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RGW 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 /> REHABILITATIVE CONSTRUCTION, NEW CONSTRUCTION, RECORDED COVENANT OR CONVERSION <br /> .� " �,� �� <br /> CHECK . <br /> ONE �� � <br /> BOX roperty N me /�/ ddress /y;� � uilding Number Permit Number <br /> cM rs <br /> �d' REHABILITATIVE CONSTRUCTION equal to or less than 5% or less of current assessed <br /> l� market improvement value of specified building* <br /> "NOTE: Applicant to provide entire cost af 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 /> (AJ ENCLOSURE REHAB COST�(s1 MULTIPLY(A)BY 100 ' (C)ASSESSED BUILDING VALUE�(D)DIVIDE(B)by(C) _% <br /> � � I <br /> � <br /> `�� � ; , ; l l�� Z�� ! � `�- r� <br /> � NEW CONSTRUCTiON OR EFlABILITATIVE CONSTRUCTION equal to more than 5% of <br /> current assessed market improvement vatue of specified building* <br /> *NOTE: Per RCW 64.55.040, RCW 64.55.020 and RGW 64.55.060 <br /> Each building enc(osure 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 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 /> ❑ TOWNHOMES ON SINGLE PLATTED 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 /> Signature of Owner or Authorized Agent Printed name of Owner or Authorized Agent Phone# Date <br /> Printed name of Business Address City Zip Code <br /> 4 <br /> chklst-new com and condo(rev 10/15) FOR OFFTCE USE ONLY <br />