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"PP 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:everetteps@everettwa.gov website:www.everettwa.gov/permit <br /> REHABILITATIVE CONSTRUCTION, NEW CONSTRUCTION, RECORDED COVENANT OR CONVERSION <br /> CHECK <br /> ONE <br /> BOX Property Name Address Building Number Permit Number <br /> El 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 (B)MULTIPLY <br /> (A)BY 100 (C)ASSESSED BUILDING VALUE (D)DIVIDE(B)by(C) _% <br /> 4/1, A00 1I (20000 '/02,5o0 1/ 5'. <br /> ❑ 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 /> aCVLOK <br /> 146ro5-5C2 .253- 4/2C--G2.9e7 __. 9/z /a,,g <br /> Signature of Owner or Authorized Agent Printed name of Owner or Authorized Agent Phone# Date <br /> 2r: L-"ti&T r, zes )0 6'05 5 .V0g. 4,30 ePif 98Q31 <br /> Printed name of Business Address City Zip Code <br /> SIGNATURE REQUIRED FOR EACH BUILDING PERMIT APPLICATION <br />