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Get Carroll County Electrical License

Carroll County Maryland 2013-2015 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. 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 For Office Use Only 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. 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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