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