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 cerfitication, 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

If this is a shop name, owner or location change,
please call 304-558-2924 to close old shop.

TYPE OF SHOP check one

APPLICATION FEE $90.00
SHOP INFORMATION

Anticapted 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 # 
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 #(If applicable)
DATE INSPECTED     
MAILING ADDRES      
     
CITY   STATE:  
ZIP CODE      
ELECTRICAL INSPECTION REPORT    
Please updoad a copy of your electrical inspection report