West Virginia State Board of Barbers and Cosmetologists
1201 Dunbar Avenue
Dunbar, WV 25064
Tel: 304.558.2924 Fax:304.558.3450
www.wvbbc.org
SHOP OPENING AND LICENSE APPLICATION
This application serves as your shop opening request/notification, electrical certification, and license application
PLEASE NOTE: According to WV Code, Chapter 30, Article 27 the Board shall be notified 20 day prior to opening a shop. All shops need to have a private entrance with a sign,
a licensed manager, proper ventilation, proper toilet facilities, covered waste containers, vacuum breakers on shampoo bowls, posted rules and regulations, and Electrical Certification
verification. IN-HOME SALONS must have separate entrance, accessible restrooms, the shop and living corridors must be separate by a solid lockable door.
RULES THAT GOVERN SHOP ARE: Chapter 30, Article 27 and 3CSR4 and 3CSR7.
TYPE OF APPLICATION
TYPE OF SHOP check one
APPLICATION FEE $90.00
SHOP INFORMATION

Anticipated Opening Date  
Physical Location      
NAME OF SHOP PHONE #
SHOP ADDRESS PHONE 2
CITY ZIP CODE COUNTY
 
Mailing Location
ADDRESS PHONE
CITY ZIP CODE STATE  
County:

OWNER/MANAGER INFORMATION
OWNER'S                  
FIRST NAME LAST NAME SSN PHONE # EMAIL
MANAGER'S                  
FIRST NAME LAST NAME SSN PHONE #    
NOTE: If this is not a NEW shop opening application, please complete the information below about the previous shop.
SHOP NAME SHOP LICENSE # DATE CLOSED    
                   
ELECTRICAL CERTIFICATION STATEMENT
Please enter the information of the licensed electrician that certified the electrical wiring within the salon/shop named above is adequate to the proposed usage of the facility.
NAME LICENSE #
DATE INSPECTED    
MAILING ADDRESS    
     
CITY STATE:
ZIP CODE    
ELECTRICAL INSPECTION REPORT    
Please upload a copy of your electrical inspection report. If the electrician does not have their own report form, please have the electrician complete the following form: Electrical Certification Statement