Fillable CITY OF VIRGINIA BEACH CONTRACTOR UPDATE FORM (City of Virginia Beach)

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CITY OF VIRGINIA BEACH CONTRACTOR UPDATE FORM (City of Virginia Beach)

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CITY OF VIRGINIA BEACH
CONTRACTOR UPDATE FORM
PLANNING/PERMITS & INSPECTIONS 2975 SABRE STREET
(757) 385-4211 SUITE 500
TDD (757) 385-4305 VIRGINIA BEACH, VA 23452
Please email a copy of this form along with: State Registration, Business License, and Tradesman Cards
for all Master Tradesmen to perminsp@vbgov.com
Contractor State Registration Number: _______________ Expiration Date: __________
All Class Code(s): _____________________________________________________________________
(i.e. BLD-Building Contractor, ELE-Electrical Contractor, etc. – as shown on your State Registration)
Business License Number: ______________ Held in What City/State: _________________________
Contractor Business Name: _____________________________________________________________
POC First Name: ___________________________ Last Name: ______________________
Address: ________________________________________ City: ________________________________
State: ____ Zip: __________ Phone: _______________ Cell: _______________
FAX: _______________ Email (REQUIRED): _____________________________________
Master Tradesmen Working Under This State Registration:
Name-First: __________ Last: ___________________ License No.: __________ Expiration: __________
Phone: ____________ Master: __________________________ Master: _________________________
Name-First: __________ Last: ___________________ License No.: __________ Expiration: __________
Phone: ____________ Master: __________________________ Master: _________________________
Name-First: __________ Last: ___________________ License No.: __________ Expiration: __________
Phone: ____________ Master: __________________________ Master: _________________________
Name-First: __________ Last: ___________________ License No.: __________ Expiration: __________
Phone: ____________ Master: __________________________ Master: _________________________
Name-First: __________ Last: ___________________ License No.: __________ Expiration: __________
Phone: ____________ Master: __________________________ Master: ________________________
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CITY OF VIRGINIA BEACH CONTRACTOR UPDATE FORM (City of Virginia Beach)

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Completed 4 June 2021

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