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APPLICATION AND CERTIFICATION OF SPECIAL VALUATION ON IMPROVEMENTS TO HISTORIC PROPERTY File With Assessor by October File No.: I. Application County: Property Owner: Parcel No./Account No.: Address Legal Description: Property Address Describe Property is on: (check appropriate box) National Historic Register Local Register of Historic Places Building Permit Date: Jurisdiction: County/City Rehabilitation Started: Date Actual Cost of $ Affirmation As owner(s) of the improvements described in this application, I/we hereby indicate by my signature that I/we am aware of the potential liability (see reverse) involved when my/our improvements cease to be eligible for special valuation under provisions of Chapter 84.26 RCW. I/We hereby certify that the foregoing information is true and complete. Signature(s) of All Owner(s): II. Assessor The undersigned does hereby certify that the ownership, legal description and the assessed value prior to rehabilitation reflected below has been verified from the records of this office as being correct. Assessed Value Exclusive of Land Prior to $ Date: Assessor/Deputy REV 64 0035-1 (6-03-97) ---PAGE BREAK--- Historic property means land together with improvements thereon, which is: Listed in a local register of historic places created by comprehensive ordinance, certified by the Secretary of the Interior as provided in P.L. 98-515; or Listed in the national register of historic places. Cost means the actual cost of rehabilitation, which cost shall be at least twenty-five percent of the assessed valuation of the historic property (exclusive of the assessed value attributable to the land) prior to rehabilitation. Special valuation means the determination of the assessed value of the historic property, subtracting for up to ten years such cost as is approved by the local review board. State Review Board means the advisory council on historic preservation established under Chapter 27.34 RCW or any successor agency designated by the state to act as the state preservation review board under federal law. Local Review Board means a local body designated by the legislative authority of the incorporated or unincorporated area. Owner means the owner of record. Historic property does not include property listed in a register primarily for objects buried below ground. Property must meet the following criteria for special valuation on historic property: Be a historic property; Fall within a class of historic property determined eligible for special valuation by the local legislative authority; Be rehabilitated at a cost which meets the definition set forth in RCW 84.26.020(2) within twenty-four months prior to the application for special valuation; and Be protected by an agreement between the owner and the local review board. Statement Of Additional Tax, Interest, And Penalty Due Upon Removal Or Disqualification From Special Valuation Under Chapter 84.26 RCW 1. Whenever property that is classified and valued as eligible historic property under Chapter 84.26 RCW is removed or disqualifies for the valuation, there shall become due and payable an additional tax equal to: The actual cost of rehabilitation multiplied by the levy rate in each year the property was subject to special valuation; plus Interest on the amounts of the additional tax at the statutory rate charged on delinquent property taxes from the dates on which the additional tax could have been paid without penalty if the property had not been valued as historic property; plus A penalty equal to twelve percent of the amount determined in and 2. The additional tax, interest, and penalty shall not be imposed if the disqualifications resulted solely from: Sale or transfer of the property to an ownership making it exempt from taxation; Alteration or destruction through no fault of the owner; or A taking through the exercise of power of eminent domain. Appeals 1. Any decision by a local review board on an application for classification as historical property may be appealed to Superior Court under RCW 34.05.570 in addition to any other remedy at law. 2. Any decision on disqualification of historic property for special valuation exemption or any other dispute may be appealed to the current year Board of Equalization by July 1st or 30 days after the disqualification, whichever is the later, except the denial on the original application. To inquire about the availability of this document in an alternate format for the visually impaired or a language other than English, please call (360) 753-3217. Teletype (TTY) users may call (800) 451-7985. You may also access tax information on our Internet home page at http://dor.wa.gov. REV 64 0035-2 (6-03-97)