EZ Permit Service
Contractor Form
Please complete the contractor registration information below. Once submitted, the County Staff will be notified and your account will be created. Please allow 7-10 working days for a new account number and password.
Your login information will be emailed to you at the address you provide below.
*
Indicates required field.
*
Business Name
*
Contact Name
Corporate Address
*
Street Address
Address Line 2
*
City
*
State
Select State
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
*
Zip Code
Check this box if Corporate Address and Mailing Address are the same.
Mailing Address
*
Street Address
Address Line 2
*
City
*
State
Select State
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
*
Zip Code
Contact Information
*
Phone Number
(ex: xxx xxx-xxxx)
*
Email
Contractor License Information
*
License Number
*
License Type
*
License Expiration Date
(ex: mm/dd/yyyy)
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