1700 13TH ST 2019-08-13 - Laserfiche WebLink

,w! a ELECTRICAL PERMIT_ . AFFlaAVfT Code Exemptions: A property owner, renter or lessee may purchase a permit to do an electrical installation on his/her own or qualified leasedroperiy under the conditions as described in RCW 19.28.261. p 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: ❑ i am a registered general contractor who is installing a temporary electrical service owned by me on a project where I am the contractor OR general 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 tenant to perform electrical work on the property);or p party granting ❑ A nonprofit corporation that holds a current tax exempt status as provided under 26 U.S.C.Sec.501(c)(3)ora nonprofit religious for you as the organization,and the total value of the electrical work does not exceed thirty thousand + AND do.lar;(530000.00). p You must select the option that applies to your situation: ❑ 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 the residence for at least 24 months after completion of the electrical work; ❑ A W ,3, 4 ial pty d , , AND myself and/or a regularly de emptoyeeNE2(s)will or be doingunit theresidentelectriprocs)erworkthat IS AND i wiltintened occupyforrentone ofsaletheor unitslease for:learn 24 months after completionscheulofd the electriandpaidcal 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 employee(s)will be doing the electrical work; ❑ and paid 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; I-1 ANEW place of business that is NOT intended for rent,sale,or lease AND I, will be doing the electrical work;orpersonally,and/or a regularly scheduled and paid employee(s) QOther property that is NOT intended for rent,sale,or lease AND I,Personally,and/or a regularly doing the arty cal work. I am a nonprofit corporation that holds a current tax ecempt status as provided and � arly scheduled and paid employee(s0 will be 1--1 organization and theototal market value of the elcurrent tax work status not px underousand 26U.S.C.Sec.501{c)(3)or a nonprofit electrical electricalll performedwork by appropriately.09 (7). electricians or certified and supervised trainees who arvolunteeringe e wkper RCW 19,28.0 certified land not and to gl ompe l workd fwor being compensated for 0 I AGREE and wish to purchase an electrical permit under the conditions described above. Owner Name(Print) Owner Signature Date PER4UT# g I Page 3 of 3