Contractor Licensing Application by jsq13914

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									                                                                                                             www.douglas.co.us 
Building Division 
Contractor Licensing: 720.733.6917 
Fax Phone: 303.660.0041 

                                          Contractor Licensing Application 

Application Date: _______________ 
(Circle those that apply to your application)                         NEW    RENEWAL   ACCOUNT CHANGE 
Print clearly and complete the following information: 
(circle type being applied for) 
                                     A      B      C     D      E      MA      MB      P      R 

Contractor Business Name: ______________________________________________________________ 

Owner Name: _________________________________________________________________________ 

E­mail Address: _______________________________________________________________________ 

Business Phone: (______) _______ ­____________ Alternate Phone: (______) _______­____________ 

Fax Number:            (______) _______ ­____________ Pager Number: (______) _______­______________ 

Cell Number:     (______) _______ ­____________ 

Address: ______________________________________________________________________________ 

City: ______________________________________State: ________________Zip:___________­______ 

Billing Address: ________________________________________________________________________ 
City:  ______________________________________State:  ___________________Zip:___________­______ 

Owner Signature: ______________________________________________________________________ 

Account Change Information:  If account change was indicated above, please complete the following: 

DC Registration #: _______________ Business Name on the account: ___________________________ 

                                                       A  B  C  D  R  MA  MB 
If changing license type, circle the type of license you will be changing to: 
Address & all other account changes: _____________________________________________________ 
______________________________________________________________________________________ 

                                       Licensing Fees and Registration Documents 
General  (GC)         A ­ $250               B ­ $200                        C ­ $150                             D ­ $150 
Mechanical            MA ­ $150              MB ­ $150 
Roofing               R ­ $150 
Electrical            No Fee                 Document requirements of:       State of Colorado Electrical         State of Colorado Master 
                                                                             Contractor License                   Electrical License 
Plumbing              No Fee                 Document requirements of:       State of Colorado Plumbing           State of Colorado Master 
                                                                             Contractor License                   Plumbing License 

Date Paid:_______________________                          Cash          CC            Check  #_____________________ 
Fee Amount: $____________________                                                        Clerk:________________________

								
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