DEPARTMENT OF HOUSING, BUILDINGS AND CONSTRUCTION

PUBLIC PROTECTION
CABINET

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Division Forms

Boiler and Pressure Vessel Forms

Boiler Installation - 179K

Boiler Installation Instructions - 106K

Pressure Vessel Installation - 179K

Pressure Vessel Installation Instructions - 106K

Pressure Piping Installation & Replacement - 285K

Pressure Piping Installation & Replacement Instructions - 106K

Repair of Boiler or Pressure Vessel - 178K

Repair of Boiler or Pressure Vessel Instructions - 103K

Routine Repair - 173K

Routine Repair Instructions - 173K

Building Code Forms

Building Official Complaint Form - 57K

Daycare Guide and Cooking Disclosure Form - 450K

Expanded Local Jurisdiction Application - 106K

Expanded Local Jurisdiction Renewal - 120K

Fire Suppression Design Criteria - 436K

Insurance and Worker’s Compensation Affidavit of Assurances - 118K

Plan Application Form - Fireworks - 87K

Plan Application Form Revised - 238K

Plan Application Submittal Guide - 1M

Plan Review Fee Schedule - 229K

Public Funding Disclosure Form - 183K

Seismic Design Category Determination Form - 93K

Single Family Dwelling New Construction Complaint Form - 154K

Kentucky Temporary Structures (KTS)

Fee Schedule Form - 150K

Model Approval Plan Application Form - 174K

Site Placement Plan Application Form - 164K

Temporary Structure Guidelines - 251K

Electrical Inspection Forms

Application for Electrical Training Program - 111K

Contract Certified Electrical Inspector (Sample) - 64K

Electrical Consumer Complaint Form - 110K

EL-13 Electrical Permit Application - 105K

Electrical Inspection Supplies Request - 110K

Elevator Forms

Alteration Permit Application - 36K

Construction and Installation Permit Application - EV-1 - 44K

Safety Test Form - 96K

Fee Schedule - 29K

Bulletin - February 2022 - 353K

New Acceptance & Alteration pre-inspection checklist for elevators - 220K

Fire Protection Report of Inspection Forms

Chemical Suppression Systems - 387K

Rangehood Suppression Systems - 419K

Firework Forms

Public Display of Fireworks and Pyrotechnics Form - 50K

Fireworks Inspection Checklist (Revised 5-2014) - 372K

Permit Application For Supervised Public Display of Fireworks - 201K

Fireworks Registration Application 2020 - 43K

Public Display of Fireworks and Pyrotechnics - 265K

Fireworks Plan Application Form - 81K

Hazmat Forms

Application to Change Company for Certified Underground Petroleum Storage Tank (UPST) Contractor - 142K

Installer/Remover Certification Renewal Form - 198K

Permit Application for Interior Lining & Repair of Underground Storage Tanks (UGST) for Petroleum Products - 328K

Permit Application to install-modify Aboveground Storage Tank (AGST) - 335K

Permit Application to Install-Modify Compressed Natural Gas (CNG) - 204K

Permit Application to Install-Modify Liquified Petroleum Gas (LPG) and Anhydrous Ammonia (NH3) - 402K

Permit Application to Install-Modify Underground Storage Tank (UGST) - 429K

Permit Application to Install Emergency Power Stand-by Power Systems - 86K

Notice of Routine Maintenance on UGST component - 301K

Underground Petroleum Storage Tank Contractor (UPST) Certification Application - 57K

HVAC Forms

HVAC Construction Permit Application: One & Two Family Dwelling - 109K

HVAC Construction Permit Application: Multi-Family Dwellings - 105K

HVAC Construction Permit Application: Homeowner One & Two Family Dwelling - 108K

HVAC Construction Permit Application: Commercial Buildings - 113K

Duct Pressure Test Verification Form - 213K

Formal Consumer Complaint Form - 100K

Notice of Local HVAC Inspection Program - 78K

HVAC Examination Registration Form - 112K

Manufactured Home Retailer & Manufacturer Forms

Affidavit of Sale - MH8 - 80K

Manufactured Home Retailer Monthly Report - MH7 - 92K

Manufactured Housing New Home Foundation Submittal - 100K

Monthly Manufacture’s Certification - 178K

Seal Purchase Application - MH12 - 75K

Recreational Vehicle (RV) Forms

Seal Purchase Application - MH12 - 75K

Recreational Vehicle Retailers Informational Bulletin 8/2017 - 158K

RV Retailer Monthly Report - RV7 - 241K

Unit Inspection for B-Seal - MH16 - 60K

Request for SKYPE Inspection of Recreational Vehicle Unit - 209K

Certified Installer & Certified Manager Forms

Certified Installer Information Bulletin 8/2017 - 91K

Certified Installer Monthly Report - MH40/30 - 151K

Manufactured Housing Consumer Forms

Consumer Complaint Form - 175K

Request for Skype RV Inspection - 209K

Consumer Protection Notice - MH10 - 76K

Release for Delivery - MH11 - 169K

Fire Safety Responsibilities - MH15 - 83K

Site Preparation Guidelines - MH17 - 90K

Frequently Asked Questions for B Seal Inspections - 454K

Kentucky Industrialized Building System (KIBS)

Application for M Seals - 22K

January 2019 Bulletin – KIBS Manufacturers - - 194K

KIBS Application Form 50-13 - 189K

KIBS Model Application Form - 115K

KIBS Site Application Form - 176K

KIBS Plan Submission Application Guide - 462K

Third-Party Inspection Notice - 43K

Plumbing Forms

Affidavit for Farmstead Exemption - 144K

Affidavit of Homeowner - 171K

Homeowner Report of Inspections - 146K

Medical Gas Installation Permit Application - 185K

Medical Gas System Record - 16K

Plan Application Form - 176K

Plan Submission Application Guide - 1M

Plumbing Formal Consumer Complaint Form - 13K

Plumbing Permit Application - 164K

Requirements for Homeowners Installing Plumbing - 145K

Water Heater Report Form PLB 94 - 47K

2022 Kentucky Plumbing Law Regulations and Code Book - 3M

Final Installation Virtual Inspection Checklist - 104K

Irrigation & Backflow Installation Virtual Inspection Checklist - 112K

Rough-In Installation Virtual Inspection Checklist - 113K

Sewer Installation Virtual Inspection Checklist - 118K

Underground Installation Virtual Inspection Checklist - 111K

Water Heater Installation Virtual Inspection Checklist - 120K

Water Service Installation Virtual Inspection Checklist - 108K

Inspector Certification Applications

Certified Inspector Fee Schedule - 16K

Initial Application for Fire Sprinkler Systems Certification - 144K

Renewal Application for Sprinkler Systems Certification - 134K

FPS 33-01 - Fire Alarm Systems Inspector certification application - 66K

FPS 33-02 - Fire Alarm Systems Inspector Certification Renewal Application - 81K

Contractor Applications and Certificates of Competency

Tip Sheet New Applicants - 49K

Prorated Fee Schedule - 698K

FPS-CC-2-2a - Application for Certificate of Competency Fire Protection Chemical - 81K

FPS-CL-1 - Application for Contractor License Fire Protection Chemical - 8K

FPS-RL-1 - Application for Contractor License Fire Protection Rangehood - 8K

FPS-RC-2-2a - Application for Certificate of Competency Fire Protection Rangehood - 82K

FPS-SC-2-2A - Application for Certificate of Competency - 83K

FPS-SL-1 - Application for Contractor License Fire Protection Sprinkler - 8K

Admitted Carrier - 17K

Surplus Lines.pdf - 15K

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