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Contractor Registration Form

  1. CWM_LOGO-RGB_Web 2

  2. West Melbourne | Building Division

    2240 Minton Road | West Melbourne, FL 32904
    Tel: 321.837.7776 | Fax: 321.952.9542
    www.westmelbourne.org

  3. Contractor Registration Form

  4. Please select one:

  5. For proper registration, you shall provide all updated information that apply to your contractor's qualifications. Incomplete and missing information will delay the registration process, and as a result no applications for permit will be properly processed.

  6. * Certified Contractor (State License).

  7. * Brevard County Contractor (Certificate of Competency).

  8. * Liability Insurance (City of West Melbourne as certificate holder).

  9. * Workman's Compensation (City of West Melbourne as certificate holder) or Florida's exemption.

  10. * Business Tax Receipt (Former Occupational License).

  11. Leave This Blank:

  12. This field is not part of the form submission.