SIGNATURE:
Bysigningthisapplication,IherebycertifythatIamtheowneroranauthorizedagentoftheownerorcompanyperformingworkstatedabove.Ifurthercertify
thatallinformationinthisapplicationiscorrectandthatallworkwillcomplywiththeSouthCarolina StateBuildingCodeandallotherapplicablestateandlocal
laws.Iunderstandthatifanyinformationprovidedisfoundtobeincorrectorfalselystatedthatthispermitwillbenulland voidandthatImayberesponsiblefor
violationofotherrelatedlawsandlocalordinances.TheDepartmentOfBuildingSafetyshallbenotifiedofanychangesintheapprovedplans orspecificationsfo
theprojectaspermitted.
Icertifytheinformationgivenonthisapplicationistrueandcorrect.
A3%CONVENIENCEFEEWILLBEADDEDTOALLCREDIT/DEBITCARDPAYMENTS.
THEREWILLBEA$30.00SERVICEFEEONALLRETURNEDCHECKS.
IMPORTANT NOTES
APPLICANT'SSIGNATURE:
INTHEEVENTOFAREQUESTFORCANCELLATIONORREFUNDOFA
PERMIT,IFGRANTED,THEMINIMUMPERMITFEE (residential/commercial)
WILLBENONREFUNDABLE.
ALLPERMITSEXPIRE6MONTHS(180days)AFTERISSUANCEORLAST
INSPECTION.ONCEA PERMIT EXPIRES, ALL FEES ARE NON‐REFUNDABLE,
INCLUDING THE MININMUM FEE.
APPLICANTNAME(PRINTED): COMPANYNAME: TITLE:
APPLICANT'SEMAILADDRESS:
Page3of3 BPA42349CI(REV.02/2020)
APPLICANT'S PHONE # WITH AREA
CODE:
PERMIT REQUESTS RECEIVED AFTER 4:00pm WILL BE PROCESSED THE NEXT BUSINESS DAY
PLEASE CLICK THE SUBMIT BUTTON TO SEND YOUR COMPLETED APPLICATION AND ATTACH ALL REQUESTED DOCUMENTS
• For individuals wishing to build and/or improve their own home without the use of a licensed
residential builder or specialty contractor, a Residential Disclosure Certification Form is required. This form is
available on our website.