Sub Contractor Authorization Form - City Of Monroe Permit Center printable pdf download

Sub Contractor Authorization Form - City Of Monroe Permit Center

SUB CONTRACTOR AUTHORIZATION FORM

ADDRESS:

City of Monroe

FAX:

(704) 282-4735

Permit Center

P.O. Box 69

EMAIL:

Monroe, NC 28110

PHONE: (704) 282-4524

Permit #:

Project Name:

Project Address:

I, _____________________________________________, of __________________________________________________ do

(Print Name)

(Sub Contractor Company Name)

hereby authorize

to be my agent for the purpose of

(General Contractor Company Name)

filing application for the issuance of a/an ____________________________

__________ permit at the address

(Trade Type - Plumb, Mech, Elec)

listed above on my behalf.

NC license #: __________________ __________________________________________

Email Address: ____________________________________________________________

NOTE: We cannot accept this form without it being completed in its entirety.

I also agree that all work done shall comply with the N.C. State Building Code and all other

applicable State and local laws. I warrant that I possess the corporate or other organizational

power to grant the authorization stated herein and that all requisite action of my company’s

management and/or governing body has been taken to enable me to make such

authorization.

________________________________________

Signature

________________________________________

Print Name

________________________________________

Print Title

_______________________________________

Date

March 25, 2014

Sub Contractor Authorization Form - City Of Monroe Permit Center