Form DIC3524 "Examination Application - Ohio Construction Industry Licensing Board" - Ohio

What Is Form DIC3524?

This is a legal form that was released by the Ohio Department of Commerce - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2020;
  • The latest edition provided by the Ohio Department of Commerce;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DIC3524 by clicking the link below or browse more documents and templates provided by the Ohio Department of Commerce.

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Download Form DIC3524 "Examination Application - Ohio Construction Industry Licensing Board" - Ohio

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OCILB Examination Application
The Ohio Construction Industry Licensing Board (OCILB), issues state licenses to Electrical, HVAC,
Refrigeration, Plumbing, and Hydronics Contractors who perform commercial work.
Applicants must:
• be at least 18 years of age
• be a U.S. citizen or a legal alien (must provide proof)
• have been a tradesperson in the type of licensed trade for which the application is filed for not
less than five years
immediately
prior to the date of application. Provide proof of working under
a licensed contractor on projects that required a permit during those five years. You must attach
at least one permit for each of the last five years and provide the license number of the
contractor you worked under. Permits are public record and can be obtained from the local
building department.
(Be advised that sewer service, water service, gas service and drain cleaning DO NOT apply).
• or currently be a registered engineer in Ohio with three years of business experience in the
construction industry in the trade for which you are applying
• never have been convicted of a disqualifying offense as defined in S.B. 337
• attach W-2’s (please cross out social security number)
OCCUPATIONAL LICENSING PROCESS FOR VETERANS
Complete entire application as instructed above. Be sure to complete Question (11); include all hands-on work
experience and inclusive dates. You MUST Attach your DD214 (training records). You may also attach any documents
that support your experience and training in the trade you are applying for such as: training certificates, job evaluation
reports, joint transcript, and /or a letter from your Commanding Officer.
Your application will be reviewed by the Board to determine eligibility to sit for the examination. You will be
notified by mail of the results of the Board review results. ONCE YOU HAVE BEEN APPROVED (valid for
one year) BY THE BOARD, YOU ARE REQUIRED TO OBTAIN A BCI and FBI BACKGROUND CHECK
PRIOR TO SITTING FOR THE EXAMINATION. Approved candidates will be provided with a PSI Candidate
Information Bulletin. The Bulletin will contain detailed instructions on how to schedule your exam(s). All
licensure exams are computer based testing by appointment at sites throughout Ohio & the U.S. Individuals who
take the examination will receive a notice advising them of their examination pass/fail status at the completion
of the exam. Those who pass both sections of the exam can receive a state license by sending a copy of the
examination results, a $25 check made payable to “Treasurer, State of Ohio”, and proof of at least $500,000
contractor liability insurance “Certificate of Liability Insurance”. Your liability insurance AND license must be
assigned to a “contracting company” as defined in Ohio Revised Code 4740.01 Section C.
Ohio Construction Industry Licensing Board
614-644-3493
William Koester, Administrative Section Chairman
6606 Tussing Road
Fax 614-728-1200
PO Box 4009
TTY/TDD 800-750-0750
An Equal Opportunity Employer and Service Provider
Reynoldsburg, OH 43068-9009
com.ohio.gov/dico/ocilb
DIC 3524 Rev 3/2020
OCILB Examination Application
The Ohio Construction Industry Licensing Board (OCILB), issues state licenses to Electrical, HVAC,
Refrigeration, Plumbing, and Hydronics Contractors who perform commercial work.
Applicants must:
• be at least 18 years of age
• be a U.S. citizen or a legal alien (must provide proof)
• have been a tradesperson in the type of licensed trade for which the application is filed for not
less than five years
immediately
prior to the date of application. Provide proof of working under
a licensed contractor on projects that required a permit during those five years. You must attach
at least one permit for each of the last five years and provide the license number of the
contractor you worked under. Permits are public record and can be obtained from the local
building department.
(Be advised that sewer service, water service, gas service and drain cleaning DO NOT apply).
• or currently be a registered engineer in Ohio with three years of business experience in the
construction industry in the trade for which you are applying
• never have been convicted of a disqualifying offense as defined in S.B. 337
• attach W-2’s (please cross out social security number)
OCCUPATIONAL LICENSING PROCESS FOR VETERANS
Complete entire application as instructed above. Be sure to complete Question (11); include all hands-on work
experience and inclusive dates. You MUST Attach your DD214 (training records). You may also attach any documents
that support your experience and training in the trade you are applying for such as: training certificates, job evaluation
reports, joint transcript, and /or a letter from your Commanding Officer.
Your application will be reviewed by the Board to determine eligibility to sit for the examination. You will be
notified by mail of the results of the Board review results. ONCE YOU HAVE BEEN APPROVED (valid for
one year) BY THE BOARD, YOU ARE REQUIRED TO OBTAIN A BCI and FBI BACKGROUND CHECK
PRIOR TO SITTING FOR THE EXAMINATION. Approved candidates will be provided with a PSI Candidate
Information Bulletin. The Bulletin will contain detailed instructions on how to schedule your exam(s). All
licensure exams are computer based testing by appointment at sites throughout Ohio & the U.S. Individuals who
take the examination will receive a notice advising them of their examination pass/fail status at the completion
of the exam. Those who pass both sections of the exam can receive a state license by sending a copy of the
examination results, a $25 check made payable to “Treasurer, State of Ohio”, and proof of at least $500,000
contractor liability insurance “Certificate of Liability Insurance”. Your liability insurance AND license must be
assigned to a “contracting company” as defined in Ohio Revised Code 4740.01 Section C.
Ohio Construction Industry Licensing Board
614-644-3493
William Koester, Administrative Section Chairman
6606 Tussing Road
Fax 614-728-1200
PO Box 4009
TTY/TDD 800-750-0750
An Equal Opportunity Employer and Service Provider
Reynoldsburg, OH 43068-9009
com.ohio.gov/dico/ocilb
DIC 3524 Rev 3/2020
Ohio Department of Commerce
OHIO CONSTRUCTION INDUSTRY LICENSING BOARD—EXAMINATION APPLICATION
MUST TYPE OR PRINT CLEARLY
1. Type of examination applied for:
Application Fee:
$25.00
CHECK ONLY ONE
Make check payable to:
____ Hydronics
____ Electrical
____ HVAC
TREASURER-STATE OF OHIO
____ Plumbing
____ Refrigeration
Mail to:
2. Full Name ____________________________________________________
Division of Industrial Compliance
First
Last
M.I.
Ohio Construction Industry Licensing Board
3. Street Address _________________________________________________
6606 Tussing Road, P.O. Box 4009
Reynoldsburg, Ohio 43068-9009
City __________________________________ State ________________
Check # _____________________
ZIP ______________
County ____________________________
Date ________________________
4. Are you a U.S. citizen? Y N
Date of Birth _______/______/_______
FOR OFFICE USE ONLY
OR
5. Are you a legal alien? Y N
(if yes, provide documentation)
Application is:
Approved ___________________
6. Home Phone (_____) ______-_______ Work Phone (_____) ______-_______
Board Member Initials
Denied _____________________
7. E-Mail Address__________________________________________________
Board Member Initials
8. Have you ever been convicted of a felony? _____ Yes _____No
Additional information needed:
If yes:
Date of Conviction: _______/________/________
_____________________________________
Ohio County of conviction: ______________________________
_____________________________________
Offense: ______________________________________________
NOTE:
9.
If approved and issued; you MUST assign your license to a
Contracting Company, indicate the Contracting Company name & your position.
Contracting Company Name _________________________________________________
Your Current Position/Title: ____ Owner
____ Employee
____ Partner
I f you are the owner, are you paying your employees by W-2? ___Yes ___No
Be very specific in nature of duties
** NOTE** You MUST indicate to the Board that you have worked the last five years as a Tradesperson,
working under a licensed Contractor, performing permitable work, and be able to prove it.
Attach a minimum of 1 permit for each of the last 5 years the licensed contractor (your employer)
obtained, and that you worked under.
(Permits are public record and can be obtained from the Building Department).
Attach copies of your W-2’s for the past 5 years, working as an Employee for the licensed Contractor.
.
NOTE: sewer service, water service, gas service and drain cleaning permits DO NOT apply
10. List below your employment history, beginning with the most recent. Attach additional sheets if necessary.
Contractor
EMPLOYER’S NAME
DATES OF
PLEASE
License # you
PHONE NUMBER
TITLE OF POSITION
AND ADDRESS
EMPLOYMENT
CIRCLE ONE
worked under.
/
/
FULL
to
OR
PART-TIME
/
/
Nature of Duties:
__________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________
3/2020
DIC 3526
Ohio Department of Commerce
OCILB Examination Application
Contractor
EMPLOYER’S NAME
PHONE
DATES OF
PLEASE
License # you
TITLE OF POSITION
AND ADDRESS
NUMBER
EMPLOYMENT
CIRCLE ONE
worked under.
/
/
FULL
to
OR
PART-TIME
/
/
Nature of Duties
: __________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________
Contractor
EMPLOYER’S NAME
PHONE
DATES OF
PLEASE
License # you
TITLE OF POSITION
AND ADDRESS
NUMBER
EMPLOYMENT
CIRCLE ONE
worked under.
/
/
FULL
to
OR
PART-TIME
/
/
Nature of Duties:
__________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________
. OCCUPATIONAL LICENSING PROCESS FOR VETERANS (only).
11
SPECIALTY: (be sure to attach a copy
BRANCH OF MILITARY
UNIT
INSTALLATION
DATES OF SERVICE
of your DD214 training records).
/
/
to
/
/
This applicant agrees to conform to Rules 4101:16-1 through 4101:16-3 of the Ohio Administrative Code relating to the
type of license indicated on the front page of this application.
I solemnly swear or affirm that the information I have supplied to each and all of the questions within this application are
complete and true to the best of my knowledge and belief.
_______________________________________
Signature of Applicant
THIS APPLICATION MUST BE NOTARIZED
Subscribed and duly sworn before me according to law, by the above named applicant this ______ day of _____________
, _______ in the County of __________________________, State of _________________________.
_______________________________________
Signature of Notary Public
_______________________________________
Printed Name of Notary Public
3/2020
DIC 3526
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