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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] COMMERCIAL BUILDING APPLICATION A permit is required on all new construction, repairs, alterations, and miscellaneous projects. Permits may not be issued the same day the application is submitted. An Access/Encroachment permit is required for driveways that access a county-maintained road. Permits expire 12 months from date of issue. 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. Commercial permits will not be issued until all submitted plans have been approved by the department. Date Plan Review # Property Owner: Mailing Address: City State Zip Phone Number: Email: A COPY OF THE CONTRACTOR’S STATE, BUSINESS AND DRIVERS LICENSE IS REQUIRED WITH THIS FORM Builder/Contractor: Mailing Address: City State Zip Phone Number: Email: Type of License State License: GA Contractor State License Expiration Date: Contractor’s Business License Issuing County: • 911 Address • Type of Structure: UTILITY COMPANY: WATER: Total A.E.M.C. Jasper City ❑ Pickens County ❑ GA Power ❑ Well ❑ Size or Square Footage - Unheated Current Zoning Use: (Circle) AG SA ER RR SR UR SPC SRPC NC HB I Does this structure comply with current zoning use, if not, has a land use change application been submitted? Yes No Is the property subject to any restrictive covenants or conditions? Yes or No If yes, are your proposed improvements in violation of such restrictions or covenants? Yes No If yes, what actions have you taken to receive a variance from the restrictions/covenants? ensure that certified personnel in NPDES will be onsite during all land disturbing activities Name of Owner or Contractor Directions to Property: Estimated Completion Date: Estimated Project Value: Signed Date: ANY ALTERATIONS, DEVIATIONS, RELOCATIONS, OR CHANGES TO THIS APPLICATION WILL VOID THIS PERMIT ---PAGE BREAK--- Updated 1/19/2024 For Office Use Only Is a copy of the septic tank permit attached to this application? If no, give reason: Parcel Number 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 PLAN REVIEW HEATED SQUARE FOOTAGE UNHEATED SQUARE FOOTAGE TOTAL SQUARE FOOTAGE FEES CERTIFICATE OF OCCUPANCY FEE TOTAL COMMERCIAL PERMIT FEE DATE PAID CASH/CHECK/CC# RECEIPT # APPROVED BY DATE COMMENTS BUILDING PERMIT NUMBER ---PAGE BREAK--- Updated 1/19/2024 Commercial Building Information Sheet Permit Gate Code: Name: Parcel ID: Please fill in Square Footage (Heated and Unheated Space) Heated Office Space Addition/Remodel Storage Bldg./Warehouse Unheated Loading Dock Addition/Remodel Storage Bldg./Warehouse Porches/Decks Total Heated Total Unheated Total Square Footage # of Stories # of Wall Height Elevator Cost Exterior Walls: Interior Walls: Masonry Wood Brick Stucco/Frame Sheet Rock Panel Plaster Pine Aluminum Siding Log Metal Vinyl Siding Concrete Block Frame Tile Plywood Unfinished Concrete Masonry Other Interior Ceilings: Roof Cover Sheet Rock Acoustic Tile Exposed Beams Aluminum Shingles Composition Metal Metal Panel Celotex Tar & Gravel Wood Tile Slate Fiberglass Panels Plaster Other Cooper Other Fireplaces: Floor Finish: Prefabricated Constructed None Carpet Tile Hardwood Pine Vinyl Concrete Double w/ 1 Chimney Qty: Other Heat: Plumbing Central Heat & Air Floor/Wall Furnace Fixtures: Single 2 3 3-Fixture w/kitchen plumbing Hot Water/Steam Base Board Space 1.5 bath w/kitchen plumbing 2 bath w/kitchen plumbing Suspended None Other Standard Other Wall Frame Roof Frame Bearing Wall Plaster Steel Wood Steel Wood Concrete Reinforced Concrete Reinforced Concrete Other Open Steel Open Wood Other Foundation Commercial Construction Type Concrete Masonry Slab Piers CB, WD, or Light Steel Load Bearing Walls Other Curt, WLS, Conc. Beams Fireproofed Steel Beams Floor Construction Story Height/Attic Reinforced Concrete Open Wood Joists None Finished Unfinished # of Stories Steel Joist Elevated Slab Wood Joist Garage Apt. Y/N Split Level Y/N Foyer Y/N Lighting Wiring Standard Recessed Incandescent Non-Metallic BX Cable Flexible Conduit Mercury Vapor Sodium Halide Residential Rigid Conduit ---PAGE BREAK--- Updated 1/19/2024 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: ---PAGE BREAK--- Updated 1/19/2024 PICKENS COUNTY PLANNING & DEVELOPMENT 1266 East Church Street, Suite 136 Jasper, GA 30143 Phone [PHONE REDACTED] Email: [EMAIL REDACTED] Fax [PHONE REDACTED] SUBCONTRACTOR AFFIDAVIT Building Permit Subdivision/Lot # Property Owner’s Name: Job Site Address: City State Zip Print Name Signature (Required) Date Mailing Address City State Zip Current Phone Number (Required) This is to certify that I am responsible for the Plumbing Mechanical Please indicate below the type of State License you hold and are using for this job Master Plumber Class I (Restricted to S/F. I level duplex and commercial up to 10,000 sq. ft.) Master Plumber Class E (Unrestricted) Conditioned Air Contractor Class I (Restricted to 60,000 BTU cooling and 175,000 BTU heating) Conditioned Air Contractor Class H (Unrestricted) A COPY OF YOUR STATE & BUSINESS LICENSE IS REQUIRED WITH THIS FORM AFFIDAVITS MUST BE SUBMITTED PRIOR TO ROUGH INSPECTION REQUESTS Plumbing/HVAC 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 plumbing and/or HVAC 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: ---PAGE BREAK--- Updated 1/19/2024 PICKENS COUNTY PLANNING & DEVELOPMENT 1266 East Church Street, Suite 136, Jasper, GA 30143 Phone [PHONE REDACTED] Email: [EMAIL REDACTED] Fax [PHONE REDACTED] SUBCONTRACTOR AFFIDAVIT Building Permit Subdivision/Lot # Property Owner’s Name: Job Site Address: City State Zip Print Name Signature (Required) Date Mailing Address City State Zip Current Phone Number (Required) This is to certify that I am responsible for the Plumbing Mechanical Please indicate below the type of State License you hold and are using for this job Master Plumber Class I (Restricted to S/F. I level duplex and commercial up to 10,000 sq. ft.) Master Plumber Class E (Unrestricted) Conditioned Air Contractor Class I (Restricted to 60,000 BTU cooling and 175,000 BTU heating) Conditioned Air Contractor Class H (Unrestricted) A COPY OF YOUR STATE & BUSINESS LICENSE IS REQUIRED WITH THIS FORM AFFIDAVITS MUST BE SUBMITTED PRIOR TO ROUGH INSPECTION REQUESTS Plumbing/HVAC 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 plumbing and/or HVAC 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: ---PAGE BREAK--- Updated 1/19/2024 PICKENS COUNTY PLANNING & DEVELOPMENT 1266 East Church Street, Suite 136, Jasper, GA 30143 Phone [PHONE REDACTED] Email: [EMAIL REDACTED] Fax [PHONE REDACTED] SUBCONTRACTOR AFFIDAVIT Building Permit Subdivision/Lot # Property Owner’s Name: Job Site Address: City State Zip Print Name Signature (Required) Date Mailing Address City State Zip Current Phone Number (Required) Builder/Contractor’s Name (Please print) Signature (Required) Date Type Batts Foil Loose Foam R-Value Thick Ceiling Wall Floor A COPY OF YOUR BUSINESS LICENSE IS REQUIRED WITH THIS FORM AFFIDAVITS MUST BE SUBMITTED PRIOR TO INSULATION INSPECTION REQUESTS Insulation 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 insulation service on the above permit. Signature: Date: Please Print Name: County Business License Registered With: Business License Number: Expiration Date: Company Name: Company Street Address: City, State, Zip Code: Phone: