Fillable City of Piedmont Contractors License Application (CITY OF PIEDMONT)

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City of Piedmont Contractors License Application (CITY OF PIEDMONT)

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The City of Piedmont Contractors License Application (CITY OF PIEDMONT) form is 1 page long and contains:

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Country of origin: US
File type: PDF

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City of Piedmont
Contractor’s License Application
Type:
☐
General
☐
Electrical
☐
Mechanical
☐
Plumbing
☐
Roofing
Date: __________________________ Full Name: __________________________________________________
Company Name: _____________________________________________________________________________
Physical Addresses
Street: _______________________________________
City: _________________________________________
State: _____________ Zip Code: _______________
Mailing Address (If Different)
Street: _______________________________________
City: _________________________________________
State: _____________ Zip Code: _______________
Phone Number: _________________________ Cell Phone Number: _____________________________
Fax Number: __________________________ E-Mail Address: ____________________________________
Signature
Printed Name
Date
General Contractors Only- Required Material
□ Workers Comp/Exempt Form
□ General Liability Insurance
License Fee:
□ First Time: $150.00/physical year (July 1-June 30 not prorated)
□ Renewal: $100.00 (before their license expires only. July 1-June 30
not prorated)
□ Expired: $150.00/physical year (July 1-June 30 not prorated)
Sub-Contractors Only (Electrical, Mechanical, Plumbing, and Roofing)- Required Material
□ CIB
□ Driver’s License
License Fee:
□ First Time: $12.50/month until CIB expiration date
Total Amount: __________
□ Renewal: $100.00 (before their license expires only)
□ Expired: $150.00 until CIB expiration date
****************************OFFICE USE ONLY*****************************
☐
Paid
☐
Unpaid
Receipt #: ______________________
Check #: _______________________
_________________________________________________
Community Development
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City of Piedmont Contractors License Application (CITY OF PIEDMONT)

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Completed 14 July 2020

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