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i fla ` "+ e r ; pit 'i1 `� •T #f*` ri.? r r •ti+,. <br /> r ' ,i e r, • ! ;I ,I 4 �t. .'` wr• <br /> 4? '}4gyp: <br /> {,, � 4 .a �� r g 1 ( �. i { -'Ili,'.N 4 'rgro g # t,^� r{pr ' y e ' '. <br /> tt(� !� ' ° ' AFFIDAVIT FOR QWNERS 9TfNG AS THE 0,43: cl tisog J �} 0► y . ' t <br /> !�V���Y� r r :� ii M ri 1 !r r •i 5 .•r ar Yo•1 s� ' <br /> � rrr r�� <br /> 'f• '. ir.. 1 '• ^ ;. <br /> +•;+►:av s i,r.,uii:+:.s u.,fv�. ..r+. 1H�+...a w+t:ds.A�Nt ,s:," e' .rii�tt•'�:a,Jrlilt 3�f; �A A .sir a•�. <br /> ABOUT CONTRACTOR LICENSING EXEMPTION <br /> RCW 18.27.140 aims to provide protection to the public from unreliable,fraudulent,financially irresponsible,or incompetent contractors. <br /> RCW 18.27.010 provides the definition of a contractor. <br /> Permits are issued to a licensed contractor unless issued to a property owner in accordance with RCW 18.27.090 exemptions. The purpose of this <br /> affidavit is to document conformance to the state requirements. <br /> I am applying for the property owner exemption under the following conditions: <br /> Must comply with all items below: <br /> I swear under penalty of perjury that: <br /> • I understand that state law requires construction to be done by a licensed contractor unless I qualify for an exemption, <br /> • 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. <br /> • The proposed construction work is not being done with the intention or for the purpose of selling the improved property within 12 months of <br /> completion of said work. <br /> • City of Everett employees will not design,make recommendations,list out all code requirements,or perform work to meet code compliance. <br /> • I agree to schedule the applicable inspections for my project so that the required inspections can be performed. I also understand I am <br /> responsible for resolving any failure to meet code requirements that may be found through inspections. <br /> • 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 <br /> the work of both rough-in and finish trades. <br /> • .I agree that I am legally and financially responsible for proposed construction activity. <br /> • I will comply with all applicable laws,ordinances,building codes,and zoning regulations. - <br /> • I am responsible for verifying whether the contractor is properly licensed with the State of Washington and has a City of Everett business <br /> license and obtains all required"work"permits for all disciplines. <br /> • 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 <br /> decision to engage an unregistered contractor to perform construction work. - <br /> • 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 <br /> while working on my property. I am willfully acting as an owner-contractor and am aware.that my homeowner's insurance may not provide <br /> coverage for those injuries. <br /> • I understand that a building permit obtained by the property owner who falsifies information to obtain an exemption provided under RCW <br /> 18.27.090 will be forfeited and I may be subject to civil and criminal penalties. <br /> ACKNOWLEDGEMENT: I HAVE READ THE ENTIRETY OF THIS DOCUMENT AND CERTIFY THAT I UNDERSTAND, <br /> 1011 AGREE TO THE CONDITIONS,AND WISH TO PURCHASE A BUILDING PERMIT UNDER THE CONDITIONS <br /> DESCRIBED ABOVE. EcEAN <br /> 4 • MAR 2 2°24 • <br /> Owner Name(Print) J EVERETT <br /> CITY It ervices <br /> perm <br /> Owner Signature Da a PERMIT# <br /> • <br /> 10/27/2021 <br />