MSV Change of Contractor Form
Change of Contractor/Architect or Engineer
A change of contractor, architect or engineer must be done under a permit number .There is a $110.00
charge for a change of contractor. The owner will submit a Change of Contractor Form completed with
notarized signatures. If the signature of the previous contractor cannot be obtained the owner must send a
certified letter/return receipt notifying the previous contractor, architect or engineer the reason for the
change .The owner must allow 10 business days for the contractor, architect or engineer to respond. A
permit application must accompany the change of contractor form, with the information and signature of the
new contractor .The new contractor must be registered with the Village or must submit the required
documents to register with the Village.
1. Change of Contractor form completed, signed and notarized.
2. Permit application by new contractor.
3. Required fees.
4. Copy of original letter sent via certified mail along with the returned receipt.
In addition to the requirements above the architect or engineer of record must authorized the new architect
or engineer to reproduce his documents. The authorization must be in writing and must be signed and sealed.
Miami Shores Village
Building Department
10050 N.E. 2ND Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CHANGE OF CONTRACTOR / ARCHITECT
Permit N._____________
Owner’s Name (Fee Simple Title Holder):__________________________ Phone #:___________________
Owner’s Address: __________________________________________________________________
City: ____________________________ State : __________________ Zip Code:__________
Job Address (Of where work is being done):____________________________________________________
City: _______Miami Shores_________ State:__Florida__________ Zip Code:____________
Contractor’s Company Name: _______________________________ Phone #:___________________
Address: _________________________________________________________________________
City: _______________________________ State:__________________ Zip Code:____________
Qualifier’s Name : ______________________________________ Lic. Number: __________________
Architect/ Engineer of Record Name: _____________________________ Phone #:_________________
Address: __________________________________________________________________________
City: _______________________________ State: _________________ Zip Code: ____________
Describe Work: ___________________________________________________________
I hereby certify that the work has been abandoned and/or the contractor/architect
is unable or unwilling to complete the contract. I hold the Building Official and the
Miami Shores harmless of all legal involvement.
Signature _______________________ Signature ________________________
Owner or Agent Contractor or Architect
The foregoing instrument was aknowledged before me The foregoing instrument was aknowledged before me
this ___ day of ________,20 ,by_______________ this ______ day of ___________, 20 by _____________
Who is personally known to me or who has produced who is personally known to me or who has produced
__________________________________ as indentification. __________________________________as indentification.
Notary Public: Notary Public:
Sign: ______________________________________ Sign:________________________________________
Seal: Seal: