4907 DELAWARE AVE 2023-10-24 - Laserfiche WebLink

EVERETT AFFIDAVIT FOR OWNERS ACTING AS THE CONTRACTOR IN LIEU OF A CONTRACTOR'S LICENSE WASHINGTON UT CONTRACTOR LICENSING EXEMPTION RCW 18.27.140 aims to provide protection to the public from unreliable, fraudulent, financially irresponsible, or incompetent contractors RCW 18.27.010 provides the definition of a contractor. IPermits are issued to a licensed contractor unless issued to a property owner in accordance with RCW 18.27.090 exemptions. The purpose of this affidavit is to document conformance to the state requirements. I am applying for the property owner exemption under the following conditions: Must comply with all items below: I swear under penalty of perjury that: • 1 understand that state law requires construction to be done by a licensed contractor unless I qualify for an exemption. • 1 am not acting as a contractor on the property that I have owned for less than 12 months, for the purpose of selling, demolishing, or leasing. The proposed construction work is not being done with the intention or for the purpose of selling the improved property within 12 months of completion of said work. 0 City of Everett employees will not design, make recommendations, list out all code requirements, or perform work to meet code compliance. 1 agree to schedule the applicable inspections for my project so that the required inspections can be performed. I also understand I am responsible for resolving any failure to meet code requirements that may be found through inspections. 1 agree as the property owner I will make sure I have the skills to act as my own general contractor, and the expertise required to coordinate the work of both rough -in and finish trades. • 1 agree that I am legally and financially responsible for proposed construction activity. 0 1 will comply with all applicable laws, ordinances, building codes, and zoning regulations. 1 am responsible for verifying whether the contractor is properly licensed with the State of Washington and has a City of Everett business license and obtains all required "work" permits for all disciplines. 1 agree as the property owner that I may be waiving certain rights that I might otherwise have under state law with Labor and Industries in any decision to engage an unregistered contractor to perform construction work. 1 agree that I may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person or their employees while working on my property. I am willfully acting as an owner -contractor and am aware that my homeowner's insurance may not provide coverage for those injuries. 1 understand that a building permit obtained by the property owner who falsifies information to obtain an exemption provided under RCW 18.27.090 will be forfeited and I may be subject to civil and criminal penalties. ACKNOWLEDGEMENT: I HAVE READ THE ENTIRETY OF THIS DOCUMENT AND CERTIFY THAT I UNDERSTAND, ✓� AGREE TO THE CONDITIONS, AND WISH TO PURCHASE A BUILDING PERMIT UNDER THE CONDITIONS DESCRIBED ABOVE. Travis Conway Bacon Owner Name (Print) 9/21 /23 =n-Al , s, C . b «W NA Owner Signature Date PERMIT # 1012712021