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RIti oF <br /> ......v3� <br /> Code <br /> ExerrrptrQnS. <br /> A property owner,renter or lessee may purchase a <br /> petrnit to do an electrical installation on his/her own or qualified leased property under the <br /> conditions as described in ROW 19.28.281. <br /> no <br /> ` 8.09 (corporation with current tax exempt status or a nonprofit religious organization may purchase an electrical <br /> 1828p ofit , <br /> Permit as described in ROW <br /> l am applying for thero <br /> p perty owner exemption under the following conditions: <br /> You must select the option that applies to your situation: <br /> l swear under penalty of perjury that: <br /> D l am a registered general contractor who is installing a temporary electrics}service owned by me on a project <br /> contractor p oiect where I am the general <br /> OR <br /> I swear under penalty of perjury that I am: <br /> 0 The owner of real property;or <br /> 1-4 The renter or lessee of real property.(You must provide a signed letter from the owner of the property <br /> tenant to perform electrical work on the property);or A Aerh�granting <br /> Dr'7 Anon nonprofit co 9 permission for you as the <br /> A corporation that holds a current tax exempt status as provided under 26 U.S.C.Sec.501(c)(3)or a nonprofit religious <br /> organization,and the total value of the electrical work does not exceed thirty00. ) <br /> AND <br /> thousand dollars($30,1100.00). <br /> You must select the option that applies to your situation: <br /> —D A single family residence THAT IS NOT intended for rent sale,or lease AND I will be <br /> 11 the residence for at least 24 months after completion of the electrical work; personally doing the electrical work AND I will occupy <br /> in A NEW 2,3,or 4 unit residential property that IS intended for rent,sale,or lease <br /> employee(s)will be doing the electrical work AND I will occupyone AND myself and/or a regularly scheduled <br /> of the units for at least 24 months after completion of the electrical work. <br /> An EXISTING 1,2,3,or 4 unit residential property that IS intended for rent,sale,or lease AND myself and/or a <br /> regularly scheduled and paid <br /> employees)will be doing the electrical work; <br /> ❑ A farm AND I,personally,and/or a regularly scheduled and <br /> paid e+nptayee(s)will be doing the electrical work; <br /> 0 An EXISTING place of business AND I,personally,and/or a regularly scheduled and paid employee(s)to <br /> in A NEW place of business that is NOT intended for rent,sale,or lease AND i, y, p yds}will be doing the electrics[work; <br /> will be doing the electricalusines work;or personally,and/or a regularly scheduled and a' <br /> Other property paid empfoyee(s) <br /> P pertY that is NOT intended for rent,sale,or lease AND i, <br /> doing the electrical work. <br /> personally,and/or a regularly scheduled and paid emptayes(s0 will be <br /> I am a nonprofit <br /> ❑ corporation that holds a current tax ecempt status as provided under 26 U.S.C.Sec.501 c 3 or a nonprofit religious <br /> organization arid the total market value of the electrical work does not <br /> or appropnatet exceed thirty thousand dollars ( 14 ) g <br /> be performedelectrrcol work Y certified electricians or certified and supervised trainees who are volunteering and not nbein electrical work will <br /> per ROW 19.28.091(7). <br /> n9 compensated for <br /> ❑ t AGREE and wish to purchase an electrical permit under the conditions described above< <br /> Owner Name(Print} <br /> Owner Signature <br /> Date <br /> PERIK/r# �5I <br /> Page3of3 <br />