Planning and Development Services
2118 South Uhl Road
Glenn Heights, TX 75154
Phone: 972-223-1690 ext. 451 / Fax: 972-274-5100
CONTRACTOR REGISTRATION
Contractor Type:
General Electrician Plumber Mechanical Backow Irrigator
Company Informaon
Owner Master Authorized Representave
Company Name:
Contact Name: Email:
Phone Number: Fax Number:
Address:
City: State: Zip:
License Informaon
Name: License Number: Expiraon Date:
Address: Phone Number:
City: State: Zip Code:
Authorized Personnel (persons other than the Master who can apply for permits)
Name: Phone Number:
Name: Phone Number:
****Prior to the issuance of permits, the following items must be submied****
1. State License required for Mechanical, Electrical, and Plumbing Contractors.
2. Valid Driver’s License or Government Issued Photo ID
3. Cercate of Liability Insurance (min. $300,000 general liability) with City
of Glenn Heights as the Cercate Holder
Signature: Date:
click to sign
signature
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