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NOTE: BEFORE YOU BEGIN, PLEASE MAKE SURE YOU HAVE ACCESS TO A DOCUMENT SCANNER OR SOME WAY TO UPLOAD REQUIRED DOCUMENTS TO THE APPLICATION. THE APPLICATION MUST BE COMPLETED IN ONE SESSION, YOU WILL NOT HAVE THE OPTION TO SAVE AND RETURN LATER TO COMPLETE.

IF YOU DO NOT HAVE A WAY TO UPLOAD YOUR DOCUMENTS, PLEASE VISIT OUR OFFICE FOR FURTHER ASSISTANCE.



Contractor Name (as it appears on contractor's license card): *
State License #: * Issued Date Expiration Date
Company Name: *

Local: *
Mailing Address Line 1: *
Mailing Address Line 2:
City: * State: * ZIP: *
Telephone: Fax:

Main/PO: *
Mailing Address Line 1: *
Mailing Address Line 2:
City: * State: * ZIP: *
Telephone: Fax:

Contractor Located Within Berkeley County *

Persons Authorized to Receive Permits
($50.00 in-state fee/ $100.00 out of state fee per authorization)

# NamePhone NumberEmail address
1 * *
2
3
4
5

Responsibility Statement: It is your responsibility to notify Berkeley County Permiting, in writing, if there is a change in authorization

***A current South Carolina State Contractor’s License Card (not the wall certificate) is required to issue Permit Authorization. Please bring your state license (or a copy) with you when applying for authorization.***
The information below regarding the business owner, cardholder, president, etc. who has the authority to sign the company or individual checks, is for Berkeley County Permitting business only, for the purpose of check writing privileges. This information must be filled out on all persons writing checks to Berkeley County Permitting Department. Include an additional sheet if necessary and a copy of each person’s drivers license, for our file.

BY SIGNING OF THIS APPLICATION, I AGREE THAT I HAVE READ AND UNDERSTAND THE ABOVE STATEMENT.

Signature State License Holder:

Print Name: *

Check Writer:

Print Name: Date of birth
Driverse License State and Number:
Expiration Date

Company/Business Federal ID#: *(If you will be paying with company checks.)
Applicant Email: *

Upload Your Supporting Documentation: