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1 <br /> RCW 64.55 MULTI-FAMILY CERTtFICA'� ION WORKSHEET <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> 425�257�88 t 0-FAX 425-257-8857-m+'w.everetiwa� <br /> VALUATION MAXIMUM, RECORDED SALE PROHIBITION, CONVERSION, OR FULL COMPLIANCE <br /> '�+'IL I 30 . s1 n.a � � o o�,� <br /> CHEf,K �� .�� �� <br /> oNE �r,dornin�oms -- --EVn�t+_,_WA__q82o�- - - - -- - ---- --- - <br /> BOX Property Name Address Building Number Permit Number <br /> ❑ vALUA71oN of 5%or less of current assessed value (per building permft appifcation) <br /> • per RCW 64.55.020 (1);reler to Everelt Municipal Code lor all other permit requirements. <br /> Calculate percentage of valua�ion divided by current assessed value(structure only). <br /> MULTIPLY CONTRACT PRICE OF WORK BV 100 DIVIDE BY ASSESS[D VALUE RESULTING PERCENTAGE <br /> ❑ FiECORDED Snohomish County Sale Prohibition Covenenant for minimum 5 years <br /> ' Per RCW 64.55.010 ;10);reler to Everett Municipal Code for all other permil�equirements. <br /> Submii covenant 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 identifies the sole owner ol ihe property <br /> described on Exhibit A (ihe "Property). Unlil termination of the covenanl, no dwelling unit in or on the PropeAy <br /> may be sold as a condominium unit except lor sales listed in RCW 64.34.400(2�. <br /> ❑ CONVERSION to condominlum (owner fnspectfon alternative) <br /> ' No permit required per RCW 64.55.090 and RCW 6a.34.400(2); reler to Everett Municipal Code lor aIi other <br /> permit requiremems. <br /> --- -- _.._... _ <br /> _ . _ -- -- _ _ <br /> __ _ <br /> Signature ut Owner or Authorized Agenl Prinled name ol ONmer or Au�horized Agent Phone k ete <br /> � ---------- -_.. ._._----�- ---�--�-- -- <br /> ----� -------' --�---� <br /> ,_ _._ ._ ._. . . ._.... <br /> Printed namc ol8usiness Address Ciry Zip Code <br /> FULL COMPLIANCE with RCW 64.55.005 through 64.55.090 <br /> All buildmg enclosure design documenis to be stamped and signeo by a Washington State Architect or <br /> Engineer, including modilications to the documents lhat become addenda or change orders lo aller those <br /> documentc, per RCW 64.55.010 (11). Building enclosure design documents are to contain a stamped <br /> stalemenl by the architect or engineer that "the undersignad has provided building enclosure documents thal in <br /> my prolessional judgment are appropriale lo satisly Ihe requirements or RCW 64.55.005 through 64.55.090", <br /> per RCW 64.55 020. <br /> Final inspeclion or Certilicate ot Occupancy will not be issued without a eigned lettei Irom an independent <br /> inspector certitying Ihat lhe building enclosure has been inspected during the course of construction and has <br /> been constructed in substantial compliance wilh the building enclosure design documents,per RCW 64.55.060. <br /> Up6ated 10%03 07 <br /> FOR OFFICE USE ONLY <br /> .. .._____——_._.--. �/-� <br />