Laserfiche WebLink
I RCW 64.55 MULTI-FAMILY CERTIFICATICIN WORKSHEET <br /> I CITY OF EVERETT PERMIT SERVICES <br /> 9200 Cedar Streel, Everatt,WA 98201 <br /> 425-Z57-8870 -FAX 425�257�9857-�yWw everettwa ojp <br /> REHABILITATIVE CONSTRUCTION, NEW CONSTRUCTION, RECORDED COVcNANT OR CONVERSION <br /> CHECK /l ��-.;y�,,1 � (� .jJf�� I2I �(.� �� � <br /> ONE �k�IL�__��� - �jJ-lla�_L-L-'Z1=�LI�SL-.__'1-��L.L'-1-� yG !� <br /> eOX Property Name �ddress Building Num6er Permit Number <br /> � REHABILITATIVE CONSTRUCTION equal to or less than 5% or less of current assessed <br /> markei improvement value of specified building• <br /> 'NOTE Applicant ro provide enGre cost of rehabllitalive consVuction ro the building enclosure for a multiunit <br /> residential building or mir.ed use project per RCW 64 55.010,which may exceed the valuation for building permit. <br /> � <br /> (A)GNCLGSURE REHAB COST (BJ MULTIPLY(A)�Y 100 (C)ASSESSED BUILDING VALUE .IDJ DIVIDE�)by�C� ='Y. _ <br /> � �'�� � �0 �_ ' N- 4 Y <br /> ❑ NEW CONSTRUCTION OR REHABILITATIVE CONST;2UCTION �qual to more than 5% of <br /> current assessed market improvement value of specffled bullding' <br /> 'NOTE: Per RCW 64 55 010, RCW 64.55.020 and RCW 64.55.060 <br /> Each building enclosure design document is ro be slamped and signei by a Washington State architea. The <br /> documenls shouid also conlain a stamped signed statement by the sa ne architect Ihat"lhe undersigned has <br /> provided building enclosure documents that m my prolessional judgme nt are appropnate b satisfy the requirements <br /> or RCW 64.55.005 Ihraugh 64 55 090'. <br /> Final inspection or 'Certificate of Occupancy' cannot be issued by the building department prior ro receipt ot a <br /> signed lefter from an independent inspector certifying that the building enclosure has been mspected during lhe <br /> course of r,onstruction and has been constructed m substanlial compliance with the building enclosure design <br /> documents. <br /> ❑ RECORDED COVENANT OF SALE fron� Snohomish County" <br /> 'NOTF: Sale Prohibition Covenant per RCW 64 55 010 <br /> Submlt site plan wdh localion of bwldmg, permrt wdh description of work an� certified copy of rewrded covenant <br /> Irom lhe real property records of Snohomish County, Washington for specified bwlding. <br /> � ❑ CONVERSION to condomiMum` <br /> � 'NOTE permits may be required by the City of Everett per the resWts of the mdependent inspection report. <br /> Ur�dersigned wdl r,omply with owner independent mspection altornative per RCW 64.55 090 and RCW 64 34.400(2). <br /> ---- --- -- - --- - —_ _ — — — - -------- <br /> SJgnafure olOwner or Authori:ad Agent Prinfed nama olOwner orAufhorized Agent Phona k Dato <br /> i <br /> I <br /> I . . _ _ _ _ . . _ __._. ..____ _. _ ....__._-___ __.__. . __-__ _ _____ . __ ._' _.._.—_—� <br /> Prinled name ol�usiness Address City Zip Code <br /> chkint-new com and cnnao uev 4RJ/OB1 FOR OFFICE USE ONLY <br />