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Get Carroll County Electrical License

Carroll County Maryland 2011-2013 Electrical License Renewal/New Form PLEASE PRINT ALL INFORMATION MD State Lic. Expires Type of License Please check the appropriate box Master Electrician - General Inactive Full Name First Middle Last Sr. Jr. III etc Company Name Mailing Address Street Address or P. O. Box Town Zip Email Address Company Phone Company s Fax Cell Phone Home Phone Is this a new company name since your last Carroll county renewal or application Please Note A licensed master electrician can only sign permits for himself/herself or company not both in Carroll County the licensee can only be self-employed or be employed by 1 electrical company not both at the same time for the purpose of securing permits whenever the licensee has at least 1 electrical permit outstanding in Carroll County. The following section is to be completed by the license holder. I solemnly affirm under the penalties of perjury that I will uphold the Carroll County Electrical Ordinance. I understand that I can not sign permits for more than one company or individual* I can not allow any unlicensed person unless employed by my company and under my direct supervision to do electrical wiring under the authority of my license. I understand that I am responsible for having all permits under my license finalized before the permit will be cleared from my license. I understand that a violation of these requirements could result in suspension or revocation of my license. License Mechanic Signature Master General 70. 00 Limited 70. 00 Restricted 60. 00 Inactive 1/2 Fee Make Checks Payable to Carroll County Commissioners Date Rec d Amount Paid Receipt Initials. Jr. III etc Company Name Mailing Address Street Address or P. O. Box Town Zip Email Address Company Phone Company s Fax Cell Phone Home Phone Is this a new company name since your last Carroll county renewal or application Please Note A licensed master electrician can only sign permits for himself/herself or company not both in Carroll County the licensee can only be self-employed or be employed by 1 electrical company not both at the same time for the purpose of securing permits whenever the licensee has at least 1 electrical permit outstanding in Carroll County. The following section is to be completed by the license holder. I solemnly affirm under the penalties of perjury that I will uphold the Carroll County Electrical Ordinance. The following section is to be completed by the license holder. I solemnly affirm under the penalties of perjury that I will uphold the Carroll County Electrical Ordinance. I understand that I can not sign permits for more than one company or individual* I can not allow any unlicensed person unless employed by my company and under my direct supervision to do electrical wiring under the authority of my license. I understand that I can not sign permits for more than one company or individual* I can not allow any unlicensed person unless employed by my company and under my direct supervision to do electrical wiring under the authority of my license. I understand that I am responsible for having all permits under my license finalized before the permit will be cleared from my license.

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