|
EVERETT
<br /> ELECTRICAL PERMIT AFFIDAVIT
<br /> Code Exemptions
<br /> 4 property owner,ranter n I. -,,ee may jxlrehace a permit to r1n an oecincal rnslanahon on his/her own or rlualifled leased property under the
<br /> corldiltons as described in RCW 19 18 161
<br /> A nonprolk emrikwatron with current tav Prempl visoli s or a nonproflr relrgkrrt organr.,ation may purchase an electrical permit as described in RCW
<br /> Q ,A fill+ ,.
<br /> I am applying for the property owner exemption under the following conditions:
<br /> You must select the option that applies to your situation:
<br /> ❑ r am a regraterse general contractor w1ho is rnstalbnq a lempr rang electrical service owned by me on a project where I am the general
<br /> ontractor
<br /> OR
<br /> wi.l," I'o"AIN of perjure that I am
<br /> ✓� "r ),,rim of real prorxaty or
<br /> i tw ranter or lessee of real property (You must provide a signed letter from the owner of Iho properly granting permission for you as it,,
<br /> Ellanant to portofrr+(-lPctrrul work on the property),of
<br /> ❑ A noriprotq ciorporabon that holds a current tax exempt status as provided under 26 U S.C.Soc, 501(c)(3)or a nonprofit ruhgiou!,
<br /> r.� ,..r+ ,.+ter Lytal value of Iho electrical work dot-i riot exceed thirty Ihousand dollars(S30.000 00).
<br /> AND
<br /> You must select the option that applies to your situation:
<br /> ❑ A single family rearoence THAT IS NOT intended for font, sale,or lease AND I will be personally doing the electrical work AND I will
<br /> occupy the resrdonce for a1 least 24 months after completion of the electrical work;
<br /> 14C W 2. 3,or 4 unit residential property Thal IS Intended for rent,solo,or loaso AND myself and/or a regularly scheduled and paid
<br /> ❑ „ y,loysals)will be doing the electrical work AND I will occupy one of the units for at toast 24 months after completion of the oleclncal
<br /> wurk
<br /> aAn EXISTING 1 2.3,or 4 unit residential properly that IS Intended for rent,sale,or lease AND myself and/or a regularly scheduled and
<br /> rand r,mployee(s)will be doing the olocincal work;
<br /> ❑ A, I.,rm AND I I,rn ona0y.and/or a regularly scheduled Lind paid employeo(s)will be doing the electrical work;
<br /> An EYISTIN(r placo of buumeas AND I,personally,and/or u regularly scheduled and paid employoo(s)will be doing the oloctrical .vork
<br /> ❑ A NEW place of business that is NOT Intended for real,sale,or luaso AND I,personally,and/or a regularly scheduled and paid
<br /> r,mpluyee(s)will tar doing the elncUrcel work,or
<br /> ❑ Uilrnr prupdrly ttral Is NOT intended for rent,sale,or lease AND I,personally,and/or a regularly scheduled and paid umployoe(s)will be
<br /> r u,ir,g lire electrical work
<br /> I am ri nunproht curpuratron that holds a current lax exempt elntuo no provided under 26 U.S.C.Soa 501(c)(3)or n nonprofit religious
<br /> orr�r�nruuun arid 1he Iota I mis"I value of the electrcal work rlooa riot oxcood thirty thousand dollars($30,000.00),and tho electrical work
<br /> r-�
<br /> IJ will be perfutme9d by appluprlalaly certified oloctnclann or curtifind and ttupervlsod Indnnns who uro volunloering and not being
<br /> romporlwoud fur eleclrrcul wnrM per RCW W 20 09IM
<br /> 0 I AGREE and wish to purchase an oloctrical purntil under the conditions doscribod above.
<br /> Neh- I Rav I
<br /> Uwrun IJurrrr+
<br /> owrrrrr Sr uli r, n,
<br /> E2308-179
<br /> Iv Umil a Ian+In i-AIInLrvn
<br /> J
<br />
|