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PICKENS COUNTY PLANNING & DEVELOPMENT 1266 East Church Street, Suite 136, Jasper, GA 30143 Phone: [PHONE REDACTED] Email: [EMAIL REDACTED] Fax: [PHONE REDACTED] MOBILE HOME APPLICATION A Permit is required on all construction projects or to locate or move mobile homes. Permits may not be issued the same day application is submitted. An Access/Encroachment permit is required for driveways that access a county-maintained road. The permit expires 12 months from date of issuance. Permit fees will be doubled if construction activity is undertaken prior to obtaining permits. Permits are Non-Transferable and Non-Refundable. Failure to schedule all required inspections will result in fines and/or stop work orders on the permit. Date: Mailing Phone Email: Property 911 Total Acres Estimated Completion Date: Project Utility Company (Check one): A.E.M.C. GA Power Water: Jasper City Pickens County Well Mobile Home Manufactured by: Installers License (Required) Manufacture ID # Year Size Decal Color Size or Square Footage: Unheated Total Current Zoning Use: (Circle) AG SA ER RR SR UR SPC SRPC NC HB I Is the property subject to any restrictive covenants or conditions? No Directions to Property: Signed Date ANY ALTERATIONS, DEVIATIONS, RELOCATIONS, OR CHANGES TO THIS APPLICATION WILL VOID THIS PERMIT Updated 2/15/2023 ---PAGE BREAK--- PICKENS COUNTY PLANNING & DEVELOPMENT 1266 East Church Street, Suite 136, Jasper, GA 30143 Phone: [PHONE REDACTED] Email: [EMAIL REDACTED] Fax: [PHONE REDACTED] For Office Use Only Is a copy of the septic tank permit attached to this application? If no, give reason: Property Location District and Land Lot Special Flood Information As per Panel # of the Flood Hazard Boundary Map dated September 29, 2010, this property IS / IS NOT in a Flood Hazard Area. Comments BUILDING PERMIT FEES ACCESS/ENCROACHMENT NEW EXISTING HEATED SQUARE FOOTAGE UNHEATED SQUARE FOOTAGE TOTAL SQUARE FOOTAGE FEES CERTIFICATE OF OCCUPANCY FEE TOTAL MOBILE HOME PERMIT FEE DATE PAID CASH/ CHECK/ CC# RECEIPT APPROVED BY DATE COMMENTS BUILDING PERMIT NUMBER Updated 2/15/2023 ---PAGE BREAK--- PICKENS COUNTY PLANNING & DEVELOPMENT 1266 East Church Street, Suite 136, Jasper, GA 30143 Phone: [PHONE REDACTED] Email: [EMAIL REDACTED] Fax: [PHONE REDACTED] SUBCONTRACTOR AFFIDAVIT Ready for Temp to Perm Service Hookup Will Call for Temp to Perm Service Hookup Building Permit Subdivision/Lot # Property Owner’s Name: Job Site Address: City State Zip Temporary Construction Power is hereby authorized on the electrical service conductors and service switch located at above mentioned address for a period of ninety (90) days. This request is made in order to complete construction of the final inspection at the above referenced location. An extension beyond the allotted time may be granted for good and sufficient reasons, provided the applicant gives notice before the expiration date, and subject to the Planning & Development’s approval. By applying for this temporary construction power permit, the applicant hereby assumes all responsibility and liability for use of electricity within the building during this period. NOTE: AN APPROVED FINAL INSPECTION AND CERTIFICATE OF OCCUPANCY IS NECESSARY BEFORE RESIDENCY IS ALLOWED. RESIDENTIAL OCCUPANCY IS NOT ALLOWED IN CONJUNCTION WITH TEMPORARY CONSTRUCTION POWER. FAILURE TO COMPLY WITH THE GUIDELINES SET WITHIN THIS PERMIT APPLICATION MAY RESULT IN IMMEDIATE DISCONNECTION OF ELECTRICAL SERVICE. VIOLATION OF COUNTY ORDINANCES MAY RESULT IN MAXIMUM FINE OF $1,000.00 AND SIXTY (60) DAYS IN JAIL, OR BOTH. Pickens County and its building inspectors are hereby relieved from any liability, damage, or loss associated with connection or disconnection of this temporary service. Print Name Signature (Required) Date Mailing Address City State Zip Current Phone Number (Required) Please indicate below the type of State License you hold and are using for this job Electrical Contractor Class I (Restricted to single-phase, not to exceed 200 amps) Electrical Contractor Class II (Unrestricted) A COPY OF YOUR STATE & BUSINESS LICENSE IS REQUIRED WITH THIS FORM AFFIDAVITS MUST BE SUBMITTED PRIOR TO SERVICE CONNECTION OR ROUGH INSPECTION REQUESTS. Electrical Contractor's Statement: The service equipment for the above referenced job location has been installed in accordance with all applicable state codes and county ordinances. In the event of any change in my status on this installation, I understand that I will be held responsible for this job until Planning and Development has been notified in writing of any changes. This is to certify that I am responsible for the electrical service on the above permit. Signature: Date: Please Print Name: County Business License Registered With: Business License Number: Expiration Date State License Number: Expiration Date Company Name: Company Street Address: City, State, Zip Code: Phone: Updated 2/15/2023 ---PAGE BREAK--- PICKENS COUNTY PLANNING & DEVELOPMENT 1266 East Church Street, Suite 136, Jasper, GA 30143 Phone: [PHONE REDACTED] Email: [EMAIL REDACTED] Fax: [PHONE REDACTED] Mobile Home Setup The setup of my personal manufactured home will be completed by myself in lieu of a licensed mobile home installer. I understand that I must comply with all the rules and regulations set forth by the Commissioner of Insurance Safety Fire Division and the mobile home Manufacture’s Setup. I also agree to abide by the manufactured homes guidelines set for in the Pickens County Code of Ordinances sections 38-459 through 38-466. I understand that violating the above-mentioned rules, regulations, and guidelines will result in stop work order, fines, and/or a delay in obtaining the Certificate of Occupancy for my mobile home. Print Name Signature Date Updated 2/15/2023 ---PAGE BREAK--- PICKENS COUNTY PLANNING & DEVELOPMENT 1266 East Church Street, Suite 136, Jasper, GA 30143 Phone: [PHONE REDACTED] Email: [EMAIL REDACTED] Fax: [PHONE REDACTED] Mobile Home Instructions 1. ON-SITE PERMITS – (Colored Card) must be displayed and seen from road for inspector to find construction site. This card must be displayed during construction on all buildings. 2. BUILDING PERMIT – Please retain the building permit you are issued for your records. This is your proof that a building permit has been obtained and may be required for utility services. 3. SCHEDULING INSPECTIONS – Call [PHONE REDACTED] to schedule your inspection at least 24 hours prior to needing the inspection. All future mobile home locations are required to have a site inspection PRIOR to delivery of the mobile home to the location. Please refer to the Pickens County Building Codes Guidelines packet for a list of inspections. 4. AFFIDAVITS – Electrical affidavit (and all required documentation) is required BEFORE power is released. 5. CERTIFICATE OF OCCUPANCY - A Certificate of Occupancy (CO) will be issued by the Planning & Development office once the final inspection has been passed and all required documentation is on file. Updated 2/15/2023 ---PAGE BREAK--- PICKENS COUNTY PLANNING & DEVELOPMENT 1266 East Church Street, Suite 136, Jasper, GA 30143 Phone: [PHONE REDACTED] Email: [EMAIL REDACTED] Fax: [PHONE REDACTED] Mobile Home & Modular Home Guidelines S38-460: All manufactured homes located in the jurisdiction shall bear a label certifying it was constructed in compliance with the National Manufactured Housing Construction and Safety Standards Act of 1974, 42 U.S.C. Section 5401, et seq. (the HUD CODE) and shall be installed in accordance with O.C.G.A. § 8-2-160, et seq. S38-461: A permit shall be required to locate a manufactured home in the jurisdiction. S38-462: All manufactured homes shall comply with the minimum health and safety standards before being issued a certificate of occupancy by the building inspector. S38-465: All manufactured homes not in a mobile home park shall comply with Section 38-181(5) of this Code: S38-181(5): Residential building setback lines shall be at least 55 feet from the centerline of the street or road. A corner lot shall meet the setback requirements of both streets. The building shall be setback from the side and rear lot lines a minimum of 15 feet. Violations of setback lines shall be subject to fines as set forth in section 38-9 and/or be subject to removal of that portion of the structure which is in violation of the setback distance. S38-466: All manufactured homes shall be secured in accordance with the tie down requirements approved by the mobile home manufacturers association. All residential and accessory structures must also comply with: S67 Table 6-1-2: Dimensional requirements by land use intensity district All items listed above are from the Pickens County Development Standards which can be found at www.pickenscountyga.gov Updated 2/15/2023 ---PAGE BREAK--- PICKENS COUNTY PLANNING & DEVELOPMENT 1266 East Church Street, Suite 136, Jasper, GA 30143 Phone: [PHONE REDACTED] Email: [EMAIL REDACTED] Fax: [PHONE REDACTED] Required Documents for Mobile Home Permits From Dealership: PT-41 Form Form 500 – Purchase Agreement Installers License For Tax Assessors Office: PT-41 Form Form 500 – Purchase Agreement Septic Permit (from Environmental Health) For Tax Commissioners Office: PT-41 Form N.O.D. Mobile Home Digest Entry (From Tax Assessor) For Planning & Development: Septic Permit (from environmental Health) PT-41 Form Form 500 – Purchase Agreement Installers License N.O.D. Mobile Home Digest Entry (from Tax Assessor) Decal Updated 2/15/2023