OWNER AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
CITY OF OTHELLO BUILDING & PLANNING DEPARTMENT 500 E MAIN STREET OTHELLO, WA 99344 (509) 488-5686 : (509) 488-3302 www.othellowa.gov
OWNER AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION We would like to advise you of the State of Washington’s requirement for ac ng as your own contractor. As the owner of a structure, whether residen al or Commercial/ Mul - Family, you are allowed to act as your own general contractor. If you choose to go this route, you will need to complete this form. If you are the authorized agent of the property owner, you will need to include wri&en permission from the property owner.
Owner name:_______________________________________________________ Date:______________________________
I am the owner or authorized agent of the owner of the property located at:___________________________________ __________________________________________________________________________________________________ I am aware of the State Contractors Registra on Act requires all persons doing any work as contractor to obtain a cer ficate of registra on from the Washington State Department of Labor and Industries. Iam aware that the it is unlawful to do any work as a contractor without a cer ficate of registra on from the Washington State Department of Labor and Industries I acknowledge that all construc on work done pursuant to the proposed building permit for the property described above will be done by the owner or owners of the property or by a licensed contractor ac ng as the owners agent.
Owner Affidavit in Lieu of Contractor Registra on: Required for property owner doing all of the work under this permit themselves. I cer fy under penalty of perjury that I am the property owner and I am exempt from the requirements of Contractor Registra on Laws. RCW 18.27 (Defini ons, RCW 18.27.010 and Exemp ons, RCW 18.27.090 I will do all my own work.
OWNER SIGNATURE_____________________________________________________________________________________ PRINT OWNER NAME_____________________________________________________________________________________
OWNER AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION We would like to advise you of the State of Washington’s requirement for ac ng as your own contractor. As the owner of a structure, whether residen al or Commercial/ Mul - Family, you are allowed to act as your own general contractor. If you choose to go this route, you will need to complete this form. If you are the authorized agent of the property owner, you will need to include wri&en permission from the property owner.
Owner name:_______________________________________________________ Date:______________________________
I am the owner or authorized agent of the owner of the property located at:___________________________________ __________________________________________________________________________________________________ I am aware of the State Contractors Registra on Act requires all persons doing any work as contractor to obtain a cer ficate of registra on from the Washington State Department of Labor and Industries. Iam aware that the it is unlawful to do any work as a contractor without a cer ficate of registra on from the Washington State Department of Labor and Industries I acknowledge that all construc on work done pursuant to the proposed building permit for the property described above will be done by the owner or owners of the property or by a licensed contractor ac ng as the owners agent.
Owner Affidavit in Lieu of Contractor Registra on: Required for property owner doing all of the work under this permit themselves. I cer fy under penalty of perjury that I am the property owner and I am exempt from the requirements of Contractor Registra on Laws. RCW 18.27 (Defini ons, RCW 18.27.010 and Exemp ons, RCW 18.27.090 I will do all my own work.
OWNER SIGNATURE_____________________________________________________________________________________ PRINT OWNER NAME_____________________________________________________________________________________
