Fillable APPLICATION FOR REGISTRATION

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APPLICATION FOR REGISTRATION

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File type: PDF

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Building Inspection Division
228 S. MASSACHUSETTS AVE.
LAKELAND, FLORIDA 33801-5086
BuildingInspection@lakelandgov.net
863/834-6012 TDD 863/834-8333
(for office staff)
AEC
#
:
APPLICATION FOR REGISTRATION
Name of License Holder:
D/B/A (Company Name):
Business Phone:
Fax #:
Mailing Address:
City, State, ZIP
Email Address:
I hereby apply for a registration with the City of Lakeland as a(n):
Architect Engineer Contractor Other
If Other, please describe: _____________________________________________________________________________
License No: ____________________________ License Type (from License): _________________________________
Contractors, please choose if Registered or Certified. (How do I know if I’m registered or certified? Registered contractors
take a county test and can only pull permits in that county. Certified contractors take a State of Florida test and can pull permits
in the entire state. Your license number will also indicate if you are registered or certified by beginning with the letter C or R.)
Certified Registered N/A
I AM FAMILIAR WITH APPLICABLE CODES OF THE CITY OF LAKELAND. I AGREE TO ABIDE BY ITS
PROVISIONS AND ANY AMENDMENTS THERETO:
Signature of Licensee: ______________________________________ Date: _________________
REGISTERED/CERTIFIED CONTRACTOR REGISTRATION REQUIREMENTS:
(The following list and this application can be emailed to BuildingInspection@Lakelandgov.net for registration)
1. Current State license certification
2. Current certificate of insurance showing general liability coverage. General and building contractors must
maintain $300,000 liability insurance and $50,000 property damage insurance. All other categories must
maintain $100,000 liability and $25,000 property damage insurance. Insurance may not limit scope to less
than license allows. Insurance must have your business name and contractor number as licensed by the
State. Include fax/email on certificate.
3. Current certificate of insurance showing worker’s comp coverage or current certificate of exemption
4. Registration fee of $22.50 for REGISTERED CONTRACTORS ONLY
5. We must be listed as “Certificate Holder” City of Lakeland
Building Inspection Division
228 S Massachusetts Ave
Lakeland, FL 33801
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APPLICATION FOR REGISTRATION

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Completed 1 December 2021

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