City of Jacksboro Texas Online Form Center

2. 
3. City of Jacksboro

   112 W Belknap Street
   Jacksboro, TX 76458
   Phone: 940-567-6321

4. Contractor License & Registration Application
6. Registration Requirements:

   Copies of State License (for all licensed), Certificate of Liability Insurance and Driver's License.

8. Contractor Type*
   -- Select One --BackflowBuilding/GeneralDemolitionElectrical (no fee)FenceFire AlarmFire SprinklerIrrigatorSignMovingPlumbing (no fee)Swimming PoolRoofMechanical (no fee)
9. Registration Fee*
   -- Select One --First Year: $50.00Renewal: $25.00
11. Business Name and Physical Address*
13. Business Physical Address*
15. Address2
17. City*
18. State*
19. Zip*
21. Business Mailing Address (if different from physical address)
23. Address 2
25. City
26. State
27. Zip
29. Business Phone*
30. Contractor Mobile Phone*
32. Email Address*
34. Acknowledgements

    I testify that the information is correct and if any changes in this information occur I will notify the City of Jacksboro within 10 working days of such change. 

    I will not perform any work within the corporate limits of the City of Jacksboro unless said work has been authorized by obtaining the required permit(s) for the City of Jacksboro.

    I understand that all fees shall apply; except that if any person shall make an application for a permit as provided in this division, after the work has been started or after the work has been partially completed or concealed, such persons shall pay double the fee or fees which would ordinarily be required.

    I understand that I must provide copies of my State License (for all licenses), Certificate of Liability Insurance, and Driver's License.

    I understand that this application will not be accepted if all required documentation and application fees are not received within 5 business days of applying.

    I understand that I may not permit nor perform any work within the city limits of the City of Jacksboro until I have received confirmation of completion and acceptance of this application.

36. Acknowledgements*

    1. I understand and agree
38. List of authorized persons to obtain permits under this registration*

    (Please state "none" if there are no additonal authorized persons.)

40. Submit

    By submitting this document I am stating that I am the Contractor or an Authorized Contractor Representative. As a Contractor Representative, I have uploaded or will provide proof of legal representation.

Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit Submit and Print

* indicates a required field