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RCW 64.55 MULTI-FAMILY CERTIFICATION WORKSHEET <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar Street. EveretL W4 98201 <br /> 425-257-Afl10-FAX 42fi�257�A857-wvpy.ever9lAVa.ofa <br /> R�HABILITATIVE CONSTRUCTION, NEW CONSTRUCTION, RECORDED COVENANT OR CONVERSION <br /> CHECH �J y rp.}. �7 , �\ ��� <br /> ONE /:(('�71�.i(�L(E' �7 i , _ �o�V� �W-�lA�1'(1(J.�I . _- -�-------- ----�- - -�--�C�� VL — <br /> BOX Propnrty Namt*� Address Building Number Permit Number <br /> � REHABILITATIVE CONSTRUCTION equal to or loss than 5% or �ess of current assessed <br /> market improvement value of speciffed buildir.g' <br /> 'NOTE Applicant to provide entire cost of rehabilitative conslruction to the building enclosure for a mulliunit <br /> residential buildmg or mixed use project per RCW 64b5 010, which may exceed the valualion for building permit <br /> (A)CNCLOSUR[REI1ACi COST �BJ MULTIPLY(A) [{Y 100,(CJ ASSESSFO �UILDING VALUE .(0)UIVIDE (B)by(C) _ ,o <br /> �Gr �i U '1 b C�C> UJ 5 J Z `� `}' `�, q-10 <br /> ❑ NEW CONSTRUCTION OR REHABILITATIVE CONSTRUCTION equal to more than 5% of <br /> current assessed market improvement value of specified building' <br /> 'NO7�[ Pcr RCW fiA 55 010. RGW 64 fi5 020 and RCW 64 55 060 <br /> [ach biulding enr.losure design document is to be stamped and signed by a Washington Stale architect The <br /> documents should also contain a stamped signed s�atement by Ihe same architect tha� the undersigned has <br /> provided building r.nclosure documenis thal in my prolessional jud�ment are appropriate to satis(y the requiremenis <br /> or RCW f,4 .5Ci OOCi throuqh G4 55 090" <br /> � 1-mal mspectirni or Ceridicate of Occupancy' cannut be issued by the building department pnor to receipt of a <br /> siyned letter from an independent inspector certAymg Ihat the building enclosure has been inspected dunng the <br /> cuurse ol conshur,hon anrl has been construded m substanlial compliance with the bwldmg enclosure design <br /> dor,umenls <br /> ❑ RECORDED COVENANT OF SALE from Snohomish County' <br /> 'NnT f Sale Prohibihrin Covenant per RCW 64 5fi 010 <br /> Submd sde plan with localion of buddmg. pennit wilh descriphon o(work and cerhfiad copy of recorded covenant <br /> from the real property �ecords of Snohonush Counly Washinglon (or speci(ied building <br /> ❑ CONVERSION to condominium` <br /> 'NOT[ permds inay be reqwred hy ihe Cdy of Everett per ihe results of the independent inspection report <br /> Undersigned will compry wi0i owner mdependent inspeclion altemahve per RCW 64 55A90 and RCW 64.34A0012) <br /> _ _ __ _ _ ._ .. .- -- - - _ --- <br /> Signofure o/Ownor or Authorfred Agenf � Piinfed name o/Owner or Aurhorfaed Agent Phono p Date <br /> I . .. . . . -- - . _ . _ . .. . _ . .. ----� ---- - --- <br /> {�nnlod nnnir ol Pusuiess AdAress Cdy Zip Code <br /> chklsbnew com nnd condo Irev 4�23/OBI FOR OFFICE USE ONLY <br />