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� � <br /> - - - - - - � <br /> RCW 64.55 MULTI-FAMILY CERTIFICATION WORKSHEET <br /> ' TT CITY OF EVERETT PERMIT SERVICES <br /> 3z0o ceear SPeet, Lvrc! 6vn 98zOt � <br /> a25-?S?.P,A'0- FAX�95 257-CGS' -. �•n_wevrc•^._a� �Z � 3 - <br /> � � �i - v �l <br /> REHABILITATIVE CONSTRUCTION, NEW CONSTRUCTION, RECORDED COVENANT OR CONVERSION <br /> CHECN � \ <br /> � oNE '/���n9c 6 y_�c_��ce _�2�� ��.�d�1--�--µ-----gi 4�l -Dif--- <br /> �' B01c P'ope7y Name ACd�ess f3,i!r, �g N�..�nber Pr�mq IJumbe� <br /> fJ REHABILITATIVE CONSTRUCTION equal to or less than 5% or less of current assessed , <br /> market improvement value of specified building' �' <br /> 'NOTF. App'��ca�t to prov,de er!ve cast of rehabii��tat�ve construc!wn to the bu�'d:ng enc'os�.:re tor a mult�un�l ', <br /> � residental bu�ld�ng or m�.xed use pro;ect per RCW 64 55 010. wh�ch may exceed the valua'ion for budd���ng permd '� <br /> (A�LtiCLOSUP[RLHA�COST�(B)�AUI TIPLV(AI f1V 1W i(CJASSESSEDBUILDING VAWFI(OJ DIVIDF �BI by l�� -��� II <br /> , I <br /> �r� NEW CONSTRUCTION OR REHABILITATIVE CONSTRUCTION equal to more than 5% of <br /> curre�t assessed market improvement value of speci(ied building' <br /> 'NOTE Per RCW 64 55 010, RCW 6A S5 070 and RCW G4 55 060 <br /> Fach bwl7 ny e��closure design document s to be stamped and signed by a Washmg�on S�a'e archdect The <br /> docwrents s���o�td also contaic a s!a^�ped s�gnetl statement by the same architect that �Ihe undersigned has <br /> prowdetl budCing enclosure Aocuments that in my prolessional;udg^��.ent are app�opr,ate to sa6sfy lhe requirements , <br /> I or RCW 64 Sfi 005 through 64.55 090 � <br /> i Final mspechon or 'Certiflcate of Occupancy' car.not be issued by U�e bmld�ng tlepartment pnor to receipt ol a �� <br /> sgned letter from an mtlependenl mspector cerhlying that Ihe bu�ldmg enclosure has 6een mspected during the <br /> � course ol consVuction and has been constructed m substanbal comphance wdh the bwlding enclosure design , <br /> � dawments �'� <br /> I �—� �— -- -- - --- - - --- -- '. <br /> I ❑ RECORDF..D COVENANT OF SALE irom Snohomish County' <br /> I 'NOTF Salc ProlnL�l�on Covenarl pPr HCVV fiA 55 010 ''. <br /> �� Suhm I sdr ni�'��wlh �ocat nn of I�.ud;f�ng, {•.e�rm�t wdh Aescnption ol wo�k and ceihfed mpy o(recorded covenan� �i <br /> from R�.e ien' proPcrty records o1 ;;nohonush County. Wash�ngton for spenhed bwld.ng ' <br /> 1 <br /> -- — --� <br /> ' I ! CONVERSION to condominium' <br /> 'NOT[ pei n�.(s n•�ay be reqwred by Itic G(y ol Everetl per D�e resu�ts of Ihe independent uispccf�on rcport <br /> � Undersignrd will comply wdh owner independent inspeclion allemat�ve per RCW 64 55 090 anA RCW G4 34 400�2) <br /> �. Signat�re nf Owner or Adlhonzed Agent Pnn�ed name ol Owncr or A�tho�i�ed Agrnt Phore M `� Date I� <br /> I <br /> Pnmed name ol Bus�ness � Address Cdy Lp Code '. <br /> Z �/3� ch4.ls1•ne�� comandconJofrn7/UI ' . PI)RqhFICI: I�Sf.OKI.Y <br /> � <br />