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DEVELOPMENT SERVICES DEPARTMENT Building Safety Division 840 West 11th Street Ste. 1100 Panama City, FL 32401 Telephone (850) 248-8350 Fax (850) 248-8384 RECIPROCITY FOR REGISTERED CONTRACTORS The following information is required to be attached to this form: 1) Copy of current State Contractor License displaying Contractor’s address. 2) Copy of current Competency Card from sponsoring county. 3) Reciprocity letter from sponsoring county with passing test scores and dates of exams signed by the Building Official or his/her representative. 4) Copy of General Liability Insurance. Bay County Building Safety Division shall be listed as Certificate Holder. 5) Copy of Workers’ Compensation Certificate. Bay County shall be listed as certificate holder. If you do not have employees, we will accept Workers Compensation Exemption. 6) Notarized Letter of Authorization (L03 form) signed by the license holder authorizing another person(s) to sign as the agent of the license holder to obtain permits and call inspections in only (if applicable). All IDs. are to be submitted to accept the Letter of Authorization. 7) Copy of your State driver’s license or State identification card. ALL PAPERWORK MUST RECORD YOUR COMPANY NAME EXACTLY AS IT APPEARS ON YOUR STATE LICENSE. (FL. STATUE 489.125 & FL. ADMIN. CODE 61G4-15.003).This information must be on file and current before obtaining a permit in Bay County. Please allow 7 to 10 working days upon receipt for processing. Once complete a confirmation will be sent via email. Contractor and Company Name Name: Company: Address: Phone Cell Email Address: Qualifier Form L09 REVISED 09-18-2025