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RCW 64.55 MULTI-FAMILY CERTIFICAT(ON WORKSHEET ; � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar Street, Evsrett,WA 88201 <br /> �25-257-8810–FAX 425267-:857–www everonwa.ora <br /> REHABILITATIVE CONSTRUCTION NEW CONSTRUCTION RECORDED COVENANT OR CONVERSION <br /> G3,s' <br /> CMECK �U�� <br /> ONE — <br /> eOx Property Neme Addroaa Buildfny Number PertMt Number <br /> . . :;' <br /> � .� <br /> REHABILITATIVE CONSTRUCTION equal to or less than 6% or less of current asseased. ' � f;'" <br /> market Improvement value of specified building" �r� <br /> •NOTE: Applicant to provide enUre cost of rehabilitaWe conatructlon to the building enclosure for a muttiunR <br /> residential building or mixed use proJect per RCW 64.5b.010,which may exceed the valuallon for building permit. <br /> 1A)ENCLOSURE REHAB COST �e)MULTIPLY�A)_BY 100�ASSESSED BUILDING VALUE f��DIVIDE.SB�bx�) __'/. , <br /> � 8ir'✓Ot� — — ; '�50 i GYlO � 2�3 ��Q' 'JJ.7v��e <br /> � ! EW CONSTRUCTION OR REHABILITATIVE CONSTRUCTION equal to more than 5°h of <br /> � , current assessed market improvement value of specified building" <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 end signed by a Wachington State architect. The <br /> docume�ts should also contafn a stamped signed statement by the same architect that'lhe undersigned has <br /> provided building enciosure documents that in my professional judgment are appropriate to satisfy the requirements <br /> or RCW 64.55.005 through 64.55.090". <br /> Final i�spection or 'Certificate of Occupancy cannot be issued by the building department prior to receipt of a <br /> signetl letter from a� independent inspector certiyfng thet the building encbsure has been inspected during 'M <br /> cou�se of construction and has been constructed in substantial compilance with the building encbsure 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 descriptlon of work and certified copy of recorded covenent <br /> from the real property records of Snohomish County,Washington for specifled building. <br /> O CONVERSION to condominium" <br /> •NOTE: pertnits may be requfred by the City of Everett per the results of the independent inspecHon report. <br /> Undersfgned will comply with owner independent inspectlon altemative per RCW 64.55.090 and RCW 64.34.400(2). <br /> Signature of Owner or Aulhorized Agent Printed neme of Owner or Authorized Agenl Phone N Dats <br /> ----- — - ----- --------- - - <br /> Printed oame of Business Address City Zip Code <br /> 4 <br /> chklst-new com and condo(rov 4/23108) FOR OFFlCE USE ONLY <br />