REVIEWED BLD2024-1450+CONTRACTOR EXEMPTION+11.4.2024_11.31.32_AM+4599862 1RECEIVED BLD2024-1450
Nov 06 2024 EXEMPTION FROM CONTRACTOR
CITY OFEDMONDS REGISTRATION VCRRFICATION
DEVELOPMENT SERVICES
DEPARTMENT FORM D
The undentried propertyowneror authorized person as described below, has applied for a building permit
from the City of Ecirnonds and crlii»s thiU hI'/shChl iS exerTtpt from provldlnR contractor repistration in
accordance with the prow{ions of RCW 18 21. The proprfty owner or iuthorl7ed person, by their :Ion iturP
below, hereby verifies to the City of Edmonds that:
Value of work under $5-KOD. The ar ftegate contract price of labor and rrratCruiIs and alioth,,r items
required for the project Is less than $XX) (X)and Is not part of ,i Lirgrr operation to be undertikrn on
the property. This exemption does not apply to a person who advertises or puts out any sign or card or
otherdevice which might indicate to the public that he/she is a contractor or that he/she is qual'rf d to
engage in the business of contractor RCIiti' 18.27,090 (9)
Owner who contracts fora project. Property owner contracting with registered contractors for the
project, and who him/herself is not performing any acti%6ty of a contractor far the purpose of leasing or
selling improved property that he/she has owned for less than twelve months RCW 1827.00(lll.
Work performed personallyonown property. Anyone personally working an property he/she owns, or
at which he/she resides, as longas the property owner, or resident, does not perform any actiw-,-ty of a
contractor on his/her property for the purpose of selling, demcihshmp, or leasing the property. RCW
IS.27.N-0(12).
X Use of own employees Property owner using him,/herself or his/her own employees to perform
mainlenanw, repair, and alteration work in or upon rnis/herown property RCW1&27 OW(13),
LILensed Architect, Engineer, Electrician or Plumber. All work performed underthis permit will be
performed byan architect, civil or professional eneincer, certified etectrician or certified plumber
operating within the scope of his/her certification. RCW 18.72_090(14),
Othel.5pecifywhich prawision of RCW 1&27.090 applies -
THE UNDERSIGNED PROPERTY OWNER ORAUifHORI.ZEDPERSON HEREBY VERIFIES THATALL
INFORMATION PROVIDED ON THIS FORM IS TRUE AND ACCURATE TO T14E RESTOF HIS OR HER
KNOVVLFDGE AND ACKNOtiWLED5ESTHAT IF ANY OF THE INFORMATION PROVIDED ON THIS FORM 15
FALSE, HE OR SHE UNDERSTAND5THAT THE BUILDING PERMIT WILL RE INIMIEDIATELYREVOKED AND
ALL FEES PAID FORFEITED_
DATED this 4TH day of NOVEMBEFR 20 24
PROPERTY OWNER/AUTHORIZED PERSON
it✓t
Signature
P"tnature
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