APPLICATION FOR ELECTRICAL AND PLUMBING PERMIT

City of Nicholson Building Inspection Office

175 Lakeview Dr Nicholson, GA 30565
Phone: 706/296-0581 Fax: 706/757-2351

Fill out the following information and turn in with all supplemental by the Nicholson Building Permit office. Any application that is to be found incomplete will not be issued a permit.

Owner's_Name:___________________________________________________________________________ ____________________ Phone:_________________
Current_Address: _________________________________________
Construction_Site_911_Address __________________________________
Subdivision: Lot# ________ Tax Parcel # __

Electrical

Contractor:

Address:

Phone: ______________ Cell #: __________________ Business License # _____________________ State License #

Size of Service Panel; (200 amp, 400 amp or three phase) _

________

Plumbing

Contractor: Address:

Phone: ___________________ Cell # _____________

Business License #: ________________ State License #: __

Numbers Of:

Toilets: _________ Bathroom Sinks _______ Separate Showers

Bath tubs & tub/Shower Combo: ____ Kitchen sinks: _ Water Heater __

Dishwasher: _______ Washer: ______ Laundry Sinks: ___ Other Fixtures if any: __________________________

THIS APPLICATION IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND THE PROPOSED WORK MEETS ALL CODES AND ORDINANCES OF CITY OF NICHOLSON.

Applicant's Signature: _________________________________

FOR OFFICE USE ONLY: Building Inspector Approval: Date___________