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By typing your name here, you are signing this form electronically. You agree you are submitting this application for processing and is the legal equivalent of your manual signature on this form. You must be the legal qualifier which match our registration records. Note: A notarized Letter of Authorization is required for an agent to sign the application or any other correspondence that calls for an agent signature.
Qualifier to authorize agents for permit drop-off/pickup, must be notarized
Pinellas County Certificate of Competency
General Liability ($100,00/$500,000 each occurrence)
Workers Compensation or State-approved Exemption Certificate
Certificate of Competency, Business Tax Receipt, and Insurance Certificate must have the same business name.
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