2029 COLBY AVE 2023-07-12 - Laserfiche WebLink

am applying for the property owner exemption under the following conditions: i LOU 111uaa .71U1GVa 1110 Vt./llvll Ula4 At. PJIVJ LV YUU1 biLUCILIU[I. I swear under penalty of perjury that: I am a registered general contractor who is installing a temporary electrical service owned by me on a project where I am the general contractor [7.7 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 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 You ust select the option that applies to your situation: 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 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, ElAn EXISTING 1, 2, 3, or 4 unit residential property that IS intended for rent, sale, or tease AND myself and/or a regularly scheduled and paid employee(s) will be doing the electrical work; ElA farm AND I, personally, and/or a regularly scheduled and paid employee(s) will be doing the electrical work; ElAn EXISTING place of business AND I, personally, and/or a regularly scheduled and paid employee(s) will be doing the electrical work; ❑ANEW place of business that is NOT intended for rent, sale, or lease AND 1, 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 1, personally, and/or a regularly scheduled and paid employee(s) will be doing the electrical work. I am 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 market value of the electrical work does not exceed thirty thousand dollars ($30,000.00), and the 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. 7U c� ? C C Owner Name (Print) Owner Signature Date PERMIT# Page 3-Affidavit