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EVE RETT ELECTRICAL PERMIT AFFIDvIT WAS; INC 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 described in RCW 19.28.261 . A nonprofit corporation with current tax exempt status or a non r ` 19-28.091 (7) p ofit religious organization may purchase an electrical permit as described in RCW i am applying for the property owner exemption under der the following conditions: You must select the option that applies toour situation: uation: I swear under penalty of perjury that: ❑ I am a registered general contractor who is installing a tempora electrical c i-Y service owned d by rye an a protect where l am the general OR I swear under penalty of perjury that I am: 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 tenant to perform electrical work on the property); or ❑ A nonprofit corporation that holds a current tax exempt status as rovide p d under 26 U organization, and the total value of the electrical work does not exceed thirty U.S.C. Sec. 501 (c)(3) or a nonprofit religious thousand dollars ($30,OOO.O0). AND You must select the option that applies toour situation: tuation: A single family residence THAT IS NOT intended for rent, sale, or lease AND I " the residence for at least 24 months after completion of the electrical work; will be personally doing the electrical work AND ! will occupy A NEW 2, 3, or 4 unit residential property that IS intended for rent, sale or le empioyee(s) will be doing the electrical work AND I will occupyone of the ase AND myself and/or a regularly scheduled and paid e 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 ren em t, sale, or lease employee(s) will be doing the electrical work; AND myself and/or a regularly scheduled and paid A farm AND I, personally, and/or a regularly scheduled 9 y and paid employee(s) will be doing the electrical work; An EXISTING place of business AND Ie p rsonally, and/or a regularly scheduled and paid employee(s) will be doingthe electrical work; A NEW place of business that is NOT intended for rent, sale, or lease AND 1, 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, ersonail doing the electrical work. p Y7 and/or a regularly scheduled and paid employee(s0 will be I am a nonprofit corporation that holds a current tax ecernpt status asfevi organization and the total market value of the electrical work doe p ded under 26 U.S.C. Sec. 601 (c)(3) or a nonprofit religious or performed s not exceed thirty thousand dollars ($30,000.00), and th electrical work will p ed 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) /5 ! AGREE and wish to purchase an electrical permit under the conditions described above. Owner Name (Print) 2 - 2,0Z Q r Si natrrr Date