1523 CEDAR ST 2024-09-17 - Laserfiche WebLink

EV1rAETT ELECTRICAL PERMIT AFFIDAVIT wA1�IF6'Du Code Exemptions: A oroperty owner. renter or lessee may purchase a permit to do an electrical installation on his/her own or qualified leased properly unser the conditions as described in RCW 19.28.261. A nonprofit corporation with current tax exemot sta'us or a nonprofit religious organization may purchase an electrical permit as described in RCW 19.28.091(7). 1 am applying for the property owner exemption under the following conditions: You must select the option that applies to your situation: swear under penalty of perjury that: ❑ I am a registered general contractor who is installing a temporary eiectr°cal service owned by me on a project where I am the general contractor 0R I c;vrrar under penalty of perjury that I am: Ti)e owner of real property: or The renter or lessee of real property. (You must provide a srgnea letter from the owne,of tho 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 p,oviced under 26 U.S.C. Sec. 541(x.)(3; or a nonprofit rel lg;ous organ°.nation. and the total value of the electrical work does not exceec thirty thousand dollars (53+0.000.00). AND You must select the option that applies to your situation: ❑ A single family resicence THAT IS NOT intended for rent. sale. or lease AND I voli be personally doing the electrical worK.AND I will occupy the residence`or at least 24 months after completion of the electrical work: A NE`dl!2. 3 or»unit residential property that IS intended fo• •ent. sale. or lease AND myself andlor a regularly srhoduIed and pair. employees)wiII be doing the electr•caI work AND i will occupy ono of the units for at least 24 months after completior of the electrical work. An EXISTING 1. 2. 3. or 4 unit residential property that IS;ntended for rent. sale. or lease AND myself an a regularly scheduled and paid employeeisl will be doing the electrical work: ❑ A farm AND i. personally• andlor a regularly sneduled and paid ernoloyee(s}will be doing the electrical work: ❑ An EXISTING place of business AND I. personally. and/or a regularly schod uled aria paid amployeer.$)w 11 be doing the electrical work: ❑ 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)will be Coing the electr-cal work: or ❑ Other property that is NOT intended for rent• sale. or lease AND 1. personally. and!or a regularly scheduled and paid employeei•sj will be doing the electrical work. I am a nonprofit corporation that holds a current tax exempt status as provided urder 26 U.S.C. Sec. 5011 c.)(3)or a nonprofit religious Dorganization and the total market value of the electrical work does not exceed thirty thousand dollars (530.000.00;. and the electrical work will be performec Dy appropriately certified electricians or certified and supervised traonees who are volunteering and not being compensated for electrical work per RCW "9.28.091 i7 i. ✓� I AGREE and wish to purchase an electrical permit under the conditions described above. Jeff Harris 0wnor Name (Punt, OWne."Srgrrattlre c PERMIT# Page 3-Affidavit