Fillable Contractor Registration Form (City of Stephenville)

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Contractor Registration Form (City of Stephenville)

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BROWSE CITY OF STEPHENVILLE (TX) FORMS

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298 W. Washington – Stephenville, TX 76401 (254)918-1213/ (254)918-1214
Contractor Registration Form Updated: February 7, 2012
Contractor Registration Form
(Mechanical, Electrical, Plumbing, Irrigation, Backflow, and Sign)
Building Inspections
The following documents are required for initial registration or changes to a current registration
with the City of Stephenville (No form is needed for a renewal.):
This completed application (Fill in every spac. Incomplete form will not be recognized.)(PLEASE PRINT)
Copy Mechanical, Electrical, Plumbing, Irrigation, Backflow, and Sign license with the State of Texas
Copy of Driver’s License and current contractor’s insurance policy.
Copy of Irrigator’s current gauge calibration.
Authorized signers: You have two ways to add authorized signers to your registration. You can provide
either one.
1. On company letterhead, provide a letter indicating by name each person who has permission to pull
permits. The letter must be signed by the license holder and dated.
2. In place of a letter, you can fill out the section below for authorized signers and sign.
Contractor Type :
(Please Circle )
Mechanical
Plumbing
Backflow
Electrical
Irrigator
Sign
License Holder Name:
Texas License#: Exp. Date:
Exp Company Name:
Mailing Address:
Physical Address:
City:
State:
Zip Code:
Phone Number
2
nd
Phone Number
Emergency #
Fax #
Company Owner’s Legal Name:
Email Address:
List of persons who are authorized to pull permit in name of contractor:
(If no one else is authorized but the license holder please label “license Holder”)
License Holder’s Name Print:
License Holder’s Signature:
Issued ID: _____________________
(City Personnel Only)
General
Contractor
Email: permits@stephenvilletx.gov
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Contractor Registration Form (City of Stephenville)

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Completed 24 January 2021

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