Licensed Contractor Registration Form

Licensed Contractor Registration

All Plumbing, Electrical, HVAC, Irrigation, and Energy Inspector
PLEASE PROVIDE THE MOST COMPLETE AND ACCURATE INFORMATION POSSIBLE

INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED

All Licensed Contractor Applicant must sign and attach a copy of their current Texas Driver’s License AND a copy of the Texas State License if registrationis for a licensed trade (i.e. Plumbing, Electrical, HVAC, Irrigation, or Energy Inspector).

Please note, the MASTER license is required for Plumbing & Electrical registrations.
Select the Licensed Contractor Type*
Please Note- Annual $110 fee for Mechanical/HVAC and Energy Inspectors
Business Name (DBA)*
Business Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Name of License Holder:*
License Holder Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
State License Number#: *
State License Expiration*

MonthDayYear
Date
Person Authorized to obtain a permit under this company name: *

First NameLast Name
Additional?
ATTACH COPY OF THE APPLICABLE STATE TRADE LICENSE:*

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ATTACH COPY OF APPLICANTS TEXAS DRIVERS LICENSE:*

Cancelof
ATTACH PLUMBING/ELECTRICAL MASTER LICENSE IF APPLICABLE:

Cancelof
The undersigned person will be held responsible for seeing that all work being performed under this registration is completed and is in compliance with the building codes and City ordinances.

Registration fees for the above mentioned are required for Mechanical, HVAC, and Energy Inspectors ONLY. Registration is valid for one calendar year. Notice of annual renewal will NOT be issued, contractors must maintain approved registration status to be an eligible contractor within the City of Everman.
Name of Submitter*

First NameLast Name
Signature*
Please verify that you are human*
Should be Empty: