Blank Kentucky Elevator Mechanic License PDF Form

Blank Kentucky Elevator Mechanic License PDF Form

The Kentucky Elevator Mechanic License form is an essential document required for individuals seeking to work as elevator mechanics in the Commonwealth of Kentucky. This application ensures that applicants meet the necessary qualifications and experience standards set forth by the state. To begin your journey toward obtaining this license, please fill out the form by clicking the button below.

The Kentucky Elevator Mechanic License application is a crucial document for individuals seeking to work in the elevator industry within the Commonwealth of Kentucky. This application requires applicants to provide essential personal information, including their name, address, and contact details, as well as details about their current employer. A significant aspect of the application is the requirement for a recent passport-sized photograph, which must accompany the form. Furthermore, applicants must detail their elevator experience, including any education, training, or apprenticeship programs they have completed. This section allows for the inclusion of additional sheets if necessary, ensuring that all relevant experience is documented. It is also important to note whether the applicant has previously held an Elevator Mechanic license in Kentucky, as this can impact the approval process. The application includes a series of acknowledgments that applicants must initial, confirming the accuracy of the information provided and the submission of a nonrefundable application fee, which varies based on the applicant's birth month and the month of application. Additional documentation may be required to verify experience and training, emphasizing the importance of thorough preparation. Overall, the Kentucky Elevator Mechanic License application serves as a gateway for qualified individuals to enter a vital profession, ensuring safety and compliance within the state's elevator systems.

Document Sample

COMMONWEALTH OF KENTUCKY

Public Protection Cabinet

Department of Housing, Buildings and Construction

DIVISION OF BUILDING CODES ENFORCEMENT

ELEVATOR SECTION

101 Sea Hero Road, Suite 100

Frankfort, Kentucky 40601-5405

Telephone: 502-573-1694 Fax: 502-573-1059

ELEVATOR MECHANIC LICENSE APPLICATION

Please type or print application. Answer all questions on both sides of this application.

An application fee is to be submitted payable to Kentucky State Treasurer.

1.

Name: _________________________________________________________________

 

Attach a recent

 

 

 

 

Last

 

 

 

First

 

 

 

MI

 

 

 

 

 

 

 

 

 

 

 

 

passport- sized, color

 

Address: _______________________________________________________________

 

 

photograph of applicant

 

 

 

 

 

 

 

 

(Street, Route or Box Number)

 

 

 

 

 

 

here.

 

City:

 

 

 

 

 

 

 

State:

 

 

 

 

Zip: __________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

County:

 

 

 

 

 

 

 

 

Telephone: (

 

)

 

 

-_________

 

 

 

Date of Birth:

/

 

/

 

Email address: __________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.Current Employer or Company Name: ______________________________________

Address:

___________________________________________________________________________________________

 

 

(Street, Route or Box Number)

 

 

 

 

 

 

City:

 

 

State:

 

 

 

 

Zip: _______________

County:_____________________________________________

Telephone: (

)

 

- __________

Federal ID Number (Business) ____________________________________________

 

 

 

 

 

3. Elevator Experience History: Education, Training or Apprenticeship Program

*Use additional sheets, if necessary. Begin with most recent work, education or training experience.

Name of Company/School/Apprenticeship Program: _______________________________________________________

Address: ___________________________________________________________________________________________

 

 

(Street, Route or Box Number)

 

 

 

 

 

 

City:

 

 

State:

 

 

 

 

Zip: _______________

County:_____________________________________________

Telephone: (

)

 

- __________

Dates of Attendance:

From ____/____/____ To ____/____/____

 

 

 

 

 

 

Type of Elevator Work/Training ________________________________________________________________________

____________________________________________________________________________________________________

Form EV-4 (Orig. 9-11)

Name of Company/School/Apprenticeship Program: _______________________________________________________

Address: ___________________________________________________________________________________________

 

 

(Street, Route or Box Number)

 

 

 

 

 

 

 

 

 

 

City:

 

 

State:

 

 

 

 

 

Zip: _______________

County:_____________________________________________

Telephone: (

)

 

 

 

 

- __________

Dates of Attendance:

From ____/____/____ To ____/____/____

 

 

 

 

 

 

 

 

 

 

Type of Elevator Work/Training ________________________________________________________________________

____________________________________________________________________________________________________

4. Have you previously held a Elevator Mechanic’s license in the Commonwealth of Kentucky?

 

 

 

 

Yes

 

No

If yes, list license number and date you were first licensed. (Attach copy of license, if available)

 

 

 

 

 

 

 

 

License Number: _______________ Date: ________________

 

 

 

 

 

 

 

 

 

 

The commissioner, in accordance with KRS Chapter 13B, may refuse to issue, suspend, revoke, or refuse to renew the license or certificate of any licensee or certificate holder pursuant to KRS 198B.4033.

Please fill in each circle acknowledging that you have included the following:

O Completed Application and required supplemental documentation (valid for one year from date of receipt)

O An initial application fee (submitted to the Department and payable to Kentucky State Treasurer).

_____ (Initial) I am not in default of any student loans backed by the KHEAA (Kentucky Higher Education Assistance

Authority). I understand that if I am in default of any student loans backed by the KHEAA, I cannot receive a Kentucky Elevator Mechanic license at this time.

______(Initial) I confirm that all information contained on and submitted with this application is current and true to the best

of my knowledge.

Applicant’s Signature: _______________________________________________________ Date:___________________

COMMONWEALTH OF KENTUCKY

 

COUNTY OF_____________________

 

The applicant, whose name is,

, being duly sworn declares that foregoing

subscribed statements are true to the best of their knowledge and belief, and that they have personally signed this application.

Subscribed and sworn to before me thisday of_________________, _______

Notary Public ______________________________

My Commission expires: ______________________

For Office Use Only

Date Received_____________________

Approved ________________________

Issue ____________________________

Pending __________________________

Board Review _____________________

Elevator Mechanic # ________________

Issue & Status _____________________

EV-4 (Orig. 9-11)

Read this section carefully!

The following information shall be submitted with application:

￿One Passport sized photograph taken within 3 months of application.

￿Documentation for verification of experience. (i.e. official Tax documents, copies of business licenses, sworn affidavit attesting to your experience or any other valid documentation of experience). For a complete list of documentation examples, go online to http://dhbc.ky.gov.

￿If applicable for proof of experience, Mechanic license applicants shall provide a copy of certificate of completion of nationally recognized training program, apprenticeship program or apprenticeship registration.

￿Proof of passage of written, oral, or computerized examination if applying pursuant to KRS 198B.4013(2)(a).

Passage of a written, oral, or computerized examination administered by the department based upon the most recent referenced codes and standards

￿Annual Fee for Elevator Mechanic License $96 ($8 per month)

￿A nonrefundable fee must be submitted with this application. Without this fee, this application will not be processed.

￿License shall be pro-rated for initial activation. The Division shall issue a license for no less than 7 months and no more than 18 months, based upon your birth month and time of application.

Mail checks only.

Credit card payments are available online.

Make checks payable to Kentucky State Treasurer.

Elevator Mechanic License

Initial Fee Chart

Use the chart below to determine the correct fee for application. The fee is based on your birth month and the month which you are applying. Add the fees if you are applying for multiple licenses.

Example: If you were born in October and you are applying in July, then the Elevator Mechanic application fee is $120. This license would be valid for 15 months. Each time you renew your license after your initial activation, your license will be valid for one year and will be subject to annual renewal in October (your birth month).

Birth Month

Elevator Mechanic License

Month you are Applying

 

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

Jan

$96.00

$88.00

$80.00

$72.00

$64.00

$56.00

$144.00

$136.00

$128.00

$120.00

$112.00

$104.00

Feb

$104.00

$96.00

$88.00

$80.00

$72.00

$64.00

$56.00

$144.00

$136.00

$128.00

$120.00

$112.00

Mar

$112.00

$104.00

$96.00

$88.00

$80.00

$72.00

$64.00

$56.00

$144.00

$136.00

$128.00

$120.00

Apr

$120.00

$112.00

$104.00

$96.00

$88.00

$80.00

$72.00

$64.00

$56.00

$144.00

$136.00

$128.00

May

$128.00

$120.00

$112.00

$104.00

$96.00

$88.00

$80.00

$72.00

$64.00

$56.00

$144.00

$136.00

Jun

$136.00

$128.00

$120.00

$112.00

$104.00

$96.00

$88.00

$80.00

$72.00

$64.00

$56.00

$144.00

Jul

$144.00

$136.00

$128.00

$120.00

$112.00

$104.00

$96.00

$88.00

$80.00

$72.00

$64.00

$56.00

Aug

$56.00

$144.00

$136.00

$128.00

$120.00

$112.00

$104.00

$96.00

$88.00

$80.00

$72.00

$64.00

Sep

$64.00

$56.00

$144.00

$136.00

$128.00

$120.00

$112.00

$104.00

$96.00

$88.00

$80.00

$72.00

Oct

$72.00

$64.00

$56.00

$144.00

$136.00

$128.00

$120.00

$112.00

$104.00

$96.00

$88.00

$80.00

Nov

$80.00

$72.00

$64.00

$56.00

$144.00

$136.00

$128.00

$120.00

$112.00

$104.00

$96.00

$88.00

Dec

$88.00

$80.00

$72.00

$64.00

$56.00

$144.00

$136.00

$128.00

$120.00

$112.00

$104.00

$96.00

File Specifics

Fact Name Details
Governing Laws The Kentucky Elevator Mechanic License is governed by KRS Chapter 198B and KRS Chapter 13B.
Application Fee The initial application fee is $96, which is nonrefundable and must be submitted with the application.
Photo Requirement A recent passport-sized color photograph must be attached to the application.
Experience Verification Applicants must provide documentation to verify their elevator experience, including tax documents or affidavits.
License Duration The license is issued for a period between 7 to 18 months, depending on the applicant's birth month and application date.
Renewal Process After the initial activation, the license must be renewed annually in the applicant's birth month.
Notary Requirement The application must be sworn before a notary public, affirming that all information is true to the best of the applicant's knowledge.

How to Use Kentucky Elevator Mechanic License

Filling out the Kentucky Elevator Mechanic License form requires attention to detail and accuracy. After completing the form, you will need to submit it along with the necessary documentation and application fee to the appropriate department for processing.

  1. Begin by typing or printing your name in the designated space at the top of the form.
  2. Provide your address, including street, city, state, zip code, and county.
  3. Enter your telephone number and email address.
  4. Fill in your date of birth.
  5. List your current employer or company name and provide their address, including street, city, state, zip code, and county.
  6. Include the telephone number and federal ID number of your employer.
  7. Detail your elevator experience history, starting with the most recent. Include the name of the company, school, or apprenticeship program, along with their address and telephone number.
  8. Specify the dates of attendance and type of elevator work or training you received.
  9. Indicate whether you have previously held an Elevator Mechanic’s license in Kentucky. If yes, provide the license number and date you were first licensed.
  10. Acknowledge that you have included all required documentation by filling in the circles provided on the form.
  11. Initial next to the statements regarding student loans and the accuracy of the information provided.
  12. Sign and date the application at the bottom of the form.
  13. Have the application notarized, if required, and ensure the notary's information is filled out correctly.
  14. Attach a recent passport-sized color photograph of yourself to the application.
  15. Gather any additional documentation required for verification of experience and include it with your application.
  16. Calculate and include the application fee based on your birth month and the month you are applying.
  17. Mail the completed application, along with the fee and all required documents, to the Division of Building Codes Enforcement at the specified address.

Your Questions, Answered

What is the Kentucky Elevator Mechanic License?

The Kentucky Elevator Mechanic License is a certification required for individuals who work on the installation, maintenance, and repair of elevators in the Commonwealth of Kentucky. This license ensures that mechanics meet specific standards of education and experience, promoting safety and compliance within the industry.

How do I apply for the Elevator Mechanic License?

To apply for the Elevator Mechanic License, complete the application form. Ensure that all questions are answered on both sides. Submit the application along with a recent passport-sized photograph and the required fee payable to the Kentucky State Treasurer. Documentation verifying your experience must also be included.

What is the application fee for the Elevator Mechanic License?

The application fee for the Elevator Mechanic License is $96, which covers a period of one year. This fee may vary based on your birth month and the month in which you are applying. A detailed fee chart is available to help determine the correct amount.

What documents do I need to submit with my application?

Along with your application form, you need to provide:

  • A recent passport-sized photograph taken within the last three months.
  • Documentation verifying your elevator experience, such as tax documents or business licenses.
  • If applicable, a copy of your certificate from a nationally recognized training program or apprenticeship.
  • Proof of passing any required examinations.

Can I renew my Elevator Mechanic License?

Yes, the Elevator Mechanic License can be renewed annually. After your initial activation, the license will be valid for one year and must be renewed in your birth month. Renewal fees apply.

What happens if I do not pay my student loans?

If you are in default on any student loans backed by the Kentucky Higher Education Assistance Authority (KHEAA), you will not be eligible to receive a Kentucky Elevator Mechanic License. You must confirm that you are not in default when submitting your application.

How long does it take to process the application?

The processing time for the Elevator Mechanic License application may vary. It is advisable to submit your application well in advance of any deadlines to allow for sufficient processing time. The application is valid for one year from the date of receipt.

What should I do if I previously held a license?

If you have previously held an Elevator Mechanic License in Kentucky, you must provide your license number and the date you were first licensed. Attach a copy of the previous license if available. This information is necessary for the renewal or re-issuance of your license.

Where do I send my application?

Applications should be mailed to the Kentucky Department of Housing, Buildings and Construction, Division of Building Codes Enforcement, Elevator Section, at the following address:

101 Sea Hero Road, Suite 100
Frankfort, Kentucky 40601-5405

Common mistakes

  1. Incomplete Application: Failing to answer all questions on both sides of the application can lead to delays or rejections.

  2. Missing Photograph: Not attaching a recent passport-sized color photograph of yourself can result in your application being deemed incomplete.

  3. Incorrect Fee Payment: Submitting the wrong application fee or not including a payment at all will halt the processing of your application.

  4. Neglecting to Provide Documentation: Not including necessary documentation for verification of experience can lead to rejection. This includes tax documents or affidavits.

  5. Omitting Prior License Information: If you have previously held an Elevator Mechanic’s license, failing to provide that information may cause issues.

  6. Incorrect Federal ID Number: Providing an incorrect or missing Federal ID number for your current employer can delay processing.

  7. Inaccurate Experience Dates: Not listing accurate dates of attendance for education or training can raise questions about your qualifications.

  8. Failure to Confirm Truthfulness: Not initialing to confirm that all information is accurate can result in your application being rejected.

  9. Ignoring Student Loan Default Status: If you are in default on student loans, failing to acknowledge this can disqualify you from receiving a license.

  10. Missing Notary Requirement: Not having your application notarized when required can lead to rejection or delays.

Documents used along the form

When applying for the Kentucky Elevator Mechanic License, several additional forms and documents may be required. These documents help ensure that all necessary information is provided and that applicants meet the qualifications for licensure. Below is a list of commonly used forms and documents associated with the application process.

  • Proof of Experience Documentation: This includes any official tax documents, business licenses, or affidavits that verify your elevator work experience.
  • Passport-Sized Photograph: A recent color photograph is required. It should be taken within three months prior to submitting the application.
  • Certificate of Completion: If you have completed a nationally recognized training or apprenticeship program, a copy of the certificate must be submitted.
  • Examination Proof: Applicants must provide proof of passing any required written, oral, or computerized examinations related to elevator mechanics.
  • Previous License Information: If you have held an Elevator Mechanic license in Kentucky before, include the license number and the date it was first issued.
  • Notarized Application: The application must be signed and notarized to confirm the accuracy of the information provided.
  • Application Fee Payment: A nonrefundable fee must accompany the application. This fee is payable to the Kentucky State Treasurer.
  • Supplemental Documentation: Any additional documentation that supports your application or experience should be included.
  • Initial Application Form: The completed application form itself is essential for processing your request for licensure.

Gathering these documents in advance can streamline the application process. Ensure that all information is accurate and complete to avoid delays. Following these guidelines will help you successfully navigate the requirements for obtaining your Kentucky Elevator Mechanic License.

Similar forms

The Kentucky Elevator Mechanic License application shares similarities with the General Contractor License application. Both documents require applicants to provide personal information, including name, address, and contact details. They also ask for work history, education, and any relevant training that supports the applicant’s qualifications. Additionally, both applications include a fee structure, which varies based on factors like the applicant's birth month and the timing of the application. This ensures that applicants are aware of the financial obligations associated with obtaining their licenses.

Another document similar to the Kentucky Elevator Mechanic License is the Plumbing License application. Like the elevator mechanic application, it necessitates proof of experience and training in the respective field. Applicants must also submit a recent photograph and pay a nonrefundable application fee. Both licenses are regulated by state authorities and require adherence to specific codes and standards, ensuring that applicants are qualified to perform their work safely and effectively.

The HVAC Technician License application also mirrors the Kentucky Elevator Mechanic License form. Each application demands detailed information about the applicant's work experience, education, and any certifications obtained. Both forms require a signed declaration affirming the truthfulness of the information provided. Furthermore, they include a fee structure that varies depending on the applicant's circumstances, which helps maintain transparency about the costs involved in the licensing process.

Lastly, the Electrical Contractor License application is comparable to the Kentucky Elevator Mechanic License application. Both documents require applicants to outline their work history and any relevant training or apprenticeships. They also necessitate the submission of supporting documentation to verify experience. Additionally, both applications involve a fee that must be paid upfront, emphasizing the importance of financial commitment in the licensing process. This ensures that only qualified individuals can obtain licenses in these critical trades.

Dos and Don'ts

Filling out the Kentucky Elevator Mechanic License form can seem daunting, but with a little guidance, you can navigate the process smoothly. Here’s a list of things you should and shouldn’t do to ensure your application is complete and correct.

  • Do type or print your application clearly. This helps avoid any confusion.
  • Do answer all questions on both sides of the application. Incomplete applications may delay processing.
  • Do attach a recent passport-sized color photograph of yourself. This is a requirement!
  • Do provide documentation verifying your elevator experience. This can include tax documents or business licenses.
  • Do confirm that you are not in default on any student loans backed by the KHEAA. This is crucial for your eligibility.
  • Don't forget to include your application fee. Without it, your application will not be processed.
  • Don't leave out your signature and date on the application. This step is essential to validate your submission.
  • Don't use pencil to fill out the form. Always use ink or a typewriter to ensure legibility.
  • Don't submit your application without checking for errors. A quick review can save you time and hassle.

By following these guidelines, you can help ensure a smooth application process. Good luck with your licensing journey!

Misconceptions

Misconceptions about the Kentucky Elevator Mechanic License form can lead to confusion and delays in the application process. Here are ten common misunderstandings explained:

  1. Only experienced mechanics can apply. Many believe that only seasoned professionals can obtain this license. In reality, apprentices and individuals in training can also apply, provided they meet certain requirements.
  2. The application fee is refundable. Some applicants think that if their application is denied, they will get their fee back. However, the fee is nonrefundable, regardless of the application outcome.
  3. Submitting the application is enough to get the license. It’s a common belief that just filling out the application guarantees a license. In fact, applicants must also submit required documentation and proof of experience.
  4. All documentation can be submitted later. Many assume that they can send in the necessary documents after submitting the application. However, all required documents must accompany the application for it to be processed.
  5. Only a written exam is required. Some applicants think they only need to pass a written test. The process may also include oral or computerized examinations, depending on the application type.
  6. Experience verification is optional. It is a misconception that proving prior experience is not necessary. Applicants must provide documentation that verifies their elevator work history or training.
  7. There’s no deadline for submitting the application. Many believe they can apply at any time without consequences. In truth, there are specific deadlines that applicants must adhere to, especially for renewals.
  8. All licenses are valid for one year. Some assume that every license issued is valid for a full year. The validity period can vary based on the applicant's birth month and the month of application.
  9. Online payments are not accepted. It is often thought that payments must be made by check only. However, applicants can pay online using credit cards, which offers more convenience.
  10. Once licensed, no further action is needed. Many believe that after obtaining the license, they do not need to do anything else. In reality, license holders must renew their licenses annually to maintain their status.

Key takeaways

Filling out the Kentucky Elevator Mechanic License application requires careful attention to detail. Here are key takeaways to ensure a smooth process:

  • Complete the application in its entirety. Answer all questions on both sides.
  • Submit a recent passport-sized color photograph with your application.
  • Provide accurate information regarding your current employer or company name.
  • Document your elevator experience history clearly, listing education, training, or apprenticeship programs.
  • Include a copy of any previous Elevator Mechanic license if applicable.
  • Pay the required application fee, which is nonrefundable and must be submitted with your application.
  • Confirm that you are not in default on any student loans backed by the KHEAA.
  • Gather necessary documentation to verify your experience, such as business licenses or affidavits.
  • Be aware of the fee structure based on your birth month and the month you are applying for the license.

Following these guidelines will help you complete your application accurately and efficiently.