503 VERALENE WAY SW 2023-09-14 - Laserfiche WebLink

Asingle family residence THAT IS NOT intended for rent,sale,or lease AND I will be personally doing the electrical work AND I will X 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. 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; 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 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 I, 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). X I AGREE and wish to purchase an electrical permit under the conditions described above. Owner Name(Print) Steven Bourque PERMIT 4E2308-105 Page 3-Affidavit Owner Signature Date 08/15/2023