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Baltimore Contractor - Electrical License

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					                             THE ELECTRICAL ADMINISTRATIVE BOARD                                            Application received:
                                     OF BALTIMORE COUNTY
                                                    County Office Building                                  Approved for license:
                                                   Towson, Maryland 21204
                                                     Phone: 410-887-3636
                                                                                                            Rejected Reason
                                    Date:


                         APPLICATION FOR ELECTRICAL LICENSE
   Master General from the State of Maryland must complete the following:

       This application (front and back)                                    Copy of Statewide license
       Copy of driver’s license                                             Copy of Statewide insurance certificate
       Complete resident agent form for out of state company                $140 check made payable to Baltimore County

   Reciprocal from other local jurisdiction must complete the following:
       This application (front and back)                                    Letter of good standing from local jurisdiction
       Copy of driver’s license                                              where you passed your test
       Complete resident agent form for out of state company                Need a copy of active local license that you
        $140 – Master General                                                 held for a year or more from the jurisdiction
        $105 – Master Limited                                                 you are reciprocating from
        $115 – Restricted

   Master General License
    Authorizes the holder thereof to install, repair, or erect any kind of electrical wiring, conduits, machinery,
    appliances, motors, fixtures, signs, electrically operated heating equipment, elevators, or any other electrical
    apparatus or device in or about any premises in Baltimore County.

   Limited License
   (Limits license holder to represent and perform work in one industrial type building in Baltimore County)
   Authorizes the holder thereof to install, repair, maintain or erect any kind of electrical wiring, conduits, machinery,
   appliances, motors, fixtures, signs, electrically operated heating equipment, elevators, or any other electrical
appa    ratus or device, but only on the premises of his employer in Baltimore County (no work for the public)

   Restricted License (ONE of the specialties listed below)
    (Can only reciprocate exact class of license between local jurisdictions, as stated below)
    Authorizes the holder thereof to install, maintain, and repair and, except with respect to electrical household
    appliances, radio and television sets, to make installation of electrical wiring from the point of distribution to the
    equipment being installed in or about any premises in Baltimore County. The following are the types of electrical
    equipment for which a restricted license is required:

    Please write the letter of your choice:
                                                                                      K. Intercom, Communications
A. Radio, TV, Cable TV                      E. Elevators
                                                                                      Equipment, Sound System
                                            F. Low Voltage Alarm and Signal
B. Antennas                                                                           L. Water Pumps
                                            Systems
C. Heating, Refrigeration, Air                                                        M. TV Electronic Surveillance
                                            G. Signs
Conditioning                                                                          Systems
D. Appliances, Tool, and Moto               H. Installation and Maintenance of
                                                                                      N. X-ray Equipment
Repairs                                     Traffic Equipment

Having read the Board’s rules and regulations, I hereby make applications for an examination and/or license as indicated
above, and submit full and accurate answers to the following questions:

FULL NAME:
                           First                                 Middle                       Last

ADDRESS:
                           Street                                City                         State              Zip

PDM EL4w                                                    Page 1 of 3                                         REV 12/10
1.     Home Telephone No.:                                            Social Security No.:

2.     Date of Birth                                                  Age Last Birthday

3.     Have you ever taken an examination before in this county?              If so, give the dates:

       Have you ever had an electrical license in this bounty before?            If so, give your license number:

4.     List county or city, license number, and type of license of the licenses you hold in other jurisdictions in Maryland



5.     List the total number of years you have been engaged in the electrical business or trade:
       List the total number of years that you worked as an apprentice or helper:
       List the total number of years that you worked as a journeyman:

6.     List all employment you have had since you first began electrical work, putting your present or last employment first
       and others in order back to your first position in the electrical business, as far as you are able. If additional space is
       needed, attach separate sheet.

      Length of Employment
                                        Worked As                 Name of Employer                         Address
     From (Mo/Yr)   To (Mo/Yr)




7.     Education. What is the highest grade completed:

       Name of your high school:

       College:                                            Trade School:

       Other courses that you have taken:

8.     If you intend on being in business for yourself or to be a representative of a company or firm, list the following:

       Name under which you will do or are doing business:

       Address:

       Telephone Number:

      NOTE: BY LAW YOU ARE ALLOWED TO REPRESENT ONLY ONE COMPANY OR FIRM AT A TIME

I hereby certify that this application has been completed in full and that all statements contained herein are true and correct
to the best of my knowledge; and if a license is granted to me, I hereby agree to use it in strict accordance with the laws and
regulations of Baltimore County.

Signature:                                                                                       Date:



                                                    FOR OFFICE USE ONLY

License Fee:                                                                 Cash Slip No.:

License Fee Deposited:                                                       Auditors No.:

Date License Issued:

PDM EL4w                                                       Page 2 of 3                                          REV 12/10
                             NEW LICENSE INFORMATION FORM
  Please complete this form with appropriate mailing information. Please make checks payable to Baltimore County.
                                    Return To: Baltimore County Office Building
                                     111 West Chesapeake Avenue, Room G21
                                             Towson, Maryland 21204



Name___________________________________________________ Balto. County Lic. #_______________
       Last     First                     M.I                .
Company________________________________________________________________________________

Mailing Address ___________________________________________________________________________

City_______________________________________State____________________Zip ___________________

Business Phone___________________________                 Home Phone ________________________________

Email: _____________________________________________________


Signature__________________________________________________________________________________




PDM EL24w                                             Page 3 of 3                                    REV 10/10
Department of Permits and                                                Baltimore County
Development Management
                                                                   James T. Smith, Jr., County Executive
Code Inspection and Enforcement                                       Timothy M. Kotroco, Director
 County Office Building
111 West Chesapeake Avenue
Towson, Maryland 21204
pdmenforce@co.ba.md.us
pdminspect@co.ba.md.us


       The Baltimore County Electrical Administrative Board requires that all companies
licensed by it designate an individual to represent them as their Resident Agent. This is to
ensure that you receive notification of any hearings as may be required before the Board.

          The Resident Agent shall complete the following form.

          ACKNOWLEDGMENT OF CONSENT TO SERVE AS RESIDENT AGENT

This is to affirm that I am a resident of the State of Maryland: that I am over the age of 18:
and have consented to act as the Resident Agent for the business named below, and to
accept service for it by certified mail, or alternatively, by ordinary mail and telephone.


                                   FULL NAME AND ADDRESS OF BUSINESS

      I further understand that it is my obligation to notify the Baltimore County Department
of Permits and Licensing upon any future change of my address, or telephone number.



_____________________________                                          _____________________
Signature of Resident Agent                                                 Dated

Resident Agent’s full name_________________________________________________

Resident Agent’s Address___________________________________________________

Resident Agent’s Phone#___________________________________________________
                         Business Telephone #       Home Telephone #

(Attach a photo static copy of Resident Agent’s Maryland driver’s license to form)

      I hereby affirm under the penalty of perjury that the forgoing information is true to
the best of my knowledge, information and belief.

                                        _______________________________

                           Visit the County’s Website at www.baltimorecountymd.gov

PDM EL2w                                     Page 1 of 2                                  REV 06/10
Department of Permits and                                                Baltimore County
Development Management
                                                                   James T. Smith, Jr., County Executive
Code Inspection and Enforcement                                       Timothy M. Kotroco, Director
 County Office Building
111 West Chesapeake Avenue
Towson, Maryland 21204
pdmenforce@co.ba.md.us
pdminspect@co.ba.md.us
                                                               Signature of Resident Agent

                    ACKNOWLEDGMENT OF CONSENT TO ALTERNATE SERVICE

This is to affirm that I am the owner and/or corporate officer of the business named below:
that I have designated a resident agent to accept service for this business: that I have
consented to my resident agent accepting service of notification of any hearings as may be
required before the Board by certified mail, or alternatively, ordinary mail and telephone.


                                   FULL NAME AND ADDRESS OF BUSINESS


             FULL NAME AND ADDRESS OF BUSINESS OWNER OR CORPORATE OFFICER

Resident Agent’s full name_________________________________________________

Resident Agent’s Address___________________________________________________

Resident Agent’s Phone#___________________________________________________
                         Business Telephone #       Home Telephone #

      I hereby affirm under the penalty of perjury that the forgoing information is true to
the best of my knowledge, information and belief.


                                                               _______________________________
                                                               Signature of Owner or Officer




                           Visit the County’s Website at www.baltimorecountymd.gov

PDM EL2w                                     Page 2 of 2                                  REV 06/10

				
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