7725 EVERGREEN WAY BIG BOX OUTLET STORES 2023-04-06

EVERETT AFFIDAVIT FOR OWNERS ACTING AS THE CONTRACTOR IN LIEU OFA CONTRACTOR'S LICENSE IMAM/10,1511 ABOUT CONTRACTOR LICENSING EXEMPTION RCW 18.27.140 aims to provide protection to the public from unreliable,fraudulent,financially irresponsible,or incompetent contractors. RCW 18.27.010 provides the definition of a contractor. Permits are issued to a licensed contractor unless issued to a property owner in accordance with RCW 18.27.090 exemptions. The purpose of this affidavit is to document conformance to the state requirements. I am applying for the property owner exemption under the following conditions: Must comply with all items below: I swear under penalty of perjury that: • I understand that state law requires construction to be done by a licensed contractor unless I qualify for an exemption. • I am not acting as a contractor on the property that I have owned for less than 12 months,for the purpose of selling,demolishing,or leasing. • The proposed construction work is not being done with the intention or for the purpose of selling the improved property within 12 months of completion of said work. • City of Everett employees will not design,make recommendations, list out all code requirements,or perform work to meet code compliance. • I agree to schedule the applicable inspections for my project so that the required inspections can be performed. I also understand I am responsible for resolving any failure to meet code requirements that may be found through inspections. • I agree as the property owner I will make sure I have the skills to act as my own general contractor,and the expertise required to coordinate the work of both rough-in and finish trades. • I agree that I am legally and financially responsible for proposed construction activity. • I will comply with all applicable laws,ordinances, building codes,and zoning regulations. • I am responsible for verifying whether the contractor is properly licensed with the State of Washington and has a City of Everett business license and obtains all required"work"permits for all disciplines. • I agree as the property owner that I may be waiving certain rights that I might otherwise have under state law with Labor and Industries in any decision to engage an unregistered contractor to perform construction work. • I agree that I may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person or their employees while working on my property. I am willfully acting as an owner-contractor and am aware that my homeowner's insurance may not provide coverage for those injuries. • I understand that a building permit obtained by the property owner who falsifies information to obtain an exemption provided under RCW 18.27.090 will be forfeited and I may be subject to civil and criminal penalties. ACKNOWLEDGEMENT: I HAVE READ THE ENTIRETY OF THIS DOCUMENT AND CERTIFY THAT I UNDERSTAND, jf AGREE TO THE CONDITIONS,AND WISH TO PURCHASE A BUILDING PERMIT UNDER THE CONDITIONS DESCRIBED ABOVE. k)du2e Owner Name(Print) 2- l6-Z3 . - Owner Signature Date PERMIT#be3 10/27/2021