City of Washington, Georgia Return To: Permit Clerk Mechanical Permit Washington City Hall 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 New Residential New Commercial Residential Renoyation/Adition Mobile Home Commercial Renovation/ Addition System Change Out Inspections System Rough In Date Complete Inspector Final Inspection All Work Complete Date Complete Inspector Permit Cost $ Signature