Fillable Contractor License Application (City of Gulfport Mississippi)

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Contractor License Application (City of Gulfport Mississippi)

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U.S.A. forms for City of Gulfport Mississippi

BROWSE CITY OF GULFPORT MISSISSIPPI (MS) FORMS

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\\UD\USERS\PLANNING\A_Templates\Permit Applications\Building.Contractor.License.App.pdf
Completion in its entirety of the application
including notarization. Must be in the name of
the qualifying party( individual tested) for the
company.
Submission of current certifications and licenses
with registration numbers (if any).
Provide five letters of reference addressed to the
Building Official of the City of Gulfport (Gary
Anderson). The letters may be from businesses
you have performed work for or from
homeowners. The letters must include the name,
title or position, addresses and phone numbers of
the persons who have personal knowledge of the
applicant’s character, experience, skills and
abilities. Letters not written on business
letterhead must be notarized. The letters are not
required if the applicant holds a Certificate of
Responsibility (COR) form the State of
Mississippi’s Board of Contractors.
Submission of a Certificate of Insurance with
Public Liability Insurance with $100,000 single
occurrence and $300,000 aggregate with
completed operations coverage. The Certificate
of Insurance shall identify the City of Gulfport as
the certificate holder using the following
information:
City of Gulfport
Department of Urban Development
Building Code Services
1410 24
th
Avenue
Gulfport, MS 39501
Submission of a copy of a current business privilege
license from the jurisdiction (municipal or county)
where your corporate business and /or company
headquarters is located.
Submission of a valid photo identification of the
qualifying party.
Payment of $100.00 contractor’s licensing fee.
(Exempt if you hold a Certificate of Responsibility
(COR) from the State of Mississippi’s Board of
Contractors.)
OPTIONAL: Submission of a notarized letter from
the qualifying party authorizing others to act on
his/her behalf. This letter must specifically
including items such as obtaining or renewing
licenses, obtaining permits, call in inspections
….etc.
If you have any questions, you may contact Building Code
Services at
PHONE: 228-868-5715 or 228-868-5714
FAX: 228-868-5716
COMPLETE AND SIGN THE
APPLICATION ON THE REVERSE
SIDE OF THIS PAGE.
Application for Contractor’s License
Requirements to Obtain a Contractor’s License
*WILL NOT BE ACCEPTED UNLESS
COMPLETED WITH ALL DOCUMENTS*
City of Gulfport
Urban Development
Building Code Services
1410 24th Avenue
Gulfport, MS 39501
Gulfport, MS 39501
1410 24th Avenue
Gulfport, MS 39501
\\UD\USERS\PLANNING\A_Templates\Permit Applications\Building.Contractor.License.App.pdf
APPLICATION FOR CONTRACTOR’S LICENSE
Instructions to Applicant
FILL THIS APPLICATION IN YOUR OWN HANDWRITING IN
INK. Before you submit your application, see that all
information called for has been completed. If your
application is incomplete, it may be returned to you for
completion, which will cause delay. This application
constitutes a part in your being considered for a license.
FOLLOW INSTRUCTIONS CAREFULLY. Applications and
tests cannot be returned to applicants.
All statements are subject to investigation and verification.
BE SURE TO ADVISE BUILDING CODE SERVICES OF ANY
CHANGES IN YOUR ADDRESS.
NAME OF APPLICANT
____________________________________
Printed Name of Applicant (First, Middle, Last)
____________________________________
Company
____________________________________
Street Address
____________________________________
P.O. Box
____________________________________
City State Zip code
____________________________________
Home Phone Work/Cell Phone
____________________________________
Fax
____________________________________
Email
TYPE OF LICENSE APPLYING FOR (Initial Box)
_____ Master Electrical
_____ Master Plumbing
_____ Mechanical/HVAC
_____ Hood & Duct
_____ Fixed Suppression
_____ Fire Sprinkler
_____ Fire Alarm
_____ Lawn Irrigation
_____ General Contractor “A”
Commercial (>$100,000 &/or 7,500 sf.)
_____General Contractor “B”
Light Commercial & Residential
_____General Contractor “C”
Residential Remodeler
_____Roofing
_____Swimming Pool
_____Other
CERTIFICATIONS/LICENSES
Please name and attach copy of all certifications and
licenses with registration numbers which you currently
hold.
CERTIFICATION/LICENSE REGISTRATION NUMBER
State below any other facts which you consider to be
successful work qualifying you for the license for which
you are applying.
_______________________________________________
______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
I HEREBY CERTIFY that this application contains no willful
misrepresentation or falsification; that the information
given by me is true and completed to the best of my
knowledge and belief. I am aware that should
investigation at any time disclose any such
misrepresentation or falsification my application may be
rejected and my name removed from the list, and
disqualified from applying in the future for a license in the
line applied for.
________________________________
Printed Name
________________________________
Signature
________________________________
Date
_________________________________________
Notary
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Contractor License Application (City of Gulfport Mississippi)

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Completed 15 July 2020

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