"Application for Issuance or Renewal of Id or Work Card for Elevator Mechanic, Elevator Mechanic Apprentice or Elevator Mechanic Helper" - Nevada

Application for Issuance or Renewal of Id or Work Card for Elevator Mechanic, Elevator Mechanic Apprentice or Elevator Mechanic Helper is a legal document that was released by the Nevada Department of Business and Industry - a government authority operating within Nevada.

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NEVADA DEPARTMENT OF BUSINESS AND INDUSTRY
Division of Industrial Relations
Mechanical Compliance Section
4600 Kietzke Lane, Suite F-151, Reno, NV 89502
Phone: (775) 688-3750
Fax: (775) 688-1664
3360 W. Sahara Avenue, Suite 170, Las Vegas, NV 89102
Phone: (702) 486-9054
APPLICATION FOR ISSUANCE OR RENEWAL OF ID OR WORK CARD FOR
ELEVATOR MECHANIC, ELEVATOR MECHANIC APPRENTICE
OR ELEVATOR MECHANIC HELPER
PLEASE PRINT OR TYPE
Initial
Renewal
License Type___________________
1.
Name of Applicant: _______________________________ License No. ___________
Date of Birth:
Social Security No.
Home Mailing Address:
Street/Apt. or P. O. Box:
City:
State:
Zip:
Area code & Phone Number:
2.
Name of Current Employer:
_
3.
Proof of Training: INCLUDE a copy of certification of successful completion of an
approved training course for Elevator Mechanic and a copy of certification of current
refresher training if required, or acceptable documentation of required work history.
Please check the box below that applies: Please read NAC 455C.460 for applicant
qualifications.
Applicant must show proof that they have successfully completed a formal educational
program or an apprenticeship that is satisfactory to the Enforcement Section.
Applicant that has completed the NEIP training program and that can present us with
the certification.
Applicant must show proof that they have at least 12,000 hours of working experience
in the construction, installation, alteration and repair of elevators.
NEVADA DEPARTMENT OF BUSINESS AND INDUSTRY
Division of Industrial Relations
Mechanical Compliance Section
4600 Kietzke Lane, Suite F-151, Reno, NV 89502
Phone: (775) 688-3750
Fax: (775) 688-1664
3360 W. Sahara Avenue, Suite 170, Las Vegas, NV 89102
Phone: (702) 486-9054
APPLICATION FOR ISSUANCE OR RENEWAL OF ID OR WORK CARD FOR
ELEVATOR MECHANIC, ELEVATOR MECHANIC APPRENTICE
OR ELEVATOR MECHANIC HELPER
PLEASE PRINT OR TYPE
Initial
Renewal
License Type___________________
1.
Name of Applicant: _______________________________ License No. ___________
Date of Birth:
Social Security No.
Home Mailing Address:
Street/Apt. or P. O. Box:
City:
State:
Zip:
Area code & Phone Number:
2.
Name of Current Employer:
_
3.
Proof of Training: INCLUDE a copy of certification of successful completion of an
approved training course for Elevator Mechanic and a copy of certification of current
refresher training if required, or acceptable documentation of required work history.
Please check the box below that applies: Please read NAC 455C.460 for applicant
qualifications.
Applicant must show proof that they have successfully completed a formal educational
program or an apprenticeship that is satisfactory to the Enforcement Section.
Applicant that has completed the NEIP training program and that can present us with
the certification.
Applicant must show proof that they have at least 12,000 hours of working experience
in the construction, installation, alteration and repair of elevators.
Applicant must show proof that they have at least 10,000 hours of working experience
in the construction, installation, alteration and repair of elevators and holds a current
Qualified Elevator Inspector (QEI) certification issued by an organization that holds a
QEI Certificate of Accreditation.
Applicant must show proof that they have at least 8,000 hours of working experience in
the construction, installation, alteration and repair of elevators, has successfully
completed at least 60 semester hours or 90 quarter hours of course work from an
accredited college or university in an engineering field relating to the construction,
installation, alteration and repair of elevators and holds a current Qualified Elevator
Inspector (QEI) certification issued by an organization that holds a QEI Certificate of
Accreditation; or
Has, on December 15, 2004, at least 6,000 hours of working experience in the
construction, installation, alteration and repair of private residence elevators.
Helper’s and Apprentice’s must present letter certifying that the applicant is currently
employed by an elevator mechanic or a licensed contractor that holds a C7 license.
4.
License Fees: INCLUDE a license fee of $150.00 for initial certification, or $75.00 for
renewal on or before September 1st, or they will be charged $150.00 for renewing an
expired license, by check, cashier’s check or money order made payable to Division of
Industrial Relations. We will no longer accept cash as a form of payment.
5.
Read and sign the following statement:
I hereby certify that all of the information provided in this application is complete and true to the
best of my knowledge. I further certify that I will comply with all requirements applicable under
the Nevada Department of Business & Industry, Mechanical Compliance Section Regulations
NAC 455C.
Signature of Applicant
Date
2
MANDATORY REQUIREMENT FOR LICENSING
Federal Welfare Reform, as implemented by the 1997 Session of the Legislature by SB
356, requires that professional and occupational licensing agencies add certain questions
regarding child support to all applications for new licenses and for renewals. Please
answer the following questions in order for your application to be processed.
CHILD SUPPORT INFORMATION
Please mark the appropriate response (failure to mark one of the three will result in denial
of the application).
I am not subject to a court order for the support of a child.
I am subject to a court order for the support of one or more children and am in
compliance with the order, or am in compliance with a plan approved by the district
attorney or other public agency enforcing the order for the repayment of the amount owed
pursuant to the order; or,
I am subject to a court order for the support of one or more children and am
not in compliance with the order or a plan approved by the district attorney or other
public agency enforcing the order for the repayment of the amount owed pursuant to
the order.
Applicant’s Social Security Number:
Signature of Applicant
Date
3
REPORT OF EXISTENCE OF NEVADA
BUSINESS LICENSE Pursuant to NRS 353C.1965
All applicants MUST complete this section.
Please select ONE option.
I have a Nevada business license number assigned by the Nevada Secretary of
State upon compliance with the provisions of NRS Chapter 76.
My Nevada business license number is:
I have applied for a Nevada business license with the Nevada Secretary of State
upon compliance with the provision of NRS Chapter 76 and my application is pending.
I do NOT have a Nevada business license number.
The Mechanical Section is not the arbiter of determining whether the applicant needs a
business license. Information about the Nevada business license can be found on the
Secretary of State's website at: http://nvsos.gov/
**The Legislative Counsel Bureau is in the process of codifying the bills from the 2013
Legislative Session, including SB 21. Once SB 21 is codified and the LCB issues the first
reprint of NRS, anticipated in October 2013, the Controller's Office will provide updated
NRS citation information to the licensing agencies for use in this document. Each
licensing agency will insert its own applicable NRS section for reference. The source of
this citation is Senate Bill21, sections 7.1-7.9, 13-16, and 21-67.
4