Special Inspections Owners Acknowledgement – Berkeley County Government

PERMIT NUMBER
Project Name
Owner's Name
First Last
Owner's Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Owner's telephone contact numbers

Phone Number	Type of phone (work/ cell / fax)

SC Registered Design Professional in Responsible Charge
First Last
Firm (optional)
License Number SC
Phone
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Applicant Name*
Applicant's Email*
You Will Be Emailed a Copy of your submitted data

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