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APPLICATION – PERMIT PICK UP Instructions/Conditions: This application form allows a licensed tradesman to send a coworker, office personnel, or other unlicensed individual to pick up a building permit on behalf of the tradesman. The following shall apply: All of the information requested below must be filled out to the satisfaction of the Planning Commission. The application must be signed by a State licensed tradesman licensed to perform the type and degree of work being applied for. The licensed tradesman signing below must already be registered with the Planning Commission, including applicable bonding and insurance. By signing below, the licensed tradesman warrants that: His/Her license has not been revoked or censured by the State since last registering with the Planning Commission. The work being performed is the same as described below. He/She will perform the work, or personally oversee the work being performed, including periodic on-site inspections, and accepts personal liability for same. The tradesman’s signature below is the true personal signature of the tradesman, and is original. A photocopied (Xeroxed) signature will not be accepted. Job Information Date: Property Owner: Location: (Street Address Is Required!) Description of work to be performed: (Description should be brief, but contain sufficient detail for the Permit Clerk to determine license applicability.) By signing below, I acknowledge that I have read and understand the contents of this application and agree to be held liable for any and all conditions required by McDuffie County, the McDuffie County Planning Commission, and this application. Tradesman’s Signature: Tradesman’s Printed Name: (As Signed Above) Tradesman’s State License This form may be reproduced (unaltered) and used by the tradesman and office staff for submittal to the Planning Commission. Again, the application form must contain the licensed tradesman’s original signature, not a photocopied signature. The printed name and license number, however, may be reproduced. Planning Commission Office Use Only: Permit # Amount