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McDuffie County Contractors Certification Form 210 Railroad Street, Suite 1544 Thomson, Georgia 30824 [PHONE REDACTED] Contractor/Company: Address: Bus. Phone: Cell Phone Email: Business Certification of Installation ____Electrical System &Components ____Plumbing System & Components ______Mechanical System & Components Location of Installation: Name of Street Address City Zip Code Date I certify that the system or components installed in accordance with plans approved by McDuffie County Planning and Zoning and the: ____2017 National Electrical Code with Georgia modifications ____2018 International Plumbing Code ____2018 International Mechanical Code The system or work provided for this location was: ____Electrical Equipment: __Mass/WHead __Meter Base Service Cable __Circuit Repair __New Circuit______ Breaker Ground Rods __Bond Bridge __Breaker Panel:____Amps ____#Circuits Smoke Alarm CO2 Alarms____ ____Plumbing Equipment: ____Toilet ____Sink ____Tub ____Shower ____WHeater ____Bib _____Laundry Sink ______Repair Supply ______Repair Waste _____Install Filter System ______Install ____Mechanical Equipment: Type System: __Electrical __Gas __Solar __GEO System: ____Central ____Space __Ductless Steam Unit Unit Contractor’s Signature Electrical License Expire: Plumbing License#: Expire: Mechanical Lic. # Expire: