3322 52ND PL SW 2023-05-10 - Laserfiche WebLink

EVERFTT ELECTRICAL PERMIT AFFIDAVIT W .1-TON 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 describedin 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: T OU mU5L select Ule OpOVn lnat aIJIJIMM, LU yvU1 anuaLwn. I swear under penalty of perjury that: Elcontractor 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 swear under penalty of perjury that I am: 0 The owner of real property; or The renter or lessee of real property. (You must provide a signed letter from the owner of the property granting permission for you as the Eltenant 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 TOU must select me option inat applies to yvul suuauVn: 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 idU 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; El A 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 I, personally, and/or a regularly scheduled and paid employee(s) will be doing the electrical work; ❑A 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 ❑Other 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 ❑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). AGREE and wish to purchase an electrical permit under the conditions described above. Owner Name (Print) Date PERMIT # Page 3-Affidavit