619 33RD ST 2020-02-24 - Laserfiche WebLink

" y.Tti4'hM. . , 47r: h cV, ,Nu L,, »• s 4;cv # 1e c* ry t�t .1..A(� ^;k p.` V - sO.p�'.^, 4� ' ,4, 0A.411:''74(" � ,.w . ._ - os pokotmuru iris alf t4rcot,rwatt", Code Exemptions: A property owner,renter or lessee may purchase a permit to do an electrical installation on his/her own or qualified leased property under the conditions as described in ROW 19.28.261. A nonprofit corporation with current tax exempt status or a nonprofit religious organization may purchase an electrical permit as described in RCW 19.28.091(7). I am applying for the property owner exemption under the following conditions: You must select the option that applies to your situation: I swear under penalty of perjury that: I am a registered general contractor who is Installing a temporary electrical service owned by me on a project where I am the general LY—I contractor OR I swear under penalty of perjury that I am: E.1 The owner of real property;or DThe renter or lessee of real property.(You must provide a signed letter from the owner of the property granting permission for you es the tenant to perform electrical work on the property);or DA nonprofit corporation that holds a current tax exempt status as provided under 26 U.S.G.Sec.501(c)(3)or a nonprofit religious organization,and the total value of the electrical work does not exceed thirty thousand dollars($30,000.00). AND You must select the option that applies to your situation: rA single family residence THAT IS NOT intended for rent,sale,or lease AND I will be personalty doing the electrical work AND i will occupy the residence for at least 24 months after completion of the electrical work; ❑ 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 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. ❑ 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 employee(s)will be doing the electrical work; CA farm AND I,personally,and/or a regularly scheduled and paid employee(s)will be doing the electrical work; An EXISTING place of business AND 1,personally,and/or a regularly scheduled and paid employee(s)will be doing the electrical work; CA NEW place of business that is NOT intended for rent,sale,or lease AND I,personally,and/or a regularly scheduled and paid employee(s) will be doing the electrical work;or EjOther property that is NOT intended for rent,sale,or lease AND I,personally,and/or a regularly scheduled and paid employee(s0 will be doing the electrical work. 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 rr--r organization and the total market value of the electrical work does not exceed thirty thousand dollars($30,000.00),and th electrica€work will J— I be performed by appropriately certified electricians or certified and supervised trainees who are volunteering and not being compensated for electrical work per RCW 19.28.091(7). I AGREE and wish to purchase an electrical permit under the conditions described above. SARA HOLLAND Owner Name(Print) as s • ✓ 'OwnerSignature ' ` —_ Date PERMIT# Page 3-Affidavit