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i _I <br /> i � --- �3�a� 3 - o��r <br /> I RCW 64.55 MULTI-FAMILY CERTIFICATION WORKSHEET <br /> I � CITY OF EVE!iETT PERMIT SERVICES <br /> � 3200 Cedar Slreet, Everett.W�98201 <br /> ' 425�257�8810-FAX 425�257-8857-�+n+nv.evr.retlwa.o�n <br /> VALUATION 67AXIMUM, RECORDED SAI E PROHIBITION, CUNVERSION, OR FULL COMPLIANCE <br /> CMECK <br /> o��E C?� ►1 s ,��� � _ 7�� c�, � h � R�. #�- 1 <br /> eoX Pioper�y Name Addresr Building Number Permil Number <br /> ❑ VALUATION of 5% or less of current assessed value (per building permit application) <br /> Comply with RCW 64.55.0�0 (1�. Reler to Everett Municipal Code for additional permit requirements. Submit sita <br /> i plan with location of building and pnrmit with description of work. Calculate percent valuation divided by current <br /> Iassessed structure value. <br /> A1ULTIPLY CONTRACT PRICE OF WORK BY 100 DIVIDE BY ASSESSED VALUE FESULTING PERCENTAGE <br /> r� , �'i��= �_, <br /> ? 7 •n n :: � <br /> � J � <br /> I ❑ RECORDED Snohomish County Sale Prohibitfon Covenant, minimum 5 years <br /> I Cumply with F;CW 64.55.010(10�. Hefer to Everett Munici��! Code lor additional permit requirements. Submit site <br /> plan with location ol buildiny and permit with description ol�vork. Submit covenant reco�ded in the real property <br /> I records of Snohomish County,W ashington, in satisfaction o�the requirements of RCW 64.55.010 ihrough <br /> 64.55.09Q The covenant idenlilies Ihe sole owner of Ihe property described on Exhibit A Qhe"Properry�. Until <br /> ; tarmination of Ihe covenant, no dwelling unit in or on ihe Property may be sold as a condominium unit except lor <br /> salos hsted in RCW 64.34.40D(2) <br /> ❑ CONVEHSION ta condominium (owner inspectfon alternative) <br /> No .rmil requiredjl mplyint� with RCW 64 55 090 and RCW 64.34A00�21. Reler to Evered Municipal Code tor <br /> ad onal per requirei i�nis. <br /> ���� �� � n� ► e �1c-�l, n � yZSl7s-�' Z� � `f�� '=h <br /> b � <br /> Signalure ol Owner or Authorized Ac��nt Pnntcd name ol Owner or Au�horized Agent Phone# Date <br /> j 1,.�/ � � <br /> `� - /J � ._ „ .� S �� � -�"r v.�• ,z _' ,'S ..� /c' (I✓r 5��, �;-r�l-... ,,.. . ti �j c� ,� <br /> Pnnted name ol E3usiness Address Gty Zip Cede <br /> I, ❑ FULL COMPLIANCE with RCW 64.55.005 through 64.55.090 <br /> I All building eoclusure design documents to be stamped and signed by a Washington State Architect or Engineer <br /> i lor compliance with all applicable codes, inciuding modifications ro the documents that become addenda or <br /> � chan�e orders to alter those documeids, per RCW 64.55.010 (11). Building enclosure desie�n documents are to <br /> contain a stamped statemenl by the architect or engineer Ihat'1he undersigned has provided building enclosure <br /> documenis Ihat in my protessional�udgment are appropriate to satisty the requirements or RCW 34.55.005 <br /> Ihruugh 64 55A90", per RCW 64.55.020. <br /> Fiiial inspeclion oi Cehificate of Occupancy will nol be issued without a signed letler irom an independent <br /> mspector certitying that the building enclosure has been inspected durinc�the course of construction and has been <br /> r.o�structed in ;ubstan�ial compliance wiUi the building enclosure design documents,per RCW 64.55.060. <br /> ; a <br /> I chklsbcom ��r�: i n7 aw FON OFFICE USE ONLY <br />