Commercial Building Permit Application 

Codes Enforcement Division 

Date of Project to Begin: ____________________ 

Total Valuation:_______________________ 

Owner Tax Map:______________________________________ 

Building Occupant:______________________________________________ 

E 911 Street Address:_____________________________________________ 

City, State and Zip:______________________________________________

Electricity Provider:__________________________________________ (Progress Energy/Pee Dee Coop) 

Nature of Work Performed:

New Building:____

Addition:________

Alteration:_______

Repair/Replacement:_______

Foundation Only:_________

Plan Review:____________ 

Type of Occupancy:

Assembly:______

Business:______

Educational:___________

Factory/Industrial:_____________

Hazardous:___________________

Institutional:_________________

Mercantile:__________________

Storage:_____________________ 

Heating:_________________  Air Conditioning:__________________ 

Exterior Construction:____________________ Construction Material Type:_________________________  

Type of Fuel:_______________________ 

Work requiring a permit shall not commence until the permit holder or his agent posts the permit card in a conspicuous  place on the premises.

Permit is valid for six months from the date of issue.

The undersigned owner or agent understands that approval of this application does not constitute a privilege to violate any applicable government ordinances, codes of law and that any omission of/or misrepresentation of the fact with or without intention of the undersigned or any alteration or change from this application, shall constitute grounds for the revocation of any permit issued, which was based on the approval of this application.

Contractor:_________________________________________________

Owner:____________________________________________________

Address on License/Business Address of Owner Builder:___________________________________________________________________________

Signature:__________________________________________________

S.C. Builders License #_______________________________________

Architect Affadavit:__________________________________________ (over 5,000 sq ft)

Payment Type: ________________________________ (Cash/Check)

Permit Issue #_________________________________

Approved By:_________________________________