Right at home.
Rev: 12/2020 Page 1 of 2
Planning & Development
Building Services
309 N. 5
th
St.
Norfolk, NE 68701
P402-844-2060 F402-844-2069
www.norfolkne.gov
2021 CITY OF NORFOLK CONTRACTORS REGISTRATION
NAME OF COMPANY: __________________________________________ COMPANY OWNER: ___________________________________________________
STREET ADDRESS: _______________________________________________ PHONE/FAX: __________________________________________________________
CITY/STATE/ZIP: _________________________________________________ EMAIL: _______________________________________________________________
MARK REGISTRATION CATEGORY BEING APPLIED FOR: 1. GENERAL CONTRACTOR
(3 YEAR PERIOD 2020-2022)
2. ELECTRICAL & FIRE ALARM
(1 YEAR PERIOD 2021)
3. ALL OTHER CONTRACTORS
(1 YEAR PERIOD 2021)
I understand this registration is authorization for my firm to work within the jurisdiction of the city of Norfolk after payment of required fees, and expiration on December 31st annually,
with the exception of general contractor registrations which are on a 3 year registration cycle, and electrical registrations which run concurrent with state licensing. I further understand
that all required permits are to be obtained prior to commencement of work and all work must be accomplished in accordance with the construction codes of the City of Norfolk, Nebraska.
PLEASE DATE
AND SIGN!
X
PLEASE DATE
AND SIGN!
DATE SIGNATURE OF FIRM OWNER
REGISTRATION FEES
Office Use Only
Insurance Expiration Date
Register
each person
PLUMBING CONTRACTOR
$50.00 renewal fee ($75.00 first time registration fee)
JOURNEYMAN PLUMBER
$25.00 renewal fee ($50.00 first time registration fee)
APPRENTICE PLUMBER
$10.00 renewal and first time registration fees
GAS CONTRACTOR
$50.00 renewal ($75.00 first time registration fee)
MECHANICAL CONTRACTOR
$50.00 renewal ($75.00 first time registration fee)
Register
one person/company
FIRE SPRINKLER OR SUPPRESSION
$50.00 renewal ($75.00 first time registration fee)
Copy of State Waterbased Fire Protection Contractor Certification Letter required for Fire Sprinkler Registration
HOUSE MOVER
$55.00 (1 move) $105 (2 or more moves in same year)
WELL DRILLER
$25.00
PRIVATE WASTEWATER (SEPTIC)
SYSTEM INSTALLER
$25.00
GENERAL CONTRACTOR
$150.00 (Total fee for 3 year period of 2020-2022).
$100.00 (When registering in 2nd year, 2021-2022), $50 (When registering in 3rd year only, 2022).
ELECTRICAL CONTRACTOR
OR
FIRE ALARM CONTRACTOR
NOTE:
$100.00 (renewal fee for 2 year period of 2021-2022).
$125.00 (first time registration fee for 2 year period of 2021-2022).
$ 75.00 (first time registration fee when registering in 2nd year only, 2022).
PLEASE PROVIDE A COPY OF STATE ELECTRICAL LICENSE FOR THE REGISTRANT.
ADDITIONAL
REQUIREMENTS
• Liability insurance in the minimum amount of “$1,000,000 per occurrence” is required of all registered contractors working in the
City of Norfolk. Liability insurance is to name the City of Norfolk as a “Certificate Holder” and provide a 30 day cancellation notice.
• A completed US Citizenship Attestation Form is required for each individual registrant.
