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EVERETT ELECTRICAL PERMIT AFFIDAVIT ;ode Exemptions: k properly Owner, renter or lessee may purchase a permit to do an electrical Installation On his/her own Or qualified leased property under the mndhipns as described In RCW 19.28.261. nonpmfit corporation with current AN exempt status or a nonprofit religious organization may honorees an electrical permil as described In RCW 192E 091(7). I am applying for the property owner exemption under the following conditions: ❑I am a regilered general contractor who is Installing a temporary electrical service owned by me on a project where I am the general contractor OR I swear antler penalty of pertury that l am, OThe owner of real properly: or ❑The renter or lessee of real property. (You must Movide a signed letter from the owner of the property granting permission for you as the tenant to perform ekepncel wVrk on Me properly); or ❑A nonprofit comoreaon that holds a current tax exempt status as provided under 25 USC.Sec. 501(c)(3) or a nonprofit religious oMa nrslion, and the feral value of the electrical work deals not exceed thirty thousand delete ($30.000 00). AND OA80gle grally re&tlenee l NA I I6 NO I Intended tor narm Safe Waage AND I" it he personally doing the excel wars AND l wall mrupy the residence for at least 24 months etter completion of the eletlncal wOrk A NEW 2, 3, Oro unit residential properly that IS intended for rend, sale, or lease AND myself and/or a regularly re eduled and pale employl will be doing the Skeptical work AND l wall occupy one of the units for at least 24 months after compldion of Me electrical work. ❑An "ISTING 1, 2, 3, or unit reaiderdial property that IS intended for rent, sale, or lase AND myself and/or a regularly ardetluled and field employees) will be doing the Steel worl A form AND 1, personally, and/or a regularly schetluked and paitl emotional will W doing the electurcol work: An EXISTING place of business AND 1, personally, and/or a regularly scheduled ark paid empbyles) wall be doing the electrical work. A NEW place of business Ma is NOT IMeMed Mr reM, sae, or ease AND I, personally, andara regularly soteduked and paid employee(s) will he doing the electrical work; or ❑Other property that or NOT intended for rend, sale. or lease AND 1. personally ,and/or a regularly scheduled and paid Notional will be doing Me ekepncal work. I am a nonprofit corporation that holds a cement tax exempt atlas as provided under 26 U.SC. Sec. 501(c)(3) or a nonpmfit rligious organization and the total market value of the ekcMcal work tices not exceed Min thousand dollars ($30,000.0% and Me electrical work mall be performed by appropn dually cemfied ebotrinam or ceNfied and supervised trainees who are volunteering and not being mmpenaaed far electrical vil per RCW 19.28.01 ❑✓ I AGREE and wish to purchase an electrical permit under the condlllons described above. Joshua Okrent Joshua Okrent 0e115¢022 Page SAhOnavrl