Chuck Wooley
Building Official
Renee' Criswell
Office Manager
Jamie Brantley
Permit Clerk
Brad Cherry
Building Inspector
Scott Allen
Code Enforcement
1034 Silver Dr., Ste 103, Greensboro, GA 30642 Telephone 706-453-3333 www.greenecountyga.gov
COMMERCIAL
Name:
____________________________________________________
Date
:__________________
Construction Address: ____________________________________ Phone Number: _____________
PERMIT AFFIDAVIT
This permit is for: New Building Addition/Renovation Other: __________________
Work Description: __________________________________________________________________
I, the undersigned property owner, certify the following to be true and accurate:
_______ Initial . I hold the title to the above property (building and land) and the public does NOT
have access to the interior of the building . If this does not apply to you STOP . You must hire a
licensed General Contractor.
_______ Initial. I plan on doing and/or overseeing all construction , materials , and any labor on my
construction project. I am not purchasing this permit for a contractor.
_______ Initial . I understand that as owner /builder , I must abide by all zoning ordinances and
building regulations in effect at the time of the permit application.
_______ Initial . I have a copy of the adopted current copy of the
International Building Code and
Georgia State Amendments
. There is a copy of the code in this office for your review, but we cannot
provide you a personal copy. It can also be found online at www.upcodes.com
_______ Initial. I understand that the Building Official and department are not there to design, alter,
or give advice on how to meet the applicable building codes, rather, only if the construction project
meets the minimum building codes.
_______ Initial. It is up to the design professional (if applicable) and the owner/builder to make sure
that the project meets the plans and specifications of the project. The building department will only
inspect the minimum building codes.
_______ Initial . I understand that as owner /builder , any contract disputes that arise with labor ,
subcontractors, or material suppliers, must be handled in a civil court with the advice of an attorney.
_______ Initial. I understand that if I compensate any person or company for work performed, it is my
responsibility as owner/builder contractor to make sure they have the applicable licenses, insurance,
permits and inspections.
_______ Initial . I understand that if any person gets injured on my construction project , they are
entitled to worker 's compensation according to state and federal laws . If they do not possess a
worker 's compensation policy , I could be held liable for all doctors ' bills and related cost from the
injury, including loss wages during recovery.
_____________________________________
Applicant Name (Print)
Applicant Signature
_____________________________________
_____________________
Date
Greene County Building Inspection Division
Sworn
and
subscribed
before
me
this
______
day of ______________ 20______.
____________________________________
Signature & Seal of Notary Public
____________________________________
Commission Expires
