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adze Exemptlon ss <br />Irby ter, renter or lessee may purcha* a permit to do an electrical installation an his/her own or qualified leased property under the <br />untitlons as described in RCW 19.28.261. <br />nonpmft corporation with ant tea exampt status or a nonprofit religious organtaetim may purchase an sloe" t permit as described..,fin RCW <br />1 am applying for the property owner exemption under the following Conditions: <br />bu must soled the Option that ap l" to 12ur situation: <br />swear under penalty of perjury that <br />I am a registered general contractor who Is Installing a temporary electrical service owned by me on a pro*A whore 1 am the general <br />contractor I <br />OR <br />l wiew tinder penalty of perjury that I arts: <br />❑ the owner of r property, or <br />The ranter or lessee of real property. (You roast provide a signed latter from the owner of the property granting permission for you as the <br />lanant to perms electrical stork of the property); or <br />A nMP011t 00tpOratksn holds a current tax exempt status as pry under° 26 U,S,C. Sec.. 501(c)(3) or a nonprofft religious <br />oManizattort, and the total value of the electrical wo* does not exceed thinv thousand coffers ($30,OOD,001, <br />nuet select the option that applies to your Situation: <br />A single, farolly rasiriwco THAT IS NOT intended for rent, We, or tease AND I will be personally doing the electrical wo* ANY I will occupy <br />the rosidento for at least 24 months after completion of the aleaftical work; <br />ANEW 2, 3, or 4 unit resklentiarl property Chat IS IntandW for rent, a", or lease AND myself and/or s regularly scheduled and paid <br />ernpkryes(s) will be doing the metrical work AND I will occupy one of the units for at least 24 months after completes of the eloctrical work. <br />An iw7t TING t. 2, 3, or 4 unit reikiential property that IS Intandett for ram, sale, or lease AND myself ;snWor a regularly scheduled and pail <br />w p (9) will be doing than electrical al wink; <br />Q A farm AND 1, personally, and/or a regularly scheduled and paid arnpoyee(s) will be doing the eiec ii"I work; <br />An EXISTING place of business AND 1, personally, ;aridtor a regularly aohacluled and paid employes(s) wM be doing the dial work; <br />A NEW place of business that is NOT Intended for rent, sale, or lease AND 1, personally, an for a regularly scheduled and paid empksyse(a) <br />will be doing the aloctrIcal work; or <br />[3 Other prop" that is NOT Intended for rent, sale, or lease AND t, peroonehy, ar%Uor a regularly scheduled and pall employea(sO will be <br />doing tfhe electrical work, <br />t am a nonprofit corporation that holds a current tax eceMt status as prow under 26 i1.S,O. SaG. 601(c)(3) or a nonprofit role <br />organization and the total merle valus of the electrical work does not exceed thirty thousand dollars ( 0,0W.00), and th electrical work wig <br />be pe formed by appropriately certified rely iricians of cxtrti d-and supervIsed trains" who are volunteering and rant being compensated for <br />electrical work per RCW 19.28.001(7). <br />I AGREE and wish to;purchose an electrical permit under the conditions described above. <br />OwrrerNeme t�U <br />Owner Swrslum Date <br />PERU 7"im Pap 3-Aftltlavlt <br />