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Project Declaration <br /> TMK Project Location ApPliCation# --- <br /> ' iLL.712 fi110, ii3 14 Oeoe Street may be provided later I <br /> ,„„ ,... , — <br /> f Project,includes: (NOTE:Electrical drawings required for residential work involving>200 Amy <br /> Building Work <br /> Fr lumbing Work <br /> Valuation of Building Work ry r more i <br /> ni bathrooms o lEle rical Work <br /> fljj>200Arnpservice <br /> Valuation of Plumbing Work <br /> Valuation of Electrical Work <br /> 52 ,000 <br /> m I <br /> L Jid) 1,009 <br /> STATEMENT ACCOMPANYING PERMIT APPLICATION PURSUANT TO CHAPTER 444,H.R.S.(RELATING TO CONTRACTORS) <br /> (SEC 444-HRS)(Select Contractor or Owner-Builder) <br /> „—— <br /> a CONTRACTOR <br /> I declare that I am licensed under the provisions of Chapter 444,HRS,of the Department of Commerce&Consumer Affairs, t) <br /> ) <br /> State of Hawaii.My license#is in full force and in effect. <br /> 1 <br /> Si tia jia,t2fIME Date ' <br /> ------ --- ------n , <br /> NOTE:RME(Responsible Managing Employee)only to sign.Notarized authorization from RME required for designated <br /> agents. <br /> Building Contractor Name License# Lic.Expiration Phone# <br /> Date <br /> Address <br /> RME1 Full Name RME2 Full Name <br /> RME1 Work Phone RME].Cell Phone RME2 Work Phone RME2 Cell Phone <br /> RME1 Email Address RME2 Email Address <br /> „„— .„,— — _„„„„— _ — .„., <br /> 7- <br /> ,../' OWNER-BUILDER <br /> P — — <br /> Section 5-1 5 Definition"Owner-builder"means owners or lessees of property who build or improve structures on their --- <br /> --- <br /> 1 property for their own use,or for use by their immediate family.This definition shall not preempt owner-builder by exemption <br /> 1 as defined by section 444-2.5,Hawaii Revised Statutes <br /> 1 <br /> 1 I <br /> I declare an exemption uncle Sec.444 2(7)for the following reasons: <br /> 1) This exemption allows me,as the owner or lessee of the property,to act as my own general contractor without <br /> possessing a license <br /> 2) To supervise the construction myself <br /> 3) To hire licensed subcontractors <br /> 4) The building is for my personal use and not for the use or occupancy by the general public <br /> 5) Building will not be built for sale or lease within one(1)year after construction is complete. <br /> Section 5-4 Definition"Owner-builder"means owners or lessees of property who build or improve structures on their <br /> ) <br /> property for their own use,or for use by their immediate family.This definition shall not preempt owner builder by exemption 11 <br /> as defined by section 444-2,5,Hawaii Revised Statutes <br /> ,Ploieerty Owner , <br /> Owner Name <br /> — <br /> , <br /> 43ickoiRD 6.T AA/th<1 , --- <br /> i la Wire <br /> _ V <br /> 2/24/2025 <br /> Hawa VI County is an equal opportunity provider and employer <br /> -_DOCUMENT 4 - PG 1 OF 3 <br />