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): *
Company Name: *
State License #: * Issued Date Expiration Date

Business Location Address:
Address Line 1: *
Address Line 2:
City: * State: * ZIP: *

Business Mailing Address:
Mailing Address Line 1: *
Mailing Address Line 2:
City: * State: * ZIP: *

Office Phone Number(s): *
Work Phone Number(s): *
Company (Contractor’s) Email*

Persons Authorized to Receive Permits
($50 per person in state / $100 per person out of state / Qualifier(s) are automatically charged)

# 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 Contractors License Card (not the wall certificate) is required to issue Permit Authorization. Please include your state license (or a copy) with you when applying for authorization.***

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

Signature State License Holder:
Print Name: *
Driver’s License State and Number:
Expiration Date

Company/Business Federal ID# or N/A: *
Permit Authorization Applicant Name: *
Permit Authorization Applicant Email: *

Upload Your Supporting Documentation: