Chuck Wooley
Building Official
1034 Silver Dr., Ste 103, Greensboro, GA 30642 - (706) 453-3333 FAX (706) 453-2579
www.greenecountyga.gov/building
HOMEOWNER
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
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/
Residential Building
_______
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______.
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
____________________________________
Signature & Seal of Notary Public
____________________________________
Commission Expires
