Fillable North Carolina Board of Barber Examiners BARBER SHOP (North Carolina)

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North Carolina Board of Barber Examiners BARBER SHOP (North Carolina)

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North Carolina Board of Barber Examiners
BARBER SHOP PERMIT APPLICATION
7001 Mail Service Center, Raleigh, North Carolina 27699
Phone (919) 814-0640 ● Fax (919) 981-5068
barbers.nc.gov ● barberboard@nc.gov
STOP! PLEASE READ BEFORE YOU BEGIN!
• This application is four pages long. Please make sure you complete all pages.
• You must file this form at least 15 days before the shop will be ready for inspection.
• Do not leave any fields blank, unless the instructions say that the field is optional or
that you can leave it blank. Otherwise, your application may be returned.
• Please be sure to have the form notarized and make sure it’s legible.
• Send the completed form to the address above along with your payment.
• Please carefully review the requirements for shops in the board’s rules. The rules
are available at www.ncbarbers.com under “Resources” and then “Laws,” or you can
ask for a copy of the rules from the contact information at the top of this page.
Shops that don’t meet the requirements in rule or statute will not be licensed, and
you may lose the inspection fee.
FEES
To open a barber shop, you will need to pay an inspection fee and a permit fee. Please
pay by check, cashier check, or money order. Please DO NOT send cash.
• Inspection fee $120. You must include the inspection fee with this application.
Your application will not be processed without this fee.
• Permit fee $50. You may also include the permit fee with the application, but
you are not required to pay this fee until after you pass inspection. However, you
cannot open the shop until you pay the permit fee. If you want to open the shop
on the same day that you pass inspection, please include $170, which includes
both fees.
CERTIFICATE OF OCCUPANCY
1. Is the shop newly built or renovated, rather than being an existing shop or salon?
[ ] Yes [ ] No
If you answered “Yes,” you must provide a copy of the certificate of occupancy from the
city or county building inspection department. Although we will conduct an inspection
for a newly built or renovated shop without the certificate of occupancy, we will not issue
the shop permit until you provide it.
SHOP INFORMATION
2. Name of barber shop. Please provide the name of the barber shop.
_____________________________________________________________________
3. Date the shop will be ready for inspection. ______________________________
4. Shop physical address. Please indicate the physical location for the shop.
Address: _____________________________________________________________
Address: _____________________________________________________________
City: __________________ State: NC ZIP: _________________
County: _____________________________________________________________
5. Shop mailing address. Please indicate the current mailing address for the shop. If
the mailing address is the same as the physical address, you may leave these fields
blank.
Address: _____________________________________________________________
Address: _____________________________________________________________
City: __________________ State: NC ZIP: _________________
6. Other contact information (optional). We encourage you to provide up-to-date
telephone, fax, or email information, if available.
Phone: _________________________ Fax: ___________________________
Email: _____________________________________________________________
7. Physical dimensions. Please indicate the width and length of the shop.
Width (feet): ____________________ Length (feet): ________________________
8. Fixtures and equipment. [ ] New [ ] Used [ ] Both
9. Number of barber chairs. ________________
10. Business hours. Please indicate the expected business hours for the shop.
_____________________________________________________________________
REGISTERED BARBER MANAGER
11. Registered barber manager. Please complete the information below for the
person who will be the new manager. The manager:
• Must be a registered barber with a current license from our board.
• Cannot be manager of another shop or a barber school at the time he or she
becomes manager of this shop.
Last name: ____________________ First name: _____________ MI: _______
(Optional)
License number: ______________________
Address: _____________________________________________________________
Address: _____________________________________________________________
City: __________________ State: _________ ZIP: _________________
Phone (optional): _______________________ Fax (optional): __________________
Email (optional): _______________________________________________________
SHOP OWNER
12. Is the registered barber manager also the shop owner? [ ] Yes [ ] No
If you answered yes to question 12, you may skip the rest of this section and go to the
“Notarization” section below.
13. Shop owner. Please complete the information below for the person who owns the
shop. If this person is the same as the registered barber manager, you may skip this
section.
(Optional)
Last name: ____________________ First name: _____________ MI: _______
Address: _____________________________________________________________
Address: _____________________________________________________________
City: __________________ State: _________ ZIP: _________________
Phone (optional): _______________________ Fax (optional): __________________
Email (optional): _______________________________________________________
MAKE SURE YOU COMPLETE THE ATTESTATION ON THE NEXT PAGE
ATTESTATION
I, ______________________, the registered barber, declare that I shall have full control
of the operation of the barber shop and will be fully responsible for the shop operations,
I will comply with all laws regulating barber shops and barbers, and I will notify the
Board of Barber Examiners and return the shop permit if I no longer manage the shop.
Manager signature: _________________________
STATE OF NORTH CAROLINA
County of __________________ Notary signature:
Subscribed and sworn to before me this _______ day of ________________________
My commission expires on: _______________________________________________
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North Carolina Board of Barber Examiners BARBER SHOP (North Carolina)

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Completed 31 August 2021

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