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EVERETT.______.._..._...-_
<br />Code Exemptions:
<br />A property owner, renter or lessee may purchase a permit to oo an electrical installation or his'her rfNn or qualified leased propeily under .'iv
<br />eonditiors as described in RC'At 19.28.261.
<br />A nonprofit corporation with current tax exempt status or a nonprofit teliclious orgFn zation may purchase an Etlerfnoal perry t as cescrioed i,:::
<br />.19.213.091(7).
<br />an-i applying for the property owner exernption under the If:r!libclnring condiI iirl s:
<br />YOU must select the option that applies to our situation:
<br />' I"swear under penally of perj,ary That:"._._..��_.._...._.,..._•...___.,__.____......,,..,.....,..........._...._,_ .._.._....,.. __..,.�,f,,,,
<br />I am a registered general contractor who is owned be a tempt racy elecl•tcal service owby me on , proj-.:ct where I ru•n the general
<br />I —I contractor
<br />OR
<br />1 swear under penalty of perj.iry that I am:
<br />1.1L) The owner or real prooerly; or
<br />-� The renter or lessee of real property. ( You must provide a signed letter from the owner of t)) propert.,, gtarting permission for act. tl
<br />tenant to perform electrica, work on the properly); or
<br />�I A. nonprofit corporation .hat holds a current tax exempt status as provided under 26 U.S.C. Sac. ti01((;)(3) or a nonprofit religious
<br />organization and the total value of the elortr cal work does n)t exceed thirty thousand dollars t$30,0(0.00;.
<br />AND
<br />YOU mast !select the option that applies to your situation:
<br />K7 A single family residence THAT IS NOT intended for rent, sale, or lease- AND I will oe IzE rso ially doir _ the elecirica' work AND I will
<br />occupy the residence for at least 24 months after completion of the elec tri.,atl work;
<br />_ A NEW 2, 3, or 4 unit residential property :het IS intenced for rent, sale, or lease AND rrrys e1 arihor a regt Iarly sched.tled and I = r
<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 elec
<br />work.
<br />CAn EXISTING 1, 2, 3, or 4 unit residential oroperty that IS intended for rent, sale, or lease A ND myself and.or)p reg.ilarly :;cheduloci and
<br />paid employee(s) will be going the electrical work;
<br />—� A, farm AND I, personally, and/or a regularly scheduled and paid amployee(s) will be dicing t'ta el,-ctric:al w•t rk;
<br />h) An EXISTING place of business AND I, personally, and/or a regularly scheduled and pied a r:plovee(.; vt 11 Ix- doirig the electrical work;
<br />-� A NEW place of business :hat :s NOT intandad for rent, sale, or lease AND !. personally ,n:llor:> r•egcderly schoclu,ed and paid
<br />employee(s) will be doing the electrical work or
<br />-I Other properly that is NOT intended for rent, sale, or lease AND i, personally and/or a regu arty :;cheyule c and oaid ernployee(s) will r) a
<br />doing the electrical work.
<br />I am a nonprofit corporation that holds a current tax exornpt status as prop iced under 26 U ; ..C:. See. 501(c)(3) or a nonprofit religious
<br />organization and the total market value of lne E-lectrical work does not exceed thirty thousands dohars MCI, )00.00). and ':he electricA worl•
<br />will be performed by appropriately certified electricians or certified anc supervised trainees %rho are volunt( ering and not;)einc
<br />compensated for electrical worK per RCW 19.28.091(7).
<br />NI AGREE and wish to purchase an electrical permit uinder i fre conditions ve s+;riiloEus above.
<br />Owner Narrx- (Print) ---'
<br />Owner Sigma -e �w Date
<br />wag;>3•Affidavt,.
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