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RCW 64.55 BUILDING ENVELOPE SUBMITTAL WORKSHEET <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar Street,Everett,WA 98201 <br /> 425-257-8810 email.Dveretteps@everettwa.gov website:www.everettwa.gov/perpitt <br /> REHABILITATIVE CONSTRUCTION, NEW CONSTRUCTION,RECORDED COVENANT OR CONVERSION <br /> ONE CHECK <br /> psse,..„4„..-„,_pivt-te g--71 f7 � Ave , t4v4'r�' �' 4,0 r7 <br /> BOX Name Address BuildingNumber Pe it Number <br /> e REHABILITATIVE CONSTRUCTION equal to or less than 5% or less of current assessed <br /> market improvement value 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:(!3 MULTIPLY(A)BY 100 (C, ASSESSED BUILDING VALUE DIVIDE(B)b '< <br /> $ 91 Q <br /> 0 NEW CONSTRUCTION OR REHABILITATIVE CONSTRUCTION equal to more than 5%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 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(Sale Prohibition Covenant)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 /> ❑ TOWNHOUSES ON SINGLE PLATTED LOTS (Unit Lot Subdivision) <br /> Can submit for building permit while concurrently seeking to obtain unit lot subdivision for each townhome. This <br /> exemption is an alternate to-providing building enclosure design documents for the townhome building,if the unit lot <br /> subdivision is not approved.:Certificate of Occupancy will not be issued without approved subdivision. The <br /> applicant accepts the risk involved to obtain a single platted lot exemption to RCW 64.55 for each unit of building. <br /> Sig . re of Owne • Authorized Agent Printed name of Owner or Authorized Agent Phone# Date <br /> E 8 -tsrtrt,s4-Vrte C..-L-G. • a.12. .:i t pd <br /> Printed name of Business AddressCity Zip Code <br /> SIGNATURE REQUIRED FD$FACH BUILDING PEEWIT APPLICATION <br />