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� � <br /> RCW 64.55 MULTI-FAMILY CERTIFICAIION WORKSHEET <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> 425-257-8870—FAX 425•257-8857—www everettwa.ora <br /> VALUATION MAXIMUM, RECORDED SALE PROHIBITION, CONVERSION,OR FULL COMPLIANCE <br /> �Y110ASa�. �+'IG 1 � . Sin.c7 �07�� •0�'7 <br /> CHECK E v��+ wa�q���--- . Z(�.- � - <br /> oNE CpPld.O(_�1(11U�1S---- --- ------- �- BuildingNumber PermitNumbei <br /> BOX Property Name Address <br /> ❑ VALUATtoN of 5% or less of current assessed value (per building permit application) <br /> ' Per RCW 64.55.U20 (1);reler to Evereq Municipal Code for all other permit requirements. <br /> Calculate percentage ol valuation divided by current assessed value (structure only). <br /> MULTIPLY CONTRACT PRICE OF WORK BV 100 DIVIDE BY ASSESSED VALUE RESULTING PERCENTAGE <br /> ❑ RECORDED Snohomish County Sale Prohibition Covenenant for minimum 5 years <br /> ' Per RCW 64.55.010 (10);reler to Everett Municipal Code for all olher permit requirements. <br /> Submit covenant recorded in the real property records o1 Snohomish Counly,Washington, in satisfaction of the <br /> requiremenls of RCW 64.55.010 lhrough 64.55.090. The covenant identilies ihe sole owner ol the propeAy <br /> described on Exhibit A (the "Property). Until termination of Ihe covenant, no dwelling unit in or on lhe Property <br /> may be sold as a condominium unit except for sales listed in HCW 64.34.400(2). <br /> ❑ CONVERSION to condominlum (owner inspection alternative) <br /> ' No permit required per FCW 64.55.090 and RCW 64.34.400(2);reler to Everett Municipal Code tor all other <br /> permit requiremenis. <br /> SignaWre of Owner or Authorized Agenl Printed name ol Owner or Authorized Agent Phone M Date <br /> — - --. . . . . __ .. ._ _. _. <br /> ---� ----__ _.-- ' <br /> � ---�� - -- - - . . . � <br /> ----__ __.__. Cit Zip Code <br /> Printed name ol Business Address Y <br /> FULL COMPLIANCE with RCW 64.55.005 thr0ugh 64.55.090 <br /> All building enclosure design documents to be stamped and signed by a Washington State Architect or <br /> [ngineer, including moditications to the documents lhal become addenda or change orders lo aller those <br /> documents, per RCW 64.55.010 (11). Building enclosure design documents are lo contain a stamped <br /> statement by the architect or engineer thal "the undersigned has provided building enclosure documents Ihat in <br /> my prolessional judgment are appropriate tc satisly lhe requirements or RCW 64.55.005 lhrough 64.55.090", <br /> per RCW 64.55.020. <br /> Final inspection or Certilicale ol Occupancy will not be issued without a signed letter Irom an independent <br /> inspector cenilying that the building enclosure has been inspected during the course ol construction and has <br /> been constructed in substantial compliance with ihe building enclosure design documenls,per RCW 64.55.060. <br /> FOR OFFICE USE ONLY <br /> Updaled 10r03'07 <br /> ___ _._--___-- � �� .1 <br />