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Contractor Registration Application

1. Contractor Registration Information This section is complete This section is incomplete
2. Contractor Registration Application: This section is complete This section is incomplete
3. Other: This section is complete This section is incomplete
4. Acknowledgement Signature: This section is complete This section is incomplete

City of Saginaw
Permit Department, 301 S. Saginaw Blvd., Bus: 817-230-0453, Fax: 817-232-8565, E-mail: permits@saginawtx.org
To be completed by City Staff:
Permit Date:_______________ Permit #:__________________ Total Fee:__________________ Receipt #:__________________
Contractor Type:
Company Name:
Company Physical Address:
City:
State:
Zip Code:
Company Mailing Address:
City:
State:
Zip Code:
Company Phone:
Company Fax:
Primary Contact:
Email Address:
Name of License Holder:
License Type:
License Number:
License Expiration Date:
License Expiration Date:
Name of Persons Authorized to Pull Permits under the Master License Holder
Signature of Master License Holder:
Date:
Date:
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I testify that the above information is correct and that if any change in this information occurs, I will notify the building inspections department within 10 working days of such change.
Applicant Signature:
Today's Date:
Today's Date:

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