I, state as follows:
1) I have made application for a building permit from the City of Des Moines, Washington.
2) I understand that state law requires that all building construction contractors be registered with the State of Washington. The
exceptions to this requirement are stated under Section 18.27.090 of the Revised code of Washington, a copy of which is printed with
this affidavit.
3) I understand that prior to issuance of a building permit for work which is to be done by any contractor, the City of Des Moines must
verify either that the contractor is registered by the State of Washington or that one of the exemptions stated under RCW 18.27.090
4) In order to provide verification to the City of Des Moines of my compliance with this requirement, I hereby attest that after reading
the exemptions from the registration requirement of RCW 18.27.090, I consider the work authorized under this building permit to be
exempt under the exemption which has been checked, and will therefore not be performed by a registered contractor.
Building Department
21630 11th Avenue South, Suite D
Des Moines, WA 98198
(206)870-7576 fax:(206)870-6544
in Lieu of
General Contractor
Project Address: Date:
(1) An authorized representative of the United States government, the state of Washington, or any incorporated city, town, county,
township, irrigation district, reclamation district, or other municipal or political corporation or subdivision of this state;
(2) Officers of a court when they are acting within the scope of their office;
(3) Public utilities operating under the regulations of the utilities and transportation commission in construction, maintenance, or
development work incidental to their own business;
(4) Any construction, repair, or operation incidental to the discovering or producing of petroleum or gas, or the drilling, testing,
abandoning, or other operation of any petroleum or gas well or any surface or underground mine or mineral deposit when
performed by an owner or lessee;
(5) The sale of any finished products, materials, or articles of merchandise that are not fabricated into and do not become a part of a
structure under the common law of fixtures;
(6) Any construction, alteration, improvement, or repair of personal property performed by the registered or legal owner, or by a
mobile/manufactured home retail dealer or manufacturer licensed under chapter 46.70 RCW who shall warranty service and repairs
under chapter 46.70 RCW;
(7) Any construction, alteration, improvement, or repair carried on within the limits and boundaries of any site or reservation under
the legal jurisdiction of the federal government;
(8) Any person who only furnished materials, supplies, or equipment without fabricating them into, or consuming them in the
performance of, the work of the contractor;
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List of registered contractor exemptions under RCW 18.27.090
Permit #
Applicant's signature
(15) Any person who engages in the activities herein regulated as an employee of a registered contractor with wages as his or her sole
compensation or as an employee with wages as his or her sole compensation;
(16) Contractors on highway projects who have been prequalified as required by RCW 47.28.070, with the department of
transportation to perform highway construction, reconstruction, or maintenance work;
(17) A mobile/manufactured home dealer or manufacturer who subcontracts the installation, set-up, or repair work to actively
registered contractors. This exemption only applies to the installation, set-up, or repair of the mobile/manufactured homes that were
manufactured or sold by the mobile/manufactured home dealer or manufacturer;
(18) An entity who holds a valid electrical contractor's license under chapter 19.28 RCW that employs a certified journeyman
electrician, a certified residential specialty electrician, or an electrical trainee meeting the requirements of chapter 19.28 RCW to
perform plumbing work that is incidentally, directly, and immediately appropriate to the like-in-kind replacement of a household
appliance or other small household utilization equipment that requires limited electric power and limited waste and/or water
connections. An electrical trainee must be supervised by a certified electrician while performing plumbing work.
(14) A licensed architect or civil or professional engineer acting solely in his or her professional capacity, an electrician certified under
the laws of the state of Washington, or a plumber certified under the laws of the state of Washington or licensed by a political
subdivision of the state of Washington while operating within the boundaries of such political subdivision. The exemption provided
in this subsection is applicable only when the person certified is operating within the scope of his or her certification;
(13) An owner who performs maintenance, repair, and alteration work in or upon his or her own properties, or who uses his or her
own employees to do such work;
(12) Any person working on his or her own property, whether occupied by him or her or not, and any person working on his or her
personal residence, whether owned by him or her or not but this exemption shall not apply to any person who performs the activities
of a contractor on his or her own property for the purpose of selling, demolishing, or leasing the property;
I understand that I may be waiving certain rights that I might otherwise have under
state law in any decision to engage an unregistered contractor to perform
construction work
Page 2
(11) An owner who contracts for a project with a registered contractor, except that this exemption shall not deprive the owner of the
protections of this chapter against registered and unregistered contractors. The exemption prescribed in this subsection does not
apply to a person who performs the activities of a contractor for the purpose of leasing or selling improved property he or she has
owned for less than twelve months;
(10) Any construction or operation incidental to the construction and repair of irrigation and drainage ditches of regularly constituted
irrigation districts or reclamation districts; or to farming, dairying, agriculture, viticulture, horticulture, or stock or poultry raising; or to
clearing or other work upon land in rural districts for fire prevention purposes; except when any of the above work is performed by a
registered contractor;
(9) Any work or operation on one undertaking or project by one or more contracts, the aggregate contract price of which for labor
and materials and all other items is less than five hundred dollars, such work or operations being considered as of a casual, minor, or
inconsequential nature. The exemption prescribed in this subsection does not apply in any instance wherein the work or construction
is only a part of a larger or major operation, whether undertaken by the same or a different contractor, or in which a division of the
operation is made into contracts of amounts less than five hundred dollars for the purpose of evasion of this chapter or otherwise.
The exemption prescribed in this subsection does not apply to a person who advertises or puts out any sign or card or other device
which might indicate to the public that he or she is a contractor, or that he or she is qualified to engage in the business of contractor;
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