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RCW 64.55 MULTI-FAMILY CERTIFICA710N WORKSHEET <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857-Nv+w everettwa.ora <br /> VALUATION MAXIMUM, R�CORDED SALE PROHIBITION, CONVERSION, OR FULL COMPLIANCE <br /> �Y11pA S¢�. �+'IG. 1 3� . S'i M.c� /1�� �t� �.�9, <br /> CHECK E V17J1�'�' �I �d ��_ .___ '_'+.�.�".'.__. <br /> ONE �nd.orn��n�oms___—_----_----.�P`--BZ-=r-- BuildingNumber Perm:tNumber <br /> BOY PropeAy Name Address <br /> C7 VALUAT1oN of 5% or less of current assessed value (per building permit application) <br /> ' Per RCW 64.55.020(1);refer to Everett PAunicipal Code tor all other permit requirements. <br /> Calculate percentage ol valuation divided by current assessed value (structure only). <br /> MULTIPLY CONTRACT PRICE OF WORK BY �00 DIVIDE BY ASSESSED VALUE fiESULTING PERCENTAGE <br /> ❑ RECORDED Snohomish County Sale Prohibition Covenenant tor minimum 5 years <br /> ' Per RCW 64.55.010 (10);refer Io Everett Municipal Code for aIl other permit requirements. <br /> Submit covenanl recorded in Ihe real property recnrds ot Snohomish County,Washington, in satisfaction of ihe <br /> requirements ol RCW 64.55.0;0 lhrough 64.55.090. The covenant identilies the sole owner o1 the propehy <br /> described on Exhibit A (the "Property). Until lermination ol the covenant, no dwelling ucit in or on lhe PropeAy <br /> may be sold as a condominium unit except for sales Iisted in RCW 64.34.400(2). <br /> ❑ CONVERSION to condominium (owner inspection alternative) <br /> ' No permit required per RCW 64.55.090 and RCN! 64.34.400(2);reler to Everett Municipal Code lor all other <br /> permit requirements. <br /> SignaNre ol Owner or Authorized Agent Printed na�.�e ol Owner or Authorized Agent Phone!f Data <br /> . ._. __ _ .. - - - -_. <br /> � - -.�__. - �- --.. . . _. <br /> -- - — --- --- --_. .----_-._ _ <br /> --_ .__ __ _ _ Cit Zip Code <br /> Printed name ol Business Address 1' <br /> FUi_L COMPLIANCE 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 to the documenls that become addenda or change orders lo aller Ihose <br /> documen�s, per RCW 64.55.010 (11). Building enclosure design documents are lo contain a stamped <br /> stalement by Ihe architect or engineer that "the undersigned has pro�ided building enclosure documenis that in <br /> my prolessional judgment are appropiiate lo satisty lhe requirements or RCW 64.55.005 ihrough 64.55.090", <br /> per RCW 64.55.020. <br /> Final inspectwn or Certificale ol Occupancy will not be issued without a signed letter irom an fndependent <br /> inspedor certilying that the building enclosure has been Inspected during Ihe cour,e ol consiruction and has <br /> been constructed in substantial compliance with the building enclosure design documenis,per RCW 64.55.060. <br /> Updated 10�07-07 <br /> FOR OFFICE USc ONLV <br /> -. __._ ._--._-- 1 / � <br /> J <br />