Dumas, TX

Contractor's Permit Request Form

Application Date*

Projected Start Date*

Homeowner or Business Name*

Address where work is being done.*

Phone Number of Home or Business Owner*

Cost of Job*

BRIEF DESCRIPTION OF WORK BEING DONE*

Architect Name, Address and Phone Number*

Engineer Name, Address and Phone Number*

Select Type of Permit*

General Contractor's Name, Address and Phone Number*

Sub-Contractor's Name, Address, Phone Number*

T.A.S. REGISTRATION NUMBER IF APPLICABLE*

ASBESTOS SURVEY*

UPLOAD ASBESTOS SURVEY IF APPLICABLE or PLANS FOR JOB*

Certification*

Contractor's Signature*

Date*

Building Official Signature*

Date