Fillable UNINSURED MASTER $90 MASTER $90 MASTER RESTRICTED: $40 (Harford County Government)

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UNINSURED MASTER $90 MASTER $90 MASTER RESTRICTED: $40 (Harford County Government)

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U.S.A. forms for Harford County Government

BROWSE HARFORD COUNTY GOVERNMENT (MD) FORMS

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APPLICATION FOR MECHANICAL REGISTRATION
220 SOUTH MAIN STREET
BEL AIR, MARYLAND 21014
(410) 638-3215
FAX (410) 879-8203
□ MASTER $90
□ UNINSURED MASTER $90
□ MASTER RESTRICTED: $40 FOR EACH CATEGORY, MAXIMUM $90
□ Master Restricted Heating
□ Master Restricted Forced Air Heating
□ Master Restricted Heating – Hydronic
□ Master Restricted Ventilation
□ Master Restricted Air Conditioning
□ Master Restricted Refrigeration
□ LIMITED MECHANICAL $90
□ MASTER INSPECTOR (WAIVED FEE)
This a two year license which renews April 30
th
of even numbered years.
PLEASE PROVIDE THE FOLLOWING DOCUMENTS AT THE TIME OF YOUR APPLICATION:
CERTIFICATE OF INSURANCE AND STATEWIDE LICENSE OR RECIPROCAL COUNTY LICENSE.
NAME: _____________________________________________________________________________________________
LAST FIRST MI
ADDRESS: __________________________________________________________________________________________
COMPANY NAME: __________________________________________________________________________________
COMPANY ADDRESS: _______________________________________________________________________________
TELEPHONE: _____________________________________CELL PHONE: ____________________________________
EMAIL: _____________________________________________________________________________________________
SIGNATURE: _________________________________________________DATE: ________________________________
THE FOLLOWING INFORMATION REQUIRED ONLY FOR MASTER APPLICANT:
State License Number: ______________________________________________
Number of Apprentices employed: ____________________________________
Number of Journeyman employed: ____________________________________
List names and address of journeyman on reverse side:
Rev Oct 2020
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UNINSURED MASTER $90 MASTER $90 MASTER RESTRICTED: $40 (Harford County Government)

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Completed 13 February 2021

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