City of Washington, Georgia Return To: Permit Clerk Washington City Hall Electrical Permit 102 East Liberty Street PO Box 9 Washington GA 30673 Location Number and Street Name: Date: Expires: Permit #: Map & Parcel: Owner Name: Phone: Cell: Mailing Address: Contractor Name /Address: License #: Telephone #: Cell: Zoning: Estimated Job Cost $ Type of Work 1. New Residential 2. New Commercial 3. Generator 4. Service Repair/ Replace 5. Renovation Inspections Temp Power Date Complete Inspector Rough In Date Complete Inspector Perm. Power Date Complete Inspector Final Inspection All Work Complete Date Complete Inspector Permit Cost $ Applicant Signature: Date: