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6 � <br /> - - -� - - <br /> RCW 64.55 MULTI-FAMILY CERTIFICATION WORKSHEET <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar Street, Everett, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.orq <br /> REHABILITATt�dE CC�NSTRUCT[ON, NEW CC3NSTRUCTICDhI, RECt�RDED COVENANT tJR CQNVERSCOfV <br /> CHECK <br /> o�E Riverfront - Eclipse 3315 30th Dr., Everett, WA, 98201 _ 20 �'//�J�c�/Yj <br /> eOX Property Name Address Building Number Permit Number <br /> ❑ REHABILITAT[VE CONSTRUCTION equal to or less than 5% or less of current assessed <br /> market improvement vaEue of specified building* <br /> *NOTE: Applicant to provide entire cost of rehabilitative construction to the building enclosure for a multiunit <br /> residential building or mixed use project per RCW 64.55.010, which may exceed the valuation for building permit. <br /> (A)ENCLOSURE REHAB COST (B)MULTIPLY(A)BY 100 (C)ASSESSED BUILDING VALUE (D)DIVIDE(B) by(C) _ % <br /> ❑ NEVIt CCINSTRUCTI(}N Ot� REHA�ILITATf�/E C�NSTRUCTION equal to more than 5°lo af <br /> c�rrera� assessed m�rket ir��r�vement v�S�e o�specsfied b�aelding* <br /> *NOTE: Per RCW 64.55.010, RCW 64.55.020 and RCW 64.55.060 <br /> Each building enclosure design document is to be stamped and signed by a Washington State architect. The <br /> documents should also contain a stamped signed statement by the same architect that"the undersigned has <br /> provided building enclosure documents that in my professional judgment are appropriate to satisfy the requirements <br /> or RCW 64.55.005 through 64.55.090". <br /> Final inspection or `Certificate of Occupancy' cannot be issued by the building department prior to receipt of a <br /> signed letter from an independent inspector certifying that the building enclosure has been inspected during the <br /> course of construction and has been constructed in substantial compliance with the building enclosure design <br /> documents. <br /> C� RECC3RDED COVENANT OF SALE from Snohomish County* <br /> �NOTE: Sale Prohibition Covenant per RCW 64.55.010 <br /> Submit site plan with location of building, permit with description of work and certified copy of recorded covenant <br /> from the real property records of Snohomish County, Washington for specified building. <br /> ❑ T{�WNHC3MES {�N SfNGLE PLATTE� LOTS* <br /> �NOTE: This exemption allows the applicant to submit for building permit while concurrently seeking to obtain unit lot <br /> subdivision for each townhome. This exemption is an alternate to providing building enclosure design documents for <br /> the townhome building. Certificate of Occupancy will not be issued until RCW 64.55 is met. The applicant accepts <br /> the risk involved to apply for a single platted lot exemption to RCW 64.55 for each unit of this townhome building. <br /> Q.�C1-�L �_ �a.rt,i� Alan D Pani (425) 586-7700 02/26/16 <br /> Signature of Owner or Authorized Agent Printed name of Owner or Authorized Agent Phone# Date <br /> Polygon WLH, LLC 11624 SE 5th St., Ste 100 Bellevue 98005 <br /> Printed name of Business Address City Zip Code <br /> 4 <br /> chklst-new conl ai�d condo(rev ]0/15) POR OFFICE USE ONLY <br />