7209 7TH DR W 2019-09-17 - Laserfiche WebLink

TRC .R _-mo tions: property owner,renter or lessee may purchase a permit to do an el `cal installation on blether own or qualified leased property under the conditions as deserted in ROW 19. 8:261. nonprofit corpreation with currant tax exempt status or a;nonprofit flagitious organization may purohase an electrical permitas describedin FteW 192w:01(7). I am applying for the property owner exemption under the following conditioris: You must select the option that applies to your situation: 1 swear under penalty of perjury that in 1.am a registered general contractor who is installing a temporary electrical service by me ona project where I am the gener'al'. ▪ contractor OR I swear under penalr of perjury that tam: IZI The owner of mei proPertyl or rn The renter or lessee of mai property.(You must provide a signed letter from the owner of the property granting permission for you as the tenant to perform electrical work on the property);or an A noTiont corporation that holds a current tax earempt status as provided 26U.S.C.Sec.501(cX3)or a nonprofit religious • organization,andthe total value of the electrical' k does not exceed i r thousand ars($30,t'r_r. '3), AND You must select the option applient to your situation: 1 MUA single family residence THAT IS NOT intended for rent,sale,or lease AND t will be gy doiog the electrical AND I wilt o rpy the residence for at least 24 months alter completion of the electrical work; A NEW 2,3,or 4 unit residential property that IS intended for rent,sale,or lease AND myself a r tiled and paid Lai employee(s)will be doing the electrical work AND I will oceupy one of the units for at least 24 months atter completion_ of the electrical work: DAn EXISTING 1 2,3,or 4 unit residential property that t intended for rent,sale,or r AN and/or a regularly scheduled and paid employee(s)will be doing the electrical work A farm AND I,personally,arm a regularly scheduled-and.paid sloyee(s)will be doing the electriceil wrrrlc An EXISTING place of business AND I,personally,and/or a regularly scheduled and paid employee(s)will be doing the electrical work; in A NEW of business that is NOT intended for rent,sale,or lie AND I,personally,and/or a regularly scheduled and paid ental. s) Lai will be doing the electrical work;or Other property that is NOT intended for rent,sale,or lease AND 1,personally,and/or a regularly scheduled and paid errrployee(s0 will be doing the electrical work. tam a nonefore noteoration thatholes a current tax ecarrint status provided under 26 U.S.C.Sec 501(cX3)or a nonprofd religious rat organization and the total market value of the electrical work does not exceed thirty thousand , ; ),mid th electrical work will 1-1 be performed by-appropriately ramified electricians or certified andsupervised trainees who are volunteering and not being compensated for ' electrical work per ROW 1928.c*1(7). I AGREE and wish to purchase an electrical permit under the conditions described . AS04- tif"):cotio-Ce-- ottcri Name OW > a,t;. eatatatitat ie,"? 4tiff. • -r Stanek, Date 0 PET# , �, _ 1-01) Pogo 3of3