2115 WETMORE AVE 2023-11-28 - Laserfiche WebLink

EVERETT ELECTRICAL PERMIT AFFIDAVIT WASHINGTON 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 nonprofit religious organization may purchase an electrical permit as described in RCW 119.28.091 (7). I am applying for the property owner exemption under the following conditions: You must select the option that applies to your situation: 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 OR swear under penalty of perjury that I am: 51 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,g nization, and the total value of the electrical work does not exceed thirty thousand dollars ($30,000.00). AND You must select the option that applies to our situation: P pP Y 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 27 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 , 21 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, F-1 A NEW place of business that is NOT intended for rent, sale, or lease AND I, personally, and/or a regularly scheduled and paid employee(s) electrical work; or p oyee(s) will be doing the e , 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 b d el e performed by appropriately certified electricians i i ns or certified and supervised trainees who are volunteering and not being compensated for electrical work per RCW 19.28.091 (7). I AGREE and wish to purchase an electrical permit under the conditions described above. Owner Name (Print) C'/ Ll Owner Signa re Date PERMIT # Page 3-Affidavit