Plumbing Contractor License Application Form - City Of Torbay

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PUBLIC WORKS AND TECHNICAL SERVICES
1288 Torbay Road, PO Box 1160
Torbay, NL A1K 1K4
t. (709) 437-6532 f. (709) 437-1309
PLUMBING CONTRACTOR LICENSE APPLICATION FORM
OFFICE USE ONLY
Date Received:
Application Fee:
Staff Initials:
Application No.:
$100.00
PR
APPLICANT INFORMATION
Applicant:
Mailing Address:
Postal Code:
Home Phone:
Work Phone:
Cell Phone:
Fax:
Email Address:
Do you have a Certificate of Qualification from the Province of Newfoundland and Labrador?
Yes:
No:
*(Please attach a copy of the Certificate to this application)
With whom did you serve your apprenticeship(s)?
Have you previously held or do you currently hold a license with another municipality? Yes:
No:
If yes, please list municipality(s) and date(s):
Please list any Plumbing Certificates/Diplomas received:
Give names, addresses, and dates of two most recent plumbing installations :
1.
__________________________________________________________________________________________________________
2.
__________________________________________________________________________________________________________
Are you a business owner within the Town of Torbay? Yes:
No:
Would you like to be included in the Town’s list of registered plumbers: Yes:
No:
*If yes, please complete the attached form.
ADDITIONAL COMMENTS:
Signature: ______________________________
Date: _______________________________

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