CITY OF ALVIN Engineering Department
1100 West Highway 6 Alvin, Texas 77511 (281) 388-4271 FAX (281) 331-7516
TO: All Permit Holders
FROM: Mike Collins, Building Official
DATE: October 4, 2017
SUBJECT: Contractor Information
Please fill out the following information. You can e-mail it to schurch@cityofalvin.com or fax (281) 331-7516
All contractors will need to submit copies of any applicable state licenses, drivers license and proof of
general liability insurance showing the City of Alvin as the certificate holder.
PLEASE PRINT LEGIBLY
Business name:
Contact name:
Physical Address:
City, State, and Zip:
Mailing Address:
City, State, and Zip:
E-Mail Address (REQUIRED):
Office Number: Mobile Number:
Drivers License Number: State:
State License Information: Licensing Authority:
(HVAC, Electrician, Plumber)
PROVIDE COPIES License Number:
Expiration Date:
ECL Number: (Electricians Only)
Expiration Date:
Insurance Information: Policy Number:
Effective Date: Expiration Date:
Any Contractor who holds a State of Texas License/Certification
(Electrical, Mechanical/HVAC, Plumbing, etc.) must provide
a copy of their drivers’ license. If a contractor is given permission to pull permits under another contractor, they
must submit a notarized letter of permission and a copy of that person’s drivers license.
