Building Permit Application

2. Permit Number

3. Commercial

4. Residential

5. Traffic Zone

7. 1. Job Address

9. City

10. State

11. Zip Code

13. 2. Legal Description

14. Lot Number

15. Block Number

16. Tract Name

18. 3. Lot Dimensions

19. Road Frontage

20. Depth

21. Total Area

23. 3a. What other buildings are on this property?

25. 4. Contact Persons

27. Owner Name

28. Owner Address

    Include zip code

29. Owner Phone Number

31. Contractor Name

32. Contractor Address

33. Contractor Phone

35. Architect Name

36. Architect Address

37. Architect Phone

39. Engineer Name

40. Engineer Address

41. Engineer Phone

43. Plumber Name

44. Plumber Address

45. Plumber Phone

47. Electrician Name

48. Electrician Address

49. Electrician Phone

51. Mechanical Name

52. Mechanical Address

53. Mechanical Phone

55. Lawn Sprinkler Name

56. Lawn Sprinkler Address

57. Lawn Sprinkler Phone

59. 5. Class of Work

    1. New
    2. Addition
    3. Alteration

    1. Repair
    2. Move
    3. Demolition

    1. Pool
    2. Sign

61. 6. Describe Work

63. 7. Existing Use

65. 8. Proposed Use

67. 9. Valuation of Work

68. 10. Total Square Footage Under Roof

70. 11. Total Heated Area

71. 12. Capacity of Air Conditioner Unit

73. 13. Capacity of Heat Unit

75. 14. Special conditions, if any:

79. Permit Fee

80. Building Height

81. Front Setback

82. Side Setback

84. Rear Setback

85. Fireplace

86. Fire Sprinklers

87. Zoning District

89. Approved Use

90. Number of Dwelling Units

91. Type of Construction

92. Source of Water

94. Sewerage Type

98. Special Approvals

99. Info Required

100. Date Received

101. Not Required

103. Zoning

108. Health Department

113. Fire Department

118. Soil Conservation

123. Engineering

128. Water

133. Sewer

138. Lead*

143. Asbestos*

148. *For all repair/renovation/remodel/demolition:

     Lead test required for pre-1978 homes and child occupied facilities.<br> <br> Asbestos test required regardless of age of structure.

     Lead test required for pre-1978 homes and child occupied facilities.
     
     Asbestos test required regardless of age of structure.

152. Separate permits are required for electrical, plumbing, heating, ventilating, or air conditioning.

     This permit becomes null and void if work or construction authorized is not commenced within 6 months, or if construction or work is suspended or abandoned for a period of 1 year at any time after work is commenced.

     This permit becomes null and void if work or construction authorized is not commenced within 6 months, or if construction or work is suspended or abandoned for a period of 1 year at any time after work is commenced.

154. I hereby certify that I have read and examined this application and know the same to be true and correct. I understand that the granting of a permit does not waive the provisions of any other state or local law regulating construction or the performance of construction. I agree to call for all building, plumbing, electrical and mechanical inspections required by Columbia County and/or City of Grovetown.

156. Signature of Contractor Authorized Agent

157. Date
     Date

159. Signature of Owner

     If owner builder

160. Date
     Date

162. Permit Approved by

163. Date
     Date

165. Permit fee of:

166. Paid on:
     Paid on:

Leave This Blank:


167. 1. Receive an email copy of this form.
168. Email address

     This field is not part of the form submission.

169. Submit

* indicates a required field