Machine Translated by Google

1/11/2023

BUSINESS LICENSE APPLICATION

City or County: CITY OF FOLLY BEACH

Business Information

Corporate name:

Name shown to public: Open date:

Organizaon type: ÿ Sole proprietor ÿ LLC ÿ LLP ÿ LP ÿ Corporaon Arcles of Organizaon or

Incorporaon may be required.
Business acvity/type: NAICS/SIC/Other code:
Federal ID/SSN #: State retail sales #:

Mailing address:

Physical
address: ÿ Inside jurisdicon, Tax parcel #:_________________ ÿ Outside jurisdicon
Contact name, tle:

Contact phone: Ext. Alternate phone:

Fax: Email:

Owner or Principal(s) Information

SSN #:
Owner or Principal(s)
name(s), tle(s): SSN #:

Driver’s license #: State: Expiraon date:

Mailing address:

Work phone: Ext. Cell phone:

Fax: Email:

Job/Project Information

Project start date: Esmated end date:

Project locaon: Tax parcel #:

Project type: ÿ New construcon ÿ Renovaon ÿ Other ___________________________________________________

General contractor name:

State contractor license #: State: Expiraon date:

Copy may be required

Master/specialty license #:

Job contact name: Phone:

Total gross revenues of contract amount: $

Gross revenues, inside jurisdicon: $ Gross revenues, outside jurisdicon: $

Value of authorized deducons: $ Deducon type(s):

Contact your city or county businesslicensing oce with quesons regarding this form.
Applicaon produced by the South Carolina Business Licensing Ocials Associaon.
The SC Business Licensing Ocials Associaon is an aliate of the Municipal Associaon of SC.

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Machine Translated by Google
1/11/2023

Other Information

ÿ Yes ÿ No Buying an exisng construcon business?

If yes, purchased business’ name:
ÿ Yes ÿ No Business leasing space to another business?

ÿ Yes ÿ No Mail business license renewals to mailing address listed in the business informaon secon on the previous page?
If not, corporate address:
ÿ Yes ÿ No Change of use to building?

ÿ Yes ÿ No Erecng a new sign?

ÿ Yes ÿ No Home occupaon?

ÿ Yes ÿ No Independent contractors (Form 1099)?

If yes, names:

ÿ Yes ÿ No Leasing property?

If yes, landlord name and address:
ÿ Yes ÿ No Restricve covenants? If yes, provide copy.

ÿ Yes ÿ No Do you sell food or beverages that are prepared and/or consumed on your premises?

Applicant Certiication (Contact the municipality in which you are doing business to determine if a notarized signature is required.)

1. I hereby cerfy that all informaon provided is true and correct to the best of my knowledge and that the gross revenue is accurately reported or estimated for a
new business without any unauthorized deducon.
2. I cerfy that assessments, delinquencies and personal property taxes due to the jurisdicon are fully paid .
3. I understand that providing false or fraudulent informaon may result in penales, business license revocaon and/or
prosecuon to the fullest extent possible.
4. I am aware of and understand the jurisdicon’s requirements and codes, and the issuance of a business license is conngen t upon strict and consistent compliance
with all of the jurisdicon’s requirements.
5. I understand that failure to comply with these requirements may result in business license revocaon as well as othe r compliance or legal eorts.

6. I also understand and authorize the jurisdicon and its agents to ulize all informaon on this applicaon to ensure that all other federal, state and local laws are
complied with.

Applicant printed name: Signature:

Title: Date:

For Oce Use Only

Approved by all necessary departments? ÿ Yes ÿ No

Comments

Approved? ÿ Yes ÿ No Date:

Business license #: Rate class:

Rate Base rate: $ Every $1,000 aer: $

Amount due Fee: $ Penalties: $ Total: $

Decal required? ÿ Yes ÿ No Cost/each: $ Total: $

Receipt Amount paid: $ Date paid: Number of decals:

Sta name: Signature: Date:

Contact your city or county businesslicensing oce with quesons regarding this form.
Applicaon produced by the South Carolina Business Licensing Ocials Associaon.
The SC Business Licensing Ocials Associaon is an aliate of the Municipal Associaon of SC.

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