Address *
Email *
City, State, ZIP *
Plumbing
Email *
Contractor Name *
Name *
Fax #
Fee Schedule
{[CNAME]}
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
Expiration Date
Address *

THE FOLLOWING MUST BE ATTACHED

1. LICENSE AND PERMIT BOND: $10,000.00

2. CERTIFICATE OF INSURANCE
City of LaSalle to be named as additional insured. The certificate must bear endorsement that insurance may not be canceled by the insurer with at least ten (10) days prior written notice to the City. Cancellation of such insurance will cause automatic revocation of the permit.

  • Workman’s Compensation Insurance
    $500,000.00 Each Accident
    $1,000,000.00 Policy Limit  

  • Liability-Bodily Injury
    $100,000.00 Per Single Instance
    $300,000.00 Per Occurrence

  •  Liability-Property Damage
    $25,000.00 Minimum

3. COPY OF LICENSE (if applicable)

  • State Roofer’s License
  • Electrical License

 

Elevator
State Licenses
Fax #
Contractor License
Application
Fire Protection
City, State, ZIP *
Building
The fee for a Contractor's License.
License #
Application Type *
Electrical
Contact Person
Phone # *
License # (if renewal)
Federal ID # (EIN)
PLEASE NOTE: ALL CONTRACTORS WORKING WITHIN THE CITY LIMITS MUST HAVE A CURRENT LICENSE.

APPLICATION FEE: $100.00/12 Month License

Contractor
Contractor Type *
Phone # *
ATTENTION: BOND ISSUE MUST BE PRIOR TO CONTRACT DATE
Attachments