166721 12/10/2008 0"L CITY OF CARMEL, INDIANA VENDOR: 140180 Page 1 of 1
ONE CIVIC SQUARE ICBO CHECK AMOUNT: $30.00
CARMEL, INDIANA 46032 5360 WORKMAN IMLL ROAD
WHIT7IER CA 90601 -2298 CHECK NUMBER: 166721
CHECK DATE: 12/10/2008
DEPARTMENT ACCOUNT PO NUMBE IN NUMBER AMOUN DE SCRIPTION
1192 4355300 30.00 ORGANIZATION MEMBER
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APPLICATION
for
CERTIFICATIONS REQUIRING MULTIPLE EXAMINATIONS
1
This application is not required for Certified Building Official, Fire Inspector 11, or Certified Fire Marshal certificates.
To receive certification in a category that requires the completion of more than one examination, you must receive a passing
score on each applicable examination and receive your certificates. Once you have received all of your certificates, complete this
application and submit to the Code Council at the address indicated at the bottom of this application with appropriate fee pay-
ment. Enclose $30.00 per certification category. The $30.00 fee does not apply to the Master Code Professional certification
category.
I have passed the required examinations, hold a current certification in the applicable categories, and fulfilled additional appli-
cable requirements. I hereby request a certificate of recognition as a Code Council-certified:
Building Inspector OResidential Combination Inspector Certified Fire Code Official
Electrical Inspector Commercial Combination Inspector Certified Mechanical Code Official
o Mechanical Inspector n Combination Inspector Certified Plumbing Code Official
Plumbing Inspector Combination Plans Examiner Certified Housing Code Official
Certified Building Code Official Certified Electrical Code Official
Master Code Professional—$30 fee
does not apply to the Master Code
Professional certification category.
Certificate and Mailing Information
Name Please print your legal name (first name, middle initial, last name)
12!'11 Tresfc✓ /N.
Street
�;s Lies t TaJ X6"
City State Zip
Sig re
Note: 45 -70 days are required for verification of records prior to issuance of requested certificates.
Payment Information: e
Total number of certification categories: 1 x $30.00 per certification category 30 total to enclose.
Method of Payment Provided: ChecklMoney Order visa MasterCard American Express Discover
(Payable to ICC)
Name as it appears on credit card: Signature:
Credit Card Number Expiration Date
Month Year
Mail completed application with required payment to:
International Code Council
Certification Department
5360 Workman Mill Road
Whittier, CA 90601
7
r
Certification Categories Requiring Multiple Examinations
and Application
Candidates must pass exams and hold a current certification in the categories listed below,
meet applicable requirements for the corresponding certification, and submit the required appli-
cation along with a $30 fee for each certification category to the Code Council to receive a cer-
tificate. There is no fee for the Master Code Professional certificate. The Master Code Profes-
sional certificate is provided to those who have passed required exams, met applicable re-
quirements, and submitted an application to the Code Council. The required application for
certification categories below can be found on the next page of this bulletin.
Category Examinations Pages
Building Inspector B1, B2 7, 17, 18
Electrical Inspector E1, E2 7, 17, 18
Mechanical Inspector M1, M2 .7, 17, 19
Plumbing Inspector P1, P2 7, 18, 19
Residential Combination Inspector, B1, E1, M1, P1 7, 17, 18
Commercial Combination Inspector B2, E2, M2, P2 7, 18, 19
Combination Inspector B1, B2, M1, M2,
E1, E2, P1, P2 7, 17, 18, 19
Combination Plans Examiner B3, E3, M3, P3 7, 19,20
Certified Building Code Official (CBCO) B1, B2, B3, 01, 02 7, 17, 18, 19, 26
Certified Electrical Code Official (CECO) E1, E2, E3, 01, 02 7, 17, 18, 20, 26
Certified Fire Code Official (CFCO) 67, F3, 01, 02 7, 24, 26
Certified Mechanical Code Official (CMCO) M 1, M2, M3, 01, 02 7, 17, 19, 20, 26
Certified Plumbing Code Official (CPCO) P1, P2, P3, 01, 02 7, 18, 19, 20, 26
Certified Housing Code Official (CHCO) 64, 01, 02 7, 22, 26
Master Code Professional (MCP) 7, 35,36
Master of Special Inspection (MSI) 37, 38
5/3
6
Certification Detail Page 1 of 2
ICC
Inspector I Contractor I Renewals I UST-LAS Certificatign
Certified Professional Information: co
Infoi
Last, First MI: Liggett, Brent 1 -388-
(422-7:
Certified under this Brent Liggett cent;
name: Exa 2
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Address: 12571 Trester Ln Ceti
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City, State Zip: Fishers, IN 46038 3=
CE
317 571 -2491 M
Phone: Ex a 3? r
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Certification Type(s): Residential Building Inspector (expires cso Ex; 12/15/2009) --_s
Residential Electrical Inspector (expires Con
11/05/2011) Exam
Residential Mechanical Inspector (expires 3=
08/15/2010) LE
Residential Plumbing Inspector (expires Exarr
05/16/2011) 3'
U S'
Exam
Listings here may not reflect today's changes, additions, exam results, or 3
certifications from organizations other than ICC (including BOCA, ICBO, and SBCCI). Special
Listings are updated nightly on this web site, so please allow a full 24 hours for Exam
3
changes to be reflected here. ICC certification for code enforcement professions
attests to competent knowledge of construction codes and standards in effect on the
date of certification or renewal.
ICC does its best to maintain the privacy requests of its members and constituents.
If you believe that phone number or address information listed here should not be
displayed please contact us at 1- 888 -ICC -SAFE (422 -7233) between 8am and 7pm
(CT) for personal assistance.
Terms of Use: This listing is provided as a service to the constituents of ICC for
these purposes: locating a certified professional or contractor in your area, or
confirming status for individuals. Any other use, sale, transfer, or reproduction in
any form without the express written consent of ICC is strictly prohibited. ICC
reserves the right to incorporate some false names to detect improper use of this
service,
https: /ay. icesafe.org /eweb/DynamicPage. aspx? WebCode= ICCCRTDetail &cst_key =Oe4c4... 12/1/2008
Prescribed by Slate Board of Accounts City Form No. 201 (Rev. 1995)
r ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
„ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
G CS
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
/a 20 0
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund