CITY OF RICHMOND HILL FEE $_______________
Building and Zoning Department
P.O. Box 250 Richmond Hill, Ga. 31324
(912) 756-4521 or (912) 756-6457
Building Permit # _________________________________
Tap Fee: _______________________ Meter Install Fee: ___________
Water Connection Fee: _____________________ Sewer Connection Fee: ______________________
Reuse Fee: __________________________ Other: ____________________________________
OWNER/APPLICANT:_________________________________________DATE:_______________________
ADDRESS: _____________________________________________Email: ____________________________
PHONE:_______________________________ ESTIMATED COST:_________________________________
LOT# and SUBDIVISION: ___________________________ MAP and PARCEL #:_____________________
911ADDRESS: ____________________________________________________________________________
CONTRACTOR:___________________________________PHONE:_________________________________
ADDRESS: _____________________________________________Email: ____________________________
TYPE OF PERMIT:
SINGLE FAMILY MULTI-FAMILY COMMERCIAL
MANUFACTURED HOME TEMP OFFICE TRAILER OTHER: ______________________
ACCESSORY BUILDING (Non Prefabricated)
PURPOSE: ERECT BUILD OUT REPAIR ADDITION
PROVIDE A BRIEF DESCRIPTION OF THE WORK TO BE DONE: _______________________________________________________
_______________________________________________________________________________________________________________________
TYPE OF CONSTRUCTION: TYPE I-A FIRE RESISTIVE 3HR TYPE I-B FIRE RESISTIVE 2HR
TYPE II-A PROTECTIVE NON-COMBUSTIBLE 1HR TYPE II-B UNPROTECTIVE NON-COMBUSTIBLE
TYPE III-A PROTECTIVE COMBUSTIBLE TYPE III-B UNPROTECTED COMBUSTIBLE
TYPE IV HEAVY TIMBER TYPE V-A PROTECTED WOOD FRAME TYPE V-B UNPROTECTED WOOD FRAME
TOTAL SQUARE FEET______________________ TOTAL HEIGHT___________ # STORIES_________ BATHS_________
# BEDROOMS_______ TOTAL ROOMS_______SIZE OF BUILDING_________________ HEATING TYPE______________
AIR COND. TYPE__________________ TYPE OF ELECTRICAL______________________ PLUMBING__________________
TYPE OF ROOF_________________ FOUNDATION TYPE____________________ TYPE OF FIREPLACE_______________
PROPERTY OWNERS NAME (IF DIFFERENT THAN APPLICANT):_________________________________________________
ADDRESS: ____________________________________________________________ PHONE:______________________________
POWER COMPANY: COASTAL EMC GA.POWER
FLOOD ZONE CATEGORY: ________________ BASE FLOOD ELEVATION: ______________ DATUM: _____________
ZONING CLASSIFICATION: ________________ SETBACKS: F______ RS_______ LS________ R_________
1. You will be given a copy of the approved Neighborhood Drainage Plan for the lot pertaining to this building permit, if applicable. A C.O. for this
building will not be given if the lot is not graded to drain as shown on the approved plan.
2. The regulation to build at or above the required flood elevation has been explained to me. I understand that areas below the required elevation may
only be used for the parking of vehicles, building access, and limited storage for minimal lawn or maintenance equipment. I understand that to
enclose beneath the required elevation, there are strict requirements pertaining to hydrostatic vents or breakaway walls depending on the flood zone
in which the building is located and that there can be no partitioning of rooms. I further understand that should I violate any of these rules, I may be
required to remove the enclosure, that my insurance carrier may be notified and that further remedy may be sought through the courts.
3. Please call (912) 756-4521 by 5:00pm for inspections and give twenty four (24) hours notice.
4. Property pins must be showing and string lines pulled to each pin so that set backs can be measured before the slab can be inspected
and poured.
5. You are responsible for approvals from any subdivision Property Owner’s Association for covenant requirements prior to actual construction.
6. Approval by the Building and Zoning Department does not exempt the applicant from complying with all other governmental
regulations.
7. No Certificate of Occupancy will be issued until all tap fees, water and sewer connection fees, reuse fees and/or any other outstanding
fees are paid.
8. No additional building permits will be issued an applicant where outstanding tap, connection, reuse or other city fees exist on other properties
owned by the applicant if a tenant has moved into such property without a certificate of occupancy.
This permit must be renewed if work or construction authorized is not commenced within six (6) months or if construction is suspended or
abandoned for a period of one (1) year at any time after work is commenced.
I HAVE READ AND UNDERSTAND THE ABOVE STATEMENTS
OWNER/APPLICANT SIGNATURE:___________________________________________________DATE:___________________
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APPROVED BY:__________________________________________________ DATE:___________________
COMMENTS:________________________________________________________________________________________________
THE ISSUANCE OF THIS PERMIT AUTHORIZES IMPROVEMENTS OF THE REAL PROPERTY DESIGNATED HEREIN WHICH
IMPROVEMENTS MAY SUBJECT SUCH PROPERTY TO MECHANICS AND MATERIALMENS LIENS PURSUANT TO PART 3 OF ARTICLE 8 OF
CHAPTER 14 OF TITLE 44 OF THE OFFICIAL CODE OF GEORGIA ANNOTATED. IN ORDER TO PROTECT ANY INTEREST IN SUCH
PROPERTY AND TO AVOID ENCUMBRANCES THEREON, THE OWNER OR ANY PERSON WITH AN INTEREST IN SUCH PROPERTY SHOULD
CONSIDER CONTACTING AN ATTORNEY OR PURCHASING A CONSUMERS GUIDE TO THE LIEN LAWS WHICH MAY BE AVAILABLE AT
BUILDING SUPPLY HOME CENTERS.
