9512 HOLLY DR 2023-06-08 - Laserfiche WebLink

EVERETT ELECTRICAL PERMIT AFFIDAVIT ,ode Exemptions: %properly owner, renter or lessee may purchase a permit to do an electrical Installation on all own or qualified leased property under the conditions as described In RCW 19.28.261. %nonprofit corporation w th current tee exempt status or a nonprofit religious organization may purchase an electrical permit as described in RCW 1928091p). I am applying for the property owner exemption under the following conditions: ❑I am a registered general contractor who is Installing a temporary, elMrical service ownetl by me on a impact where I am the general contractor OR I swear under penalty of perryry that l am: OThe owner of real laoem;or ❑The render or lessee of real property. (You must provide a signed letter from the owner of the property granting permission far you as the tenant to perform electrical work M Me property); p ❑A nonplOflt canonical that holds a Wnent fax exempt status as pMNded under M U.$ Ci Sal 501(0)(3) or a nomproflt religious organization, and this total value of the elfica l work does not exceed MIRy thousand poll($30,000.0% AND OA Single Money neopenou[XAI IS NO I Inten0ertarrent.saw.(Xlaaae/ND I Will CB pOBMdlly aOmB tnB BIBGMWI WJM1ANU I will occupy the residence for at least 24 months after completion of Me slecMcal wall A NEW 2, 3, or unit residential propel that IS intended for rent, sale, or lease AND myself anchor a regularly scheduled and paid ❑ employee(s) will be cuing the elechical work AND l will occupy one of the units for at least 24 months after completion a Me electr'Ical work. ❑An EXISTING 1, 2.3. or Unit necdentlal properly that IS Intended for rem, sale, or lease AND myself and/or a regularly scheduled and trek empkyeelc) wall be doing the electrical will Ahrm AND 1, personally, andor a mgularly scheduled and paid employees) will the doing the electrical work; An EXISTING place of business AND 1, personally, andor a regularly scheduled and paid amployae(s) will be doing the eleema l wok; ❑A NEW place of business that is NOT intended for rent, sale, or vase AND 1, personally, and/or a regularly scheduled and paid immoral will be doing the elechrkal work; or ❑Offer property that'a NOT intended W rent, will or lease AND 1, personally. and/or a regularly Scheduled and pair employee(s)"it be doing the electrical wort. I am a nonprofit corporation that holds a current tax exempt steam as provided under 26 U.S.C. Sec. 501(c)(3) or a nonprofit religious ❑organization and the total merksa value M the awarded work does nor exceed thirty thousand Qdlars(130.W0.00). and Me decncal work will he performed by appropnahety carried NecMcana or certified and supernsed trainees who are vduntaenng and not being compenea ed far electrical work per RCW 19.28.091(7). Q I AGREE and wish to purchase an electrical permit under the conditions described above. AMOS KIHARA G-INLBb �LILQ�!¢ a0112022 Page Samuervil