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�vim.: �4 ':E,-,� ��� sa:..K' ','l'+. �,s�..:.�`4 *� �'���:Y �-'\� i.:..\ �£C �,uz� `` R,SS;,xu� 3.�� �z'�`�a�'� "�' '�y�71\\ y.,,\lY t- t sy,�e-xF�'¢-k \�> �.`: 4 o-,a ^1�'3�.��:: <br /> E. a, t �` -c ay..� :�.s ;1'^` .'.:: v. m P..: � ::: z.. -x`a`~a�ANRI„tx'v..I x4�z'�'al :s'_.T II <br /> i `vF I . `Se`s,..` �Vjs `h t t �` .ttVA "�/.e���I '.R t vi-t'c' , �. <...,. t <br /> .�F. s:�'.�-..*,a.-rz.ti� ..r` � �. .._ .. .4� .,n} ,. '40k mo i^ . ,�.�� �-N. <br /> . i. : ,r a .. s�ekuk ,ei Fps kv "§H Cs ..a <br /> 1. a +n N `Wel c *-QYNR m 'Fa_'ai *a k{�.i- a `a Z ve t%A.4 a��....°. AA A x`g, " S,; l- nuc :... ' „>. <br /> v - �''�....cl a:"v. s -,� � �'' ..�.`it � �.\lam; .� '�� �"'x�....�r`�� �.'�e���.�f��a2�a��`�`:���� >v>�� .a,F... ,.. _: >:! <br /> . .�... u�.. _ v _g?\'s .ems,.. ._a..._� _.._�.>. �.a E__:?. �..,.._.__ .a .,��� `,`y._,.::.,�.. _ <br /> Code Exemptions: <br /> 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 <br /> conditions as described in RCW 19.28.261. <br /> A nonprofit corporation with current tax exempt status or a nonprofit religious organization may purchase an electrical permit as described in RCW <br /> 19.28.091(7). <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 /> I swear under penalty of perjury that: <br /> ❑ <br /> I am a registered general contractor who is installing a temporary electrical service owned by me on a project where I am the general <br /> contractor <br /> OR <br /> I swear under penalty of perjury that I am: <br /> 13. The owner of real property;or <br /> ri 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 <br /> tenant to perform electrical work on the property);or <br /> ❑ <br /> 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 <br /> organization,and the total value of the electrical work does not exceed thirty thousand dollars($30,000.00). <br /> AND <br /> You must select the option that applies to your situation: <br /> A single family residence THAT IS NOT intended for rent,sale,or lease AND I will be personally doing the electrical work AND I will occupy <br /> Lathe residence for at least 24 months after completion of the electrical work; <br /> ❑ 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 <br /> 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. <br /> ❑ 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 <br /> employee(s)will be doing the electrical work; <br /> A farm AND I,personally,and/or a regularly scheduled and paid employee(s)will be doing the electrical work; <br /> El An EXISTING place of business AND I, personally,and/or a regularly scheduled and paid employee(s)will be doing the electrical work; <br /> ❑ <br /> 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) <br /> will be doing the electrical work;or <br /> ❑ <br /> Other property that is NOT intended for rent,sale,or lease AND I,personally,and/or a regularly scheduled and paid employee(s0 will be <br /> doing the electrical work. <br /> 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 <br /> ❑ <br /> organization and the total market value of the electrical work does not exceed thirty thousand dollars($30,000.00),and th electrical work will <br /> be performed-by appropriately certified electricians or certified and supervised trainees who are volunteering and not being compensated for <br /> electrical work per RCW 19.28.091(7). <br /> I AGREE and wish to purchase an electrical permit under the conditions described above. <br /> VI°Ial; ( ask ��< <br /> Owner Name(!� U <br /> t) <br /> Owner ignature Date ,� /,, 2 2 <br /> PERMIT# e- «t f-00 K� Page <br />