RENEWAL REGISTRATION APPLICATION FOR PLUMBERS CERTIFICATE
Master Plumber / Master Gas Fitter / Liquefied Petroleum / Journeyman
220 SOUTH MAIN STREET
BEL AIR, MARYLAND 21014
(410) 638-3215
FAX (410) 879-8203
MASTER PLUMBER – GAS FITTER $90 LIQUIFIED PETROLEUM (L.P.) $70
MASTER GAS FITTER $90 JOURNEYMAN PLUMBER GAS FITTER $30
This a two year license which renews April 30
th
of even numbered years.
PLEASE PROVIDE PAYMENT AND THE FOLLOWING DOCUMENTS:
1. CURRENT CERTIFICATE OF INSURANCE
2. CURRENT STATEWIDE LICENSE OR RECRIPROCAL COUNTY LICENSE
3. RENEWAL APPLICATION NOTING ANY CHANGES TO CONTACT INFORMATION
NAME: _____________________________________________________________________________
LAST FIRST MI
ADDRESS: _________________________________________________________________________
CITY/STATE/ZIP: ___________________________________________ PHONE _________________
APPLICANT E-MAIL ________________________________________________________________
FIRM NAME: ______________________________________________PHONE __________________
FIRM ADDRESS_____________________________________________________________________
FIRM E-MAIL _____________________________________________________________________
APPLICANT SIGNATURE: ________________________________________DATE: _____________
THE FOLLOWING INFORMATION REQUIRED ONLY FOR MASTER APPLICATION:
STATE LICENSE NUMBER: _________________________________
NUMBER OF APPRENTICES EMPLOYED: ____________________
NUMBER OF JOURNEYMAN EMPLOYED: ____________________
(LIST JOURNEYMAN NAMES AND ADDRESSES ON REVERSE SIDE)
Revised Oct 2020
click to sign
signature
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