HomeMy WebLinkAboutl_RENTON Owner Affidavit_20230425_v1Development Services Division
1055 S. Grady Way
Renton, WA 98057
(425) 430-7200
www.rentonwa.gov
OWNER AFFIDAVIT IN LIEU
OF CONTRACTOR
REGISTRATION
We would like to advise you of the State of Washington’s requirement for acting as your own contractor. As the owner of a
structure, whether Residential or Commercial/ Multi- 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 written permission from the property owner. If the work is electrical, we have a separate form that we
require. Please inquire.
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 Registration Act requires all persons doing any work as contractor to obtain a
certificate of registration from the Washington State Department of Labor and Industries.
I am aware that it is unlawful to do any work as a contractor without a certificate of registration from the Washington
State Department of Labor and Industries
I acknowledge that all construction 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 acting as the owners agent.
Owner Affidavit in Lieu of Contractor Registration: Required for property owner doing all of the work under this permit
themselves.
I certify under penalty of perjury that I am the property owner and I am exempt from the requirements of
Contractor Registration Laws. RCW 18.27 (Definitions, RCW 18.27.010 and Exemptions, RCW 18.27.090
I will do all my own work.
OWNER SIGNATURE_____________________________________________________________________________________
PRINT OWNER NAME_____________________________________________________________________________________
H:\CED\Data\Forms-Templates\Self-Help Handouts\Building\Owner Affidavit.pdf 2/5/19
KIRUTHI TABITHA 04/17/2023
16570 121ST AVE SE RENTON, WA 98058
KIRUTHI TABITHA
B23002257
V1
RECEIVED05/01/2023aalexander
BUILDING DIVISION