Owner or Authorized Agem Printed name ol Owner or Authorized Agenl Phone k Date <br /> - -- ------�- -- -- -...--- ----- <br /> _. ._ .. - �- --.. . ..__. .. <br /> Primed name ol Busine,s Address City Zip Code <br /> FULL COMPLIANCE with RCW 64.55.005 through 64.55.090 <br /> All building enclosure design documents to be stamped and signeA by a Washington State Architect or <br /> Engineer, including modificalions to the documenls Ihat become addenda or change orders lo aller those <br /> documents, per RCW 64.55.010 (11). Building enclosure design documents are to contain a stamped <br /> statement by the architect or engineer lhat"ihe undersigned has provided building enclosure documents thal in <br /> my professional judgment are appropriate to satisly the requirements or RCW 64.55.005 through 64.55.090", <br /> per RCW 64.55.020. <br /> Final inspection or Certilicate ol Occupancy will not be issued without a signed Ietter Irom an independenl <br /> inspector certitying that the building enclosure has been inspected during the course ot construclion and has <br /> been constructed in substantial compliance with the building enclosure design documents,per RCW 64.55.060. <br /> Updatea t0�o9;07 FOR OFPICE USE ONLV <br /> ------------- <br /> ---- � ���y <br />