Contractor Registration Form

Prefer a paper copy?

Contractor Registration Form mailto: Gary Knarr, Zoning Administrator
245 West 4th Street
Williamsport, PA 17701

Application fee

$80 / $120 / $175 The fee associated with the Contractor Registration Form is based 1, 2, or 3 years. Please send in payment (check/money order) after the application has been submitted. See Fee Schedule for more information.

1
Fee Acknowledgment
2
Application

1/2

Fee Acknowledgment

I hereby acknowledge that there is at least a minimum fee of $80.00 associated with the Contractor Registration Form and that I will send in payment (check/money order) after the application has been submitted.
Acknowledge

Business Information

Business Name *

Employer Federal or State ID Number *

First Name *

Last Name *

Address *

City *

State *

Zip *

Phone *

Alternate Phone

Email *

Insurance Information

Please check all that apply:
No Employees
Employees
Only Sub-contractors
Copy of Certificate of Worker's Compensation (only if contractor has employees)
Copy of Certificate of Liability Insurance (only if contractor has NO employees)

Please attach contractor Certificate of Liability Insurance

Add File

Compliance Information

If the Worker's Compensation or Liability insurance policy expires, lapses, or is canceled by the end of the calendar year for which registration has been accomplished with the City, or if the applicant changes the coverage to a different policy or company, the applicant is responsible to submit a new copy of the certificate of insurance coverage to the Bureau of Codes the office/City of Williamsport.

Registration fee is $ 80.00 for one year, $ 120.00 for two years and $ 175.00 for three years annually (January 1 to December 31). Checks and money orders can be made payable to "The City of Williamsport".

Any registrations applied for after January 1 WILL NOT BE PRORATED.

Effective July 1, 2009, ALL contractors/plumbers who perform residential and commercial work MUST register with the State of Pennsylvania and provide a copy of your State Registration Certificate to the Bureau of Codes Office to continue to perform work in the City of Williamsport.

Any registration filed, may be suspended at any time by the Bureau of Codes for violation of the ICC, UCC, Statewide Building Code, Zoning Ordinance, Property Maintenance Code or any other ordinances and codes, including loss of insurance coverage and failure to pay the Business Privilege Tax.

Any person, company, corporation or individual who shall violate the provisions of the Contractors Licensing Ordinance, shall upon conviction thereof in a summary proceeding, be fined not less than fifty ($50.00) dollars nor more that six hundred ($600.00) dollars and cost of prosecution for each offense. In default of payment thereof, shall undergo imprisonment in the Lycoming County Prison for a period of time not exceeding thirty (30) days. Each day or portion of day a Contractor works without having a valid registration shall be considered a separate offense.

My signature and initials on this registration constitutes I have read the above information on this application and verifies that the statements provided herein are true and that I am subject to the penalty of 18 P.A.C.S.A 4904 relating to unsworn falsifications to authorities.

Applicant Signature:

100%

Contractor Registration Form