Officials in the city of George, Western Cape province, say 22 people have been pulled from the wreckage and taken to hospital.
A team of 75 crew were on the site when the building collapsed on Monday. The cause of the incident in the coastal city is being investigated. The building crumbled at 14:09 local time (12:09 GMT), Western Cape Premier Alan Winde said.
“Seventy-five members of the construction crew have been confirmed on-site at that time of the incident,” he added.
Emergency services were seen rushing to the scene to search for survivors in the city 450km (279 miles) east of Cape Town. Two of the 22 people pulled from the wreckage later died of their injuries.
“Our thoughts are with the families and all those affected who continue to wait for word of their loved ones,” said George Mayor Ald Van Wyk.
The officials say they have been able to establish contact with some of those trapped. Currently, heavy lifting equipment and sniffer dogs have been brought in to assist the operation.
Photos have emerged showing a completely flattened construction site, with parts of the building’s roof lying atop the rubble.
“I saw one guy was working and then ‘boom’ and I saw the whole building collapsed… I’m also traumatized. It is very sad,” local councilor Theresa Jeyi was quoted as saying by Reuters news agency.
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