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RCW 64.55 MULTI-FAMILY CERTIFICAI ION WORKSHEET <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 9B201 <br /> 425�257�8810-FAX 425-257-8857-www everetlwa.ora <br /> VALUA'iION MAXIMUM, RECORDED SALE PROHIBITION, CONVERSION,Ofl FULL COMPLIANCE <br /> �1'Y1.OA52�.�+'IG ! 3� . S i n.A �p � U Q�• 0 j� <br /> CHECK E Y�t+ WA_q82og-.._ . 1 �D. _ . ._.- - <br /> ONE CpY1d.DD11(liO�7S---- --'Address Bu9dingNumbei PermitNumber <br /> _ _ ..�_. . <br /> BO% Property Name <br /> ❑ VALUA710N of 5°/a or less oi current assessed value (per building permit applfcatfon) <br /> ' Per RCW 64.55.020 (1);refer to Everett Municipal Code for all othei permil raquirzments. <br /> Calculate percentage ol valuation divided by cur;ent assessed value(structure only�. <br /> MULTIPLY CONTRACT PAICE OF WORK BY 100 OIVIDE BV ASSESSFD VALUE RESULTING PEfiCENTAGE <br /> ❑ RECORDED Snohumish County Sale Prohibition Covenenant for m(nimum 5 years <br /> ' Per RCW 64.55.010(10);reler�o Everett Municipal Code lor all other perm:t requirements. <br /> Submil covenant recorded in the real property records of Snonomish County,Washington,in satistaction of the <br /> requiremenis ol RCW 64.55.010 lhrough 64.55.090. The covenant identities Ihe sole owner of lhe propeAy <br /> described on Exhibit A (the "PropeAy). Until termination of lhe covenant, no dwelling unit in or on the Property <br /> may be sold as a condominium unil except for sales listed in RCW 64.34.400(2). <br /> ❑ CONVERSION to condominium (owner inspection alternative) <br /> ' No permit required per FCW 64.55.090 and RCW 64.34.400(2); reler to Evereit Municipal Code lor all other <br /> permit requirements. <br /> - _-- - - _ _ _ <br /> SignaWre of Owner or Authorized Agent � Printed n;ttne ot Owner or Authorized Agenl Phune k Da�e <br /> -- �---... ---- __-._.._ ._- - - - .. <br /> --- -- - -.. . . .. ._ . P _. .. <br /> Pnnted name of Business � Address City Zi Code <br /> FULL CUMPLIANCE with RCW 64.55.005 through 64.55.090 <br /> All building enclosure design documents to be stamped and signed by a Washington State Architect or <br /> Engineer, including modilications lo lhe documents that become addenda or change orders to alter those <br /> documenls, per RCW 64.55.010 (11). Building enclosure design documents are to contain a stamped <br /> statemenl by the architecl or engineer lhat "the undersigned has provided building enclosure documents lhal in <br /> my professional judgment are appropriate to satisty ihe requirements or RCW 64.55.005 lhrough 64.55.090", <br /> per RCW 64.55.020. <br /> Final inspection or CeAificate of Occupancy will not be issued without a signed letler from an independent <br /> inspector certilying that the building enclosure has been Inspected during Ihe course of construction and has <br /> been constructed in subslantial compliance with ihe building enclosure desiyn documenis,per RCW 64.55.060. <br /> � Updaled t0�03'07 — - - -- FOR OFFlCE USE ONLV <br /> f����� � <br /> \ _=" <br />