CITY OF GARRETT

							                                   CITY OF GARRETT
                                   208 N. FERRIS STREET
                     COMMUNITY DEVELOPMENT – INSPECTIONS DIVISION
                          PH: (972) 875 – 5893 FAX: (972) 875 – 0226

                     CONTRACTOR REGISTRATION FORM
                                                                                             DATE: _____________

COMPANY NAME: __________________________________________________________________________________________

COMPANY MAILING ADDRESS: ______________________________________________________________________________

CITY: ______________________________ _____________ STATE: ______________________     ZIP: _____________________

PH: _______________________________________                  CELL: ___________________________________________

         LICENSEE’S NAME: _______________________________________________________________________________

         MAILING ADDRESS: _______________________________________________________________________________

         CITY: ___________________________________________       STATE: ___________________ ZIP: _____________

         PH: __________________________________________          CELL: ______________________________________

           CONTRACTOR REGISTRATION            $75.00             RENEWAL OF $37.50 IS ONLY FROM DEC. 1 TO
                                                                 JAN. 31, IF CONTRACTOR IS REGISTERED THE
                                                                 PREVIOUS YEAR.
            INDICATE TYPE OF CONTRACTOR                            STATE LICENSE REQUIRED
         (CHOOSE ONLY ONE PER REGISTRATION)                        (SUBMIT COPIES)


  RESIDENTIAL BUILDER                                                                                  YES / NO
  COMMERCIAL BUILDER                                                                                   YES / NO
  CEMENT       ($2,500 BOND REQUIRED)                                                                  YES / NO
  ELECTRICAL (STATE CONTRACTOR AND MASTER LICENSE REQUIRED)                                            YES / NO
  ENERGY INSPECTOR                                                                                     YES / NO
  FENCE                                                                                                YES / NO
  IRRIGATION                                                                                           YES / NO
  MECHANICAL                                                                                           YES / NO
  PLUMBING                                                                                             YES / NO
  ROOF                                                                                                 YES / NO
  SIGN                                                                                                 YES / NO
  SWIMMING POOL                                                                                        YES / NO


             BACKFLOW TECH & RIGHT-OF-WAY CONTRACTORS MUST FILL OUT DIFFERENT FORM

REQUIRED ITEMS TO ATTACH (PER LICENSEE):

  VALID DRIVER’S LICENSE #: _________________________________              STATE: ________
  STATE LICENSE #: ___________________________________________
  STATE LICENSE #: ___________________________________________

PLEASE LIST THREE (3) COMPANIES IN WHICH YOUR COMPANY HAS RECENTLY PERFORMED:
______________________________________ __________________________________ ____________________________

PLEASE LIST THOSE WHO WILL HAVE AUTHORITY TO APPLY FOR PERMITS IN YOUR COMPANY NAME:
______________________________________ ___________________________________ ____________________________
         REGISTRATION DENIAL WILL OCCUR IF CONTRACTOR SUBMITS INCORRECT INFORMATION ON
         REGISTRATION APPLICATION. REGISTRATION REVOCATION AND SUSPENSION WILL ALLOW THE
         BUILDING OFFICIAL THE AUTHORITY TO CALL A HEARING BEFORE THE BUILDING COMMISION FOR
         REVOCATION OR SUSPENSION OF A CONTRACTOR’S REGISTRATION.

APPLICANT SIGNATURE: ___________________________________           PRINTED NAME: ___________________________