211 95TH PL SE 2020-02-25 - Laserfiche WebLink

11111/ EVERETT ELECTRICAL PERMIT AFFIDAVIT WASHINGTON 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 RCW 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 contractor OR I swear under penalty of perjury that I am: The owner of real property:or nThe renter or lessee of real 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 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 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: [ /1 A single family residence THAT IS NOT intended for rent,sale,or lease AND I will be personally doing the electrical work AND I will occupy Iv 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: A farm AND I,personally,and/or a regularly scheduled and paid employee(s)will be doing the electrical work: nAn EXISTING place of business AND I, personally,and/or a regularly scheduled and paid employee(s)will be doing the electrical work: jA 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 jOther 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. [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 — organization and the total market value of the electrical work does not exceed thirty thousand dollars($30.000.00),and th electrical work will — 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. Brenda Keller Owner MenPrint) (Owner .gna`tt`rre Date r '7 l Q PERMIT# age 3-Affidavit