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----- � _ ��� __�q v�:� � <br /> RCW 64.55 MULTI-FAMILY CERTIFICATION WORKSHEET <br /> F CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar Street, Everett, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.orq <br /> REHABILITATIVE CONSTRUCTtt?(V, NEW Cf)NSTFtUCTlQN, REG(7RQED COVENANT OR CONVERSIUN <br /> CHECK <br /> or�E Riverfront - Eclipse 3511 31 st Dr., Everett, WA, 98201 19 <br /> BOX Property Name Address Building Number Permit Number <br /> ❑ REHABILITATIVE CONSTRUCTI()N equal ta �r {ess than 5% c�r less of current assessed <br /> rnarket improvement value af 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 /> ❑ NE1�! GQNSTRUCTft�� UR REHABI�lTAT[VE CQNSTRUG7IC?� equal to �rao�e than 5°f� of <br /> �urr�nt a�sessed m�r�Cet im�rov�r�en� val�e e�f specified t�c�a6cfing* <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 /> � RECORDED CC)VENANT 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 /> ❑ TawNHa�Es ar� s����.E P�aTTEo 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.Q.G� �- !'U-n-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 com and condo(rev 10/15) FOR OFFICE USE ONLY <br />