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Name of Company
DBA Name if required
Full name of someone with financial accountability for the company.
Title held within the company
This will be the email address for all permits and communication
Please select if you generally work for commercial or residential or both
Please select the trade you will be doing work under
COI listing City of Brooklyn as certificate holder.
HVAC, Electrical, Plumbing, Fire Protection
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. 4) I do hereby certify that I will abide by the provisions of the Brooklyn Codified Ordinances, which I am fully aware of the requirements of the Building Codes that all required permits will be obtained and this will be strictly observed subject to forfeiture of the Certificate of Registration. By signing below I also hereby acknowledge I will contact Ohio Protection Services (800-362-2764) and abide by the EPA Lead Safe Work practices if applicable. I do hereby certify that the facts contained in and attached to the foregoing application are true to the best of my knowledge and belief.
The city will call to secure payment with a credit card (no additional fee) or you can mail in a check to : 7619 Memphis Ave, Brooklyn, Ohio 44144
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If you prefer to mail in a form here is the application.