Chuck Wooley
Building Official
GAS PERMIT
OWNER
INFORMATION
Owner
Name:
_____________________________________________________________________
Address:
_______________________________________
City:
______________GA
Zip:
_________
Phone:
______________________
Email:
______________________________________________
Name
of
Company:
_________________________________________________________________
Main
Contact:______________________________________________________________________
Address:________________________________________
City:_______________GA
Zip:________
Contact
Phone:______________________________Email:_________________________________
CONTRACTOR
INFORMATION
Business
License
#__________________________
State
License
#__________________________
(Copy
of
business
license
and
certification
card
if
applicable
must
be
provided.)
APPLICATION
Permit # _______________________ Fee ____________________ Date _______________________
OFFICE USE ONLY
Zoning Approval ________________________ Final Approval _______________________________
Use Classification _____________________________ Type _________________________________
Type
of
Fuel:
Natural
LP
Subdivision:
____________________________________
Lot
#:
_________
Parcel:
_____________
Equipment:
Enter
quantity
on
each
line.
Hot
Water
Heater,
Heating
System.....
Cooking
Range, Dryer........................
Baking
Oven.......................................
Refrigerator.............................
Fireplace
(gas
line
only)..........
Grill.........................................
Other:
__________________
Applicant's
Signature:
__________________________________________________________
Date:
____________
The
Greene
County
Board
of
Assessors,
in
accordance
with
Ga.
Law
must
give
reasonable
notice
to
property
owners
prior
to
making
a
site
visit.
Notice
is
hereby
given
that
a
representative
of
the
appraisal
staff
will
be
listing
new
construction
from
active
building
permits
for
changes
and
improvements
which
have
been
made
to
the
property.
BTU
Total # of ALL appliances.......
Quantity
FEE:
$50
Minimum
$50
Re-inspection
Fee
Greene County Building and Zoning Department
1034 Silver Dr., Ste 103, Greensboro, GA 30642 - Telephone (706) 453-3333 - FAX (706) 453-2579
www.greenecountyga.gov/building
