The Backflow Assembly Tester Registration is the City of Dallas form that a licensed backflow tester completes to register as a Backflow Tester Contractor, either as a new registration or as a renewal. It is one of the City of Dallas forms connected to Dallas permit work: the form states that the licensed tester is the only person authorized to sign permits or validations to perform a backflow test. On FillingPDF you can fill out the form online and download or print the completed PDF. The City of Dallas publishes the original PDF at its website and accepts the registration only through the channels described below.
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What is Backflow Assembly Tester Registration – Dallas, TX?
The Backflow Assembly Tester Registration is the City of Dallas form by which a licensed backflow tester applies, under the City Code, for registration as a Backflow Tester Contractor. A box at the top marks the application as NEW or RENEWAL.
The form is issued by the City of Dallas. Its header names the Planning & Development Department, 320 E Jefferson Blvd, Dallas TX 75203, telephone (214) 948-4480. It collects the tester's state license number and expiration date, contractor number, email, name, street and mailing addresses, phone and fax numbers, and a certificate of occupancy (C.O.) number when the company is located within the Dallas city limits.
The form also records the tester's name and a PIN of 4 digits or less. It states that the Licensed Backflow Tester is the only person authorized to sign permits or validations to perform a backflow test. The responsible license holder signs a sworn statement that the information is true and correct, and a Registration Clerk or Notary Public completes the "Sworn to me" block.
According to the form, Backflow Tester Certificates of Registration provided for in the Code expire annually upon the expiration date of the State License. Changes or corrections to registered information are made on this same form, marked as amended. The form states that a record change fee applies.
This is a registration form for the tester. It is not a building permit application.
Who needs to file Backflow Assembly Tester Registration – Dallas, TX?
Licensed backflow testers who want to be registered with the City of Dallas as a Backflow Tester Contractor use this form. The licensed tester is the person who signs it, as the "Responsible License Holder".
- New registrations: the Licensed Tester must personally appear at 320 E Jefferson Blvd. Dallas TX 75203 with the completed original form, their current Backflow Tester's pocket license, an approved photo identification and the payment the form requires.
- Renewals: the tester renews with the same form and the same documents. A renewal can be handled in person at any Building Inspection office or online through the contractor's Dallas website. If it is not done in person, the form must be notarized.
- Companies inside the city limits: if the company is located within the city limits of Dallas, the form asks for its certificate of occupancy number.
- Changes to registered details: the same form is used, marked as amended.
The form says that only the Licensed Backflow Tester is authorized to sign permits or validations to perform a backflow test. It sets no separate rule for anyone else signing on the tester's behalf.
When to file Backflow Assembly Tester Registration – Dallas, TX
File the form when you first need to be registered as a Backflow Tester Contractor in Dallas, and again for each renewal. The form says the Backflow Tester Certificates of Registration expire annually upon the expiration date of the State License, so the registration follows the cycle of your state license. The form prints no other deadline or lead time. It also gives no processing time. Contact the City of Dallas at (214) 948-4480 for questions about timing. If your registered information changes during the year, resubmit the same form marked as amended; the form states that a record change fee applies.
Documents you need
- Your current Backflow Tester's pocket license, required for each registration, new or renewal.
- An approved photo identification, required with the original registration and with each renewal.
- Payment by check payable to "City of Dallas", required for each registration and renewal; confirm the amount with the City.
- A notary's completion of the form, only for a renewal that is not done in person.
- The certificate of occupancy number (C.O. #), entered on the form only if your company is located within the city limits of Dallas.
How to fill out Backflow Assembly Tester Registration – Dallas, TX
Mark new registration or renewal
At the top, check NEW or RENEWAL, and enter your contractor number on the Contractor # line.
Enter the date and license details
Fill in the Date, your State License # and its Expiration Date. The City registration expires with the state license, so enter the date exactly.
Enter contractor number and email
Complete Contr. # and Email. Do not use "Same"; the form requires all information to be complete.
Enter the tester's name and address
Write the Name of Tester, then the Address (number, street, city, state, ZIP) and the Mailing Address in the same format.
Enter phone and fax numbers
Complete the Phone Number and Fax Number lines with area codes.
Add the certificate of occupancy number
If the company is located within the city limits of Dallas, enter the certificate of occupancy number on the C.O. # line.
Enter the tester name and PIN
Under the statement that the Licensed Backflow Tester is the only person authorized to sign permits or validations, enter the tester's name and a PIN # of 4 digits or less.
Sign the sworn statement
The Responsible License Holder signs on the SIGNED X line. The "Sworn to me" block is completed by the Registration Clerk or Notary Public, so leave it for them.
Review, download and prepare to submit
Check that no line is blank or marked "Same", then download or print the completed PDF from FillingPDF. Gather your pocket license, photo ID and payment as described under How to submit.
How to submit Backflow Assembly Tester Registration – Dallas, TX
Registration is handled in person, and renewals can also be handled online through the contractor's Dallas website.
- Original registration (in person only): the Licensed Tester must personally appear at 320 E Jefferson Blvd. Dallas TX 75203. Bring the completed original form, your current Backflow Tester's pocket license, an approved photo identification and payment. Make checks payable to "City of Dallas".
- Renewal in person: at any Building Inspection office, with all the same documents and payment.
- Renewal online: through the contractor's Dallas website. If you do not register in person, the form must be notarized.
- Changes: submit them on this same form, marked as amended.
A registration fee applies, and a separate record change fee applies to amendments. The form states the amounts. This page does not repeat them, so confirm the current amounts with the City of Dallas at (214) 948-4480. FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Leaving the form incomplete: the form states it must be completely filled out in order to be accepted for registration.
- Writing "Same" in an address or other line; the form says all information must be complete and "Same" must not be used.
- Sending an original registration by mail or through someone else when the Licensed Tester must personally appear at 320 E Jefferson Blvd.
- Arriving for an original registration without the pocket license, photo identification or payment.
- Submitting a renewal without notarization when you are not registering in person.
- Entering a PIN longer than 4 digits; the form limits it to 4 digits or less.
- Making the check payable to anyone other than "City of Dallas".
- Submitting a change on a new or different document instead of this form marked as amended, and omitting the record change fee.
Frequently asked questions
What is the Backflow Assembly Tester Registration?
It is the City of Dallas form a licensed backflow tester submits to register as a Backflow Tester Contractor. The form has boxes for a new registration or a renewal, and the registration expires annually with the tester's State License.
Is the backflow tester registration a Dallas permit?
No, it registers the tester rather than approving a permit. The form says the Licensed Backflow Tester is the only person authorized to sign permits or validations to perform a backflow test. For permit questions, call the City at (214) 948-4480.
Can I register as a backflow tester in Dallas online?
Only renewals. The form says an original registration requires the Licensed Tester to appear in person at 320 E Jefferson Blvd. Renewals can be done online through the contractor's Dallas website, and the form must be notarized if you do not register in person.
What do I bring to register as a backflow tester in Dallas?
Bring the completed original form, your current Backflow Tester's pocket license, an approved photo identification and payment. Checks are made payable to "City of Dallas". The same documents are required for each renewal.
How much does the Dallas backflow tester registration cost?
A registration payment applies, by check payable to "City of Dallas", and a record change fee applies to amendments. The form prints both amounts, so confirm the current figures with the City at (214) 948-4480 before you go.
When does my backflow tester registration expire?
It expires annually upon the expiration date of your State License, according to the form. Renew with the same form, in person at any Building Inspection office or online through the contractor's Dallas website.
How do I change information on my backflow tester registration?
Submit the changes on this same form and mark it as amended. The form states that a record change fee applies, so ask the City at (214) 948-4480 about the current amount.
Can I fill out the backflow tester registration online on FillingPDF?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not file the registration with the City of Dallas; you submit it through the City's channels.
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