PRE-SCREEN ApPLICATION

CITY OF ATLANTA - BUREAU OF BUILDINGS Date

55 Trinity Avenue, Suite 3900, Atlanta, Georgia 30303 - (404) 330-6150
Application Number

*' REQUIRED SECTION- -< < \1'1'1 Ie,\ liON \\ II I NO I HI I'IWeI SSI I) ! 'NI I SS RI <)! IRI I> SI C11()NS \R I.
< C()1\ 11'1U I..

PROJECT ADDRESS ZONING

PROJECT
NAME: RELATED CAP

DETAIL WORK DESCRIPTION:

# of Units _
*Ttl Cost of Constr.: $ # of Buildings _
*PROPERTY OWNER: Applicant

"Name:

"Street Address *City "State *Zip Code

*Phone Number *Email Address

*CONTRACTOR / BUILDER: o Property Owner 0 Applicant 0 To Be Determined

*Name: Company Name

*Street Address *City *State *Zip Code

"Phone Number *Email Address

*City County License #

ARCHITECT / ARCHITECTUALCOMPANY:
~~----
*Expiration Date
ON/A
*State Contractor's \ License #
ENGINEER / ENGINEERING COMPANY:
*Expiration Date
ON/A

Name / Company Name Name / Company Name

Street Address Street Address

City State Zip Code City State Zip Code

Phone Number Georgia License # Phone Number Georgia License #

Email Address: Email Address:

*Name: Company Name

"Street Address *City "State *Zip Code

"Phone Number "Email Address

C('"lben 1:2-09
 CITY OFATLUITA • Depart.-t 01PIaaDIac f4 CoauaaaltJ' Dnel~ - B_a 01 BaDdiap
55 Trinity Avenue S.W. - Suite 3900 - Atlanta, Georgia 30303
Phone: (404) 330-6150 - WWW.ATLANTAGA.GOV

PROJECTADDRESS: PERMIT#: _

ApPLICANT RESPONSIBILITY

To insure that your application will be processed ALL applicable information MUST be provided. The City of Atlanta
Bureau of Buildings is not responsible for any incorrect information provided on this application.

Termination of application due to inaccuracies in application information will result in forfeiture of any fees paid.

By accepting the Terms of Use below you affirm to the following:

I affirm to the best of my knowledge that the projected cost of construction entered on this application is based on
contractor's or design professional's estimate. I understand this value will be compared to Building Plan Reviewer's
estimate. Building Plan Reviewer's estimate is generated using the current Building Standard cost of construction as
adopted in the City of Atlanta Code of Ordinance. I understand thatthe cost of permit wiII be generated based on the
largest value of the proposed cost of construction.

Applicant's Name Applicant's Signature Date

CONTRACTOR LICENSING - CITY OF ATLANTA BUREAU OF BUILDINGS

I affirm that this permit shall be issued and work done Pursuant to O.C.G.A. § 43-41-14, any person or business organization
seeking to perform any contracting activity or work which must be undertaken by a licensed residential contractor or general
contractor is required to furnish to the Director of the Bureau of Buildings, a sworn written document containing his or her
residential contractor or general contractor license number or in the case of a business organization, the identity of the
qualifying agent obtaining the permit and whose technical and personal qualifications have been determined by investigation
and examination as provided in Chapter 41 of Title 43 of the Georgia Code except as exempted therein. This requirement may
include a scope of work requiring licensure under Chapter 14 of Title 43 of the Georgia Code but does not authorize any such
work for which some other type of license is required by Chapter 14.

In order to comply with O.C.G.A. § 43-41-14 I affirm that the Exception to Contractor Licensing Requirements is allowed
because exemptions and exceptions are set forth in O.C.G.A. § 43-4]-17 and may be allowed by other applicable state law shall
be met or that the Contractor is duly registered with the State Licensing Board for Residential and General Contractors,
based on my examination of plans and other relevant documents, and having made such other and further diligent inquiries
concerning the project which is the subject of above referenced building permit application, including without limitation, a
review of all applicable state and local laws, ordinances, building codes and zoning codes, as are necessary to confirm that the
scope of the work for this project is work that is permitted, to lawfully undertake pursuant to the above referenced license.

Q I have read and accept the above terms.

Applicant's Name Applicant's Signature Date

 Demolition Permit Procedures
For The City of Atlanta
Bureau of Buildings
A Rodent Letter and Plumbing Permit for a sewer plug are required for
Demolition permits.
Residential and Commercial-less than one (1) acre
- Three (3) site plans reflecting trees, buildings, roads and driveways

- Detail sheets provided by the Bureau of Buildings to the applicant will illustrate installation of
silt fencing at the perimeter of the land disturbance activity along with construction
entrance/exit details and tree protection

- A current Rodent Letter establishing that the property has been treated for rodents. (This letter
must be on exterminating companies letter head.)

- A plumbing permit for the sewer plug.

- Notation to be placed on the plans by BOB staffwill state:

"Silt fencing and construction entrance/exit shall prohibit soil from exiting the site. This
permit is not valid if an existing stream is located on the property. A separate plan review
and approval is required from Site Development and Arborist."

Residential and Commercial Demolitions-greater than one (1) acre

h I)''\e(q')
- Applicant must submit ~tsite plans with erosion control. Plans will be forwarded to
Zoning, Site Development and Arborist for review and approval.

- A current Rodent Letter establishing that the property has been treated for rodents. (This letter
must be on exterminating companies letter head.)

- A plumbing permit for the sewer plug.

3 Copies - Site Development

3 Copies - Arborist
2 Copies - Zoning

All Residential and Commercial Asbestos Removal:

Will this project involve the removal or encapsulation of asbestos? [ 1 Yes [ ] No

If yes, this permit may not be issued until you have presented this office-with your Notification of Asbestos
Renovation, Encapsulation, or Demolition from the Georgia Department of Natural Resources, Asbestos
Licensing and Certification Unit, Enviroumental Protection Division. By signing this demolition form, you
hereby certify that you have read and examined this demolition form and know the same to be true and
correct. All provisions of laws and ordinances governing this type of work will be complied with whether
specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other state or local law regulating construction and demolition on any property.

______________________ Owner/Agent Date

Any of the following E.P.D. Offices can provide information:

Atlanta: (404) 363-7026 Brunswick: (912) 264-7284 Savannah: (912) 353-3225

Notification forms can be provided by fax or mail. They are also available from the E.P.D. website at:
\\\\'w.dnLstare.£!l1.lIs/dnr/enviroll OR www.sranet.oru/dnr/environ

Mail: EPD Asbestos Program OR EPD Coastal District Office

4244 International Parkway, Suite 104 One Conservation Way
Atlanta, Georgia 30354 Brunswick, Georgia 31520

Note: If you are demolishing a structure and DO NOT plan on building a structure to replace the
existing you will have additional steps before your demolition permit is considered.