Contractor Registration / Listing Application printable pdf download

VOLUSIA COUNTY

CONTRACTOR REGISTRATION / LISTING APPLICATION

For contractors authorized per Florida Statutes 489 Parts I & II and Volusia County Ordinance Ch. 22

Applicant (Licensee) name: ______________________________________________________________

Company name: _______________________________________________________________________

Address: _____________________________________________________________________________

City: _________________________________________ State: ______ Zip Code: ___________________

Address Mailing: (if different) _____________________________________________________________

City: _________________________________________ State: ______ Zip Code: ___________________

Bus. Ph: (_____)______________ Cell Ph: (_____)_______________ Bus. Fax: (_____)______________

E-mail address:

Preferred method of notification: mail / phone / fax / e-mail (please circle one)

State License Number:

(Copy of state license

required)

Fees: Contact Contractor Licensing for current fee.

State Registered / Local Specialty Contractors & Journeymen*

*Fees reflect the current Building Activity fee resolution adopted by Volusia County. The fee includes a 1

certification fee and is calculated in

accordance with a 2 year renewal cycle prorated at the time of application. Contact Contractor Licensing for exact amounts.

**Payment by cash, check, credit card or money order**

. Contractor Licensing will e-mail

If you wish to pay by credit card online please mark here

you to give you the information you will need.

The Cities of Daytona Beach, Daytona Beach Shores, DeBary, DeLand, Deltona, Edgewater, Holly Hill,

Lake Helen, New Smyrna Beach, Oak Hill, Orange City, Ormond Beach, Ponce Inlet, Port Orange, and South Daytona

participate by Interlocal agreement in the Volusia County Contractor Licensing Program.

Certified contractors may decline participation in the licensing program.

Proof of insurance is required in the form of a certificate of insurance, identifying Volusia County as the certificate

holder (see bottom of page). Coverage amounts as required by Rule 61G4 & 61G6, Florida Administrative Code.

Workers Compensation or Exemption required per F.S. 489.114 & 510.

Certified contractors may decline participation in the Volusia County Contractor Licensing Program.

Proof of licensure and insurance will be required for each permit application. This would also apply

to contractors working in cities that have elected, by Interlocal agreements, to allow Volusia County

to administer their contractor licensing program.

For information about the Contractor Licensing Program, please call one of the following numbers:

DeLand (386) 736-5957 Opt. 2

Daytona (386) 248-8158 Opt. 2

New Smyrna (386) 424-6828 Opt. 2

Fax (386) 740-5215

E-Mail

County of Volusia

Contractor Licensing

123 West Indiana Ave, Room 203

DeLand, Florida 32720

Contractor Registration / Listing Application

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