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CITY OF TYBEE ISLAND
CONTRACTOR REGISTRATION
APPLICATION
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Business Type (circle one):
Sole Proprietor
Partnership c ation
LLC Other:
Type of Contractor
.General ❑ Electrical ❑ Mechanical ❑ Plumbing ❑ Other
Has this business or anyone connected with this business been cited or charged with any violation of Georgia Law,
Federal Law, Local Ordinance, or any Rule or Regulation of the State R ue Commissioner or any Rule or Regulation of
the City or County within the past 12 months? (circle one) YES or NO (If YES, list details)
1. Include a coov of your local business license.
2. Any business that requires state licensing must include a copy of state license.
List person(s) authorized to request inspections:-- Z\ANN ,
I hereby make application to the City of Tybee Island for a Contractor Registration. I certify that the above statements are true
and correct. I understand that the processing fee of $20.00 is non-refundable. I further understand that the provision of false
information on this application may result in the revocation of this registration by the City of Tybee Island.
Date a\'u\,
Applicant Signature
Printed Name
c„,
Received by Date
ROUTING
APPROVAL
BY
DATE
FEE
Administrator
REQUIRED
Contractor Registration 20.00
Zoning Approval
REQUIRED
Reason for denial:
City of Tybee Island
403 Butler Avenue
Attention: Contractor Registration, P.O. Box 2749,
Tybee Island, Georgia 31328-2749
Telephone (912) 786-4573 FAX (912) 786-9539
www.cityoftvbee.orq
City of Tybee use on/y:
Date
New
Renewal
License #
SAVANNAHI•=
Revenue Department �IIIII
305 Fahm St 1 PO Box 1228 1 Savannah, GA 31402-12281(912)651-6445
2021 BUSINESS TAX CERTIFICATE
Expires: December 31, 2021
J.D.R. CONSTRUCTION & DESIGN
208 E MONTGOMERY CROSS RD
SAVANNAH GA 31406
Business Owner(s): JOHN D ROBERTS JR
JANICE L ROBERTS. R JASON SOMERS. LEE ANNE
Permit # 130417 Additional Info:
NAICS: 238990
Tax Class: B
Classification: All Other Specialty Trade Contractors
THIS CERTIFICATE MUST BE DISPLAYED PROMINENTLY IN THE BUSINESS
PM 1D: 22666
fi 1/25/2021 11:31:31AM
STATE OF GEORGIA
BRAD RAF' t + NSPERGER, Secretary of State
State Licensing Board for Residential and General Contractors
LICENSE NO. } r GCC0000943
J D R_C ilstruction & Resign Inc
John D Roberts J
208 E. Mt ntgoinery Crossroad
Savannah GA 31406=
Qualifying Agent John D Roberts; Jr
Qualifying Agent License NO: GCQA000039
General Contractor Company
EXP DA i'L - 06/30/2022 Status: Active
Issue Date: 04/25/2008