Contractor-Registration-Form-2021Revised: Jan 2019
BUILDING INSPECTIONS
CONTRACTOR REGISTRATION
(Please Check ) ANNUAL REGISTRATION FEE: $105.00
General Contractor Types
________ General Contractor _____ New Registration
or
________ Pool Contractor _____ Renewal
________ Sign Contractor ______Licensed Trade (no charge)
LICENSED TRADES: Electric, Plumbing, HVAC, Well & Irrigation licenses do not require payment.
The information on this form is still required.
NAME OF BUSINESS: ________________________________________________________________
BUSINESS OWNER: _________________________________________________________________
LICENSE HOLDER: _________________________________________________________________
BUSINESS ADDRESS: ________________________________________________________________
CITY, STATE, & ZIP: ________________________________________________________________
TELEPHONE NO: ___________________________FAX NO: _________________________
E-MAIL ADDRESS: __________________________LICENSE NO: ______________________
BUSINESS OWNER: ____________________________________ DATE: _____________________
**Original Signature required**
List anyone authorized to sign permit applications and new meter installation application
Name: Phone:
**If no one is listed above, OWNER will be the ONLY person able to sign on behalf of the company.**
BUILDING INSPECTIONS, 1400 Main St., Ste. 250, Southlake, TX 76092
Phone # 817-748-8237 or 8236 Fax # 817-748-8241 E-mail: permittechs@ci.southlake.tx.us
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Freedom Solar Power
Adrian Buck
Adrian Buck
4801 Freidrich Lane, Suite 100
Austin, Texas 78744
512-220-8203
adrian@freedomsolarpower.com 28621 / 332049
2/2/2021
Michael Pensabene 512-220-8203
Kate Penshorn 512-220-8203