Village of Estero Building and Permitting Services
9401 Corkscrew Palms Cir
Estero, FL 33928
Tel # (239) 221-5036 | Fax # (239) 319-2235
Contractor Registration Form
The Village of Estero Building and Permitting Services is requiring registration from contractors who will be
applying for building permits in the Village of Estero.
The documents necessary for registration include:
•
Copy of an Active State License or Lee County Competency Card
•
Proof of Liability Insurance
•
Proof of Workman’s Compensation Insurance Or Workers comp Exempt Certificate
•
There will be a NO charge for registration at this time
Note: Village of Estero needs to be listed as a Certificate Holder (for notification purposes only).
The Contractor or Authorized Agent may bring these documents to the Village of Estero Building and Permitting
Services when applying for the first building permit. Registration will be completed right over the counter and
documents will be filed.
Please complete this form and submit items above and an updated authorized agent affidavit, (if
applicable.)
Contract (License Holder) Information:
1.
Contractor’s Name: __________________________________________________________
a.
License Number: _____________________
b.
Signature: __________________________________________________________________
c.
Company Information:
2.
Company Name: ____________________________________________________________
a.
Address: ___________________________________________________________________
b.
City: __________________ State: ____________________ Zip __________
c.
Office Phone #: _______ - ________ - ________
d.
Fax #: _______- ________ - _________
e.
Mobile Phone#: _______ - ________ - ________
f.
Email: __________________________________________________________
g.
Contractor registration form and attachments can be sent to
permitting@estero-fl.gov
or faxed to 239-319-2235
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