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Michigan Contractor - Residential License

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					BCS/LBL-010 (08/12)




           INDIVIDUAL RESIDENTIAL BUILDER LICENSE APPLICATION CHECKLIST

This checklist is intended to assist you with filing a complete Individual Residential Builder License Application; do NOT mail it
along with your application package. All applicable items listed must be completed and submitted for your application to be
processed.


    Individual Residential Builder License Application (BCS/LBL-010)

        Completed all fields on the application in blue or black ink

        Signed and dated application


    Included a Check or Money Order from a US Financial Institution payable to the "State of Michigan" in the amount of $195.00


    Included a copy of your Driver's License or State Issued Photo ID

    NOTE: If you are NOT a Michigan resident, you must also complete and submit the Consent to Service of Process form
          (BCS/LCL-900) for your out-of-state address. However, you are required to maintain a place of business in Michigan.

    Included a copy of the official certificates of completion for the 60 hours of prelicensure education for the subjects of:

        Business Management, Estimating, and Job Costing (6 hours)

        Design and Building Science (6 hours)

        Contracts, Liability, and Risk Management (6 hours)

        Marketing and Sales (6 hours)

        Project Management and Scheduling (6 hours)

        The Michigan Residential Code (6 hours)

        MIOSHA Construction Safety Standards (6 hours)

        18 hours of other topics from the approved prelicensure course list located at www.michigan.gov/builders under "Spotlight"


    Included a filed copy of your Certificate of Assumed Name (DBA) (if applicable)

    NOTE: Do NOT list the name of a corporation, LLC, or partnership in the line marked DBA on page 1 of the application.
          If you have a corporation, LLC or partnership you must submit a separate application form BCS/LBL-020

    Included the Request for Conviction History of an Applicant (BCS/LCE-020), Request for Disciplinary Action Information
    (BCS/LCE-021), or the written statement regarding unlicensed activity if you answered "yes" to any of the questions on
    page 1 of the application.




All forms can be found at www.michigan.gov/builders by clicking on "Forms and Publications" on the right hand side.
                                                                                                                                     I-RB
BCS/LBL-010 (08/12)
Page 1


Michigan Department of Licensing and Regulatory Affairs
                                                                                  FEE DUE $195.00
Bureau of Commercial Services - Licensing Division                              FEE IS NON-REFUNDABLE
BUILDERS UNIT
P.O. Box 30245, Lansing, MI 48909
517-373-8376 www.michigan.gov/builders




INDIVIDUAL RESIDENTIAL BUILDER LICENSE APPLICATION
AUTHORITY: P.A. 299 of 1980, as amended.
COMPLETION: Mandatory
PENALTY:    Failure to complete may result in denial of your application



Name (First, Middle, Last)                                                                  Social Security Number               Date of Birth



Home Address (Number & Street) NOT POST OFFICE BOX #                              City                                   State               ZIP Code



County                              Home/Cell Telephone Number             E-Mail Address



Business Address (Number & Street) NOT POST OFFICE BOX #                          City                                   State               ZIP Code



County                              Business Telephone Number              E-Mail Address



SOLE PROPRIETOR - D/B/A INFORMATION - If you will be conducting business in a name other than your given name, you must indicate that below. You
may not include a corporation, LLC or partnership name on this license. An application for a corporation, LLC or partnership may be found at
www.michigan.gov/builders under Forms & Publications. Supply a valid copy of the Certificate of Assumed Name from the County Clerk's Office filed in the
county where your business is located.
D/B/A



Have you ever been convicted of a felony?

     Yes - Download the form BCS-LCE-020 "Request for Conviction History of Applicant". The form can be downloaded and                              No
           completed to accompany this application. See www.michigan.gov/builders and select Forms & Publications. The form must
                                                                                                                             .
           be included to avoid delays in processing your application.

Have you or any firm or company in which you were a member, partner, officer or employee ever had disciplinary action taken against any license, registration
or permit now held or have ever held? (Includes, but is not limited to final orders, suspension, revocation, denial, etc.)

     Yes - Download the form BCS/LCE-021 "Request for Disciplinary Action Information". The form can be downloaded and completed                    No
           to accompany this application. See www.michigan.gov/builders and select Forms & Publications. The form must be included
           to avoid delays in processing your application.

                           FEE PAYMENT INFORMATION                                                 FOR OFFICE USE ONLY - VALIDATION




   Individual Residential Builder                $ 195.00          (2101-01 = $165.00)
                                                                   (2101-15 = $ 30.00)




                             FEES ARE NON-REFUNDABLE

 Make your check or money order in U.S. Currency payable to:

                                   STATE OF MICHIGAN

 FEES ARE NOT REFUNDED EXCEPT UNDER AUTHORITY P.A. 152 OF
 1979, AS AMENDED, AND R338.943 AND R338.944.
LARA is an equal opportunity employer/program. Auxiliary aids, services and other reasonable accommodations are available upon request
to individuals with disabilities.
BCS/LBL-010 (08/12)
Page 2




PRELICENSURE EDUCATION REQUIREMENT: Individuals applying for licensure as a Residential Builder are required to complete 60 hours of approved
prelicensure education courses prior to submitting this license application. The list of approved courses may be found at www.michigan.gov/builders under
the "Spotlight" section. Applicants must submit a copy of the official certificate(s) of completion from the course provider.


I certify that I have completed:

   a) 6 hours of courses in business management, estimating, and job costing.                        Yes             No

   b) 6 hours of courses in design and building science.                                             Yes             No

   c) 6 hours of courses in contracts, liability, and risk management.                               Yes             No

   d) 6 hours of courses in marketing and sales.                                                     Yes             No

   e) 6 hours of courses in project management and scheduling.                                       Yes             No

   f) 6 hours of courses in the current Michigan residential code.                                   Yes             No

   g) 6 hours of courses in construction safety standards promulgated under the                      Yes             No
      Michigan occupational safety and health act.
   h) A total of 60 hours of approved courses.                                                       Yes             No

List the license numbers of all residential builder, maintenance and alteration contractor, or construction salesperson licenses currently or previously held by
you.




YOU MUST SIGN AND DATE THE APPLICATION BELOW.

I hereby certify that the statements in this application are true and correct. I have not withheld information which might affect the decisions to be made on
this application. I am aware that a false statement or dishonest answer may be grounds for denial of my application or disciplinary action against my license,
or may be punishable by law. I hereby authorize the Department of Licensing and Regulatory Affairs and its agents to investigate any statements made by
me in this application, including checking criminal, civil, and administrative records. I authorize the Department and its agents to examine my books and
records at the Department's discretion. I understand that I will not be eligible to engage in activity requiring licensure until a license is approved and issued.




  Signature of Applicant                                                                                                                    Date


NOTE:
It is the applicant's responsibility to be aware of and comply with all regulations pertinent to the application process, licensure and practice.
Allow approximately 3 weeks for processing of a properly submitted application.
All requirements for licensure must be completed within 1 year of filing this application.
CONTINUING COMPETENCY REQUIREMENT - Effective January 1, 2009, all licensees are required to complete 21 hours of activities demonstrating
continuing competency every 3 years for the first 6 years of licensure. Details on fulfilling the requirement may be found at www.michigan.gov/builders.
Mail your completed, signed, two-page application, all required documents and payment to:
                                                           Department of Licensing and Regulatory Affairs
                                                           Bureau of Commercial Services - Licensing Division
                                                           BUILDER'S UNIT
                                                           P.O. Box 30245, Lansing, MI 48909

				
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