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2. Business Information
4. Name of Business*
6. Business Owner's Name
8. Type of Business*
   -- Select One --MechanicalElectricalPlumbingSign
10. Address1*
12. City*
13. State*
14. Zip*
16. Phone Number*
17. Cell Number
19. Email Address
21. Upload Master License
22. Upload Contractor License
24. Insurance Information
26. Insurance Agent
27. Insurance Agent's Phone Number
29. Upload Certificate of Liability Insurance
31. Please contact your insurance agent and have them email all insurance renewals to permits@cityofwebster.com instead of mailing or faxing.
33. License Information & Fee
    No permit shall become effective until the required license and certificate of insurance has been submitted and is on file with the city. There is no registration fee.
35. Electronic Signature*

    By checking I agree, you agree and acknowledge your electronic signature is valid and binding in the same force and effect as a handwritten signature.

    1. I Agree
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit Submit and Print

* indicates a required field