Chuck Wooley
Building Official
1034 Silver Dr., Ste 103, Greensboro, GA 30642 Telephone 706-453-3333 www.greenecountyga.gov
PHVAC ERMIT
Permit
#
______________________
Fee
__________________
Date
___________________
OFFICE
USE
ONLY
PROPERTY
INFORMATION
OWNER
INFORMATION
Owner Name:______________________________________________________________________
Address:________________________________________ City:_______________GA Zip:________
Phone:_______________________Email:_______________________________________________
Name
of
Company:
_________________________________________________________________
Address of project: _______________________________ City:_______________GA Zip:_________
Subdivision:_____________________________________ Lot #: _________ Parcel: ____________
Main
Contact:______________________________________________________________________
Address:________________________________________
City:_______________GA
Zip:________
Contact
Phone:______________________________Email:_________________________________
CONTRACTOR
INFORMATION
Business
License
#__________________________
State
License
#__________________________
(Copy
of
business
license
and
certification
card
if
applicable
must
be
provided.
)
Greene County Building Inspection Division
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WORK PERFORMED
New Service Replacement Service
Number of air condition units: ________
Number of furnace units: _______
Number of heat pump units: ___________
Gas line Pressure check for gas meter replacement
Name:___________________________ Size:__________ Model:______________________ BTUH Loss________
Name:___________________________ Size:__________ Model:______________________ BTUH Loss________
Name:___________________________ Size:__________ Model:______________________ BTUH Loss________
HVAC PERMIT
Chuck Wooley
Building Official
1034 Silver Dr., Ste 103, Greensboro, GA 30642 Telephone 706-453-3333 www.greenecountyga.gov
COOLING UNIT TYPE
Name:___________________________ Size:__________ Model:______________________ BTUH Gain________
HEATING UNIT TYPE
Name:___________________________ Size:__________ Model:______________________ BTUH Gain________
Name:___________________________ Size:__________ Model:______________________ BTUH Gain________
GREASE HOOD
Name:___________________________ Size:__________ Model:_______________________ BTUH Gain_______
Name:___________________________ Size:__________ Model:_______________________ BTUH Gain_______
VENTILATION
Name:___________________________ Size:__________ Model:______________________ BTUH Gain________
Name:___________________________ Size:__________ Model:______________________ BTUH Gain_______
Applicant's Signature: __________________________________________________________ Date: ____________
***The Greene County Board of Assessors, in accordance with Ga. Law must give reasonable notice to property owners prior to making a site visit.
Notice is hereby given that a representative of the appraisal staff will be listing new construction from active building permits for changes and
improvements which have been made to the property.
Address of project: _______________________________ City:_______________GA Zip:_________
Address of project: _________________________________________
Fees
Due
Heating
Cooling
Units
$50
x
________
=
Fee
$________
RE-INSPECTION
FEES
ARE
$50/EACH.
Greene County Building Inspection Division
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