South Carolina Department of Labor, Licensing and Regulation
Contractor’s Licensing Board
110 Centerview Drive, Columbia, SC 29210 (overnight mail)
PO Box 11329, Columbia, SC 29211 (regular mail)
Telephone (803) 896-4686 Fax (803) 896-4814
www.llr.sc.gov/pol/contractors
GENERAL & MECHANICAL CONTRACTOR’S LICENSE APPLICATION
Document 165
Use this application to: Apply for a new license, Reinstate a lapsed license, or if you have changed your Federal ID
number or form of business. If you have a current license and are making revisions to your license (i.e. adding a
qualifier, increasing financial group limit), don’t not use this application; submit a Revision Application, Document 180.
INSTRUCTIONS
1. INITIAL APPLICATION - GENERAL INFORMATION:
A. LICENSING PERIOD: For GENERAL CONTRACTORS: all licenses expire October 31 every even-numbered year.
For MECHANICAL CONTRACTORS: all licenses expire October 31 every odd-numbered year.
B. LICENSE FEE: The fee is based on the date you submit your application; see “Fee Schedule” on page 2 to determine
the amount to submit. Make check or money order payable to: SCCLB.
C. FINANCIAL STATEMENT: You must submit a financial statement in your DBA “doing business as” name, for a
period not more than 12 months in the past. Groups 1 and 2 require an owner-prepared notarized financial statement;
you can use our form, Document 172. Groups 3 and 4 require a compiled financial statement prepared by a licensed
accountant. Group 5 requires an audited financial statement prepared by a licensed certified public accountant, to
include all notes and disclosures in accordance with GAAP (generally accepted accounting principles). Contact your
accountant for more information on compiled and audited financials. See page 4 for more details.
D. APPLICATION STATUS: After approximately 7 business days, you can check the application status online at:
https://verify.llronline.com/LicLookup. If there are any issues, you will be contacted by email, phone, fax, and/or mail.
E. S.C. SECRETARY OF STATE: Business corporations, nonprofit corporations, limited liability companies, limited
partnerships and limited liability partnerships must register (803-734-2158 or www.sos.sc.gov; see Business Filings).
Sole proprietorships and general partnerships are not required to register.
2. APPLYING FOR A LICENSE:
A. BY PSI EXAM
1. Send PSI your completed Examination Registration form located in their Candidate Information Bulletin (CIB),
along with the exam fee listed. You can obtain the CIB at: https://candidate.psiexams.com
2. You must take both a technical exam and the S.C. Business Management and Law exam. After approval by PSI, you
will be sent a Registration Confirmation Notice advising you of the 1 year eligibility to take the examinations.
3. Exams must be passed prior to submitting completed application to the Board with all required documentation and fee.
Submit completed application to the Board with all required documents (see checklist on page 8).
B. APPLYING BY WAIVER/RECIPROCITY, NASCLA (National Association of State Contractors Licensing
Agencies) Exam, or the MASC (Municipal Association of South Carolina) Exam
Contact your state licensing board for an examination waiver form or license verification form; copies of a license or nonS.C. exam results are not accepted. Contact NASCLA for an exam transcript: (866) 948-3363 or info@nascla.org. A
technical examination must have been passed having attained a grade of 70% or better with one of the participating state(s)
listed on page 6, NASCLA, or MASC. The applicant must not have any outstanding complaints with any other licensing
agency, and all applicants must be currently licensed or certified with the jurisdiction that administered the exam, be in
good standing, and have been working in the classification in which he/she is applying for a period of two years. SC has
a reciprocal agreement with the states listed on page 6 only. If your state is not listed, you must take the exams through
PSI (see Section 2A above.)
Submit completed application to the Board with all required documents (see checklist on page 8).
KEEP THIS INSTRUCTIONS PAGE FOR YOUR INFORMATION; MAKE COPIES OF EVERYTHING YOU SUBMIT FOR
YOUR RECORDS! IF MAILING YOUR PAPERWORK BY A TRACEABLE MAILING SERVICE (FEDEX, PRIORITY MAIL, etc.),
USE THE OVERNIGHT MAIL ADDRESS LISTED ABOVE.
Document 165
Page 1 of 8
Rev 01/2015
S.C. CONTRACTOR’S LICENSING BOARD
GENERAL & MECHANICAL
CONTRACTOR’S
LICENSE APPLICATION
OFFICE USE ONLY
AMOUNT $
CHECK NO.
DATE OF ISSUE:
www.llr.sc.gov/pol/contractors
G
M
QP
CLASS
Document 165
Mailing:
110 Centerview Drive, Columbia SC 29210 (overnight mail)
P.O. Box 11329, Columbia SC 29211 (regular mail)
APPLICATION MUST BE TYPED, PRINTED IN INK, OR FILLED-IN ONLINE
Mailed between the dates of:
FEE
SCHEDULE:
General Contractor
LICENSE EXPIRES:
10/31/2016*
10/31/2018**
10/31/2020***
08/01/14 - 07/31/15
08/01/15 - 07/31/16
08/01/16 - 07/31/17
08/01/17 - 07/31/18
08/01/18 - 07/31/19
=
=
=
=
=
Mailed between the dates of:
Mechanical Contractor
$350*
$175*
$350**
$175**
$350***
LICENSE EXPIRES:
10/31/2015*
10/31/2017**
10/31/2019***
08/01/14 - 07/31/15 =
08/01/15 - 07/31/16 =
08/01/16 - 07/31/17 =
08/01/17 - 07/31/18 =
08/01/18 - 07/31/19 =
$175*
$350**
$175**
$350***
$175***
ATTENTION CHECK WRITERS: BY PROVIDING US YOUR CHECK, YOU AUTHORIZE US TO: (1) USE INFORMATION FROM THE CHECK TO MAKE A ONE-TIME ELECTRONIC FUND TRANSFER FROM YOUR ACCOUNT, OR, TO
PROCESS THE PAYMENT AS A CHECK TRANSACTION, AND, (2) TO COLLECT A FEE THROUGH ELECTRONIC FUND TRANSFER FROM YOUR ACCOUNT IF YOUR PAYMENT IS RETURNED UNPAID.
1. LICENSEE INFORMATION:
The individual or company listed in this section will be designated as the “license holder”. You must sign contracts, apply for
permits, conduct business, and advertise in this name only. (See S.C. Code Ann. Section 40-11-20, 130, 230, 240 and 370(B).)
Licensee/Entity DBA Name:
DBA - “Doing Business As” Name (Exact name you will conduct contracting business in South Carolina)
 Are you a current or previous S.C. Contractor?
 Is this a reinstatement application? Yes
No
No
Yes
S.C. License No.:
 Is this a name change or form of business change? Yes
No
Select your DBA (“doing business as”) form/style of business:
Individual or Sole Proprietorship
Partnership
*must submit Federal ID# for these forms/styles of business
Corporation*
LLC*
LLP*
Other:
Mailing Address:
(i.e. P.O. Box)
City
State
Zip
County
City
State
Zip
County
Business Address:
Same as above
(Physical Street Address - No P.O. Boxes)
Business Telephone:
Federal Tax ID#:
Fax Number:
Licensee/Entity Contact Email Address:
2. QUALIFYING PARTY “QP” INFORMATION (this section must be completed by the QP):
The individual qualifying this license by exam or waiver. Make a copy of Sections 2, 3, and 4 for each additional QP.
Qualifying Party (QP) Name:
SSN:
Home Address:
Street
City
Home Telephone:
Date of Birth:
State
Zip
County
Position/Title with this Entity:
Driver’s License No./State Issued:
Are you currently or were you previously a SC general or mechanical contractor? Yes*
No
License No.:
*If yes, check one of the boxes below (only if it applies)
I am requesting to transfer my qualifications from the above license.
I am requesting to be a dual qualifier for both entities (please submit Document173 with this application).
Document 165
Page 2 of 8
Rev 01/2015
3. BACKGROUND INFORMATION: To be completed by each “QP” and OWNER/PRESIDENT/AUTHORIZED OFFICER.
The Owner/Pres/Auth.Officer only needs to complete one page if there are multiple QP pages .
All “YES” answers must be accompanied with a written explanation and supporting legal documentation, i.e. court
documents stating the disposition, payment arrangement correspondence, documentation of dispute, etc..
a) Have you ever had a license, certification or registration cancelled, surrendered, revoked, suspended, restricted or disciplined by any federal,
state or local authority or contracted without a proper license?
Qualifying Party:
Yes
No
Owner/President/Authorized Officer:
Yes
No
b) Is any investigation or disciplinary action currently pending against you or an organization of which you are or were an officer, principal,
qualifying party or major shareholder?
Qualifying Party:
Yes
No
Owner/President/Authorized Officer:
Yes
No
c) Have you or an organization of which you are or were an officer, principal, qualifying party or major shareholder ever been issued a Cease
and Desist Order for unauthorized practice?
Qualifying Party:
Yes
No
Owner/President/Authorized Officer:
Yes
No
d) Have you ever been convicted in a court of competent jurisdiction of this or any other state, district, or territory of the United States, or of a
foreign country of the offense of forgery, embezzlement, obtaining money under false pretenses, theft, extortion, or conspiracy to defraud or
other like offense, has been convicted of a felony or a crime involving moral turpitude, or pled nolo contendere to any such offense?
Qualifying Party:
Yes
No
Owner/President/Authorized Officer:
Yes
No
e) Are you currently or have you ever been licensed or registered in any profession in any federal or state jurisdiction?
Qualifying Party:
Yes
No
Owner/President/Authorized Officer:
Yes
No
f) Within the last 10 years, have you or any business entity of which you are or were an officer, principal, or major shareholder had an
outstanding monetary judgment related to construction?
Qualifying Party:
Yes
No
Owner/President/Authorized Officer:
Yes
No
4. AFFIDAVIT OF QUALIFYING PARTY and OWNER/PRESIDENT/AUTHORIZED OFFICER:
I, the qualifier listed on this application, am a full-time employee in a responsible position with the applicant requesting this license. We, the
qualifier and owner/president/authorized officer, affirm that all statements contained herein are true and correct to the best of our knowledge
and belief. We further understand that false or incorrect information provided by either of us may result in the cancellation or denial of a license
issued pursuant to this application and may be subject to civil and criminal proceedings. We agree that all information in this application may be
verified and investigated. We have read, and are familiar with the South Carolina Contractors Practice Act regulating contracting and hereby
agree to abide by such laws. See Section 40-11-130 or statutes for further clarification.
Qualifying Party:
Signature
Title
Date
Owner/President/Authorized Representative:
Print Name
*** THIS SECTION MUST BE
Signature
Title
Date
NOTARIZED ***
Sworn and Subscribed before me this
day of
, 20
My Commission Expires
Notary Public
5. BUSINESS INFORMATION:
List the names of all personnel in responsible charge and authorized to pull permits for this license (i.e. owner, president, vice-president, etc.)
Name
Document 165
Title
DOB
Page 3 of 8
Address
Telephone
Rev 01/2015
CLASSIFICATIONS and CONTRACT LIMITS
6. GENERAL CONTRACTORS: Select both the Classification(s) and Contract Limit/Number for which you are applying:
a. Building Classifications:
Specialty Classifications:
Building General Contractor (PSI or NASCLA)
Note to building exam applicants:
If you took the PSI limited building exam, you are
limited to building 3 stories in height, and you can
only apply for “Contract Limits/Groups” 1, 2, or 3
(see group limits below); you must have taken the
unlimited building exam to select Groups 4 or 5
Boring and Tunneling **
Concrete
Interior Renovation **
Marine
Masonry**
Pre-Engineered Metal Buildings
Railroad Lines**
General Roofing
Specialty Roofing
Structural Framing
Structural Shapes **
Swimming Pools
Wood Frame Structures
Public Utility Electrical
Boiler Installation
Glass & Glazing
Highway Classifications:
Asphalt Paving
Concrete Paving
Bridges
Incidental **
Grading
Public Utilities Classifications:
Pipelines
Water and Sewer Lines
Water and Sewer Plants
**A technical examination is not required for these classifications.
b. Contract Limits/Group Number for General Contractors:
Select your requested group limitation.
Personal financial statements can only be used for a Sole Proprietorship, Partnership, or Sole-Member LLC.
Submit a Self-Prepared Notarized Financial Statement (Document 172)
Group One
$ 30,000 limit per bid and job
- - Net worth requirement
Group Two
$100,000 limit per bid and job
- - Net worth requirement
$ 6,000
$ 20,000
Submit a Compiled or Reviewed Financial Statement prepared by a licensed CPA (SSARS accountant’s report with balance sheet)
Group Three
$350,000 limit per bid and job
- - Net worth requirement
$ 70,000
Group Four
$750,000 limit per bid and job
- - Net worth requirement
$150,000
Submit an Audited Financial Statement prepared by a licensed CPA (GAAP accountant’s report, balance sheet, notes & disclosures)
Group Five
$ bid and job unlimited
- - Net worth requirement
$250,000
7. MECHANICAL CONTRACTORS: Select both the Classification(s) and Contract Limit/Number for which you are applying:
a. Classifications:
Heating
Air Conditioning
Plumbing
Electrical
Refrigeration
Lightning Protection Systems
Pressure and Process Piping/2P
Packaged Equipment (Limited to 25 tons cooling and 500,000 BTU/HR heating per unit (includes heat pumps and split systems)
b. Contract Limits/Group Number for Mechanical Contractors:
Select your requested group limitation.
Personal financial statements can only be used for a Sole Proprietorship, Partnership, or Sole-Member LLC.
Submit a Self-Prepared Notarized Financial Statement (Document 172)
Group One
$ 17,500 limit per bid and job
- - Net worth requirement
Group Two
$ 30,000 limit per bid and job
- - Net worth requirement
$
3,500
$
6,000
Submit a Compiled or Reviewed Financial Statement prepared by licensed CPA (SSARS accountant’s report with balance sheet)
Group Three
$ 50,000 limit per bid and job
- - Net worth requirement
$ 10,000
Group Four
$125,000 limit per bid and job
- - Net worth requirement
$ 25,000
Submit an Audited Financial Statement prepared by a licensed CPA (GAAP accountant’s report, balance sheet, notes & disclosures)
Group Five $ bid and job unlimited
- - Net worth requirement
$100,000
.
Document 165
Page 4 of 8
Rev 01/2015
WORK EXPERIENCE AFFIDAVIT
EVERY NEW QUALIFIER MUST COMPLETE THIS FORM and CURRENT QUALIFIERS ADDING A NEW CLASSIFICATION
DISREGARD THIS PAGE IF YOU ARE APPLYING BY ONE OF THE FOLLOWING:
Exam waiver from a reciprocal state,
NASCLA exam, or MASC certification
(Check if applicable)
Reinstating an expired license using
the same qualifier(s)
Applying for a new license with currently
licensed or previous licensed qualifier(s)
***DISREGARD THIS PAGE IF YOU CHECKED ONE OF THE BOXES ABOVE***
8. WORK EXPERIENCE: Submit 2 years of actual HANDS-ON in the field work experience in the past 5 years as a full-time
employee in the field of work you are requesting. Only commercial contracting experience is accepted, except for the Interior
Renovation classification. If you are in a supervisory position, submit the hands-on work you supervise employees doing in
the classification(s) you are applying. DO NOT list job titles, i.e. “PROJECT MANAGER”, “ESTIMATOR”, “SUPERVISOR”,
“BUILDER”, “ELECTRICIAN”, ETC. DO NOT list administrative duties (i.e. scheduling, ordering, obtaining permits, change
orders, etc.). Copy this page as necessary.
You may substitute this form with a notarized resume or notarized letters of reference by licensed contractors or other verifiable references.
Qualifying Party Name:
Classification(s) requested:
Project Name(s)
Describe Actual Job Duties
Project Dates
Contact Person
(List only the largest projects of
$5000 or more)
(DETAILED field work in which you are
applying)
(2 years within
previous 5 years)
(Individual/company information to contact for verification)
Address & Telephone
The information contained herein is true and correct. I meet the experience requirements to serve as a primary qualifying party for the
applicant herein based upon the requirements set forth in Section 40-11-230 of the 1976 South Carolina Code of Laws Ann., as amended.
Qualifying Party Signature
Title
Sworn and Subscribed before me this
day of
Date
,
My Commission Expires
Notary Public
Document 165
Page 5 of 8
Rev 01/2015
(to be completed by exam qualifier)
AFFIDAVIT OF ELIGIBILITY
Pursuant to section 8-29-10 of the South Carolina Code of Laws (1976 as amended), the Department of Labor,
Licensing and Regulation must verify the lawful U.S. presence of any person who applies for a South Carolina
license. Please complete and sign this Affidavit of Eligibility. The information provided is subject to verification.
Section A: LAWFUL PRESENCE in the United States.
I, (please print your full name)
under the laws of the State of South Carolina that (check 1, 2 or 3 below):
swear or affirm under penalty of perjury
1.
I am a United States citizen or legal permanent resident eighteen years of age or older; or
2.
I am not a US citizen but am lawfully present in the US as evidenced by one of the following
a.
I am a qualified alien as defined in 8 U.S.C. sec 1641, eighteen years of age or older.
b.
I am a nonimmigrant under the “Immigration and Nationality Act,”
Federal Public Law 82-414 as amended, eighteen years of age or older.
3.
I am not physically present in the US under 8 U.S.C. sec 1621 (c) (2) (c) or employed in the US
pursuant to 8 U.S.C. 1621 (c) (2) (a) (check either a or b below):
a.
I am a US citizen, not physically present or employed in the United States.
b.
I am a Foreign National, not physically present or employed in the United States.
If you selected either 3.a. or 3.b., you do not need to complete Section B. Skip to Section C.
Section B: Secure and Verifiable Document. This section must be completed if you checked number 1 or 2 in Section A
1. Please check the acceptable secure and verifiable document(s) you hold. A copy of the verifiable document(s) must be
attached to the Affidavit of Eligibility.
A valid South Carolina Driver’s License, South Carolina Driver’s Permit or South Carolina
Identification Card. Number:
Date of Expiration:
A valid out-of-state issued photo Driver's License or photo identification card, photo driver’s permit.
State:
Number:
Date of Expiration:
Permanent Resident Card; Alien Number:
Card Number:
Date of Expiration:
Employment Authorization Card; Alien Number:
Card Number:
Date of Expiration:
Certificate of Naturalization with intact photo.
Certificate of (US) Citizenship with intact photo.
Other: (Name of verifiable document):
Document 165
Page 6 of 8
Rev 01/2015
2. Enter the state or the federal agency name where the secure and verifiable document(s) was issued.
(If issued by a state agency, include both the state and agency name.)
3. Please provide your social security number*:
(Include a copy of the card with this Affidavit)
Section C: Attestation.

I understand that this sworn statement is required by law because I have applied for or seek reinstatement of a
professional or commercial license as provided for in 8 U.S.C. §1621. I understand that state law requires me to
provide proof that I am lawfully present in the United States.

I understand that in accordance with section 8-29-10 of the South Code, a person who knowingly and willfully
makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a felony.

I am the person identified above, and the information contained herein is true and correct to the best of my
knowledge. I understand that under South Carolina law, providing false information is grounds for denial,
suspension or revocation of a license, certificate, registration or permit.
Signature
Date
Please print your name as shown on your secure and verifiable document.
Professional License Type:
Contractor’s license
License Number (if already licensed):
South Carolina Law requires that every individual who applies for an occupational or professional license provide a social security number for use
in the establishment, enforcement and collection of child support obligations and for reporting to certain databanks established by law. Failure to
provide your social security number for these mandatory purposes will result in the denial of your licensure application. Social security numbers
may also be disclosed to other governmental regulatory agencies and for identification purposes to testing providers and organizations involved in
professional regulation. Your social security number will not be released for any other purpose not provided for by law.
Other personal information collected by the Department for the licensing boards it administers is limited to such personal information as is
necessary to fulfill legitimate public purpose. The South Carolina Freedom of Information Act ensures that the public has a right to access
appropriate records and information possessed by a government agency. Therefore, some personal information on the application may be subject to
public scrutiny or release. The Department collects and disseminates personal information in compliance with The South Carolina Freedom of
Information Act, the South Carolina Family Privacy Protection Act, and other applicable privacy laws and regulations. Additionally, the
Department shares certain information on the application with other governmental agencies for various governmental purposes, including research
and statistical services.
Document 165
Page 7 of 8
Rev 01/2015
APPLICATION CHECK LIST
NEW LICENSEES (Submit all 5 of the following):
1.
License Application, Document 165 (Affidavit of Eligibility page to be completed by the Qualifier)
2. Submit one of the following; a, b, c, or d:
(a )
Exam scores:
PSI exam score report (S.C. exams only) 800-733-9267, or
NASCLA exam transcript (national building exam) 866-948-3363 or info@nascla.org
(b)
Reciprocity/W aiver form
Waiver/Reciprocity Agreements: Exam must have been taken in the state listed below. If you obtained a license in a state
listed below by waiver or by grandfather, you are not eligible to apply by waiver/reciprocity. If your state is listed but the
classification or exam you took is not listed, you are not eligible to apply by waiver agreement and must take the necessary
exams. If your state and classification is listed below, contact your state licensing board for a License Verification or Examination
Waiver form to enclose with your application. Copies of a license or non-S.C. exam score sheets are not accepted.
ALABAMA: Electrical
GEORGIA:
Non-Restricted Electrical = Electrical
Non-Restricted Conditioned Air (exam passed after 06/30/1980) = AC & HT
LOUISIANA:
Asphalt Hot & Cold Plant Mix and Asphalt Surface Treatment = Asphalt Paving
Tunnels = Boring & Tunneling
Concrete, Steel, & Wood Bridges = Bridges
Building Construction = Building
Paved Highways, Concrete & Soil Treatment = Concrete Paving
Transmission Pipeline = Pipelines
Earthwork, Drainage, & Levees = Grading
Industrial Piping = Pressure & Process Piping
Sewer, Storm Drains & Waterlines = Water & Sewer Lines
Filter Plants & Water Purification = Water & Sewer Plants
MISSISSIPPI:
Building
Electrical
NORTH CAROLINA:
Intermediate/Unlimited Electrical
Building
Water & Sewer Lines
Water & Sewer Plants
Grading
Roofing
Highway (exam passed prior to 04/01/1999)
OHIO:
Electrical
Plumbing
Packaged Equipment (HVAC)
PENNSYLVANIA:
Electrical (Reading, PA ONLY)
TENNESSEE:
BC-A, b; BC-b; BC-C = Limited Building
BC; BC-A, B; BC-B, BC-B, C = Unlimited Building
CE = Electrical
CMC-A = Plumbing
CMC-C = AC & Refrigeration
CMC = AC, Refrigeration & Plumbing
TEXAS:
Class B Air Conditioning or Class B Air Conditioning/ Refrigeration = Packaged Equipment
Class A Air Conditioning/Refrigeration or Class A Air Conditioning = AC & HT
Class A Refrigeration = Refrigeration
Master Electrician = Electrical
UTAH:
B100 = Unlimited Building
R100 = Limited Building
S260 = Concrete
S310 = Grading
S353 = Heating
S240 = Glass & Glazing
S350 HVAC = Air Conditioning
S351 = Packaged Equipment
S360 = Refrigeration
S280 = General Roofing
S320 = Structural Framing
S380 = Swimming Pools
S390 = Water & Sewer Lines
(c )
The Municipal Association of South Carolina (MASC) card (submit copy of card or certification letter)
Master Electrician (exam passed after 01/01/1990)
Master Plumber (exam passed after 01/01/1990)
Master Mechanical (exam passed after 09/06/2013)
(d )
Submitting 2 years of W ork Experience - for Interior Renovation, Boring & Tunneling, Highway Incidental, Masonry, Railroad,
and Structural Shapes classifications ONLY
3.
PSI Business Management & Law exam score sheet 800-733-9267
4.
Financial Statement:
Self-Prepared (Group One or Two)
(must be signed, dated & notarized)
5.
“Compiled” (Group Three or Four)
(from a licensed PA or CPA with Acct’s report)
“Audited” (Group Five)
(from a licensed PA or CPA with Acct’s report)
License fee - $350 or $175 (see page 2 of this application)
REINSTATEMENTS (Must submit all 3 of the following):
1.
2.
License Application, Document 165 (Affidavit of Eligibility page to be completed by the Qualifier)
Financial Statement:
Self-Prepared (Group One or Two)
(must be signed, dated & notarized)
3.
“Compiled” (Group Three or Four)
(from a licensed PA or CPA with Acct’s report)
“Audited” (Group Five)
(from a licensed PA or CPA with Acct’s report)
License fee - $350 or $175 (see page 2 of this application)
Document 165
Page 8 of 8
Rev 01/2015