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BOILER AND PRESSURE VESSEL CONTRACTOR …

PLB-BPV-1 (Revised Dec. 2014) COMMONWEALTH OF KENTUCKY Public Protection Cabinet Department of Housing, Buildings and Construction DIVISION OF PLUMBING BOILER Inspection Section 101 Sea Hero Road, Suite 100 Frankfort, Kentucky 40601-5412 (502) 573-1708 Fax (502) 573-1058 BOILER AND PRESSURE VESSEL CONTRACTOR LICENSE APPLICATION (To install, erect, or repair boilers, PRESSURE vessels, and PRESSURE piping) Please type or print application. Answer all questions on this application. A nonrefundable application fee of $250 payable to Kentucky State Treasurer shall be submitted with this application. 1. Name: _____ __ Last First MI Address: _____ (Street, Route or Box Number) City: State: Zip: _____ County: Telephone: ( ) -_____ Date of Birth: / / Social Security number: - -_____ E-Mail Address: _____ 2.

PLB-BPV-1 (Revised Dec. 2014) COMMONWEALTH OF KENTUCKY Public Protection Cabinet Department of Housing, Buildings and Construction DIVISION OF PLUMBING

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