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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�BB10-FAX 425-257•8857-Lv,ww everetM1va.ora <br /> VALUATION MAXIMUM, RECORDED SALE PROHIBITION, CONVERSION,OR FULL COMPLIANCE <br /> �1'YIA.lS2.t. �' �L 1 � . Si n.c7 J <br /> CHECK E v���- <br /> Z o7 �i• o43 <br /> oNE �nd.ornin�oms------------ .�_WA_q$2.�4 — . - � - ----- <br /> ------- - <br /> BOX Property Name Address Building Number Permit Numher <br /> ❑ VALUATION of 5% or less ot current assessed valu� (per building permit applicatfon) <br /> ' Per RCVJ 64.55.020 (1);reler to Everett Municipal Code lor all other permit requirements. <br /> Calculate percentage ol valuation divided by current assessed value (strucWre only). <br /> MULTIPLY CONTRACT PRICE OF WORK BV 100 DIVIDE BY ASSESSED VALUE RESULTING PERCENTAGE <br /> ❑ RECORDED Snohomish County Sale Prohibitfon Covenenant for minimum 5 yean <br /> ' Per RCW 64.55.010(10); reler to Everett Municipal Code lor all other permit requirements. <br /> Submit covenant recorded in the real property recoids ol Snohomish County,Washington, fn salistaclion ol lhe <br /> requirements ol RCVJ 64.55.010 lhrough 64.55.090. The cov�nant identilies lhe sole owner ol the property <br /> described on Ezhibit A (the "Property). Until lermination ol the covenant, no dwelling unit in or on the Property <br /> may be sold as a condominium unit except ior sales listed in RCW 64.34,400(2). <br /> O CONVERSION to condominfurn �owner Inspection alternative) <br /> ' No permil required per RCW 64.55.OS10 and RCVi 64.34.400(2);refer to Everetl Municipal Code tor al1 other <br /> permit requirements. <br /> --- _ -- - _ _ - - - <br /> - _ .. _ <br /> SignaWre ol Q`vner or Authorized Agent� � Printed name o1 Owner or Authorized Agent Phune k Date <br /> � - - --_. . _ _... _ ._.- - <br /> � -'---------�---- ---- - <br /> --- --- ----- Cit ZipCade <br /> Printed name ol Business Address Y <br /> FULL COMPLIANCE with RCW 64.55.005 through 64.55.090 <br /> All building endusure design documents to be star�ped and signed by a Washington State Architect or <br /> Enyinee�, including modilications to Ihe documents that become addenda or change orders lo alter lhose <br /> dor.umenis, per RCW 64.55.010 (11). Building enclosure design documents are to contain e stamped <br /> statement by ihe architecl or engineer that "the undersignad has provided building enclosure documents that in <br /> my professionat judgmant are appropriate to satisly ihe requirements or RCW 64.55.005 through 64.55.090", <br /> per RCW 64.55.020. <br /> Final inspection or Certilicate ot Occupancy will not be issued wilhout a signed letler irom an independcnt <br /> inspeclor certilying Ihat the building enclosure has been inspected during the course ol construction and has <br /> been constructed in substantial compliance with the building enclosure design documents, per RCW 64.55.060. <br /> FOR OFFICE USE ONLV <br /> uPa�iea+o�oim <br /> --- -------- -- _—' — ��� <br />