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Dawson County Community Development Electrical Permit Application Commercial or Residential (check one) Tax Map Parcel Number Location of Project Power Company: Description of project Owner's Name Mailing Address Phone Number (please do not provide unlisted numbers) Email address: 24-Hour Emergency Contact: Phone: Contractor's Name License Number Contractor’s Address Contractor’s Phone Contractor's Email Release form must be signed (page 2) Commercial or Residential Properties 25 Justice Way, Dawsonville, GA 30534 [PHONE REDACTED] METER BASE ONLY ---PAGE BREAK--- Release Form (Signature Required) Electric or Meter Base Permits Residential or Commercial All work must be designed in accordance with the following adopted codes: 2018 International Building Code with Georgia Amendments 2018 International Residential Code with Georgia Amendments 2018 International Fire Code with Georgia Amendments 2018 International Plumbing Code with Georgia Amendments 2018 International Mechanical Code with Georgia Amendments 2018 International Fuel Gas Code with Georgia Amendments 2015 International Energy Conservation Code with Georgia Amendments 2023 National Electrical Code with Georgia Amendments 2010 Department of Justice ADA Requirements Dawson County Adopted Ordinance Signature: (Initial) Temporary connection shall not exceed the period the building permit is valid or completed. The state-licensed electrician (or owner) who has requested this release accepts all liability and responsibility for using electricity at this location. It is understood that no occupancy will be allowed during this temporary connection period, and any violation will result in a citation and disconnection of service without any notice. By requesting this inspection, the licensed electrician, builder, and owner understand the requirements for temporary power and will relieve Dawson County inspectors from any liability or loss for ordering connection or disconnection of electrical service. It is also understood that they are to have a Dawson County Business License or be registered with Dawson County to work within the County. Revised 03/07/2024 Page 2 initial and sign SIGN