"Request for an Approved Exemption in Accordance With (Nac 455c.116 or 455c.448)" - Nevada

Request for an Approved Exemption in Accordance With (Nac 455c.116 or 455c.448) is a legal document that was released by the Nevada Department of Business and Industry - a government authority operating within Nevada.

Form Details:

  • Released on September 17, 2019;
  • The latest edition currently provided by the Nevada Department of Business and Industry;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Nevada Department of Business and Industry.

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4600 Kietzke Lane
STATE OF NEVADA
3360 West Sahara Ave
Suite F-151
Suite 170
MECHANICAL COMPLIANCE
Reno, Nevada 89502
Las Vegas, Nevada 89102
SECTION
Telephone: (775) 688-3750
Telephone: (702) 486-9054
mcs.reno@dir.nv.gov
mcs.LV@dir.nv.gov
Request for an Approved Exemption
Clear Form
In Accordance with (NAC 455C.116 or 455C.448)
Date Exemption Requested:
Requested by:
(Name, Phone & Email)
Contractor, Installer or Owner of Equipment:
Location Name:
City:
State:
Zip:
State Identification Number(s): NV 
Exemption from Requirement:
Reason:
Conditions (Jurisdictional Use Only):
Approval:
Name/Signature:
Title:
Date:
 Yes  No
Inspector
 Yes  No
Supervisor
 Yes  No
Chief
Rev (04/23/20) E
4600 Kietzke Lane
STATE OF NEVADA
3360 West Sahara Ave
Suite F-151
Suite 170
MECHANICAL COMPLIANCE
Reno, Nevada 89502
Las Vegas, Nevada 89102
SECTION
Telephone: (775) 688-3750
Telephone: (702) 486-9054
mcs.reno@dir.nv.gov
mcs.LV@dir.nv.gov
Request for an Approved Exemption
Clear Form
In Accordance with (NAC 455C.116 or 455C.448)
Date Exemption Requested:
Requested by:
(Name, Phone & Email)
Contractor, Installer or Owner of Equipment:
Location Name:
City:
State:
Zip:
State Identification Number(s): NV 
Exemption from Requirement:
Reason:
Conditions (Jurisdictional Use Only):
Approval:
Name/Signature:
Title:
Date:
 Yes  No
Inspector
 Yes  No
Supervisor
 Yes  No
Chief
Rev (04/23/20) E