916 PACIFIC AVE 2ND FLOOR 2025-06-30

Code Exemptions: A property owner, renter or lessee may purchase a permit to do an conditions as described in RCW 19.28.261. 'A nonprofit corporation with current tax exempt status or a nonprofit 19.28.091(7). installation on his/her own or qualified leased property under the organization may purchase an electrical permit as described in RCW I am applying for the property owner exemption under the following conditions: .+.. ••_ �c��a.a a��c a�Na�UII Ludt aipplICs tv yOur slivalfon: 1 swear under penalty of perjury that: I am a registered general contractor who is installing a temporary electrical service owned by me on a project where I am the general LTJ contractor OR I swear under penalty of perjury that I am: 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 tenant to perform electrical work on the property); or ❑ A nonprofit corporation that holds a current tax exempt status as provided under 26 U.S.G. 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 IU %JPL U1I a! laa c1ppilCs LU your situaLlon; ❑ A single family residence THAT IS NOT intended for rent, sale, or lease AND 1 will be personally doing the electrical work AND I will occupy the residence for at least 24 months after completion of the electrical. work; 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. An 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; ❑ A farm AND I, personally, and/or a regularly scheduled and paid employee(s) will be doing the electrical work; An 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 Other property that is NOT intended for rent, sale, or lease AND 1, 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 exempt 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). � ] I AGREE and wish to purchase an electrical permit under the conditions described above. Owner Name (Print) PERMIT # Page 3-Affidavit