SEWER AND WATER APPRENTICE RENEWAL All licenses are to be ...
SEWER AND WATER APPRENTICE RENEWAL
July 1, 2017 through June 30, 2018
NORTH DAKOTA STATE PLUMBING BOARD SFN 52454 (4-2017)
All licenses are to be renewed on or before June 30, 2017. There is no fee for a Sewer and Water Apprentice for the first 3400 hours. The renewal fee after 3400 hours is $25.00. Please include the renewal fee with the renewal form. The Sewer and Water Contractor must sign for hours credited. Sewer and Water Apprentices must work under the direct supervision of either a Sewer and Water Contractor or Sewer and Water Installer at all times. Our office encourages you to write the Sewer and Water Installer's examination when eligible, as you may then work without direct supervision. Sewer and Water Code Books are available from this office or can be purchased through our website at www.ndplumbingboard.com/store/code-books. Please include $23.00 for this book with your renewal.
Please print. Return this renewal form with your payment. Information Required Name
Email Address
Address
City
State
License Number
Telephone Number
Cell Phone Number
ZIP Code
Have you ever been convicted of a felony under the laws of this state or any other jurisdiction? No Yes - explain in full on a separate sheet of paper.
Employer's Name Address
City
Business Telephone Number
Fax Number
Credit Hours According to our Records
Number of Hours Worked 7/1/2016
State
- 6/30/2017
ZIP Code
Total
Call Pluming Board for hours Contractor's Signature
Hours Worked for Another Employer Contractor's Signature
License Number
Dates
Total
License Number
North Dakota State Plumbing Board - 1110 College Drive Suite 210 - Bismarck, ND 58501 701-328-9977 - 701-328-9979 (Fax) [email protected] - ndplumbingboard.com
July 1, 2017 through June 30, 2018
NORTH DAKOTA STATE PLUMBING BOARD SFN 52454 (4-2017)
All licenses are to be renewed on or before June 30, 2017. There is no fee for a Sewer and Water Apprentice for the first 3400 hours. The renewal fee after 3400 hours is $25.00. Please include the renewal fee with the renewal form. The Sewer and Water Contractor must sign for hours credited. Sewer and Water Apprentices must work under the direct supervision of either a Sewer and Water Contractor or Sewer and Water Installer at all times. Our office encourages you to write the Sewer and Water Installer's examination when eligible, as you may then work without direct supervision. Sewer and Water Code Books are available from this office or can be purchased through our website at www.ndplumbingboard.com/store/code-books. Please include $23.00 for this book with your renewal.
Please print. Return this renewal form with your payment. Information Required Name
Email Address
Address
City
State
License Number
Telephone Number
Cell Phone Number
ZIP Code
Have you ever been convicted of a felony under the laws of this state or any other jurisdiction? No Yes - explain in full on a separate sheet of paper.
Employer's Name Address
City
Business Telephone Number
Fax Number
Credit Hours According to our Records
Number of Hours Worked 7/1/2016
State
- 6/30/2017
ZIP Code
Total
Call Pluming Board for hours Contractor's Signature
Hours Worked for Another Employer Contractor's Signature
License Number
Dates
Total
License Number
North Dakota State Plumbing Board - 1110 College Drive Suite 210 - Bismarck, ND 58501 701-328-9977 - 701-328-9979 (Fax) [email protected] - ndplumbingboard.com
