Contractor Information - City of Martinsville, Indiana

City of Martinsville License Number
Fee
Date Issued
MM slash DD slash YYYY
Expiration Date
MM slash DD slash YYYY
C of I Attached
Building Permit
Electrical Permit
Type of Construction Activity
Addition / Subdivision
Lot No
Address of Construction Activity
Street Address Address Line 2 City State ZIP Code
Owner of Property
Name
Telephone
Address
Street Address Address Line 2 City State ZIP Code
Email*
Electrical Contractor
Name
Telephone
Address
Street Address Address Line 2 City State ZIP Code
Email*
Mechanical Contractor
Name
Telephone
Address
Street Address Address Line 2 City State ZIP Code
Email*
Applicant Name
Date
MM slash DD slash YYYY

Owner of Property