Fillable Contractor Application 1.%5B1%5D Building Lic App Smaller DON REV3 Layout 1

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Contractor Application 1.%5B1%5D Building Lic App Smaller DON REV3 Layout 1

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version: 02/01/2019
Electrical
Plumbing
Building Inspections Division
8101 Ralston Road,
Arvada, CO 80001
Phone: 720-898-7620 Email: buildingpermits@arvada.org
Fax: 720-898-7603 Website: www.arvadapermits.org
Contractor License Application
o
Renewal
o
New
o
Name Change
o
New Owner
Company Name:
Contact Name:
Business Address:
City:
State:
Zip:
Phone:
Alt. Phone:
Email Address:
Please provide a local address if above address is not located in Colorado or a PO Box:
Address: City & State: Zip:
Applicant intends to do business as:
o
Sole Proprietor
o
Partnership
o
Corporation
o
LLC
o
Other
Is this business a franchise? oYes oNo If yes, please indicate in the Company name the title in which you reside to
differentiate your business from the other franchised businesses.
o
I-B
Builder’s Unlimited $200
o
VI-P
Plumbing Contractor $75
o
II-B
Builder’s Limited $150
o
VII-M
Mechanical Contractor $75
o
III-B
Builder’s Misc./Residential C $75
o
VIII-D
Building Moving Contractor $75
o
IV-B
Builder’s Sub-Contractor $75
o
IX-R
Roofing Contractor $75
o
V-B
Homeowner’s “Limited” License $50
o
E
Electrical Registration $0
o
RA
Radio Amplification $0
Name/Title
Name/Title
Statements made on this application are subject to verification. False or misleading information may be cause for denial, suspension
or revocation of this license. Any changes made in ownership, address, phone numbers licensed supervisory personnel, or name of
company must be sent to the City of Arvada, Building Inspection Division, in writing, immediately. the undersigned hereby certifies that
the information contained on this license application together with attachments, are accurate and true and further agrees that, if
granted a license or electrical registration to operate in the City of Arvada, he/she will comply with all City of Arvada building, plumbing,
mechanical, electrical and ancillary codes and amendments as adopted by the City of Arvada and will comply with the license
regulations and responsibilities of the City of Arvada.
Owner or Officer Signature Title Date
Signature of Master If applicable. (if you are applying for plumbing or electrical Date
Include copies of Master and Contractors’ license(s))
OFFICE USE ONLY
Lic#:
Date:
click to sign
signature
click to edit
version: 02/01/2019
License Type
Work Allowed
Qualifications
Builder’s
Unlimited
I-B
Construct, erect, alter, repair or demolish any structural type or occupancy group.
Passing test from ICC F11 min or
Licensed in a Colorado
jurisdiction where you have
tested.
Builder’s Limited
II-B
Construct, alter, repair or demolish single-family dwellings, two-family dwellings, townhouses,
condominiums and apartment buildings not exceeding three stories in height and not having
more than seven dwelling units and not involving reinforced concrete above grade. The
licensee may complete nonstructural interior finish or remodel of any type of building.
Passing test from ICC F12 min
or Licensed in a Colorado
jurisdiction where you have
tested.
Builder’s Misc./
Residential C
III-B
Construct, alter or repair non-habitable buildings or portions of habitable buildings or
structures, such as private garages, carports, patios, sheds, basement finishes and non-
structural remodel of residential occupancies, signs, swimming pools or fences. This license
shall also allow minor nonstructural repair or remodel of less than two thousand ($2,000)
valuation on any type of building. This license shall be issued to building demolition
contractors.
Passing test from ICC F13 min or
Licensed in a Colorado
jurisdiction where you have
tested.
Builder’s Sub
Contractor
IV-B
This license shall be issued to those engaged in contracting for labor or for labor and material
involving ONLY ONE TRADE, such as masonry, framing, drywalling, glazing, concrete flat work,
irrigation systems, siding, elevator contractors, automatic fire protection systems, solar panel
installation, installation of radon mitigation system, fire detection systems or burglar alarms, but
shall not authorize any electrical, plumbing or mechanical work.
Passing test from ICC F14
min or 2 notarized letters.
Homeowner’s
“Limited”
V-B
This license shall be issued to an individual and is limited to the building of a single- family
residence to be owned and occupied by the licensee. The licensee may perform all or part of the
work personally or act as a general contractor; in either case, the licensee shall be fully
responsible for the performance of all the work in accordance with the city's building codes and,
further, shall pursue the completion of all work in an orderly and diligent manner. Documentation
shall be submitted with the permit application to show that the individual owns the property to
be built on and that if there is a construction loan; the loan is issued to the individual.
Plumbing
VI-P
This license shall entitle the holder to contract for and perform all work involving sanitary
plumbing, potable water piping, the installation of plumbing appliances and apparatus and
related plumbing work.
State of Colorado Master
Plumber
State of Colorado Contractor
License
Mechanical
VII-M
Erect, install or construct all mechanical systems, including hot water heating systems, air
conditioning systems, refrigeration systems, or install boilers, evaporative coolers, and sheet
metal work. This license shall entitle the holder to replace existing domestic water heaters,
boilers, and evaporative coolers, and all connections thereto. Other connections to the potable
water system must be performed by either a state-licensed master plumber in the employ of the
licensed mechanical contractor or city-licensed plumbing contractor unless specifically
exempted in the Colorado State Plumbing Code. Line voltage electrical work must be done by
a city-registered electrical contractor.
Passing test from ICC F29 or
License from Colorado
jurisdiction where you have
tested.
Moving
VIII-D
Move any building or structure, subject to all applicable regulations of the city. Before a moving
license is granted, the applicant shall file with the building official, a Certificate of Insurance in
the same amounts and subject to the same requirements as for municipal contractors' licenses
set forth in section 78-188
Roofing
IX-R
This license shall entitle the holder to do roofing of any building or structure including
nonstructural decking repair or replacement.
Passing test from ICC F14 or
License from Colorado
jurisdiction where you have
tested.
Electrical
E
To be qualified for registration as an electrical contractor, an applicant must hold a valid
electrical contractor's license issued by the state according to C.R.S. § 12-23-101 et seq.
State of Colorado Master
Electrical State of Colorado
Contractor License
Radio Amplification
RA
Erect, install or construct all radio amplification systems, This license shall entitle the holder to
replace existing radio amplification systems. Line voltage electrical work must be done by a
city-registered electrical contractor.
Certificate of in-building system
training issued by a nationally
recognized organization, school
or a certificate issued by the
manufacture of the equipment
being installed.
I am a “natural person” or a “sole proprietorship,” NOT a corporation, partnership, company or other similar entity
and MUST complete this affidavit and submit it with the required documentation.
1. I, swear or affirm under penalty of perjury
under the laws of the State of Colorado that (check one):
I am a United States citizen; or
I am a Permanent Resident of the United States; or
I am lawfully present in the United States pursuant to Federal law.
2.
I understand this sworn statement is required by law because I have applied for a “Public Benefit.”
3.
I understand state law requires me to provide proof that I am lawfully present in the United States prior to
receipt of this public benefit.
4.
I acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is
punishable under the laws of Colorado.
5.
I have attached a copy of one of the acceptable documents provided by the state of Colorado and I presented it to
the agency as proof of identification that I am at least 18 years of age and I am lawfully in the United States.
AFFIDAVIT FOR LAWFUL PRESENCE VERIFICATION
Because of Colorado House Bill 06S-1023 (C.R.S. 24-76.5-103), this affidavit is MANDATORY and must be
submitted along with a copy of one of the accepted forms of identification to prove lawful presence in the United
States. Colorado law now requires that the City of Arvada verify all natural persons 18 years or older or sole
proprietors who are applying for a public benefit are lawfully present in the United States prior to receiving the
public benefit. A public benefit includes the application or a renewal of a grant, loan, contract, and professional or
commercial licenses provided by an agency of the state or local government.
FOR CORPORATIONS/PARTNERSHIPS/COMPANIES ETC. ONLY
The applicant, for whom I am authorized to sign, is NOT a “natural person” or “sole proprietorship,” but a
corporation, partnership, company or other similar entity. HB 06S-1023 is not applicable.
I understand this sworn statement is required because the applicant has applied for a “Public Benefit.” I further
acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is
punishable under the laws of Colorado.
Printed Name and Title of
Applicant’s Representative
Signature of Applicant’s
Representative
Date
Name of Business
OR
FOR “NATURAL PERSONS” OR SOLE PROPRIETORS ONLY
Applicant’s Printed Name
Applicant’s Signature
Date
Name of Business (If applicable)
Revised 08/01/07
click to sign
signature
click to edit
ACCEPTED FORMS OF IDENTIFICATION TO PROVE LAWFUL PRESENCE IN THE UNITED STATES:
(1) A valid Colorado driver license (includes only a current driver license; or valid Colorado identification card , or
(2) U.S. military card or military dependent's identification card, or
(3) U.S. Coast Guard Merchant Mariner Card, or
(4) Native American Tribal Document.
(5) Certificate verifying naturalized status issued by an authorized agency of the United States bearing Applicant's intact
photograph impressed with the raised embossed seal of the issuing agency;
(6) Certificate verifying United States citizenship issued by an authorized agency of the United States bearing Applicant's
intact photograph impressed with the raised embossed seal of the issuing agency;
(7) Valid driver license or ID card bearing applicant's photograph issued by a lawful presence state. All states are lawful
presence states including the District of Columbia with the exception of: Hawaii, Illinois, Maryland, Nebraska, New
Mexico, Utah, and Washington. If on the face of the license or ID card presented it says that it is an enhanced
driver license or ID card, and then it is to be accepted as a lawful presence document.
(8) Valid immigration documents demonstrating Lawful Presence and verified through the Systematic Alien Verification
for Entitlements, administered by the United States Citizenship and Immigration Services of the Department of
Homeland Security. Valid immigration documents are as follows:
o Unexpired Foreign Passport bearing an unexpired "Processed for I‐551" stamp or with an attached
unexpired "Temporary I‐551" visa.
o Unexpired Foreign Passport accompanied by an "I‐94" indicating a specific future "until" date.
o "I‐94" with refugee or asylum status.
o Unexpired "Resident Alien" card, "Permanent Resident" card, "Temporary Resident" card, or "Employment
Authorization" card.
Waiver Process
If you cannot produce any documentation necessary to prove lawful presence, you may request a waiver, (Form DR
4678). The waiver is available for individuals who:
Due to chronic health or medical condition, lack sufficient mobility to appear in person to apply for a Colorado
Driver license or Colorado identification card, or
Due to lack of a permanent physical address in Colorado, do not qualify for a Colorado driver license or Colorado
identification card, or
May lack sufficient documentation to receive a Colorado driver license or Colorado identification card.
The waiver and all supporting documentation must be presented by you or a representative at a participating
Colorado driver’s license office, not at the City Department where you are requesting the benefit. Arvada cannot
approve the benefit until the waiver process has been completed.
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Contractor Application 1.%5B1%5D Building Lic App Smaller DON REV3 Layout 1

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Completed 16 July 2020

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