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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-�+ww evereltwa.ora <br /> VALUATION MAXIMUM, RECORDED SALE PROHIBITION, CONVERSION,OR FULL COMPLIANCE <br /> �-._.Or11�P.1S2*.�+'(L 1 3� . Si nA �d�0�' UQ'q <br /> CHECK G V.a�+.�t+ .WA .q82o�q-.__ . .Z� . __. <br /> oNE �ndocnin��ms----------- -- , .. - -�- ---- -- - <br /> BOX Property Name Address Building Number Fermit Number <br /> ❑ VALUATION of 5% or less ot current assessed value (per bufiding permit application) <br /> ' Per RCW 64.55.020(1); refer to Everett Municipal Code lor all other permil requiremenls. <br /> Calculale percentage of valualion divided by current assessed value (structure only). <br /> MULTIPLY CONTRACT PR�CE OF WORK BY 100 �IVIOE BV ASSESSED VALUE RESULTING PEFiCENTAGE <br /> ❑ RECORDED Snohomish County Sale Prohibition Lovenenant for minimum 5 years <br /> • Per RCW 64.55.010(10);reter to Everett Municipal Code lor all other permit requirements. <br /> Submil covenanl recorded in the real property records ol Snohomish County, Washington, in satislaction of the <br /> requirements of RCW 64.55.010 lhrough 64.55.090. The covenant identities Ihe sole owner of Ihe property <br /> described on Exhibit A (lhe "PropeAy). Until lermination o1 lhe covenant, no dwelling unit in or on Ihe PropeAy <br /> may be sold as a condominium unit except lor sales listed in RCW 64,34.400(2�. <br /> ❑ CONVERSION to condominium (owner Inspection alternative) <br /> 'Ne permit required per RCW 64.55.090 and RCW 64.34.400(2); refer to Everett Municipal Code lor all other <br /> permit requirements. <br /> ------ -- -- - - <br /> -- -- - -- - <br /> SignaWre ol Owner or Aulhorized Agent Printed name of Owner or Authorized Agent Phone k Date <br /> ----'-� ---- -- �- - '----- - <br /> _ . .. .- -... _ ...._. .. <br /> .._ _ _.__..____ -� ----- -._ . -- <br /> . -..---�-- ---- Cit ZipCode <br /> Pnmed name ol Business Address Y <br /> FULL COMPLIANCE with RCW fi4.55.005 through 64.55.090 <br /> All huilding enclosure design documents to be stamped and signed by a Washington State Architect ar <br /> Engineer, including modilications to the documents tha; become addenda or change orders to alter ihose <br /> documents, per RCW 64.55.010 (11). Building enclosure design documents are to contain a stamped <br /> statement by the architect or engineer that "ihe undersigned has provided building enclosure documents that in <br /> my prolessional judgmenl are appropriale to satisfy lhe requirements or RCW 64.55.005 through 64.55.090", <br /> per flCW 64.55.020. <br /> Final inspecGon or Certiticate of Occupancy will not be issued without a signed letter Irom an independent <br /> inspector certilying that the building enclosure has been inspecled during the course of conslruction and has <br /> been constructed in substanlial compliance with Ihe building enclosure design documents,per RCW 64.55.060. <br /> UpCated 10�03'07 FOfi OFFICE USE ONLV <br /> /I r <br /> ___ _ ___ �>/ :�/ <br />