Fillable Applicant Declaration for Assessment and Collection of Impact (City of Sammamish)

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Applicant Declaration for Assessment and Collection of Impact (City of Sammamish)

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Applicant Declaration for Assessment and Collection of Impact Fees
Page 1 of 2
Updated 11/2/2017
Applicant Declaration for Assessment and Collection of Impact Fees
Name (printed): Company (if applicable):
Preliminary Plat Name: Number of Lots:
Pursuant to Sammamish Municipal Code (SMC) 14A.15.020(6) and 14A.25.030(2), final plat and building permit
applicants must declare, at the time of such application, their desired option for the payment of impact fees. The Code
provides three options for the assessment and payment of impact fees: payment at final plat or building permit
application (Option 1), payment at building permit issuance (Option 2), or at final inspection or closing of first sale after
issuance of applicable building permit (Option 3).
Please note that if a project has a condition of approval that includes a specific schedule for payment of impact fees,
that schedule must be followed. Option 2, 3 and 4 are not applicable for such projects.
For all impact fees, select option for payment:
Option 1 – Follow schedule for payment of impact fees on preliminary approval
Option 2 – Application (impact fees assessed and collected at time of final plat or building permit application)
Option 3 – Issuance (impact fees assessed and collected at time of building permit issuance)
Option 4 – Deferral (impact fees assessed and collected at time of building permit issuance)
Write the number of lots for which the payment of impact fees be deferred (maximum of 20): ______
Description of deferred lots (phase & lot numbers, or attach list of parcel numbers):
Platted Development
Option 1 – Follow Conditions of Approval
Per conditions of preliminary approval; for subdivision applicants,
please provide the Hearing Examiner’s decision with this document.
For short subdivision applicants, please provide a copy of the
preliminary approval.
Option 2 – Application
Impact fees assessed and collected at final plat application
Option 3 – Issuance
Impact fees assessed and collected at building permit issuance
If not deferring payment of any or all impact fees (Option 1, 2 or 3)
I understand that by not deferring payment of impact fees, I am responsible for paying 100% of traffic, school, and parks
impact fees per the conditions of preliminary approval, per conditions of preliminary approval, at final plat application, or
at building permit issuance, as indicated above.
Signature Date
_______________________________________ _______________________________________
801 228
th
Avenue SE, Sammamish, Washington 98075-9509
Phone: 425-295-0500 ● Fax: 425-295-0600 ● www.sammamish.us
Applicant Declaration for Assessment and Collection of Impact Fees
Page 2 of 2
Updated 11/2/2017
Platted Development
Option 4 – Deferral*
*Limited to 20 lots per applicant per year
Impact fees assessed at time of request and collected at final inspection or
closing of the first sale of the property occurring after the issuance of the
applicable building permit, whichever comes first.
A request for deferral of impact fees shall be made at the time of final plat
application.
Under Chapter 14A.25 SMC, applicants for single-family attached or single-family detached residential building permits
within short or regular subdivisions may request to defer payment of required impact fees until the sooner of (a) final
inspection; or (b) the closing of the first sale of the property occurring after the issuance of the applicable building
permit.
Any request for impact fee deferral must be accompanied by an administrative fee in an amount equal to one hour at
the City’s hourly rate for planning as stated in the City’s current fee schedule. The amount of impact fees to be deferred
shall be assessed as of the date the request for deferral is submitted.
An applicant requesting a deferral must grant and record a deferred impact fee lien, in an amount equal to the deferred
impact fees as determined under SMC 14A.25.030(3), against the property in favor of the City in accordance with the
requirements of RCW 82.02.050(3)(c). Upon receipt of final payment of all deferred impact fees for the property, the
City shall execute a release of deferred impact fee lien for the property. At the time of the release, the property owner is
responsible, at his or her own expense, for recording the lien release. The term of an impact fee deferral may not exceed
18 months from the date the building permit is issued.
If deferring payment of impact fees (Option 4)
I understand that by deferring payment of impact fees for up to 20 lots, I am responsible for paying 100% of traffic, school,
and parks impact fees for the deferred lots either at the time of final inspection or the closing of first sale of the property,
whichever occurs first.
Signature Date
_______________________________________ _______________________________________
STAFF USE ONLY
Related Permit Numbers:
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Applicant Declaration for Assessment and Collection of Impact (City of Sammamish)

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Completed 24 January 2021

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