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OCT-18-2019 11: 11 FROM:MATT NNOOD 2067891834 03:4253492298 P.4
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<br /> �v � - ` ELECTRICAL PE MIT AFFIDAVI ` �,,r
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<br /> Code Exemptions;
<br /> A property owner,renter or lessee may purchase a permit to do en electrical Installation on his.lher own or qualified leased property under the
<br /> conditions ea described in RCW 1$-28.261.
<br /> A nonprofit corporation with current tax exompt status or a ronprofit religious organization may purchase an electrical permit as described in RCW
<br /> 19.26,091(7). --
<br /> I am applying for the property owner exemption under the following conditions:
<br /> You must select the option that applies to your situation: -
<br /> I swear under penalty or perjury that:
<br /> I am a registered general contractor who is Metalling a temporary electrical service owned by me on a project where I am the general
<br /> L._..
<br /> Contractor
<br /> OR
<br /> IIsswear under penalty of perjury the'.tam;
<br /> ;:ct The owner of real property;or
<br /> ���' The renter or lessee of reel property.(You must provide a signed letter from the owner of the property granting permission for you as the
<br /> tenant to perform electrical work on the property);or
<br /> A nonprofit corporation that holds a current tax exempt status as provided under 26 U.S,C.Sec,601(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 /> A single family residence THAT IS NOT intended for lent,sale,or lease AND I will be personally doing the electrical work AND I will occupy
<br /> 73 the residence for at leant 24 months after completion of the electrical work:
<br /> r"'j A NEW 2,3,or 4 unit residential property that IS Intended for rent,sale,or lease AND myself endlor a regularly scheduled and pale
<br /> 1--1 employee(a)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 /> nAn EXISTiNG 1,2,3,or 4 unit residential property that IS intended for rant,eels,or lease AND myaeff and/or a regularlyscheduied and paid
<br /> empieyee(s)will De doing the electrical work;
<br /> A farm AND I,poreonally,endlor a regularly scheduled and paid employee(s)will be doing the electrical work;
<br /> 0 An EXISTING place of business AND I,personally,and/ora regularly scheduled and paid employees)will be doing the electrical work;
<br /> r n A NEW place of business that la NOT Intended for rent,sale,orlease AND I,pensonany,and/or a regulerly scheduled end paid employee(s)
<br /> t...J will be doing the electrical work;or
<br /> ri Other property that Is NOT intended for rent,sale,or lease AND I,personally,and/or a regularly scheduled and paid employee(a0 will be
<br /> I 1 doing the electrical work.
<br /> I em a nonprofit corporation that holds a current tax ecempt status es provided under 26 U.S.C,Soc,.501(c)(3)or a nonprofit religious
<br /> n organization and the total market value of the electrical work does not exceed thirty thousand dollars($30,000.00),and th electrical work will
<br /> i.....1 be performed by appropriately certified electrician°or certified and supervised trainees who are volunteering and not being Compensated for
<br /> electrical work per RCW 19.28.001(7).
<br /> I AGREE and wish to purchase an electrical permit under the conditions described above.
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<br /> Owner Name(Print)
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