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Permits are issued to a licensed contractor unless issued to a property owner in accordance with RCW 18.27.090 exemptions affidavit is to document conformance to the state requirements. I am applying Tort e property owner exemption under the following conditions: nn��+ �,,.Y,�i.. "►,ith all items below: swear under penalty of perjury that: • I understand that state law requires construction to be done by a licensed contractor unless 1 qualify for an exemption. EVERETT WAS"INO70N AFFIDAVIT FOR OWNERS ACTING AS THE CONTRACTOR IN LIEU OF q CONTRACTOR'S LICEN: ABOUT CONTRACTOR LICENSING EXEMPTION RCW 18,27,140 aims to provide protection to the public from unreliable, fraudulent, financially irresponsible, or incompetent contractors RCW 180270010 provides the definition of a contractor. The purpose of this • I 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. • City of Everett employees will not design, make recommendations, list out all code requirements, or perform work to meet code compliance. � I 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. I 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 1 am Iegar�Sy and financially responsible for proposed construction activity. • I will comply with all applicable laws, ordinances, building codes, and zoning reg��lations. • I 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. � I 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. I agree that I may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person or their employees P 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: IHAVE 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. Owner Name (Print) er Signature 10/27/2021 w 7� Date PERMIT #