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Contractor Registration rev 9-25-2017 LW9-2017 LW Approved By: ________________ Division Staff Date: ________________________ Division Staff License Number: ______________ Division Staff CONTRACTOR REGISTRATION Business Name: Owner Name: Contact Name: Business Address: City, State, Zip: Office Phone #: Fax #: Mobile #: Contact Email Address: General Contractor (includes Builders) (Initial-$150.00/Renewal-$100.00) Plumbing Master * (No Charge) Mechanical Contractor * (No Charge) Sign Contractor (Annual-$150.00/Renewal-$100.00) Electrical Master * (No Charge) Electrical Contractor * (No Charge) Utility Contractor (Annual-$50.00/Renewal-$50.00) Electric Sign Master * (No Charge) Electrical Sign Contractor * (No Charge) Backflow Tester (No Charge) Irrigator * (No Charge) Your registration requires renewal every year. The cycle begins January 1 and ends December 31 of each year. LICENSE HOLDER INFORMATION License Holder Name: License Holder Address: City, State, Zip: License Holder Mobile #: License Holder Email: State License #: Exp. Date: PERSONS AUTHORIZED TO SIGN PERMITS Name: Phone #: Name: Phone #: Name: Phone #: Please attach the following items with this application: Copy of Certificate of Insurance with the City of Schertz listed as the certificate holder (general liability is minimum of $300,000). _____________________________________________________________________________________________________________ Signature of Applicant Printed Name Date PLANNING & COMMUNITY DEVELOPMENT INSPECTIONS DIVISION 1400 SCHERTZ PARKWAY, BLDG. #1 SCHERTZ, TEXAS 78154-1634 (210) 619-1750, FAX (210) 619-1769 EMAIL: inspections@schertz.com