1416 12TH ST 2025-04-18 - Laserfiche WebLink

• • 1 I�,w1,/T a.}y",/ ` ! ■■■{ 1P ":T■1.Rt` -.N- T 1 .N , 4 Z to , x t , Y C. ' b J! ; 0 5. `t 1b Y4' Wh' 1`. 1 WAINI,(GT - YA ?!... �. . 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 19.28.091(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: 1 ( I am a registered general contractor who la installing a temporary electrical service owned by me on a project where I am the general 1 contractor OR I swear under penalty of perjury that I am: kci 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 ntenant to perform electrical work on the property);or nA 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 value of the electrical work does not exceed thirty thousand dollars($30,000.00). AND You must select the option that applies to your situation: � A single family residence iidence THAT IS 24 months NOT intended completion rent,the electrical or ot i lease AND I will be personally doing the electrical work AND I will occupy �� the ❑ A NEW 2,3,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. nAn EXISTING 1,2,3,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; nA farm AND I,personally,and/or a regularly scheduled and paid employee(s)will be doing the electrical work; nAn EXISTING place of business AND I,personally,and/or a regularly scheduled and paid employee(s)will 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 doing the electrical work;or nOther property that is NOT Intended for rent,sate,or lease AND I,personally,and/or a regularly scheduled and paid employee(s0 will be doing the electrical work. I am a nonprofit corporation that holds a current tax ecempt 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 th electrical work will — be performed by appropriately certified electricians or certified and supervised trainees who are volunteering and not being compensated for electrical work per RCW 19.28.091(7). 71 I AGREE and wish to purchase an electrical permit under the conditions described above. wnm Print) Z 0-G) Owner Signature De PERMIT# Page 3-Affidavit