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<br /> Code Exemptions:
<br /> A property owner,renter or lessee may purchase a permit to do an electrical installation on his/herown or qualified leased property undethe
<br /> conditions as described in RCW 19.28.261
<br /> A nonprofit corporation with current tax exempt status or a nonprofit religious organization may purchase an electrical permit as described in RCW
<br /> 19.38.081(7).
<br /> am applying for the property owner exemption under the following conditions:
<br /> You must select the option that applies to your situation:
<br /> '
<br /> 1 swear under penalty of penury that:
<br /> ! I am a registered general contractor who is installing a temporary electrical service owned by me ors a project where I am the general
<br /> / contractor
<br /> OR
<br /> I swear undepenalty of perjury that I am:
<br /> 11] The owneof reaproperty;or
<br /> ) T���e ��v�n�p��y ������i�os�n�����/���r�t��������nn���xpm�mo
<br /> / / �num��n ��������� ��m
<br /> A nonprofit corporation that holds a current tax exempt status as provided under 26 U.S.C.Sec. 501(c)(3)or a nonprofit religious
<br /> organization,and the total value of the electrical work does not exceed thirty thousand dollars($30,000.00).
<br /> AND
<br /> You must select the option that applies to your situation:
<br /> Asingle family msidonn*THAT|SNOT intended for rent,sale,o,lease AND|will bepe�onaUvdoing the e|e�rioa|work AND|wiUoccupy
<br /> ^/ the residence for at least 24 months after completion of the electrical work;
<br /> | A NEW 2,3,or 4 unit residential property that IS intended for rent,sale,or lease AND myself and/or a regularly scheduled and paid
<br /> I— employee(s)will be doing the electrical work AND I will occupy one of the units for at least 24 months after completion of the electrical work.
<br /> An EXISTING 1,2,3,or 4 unit residential property that IS intended for rent,sale,or lease AND myself and/or a regularly scheduled and paid
<br /> — employee(s)will be doing the electrical work;
<br /> F—1 A farm AND I,personally,and/or a regularly scheduled and paid employee(s)will be doing the electrical work;
<br /> | { An EXISTING place of business AND Ipersonally, and/or a regularly scheduled and paid employee(s)will be doing the electrical work;
<br /> r-- A NEW place of business that is NOT intended for rent,sale,or lease AND Ipersonally,and/or a regularly scheduled and paid employee(s)
<br /> I will be doing the electrical work;or
<br /> | | Other property that is NOT intended for rent,saleor lease AND I,personally,and/or a regularly scheduled and paid employee(s0 will be
<br /> / / doing the electrical work.
<br /> I am a nonprofit corporation that holds a current tax ecempt status as provided under 26 U.S.C.Sec. 501(c)(3)or a nonprofit religious
<br /> F—| organization and the total market value of the electrical work does not exceed thirty thousand dollars($30,000.00),and thelectrical work will
<br /> | { heperformed b'appropriately certified electricians u,mertifiodand supervised trainees who are volunteering and not being compensated for
<br /> electrical work per RCW 19.28,091(7).
<br /> |./! I AGREE and wish to purchase an electrical permit under the conditions described above.
<br /> ,—...........i
<br /> � � / ��/����- � m�l��/
<br /> �~ / �}�� .`� �~ ~' '`,/ ~~ '�~y�
<br /> Owno Name(Print)
<br /> �y /.--5 Ar„,.., -.„, ~
<br /> _ ) \; _/�v 4 / 1
<br /> Owner Signature » uo'b
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<br />
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