InternaƟonal Code Council
ApplicaƟon for CerƟficaƟon Renewal
PLEASE NOTE: Paper applicaƟons will incur an addiƟonal $15 fee
per applicaƟon for processing.
Most cerƟficaƟons can be renewed online at www.iccsafe.org/renewals.
Renewal Information—PRINT LEGIBLY
Name: _____________________________________________________________________________________________________________
Street Address: ________________________________________________________________________ Is this a home address? _________
City: _________________________ State: ______ ZIP: _______________
Home Phone No.: ____________________________________
Work Phone No.: ______________________________________________
Fax Number No: _____________________________________
E-mail (required): _____________________________________________________________________________________________________
Certificate No.: _______________________________________________
ICC Membership No.: _________________________________
Job Title/Department: _________________________________________
Jurisdiction/Business: _________________________________
Please note that beginning January 2015, important changes to the ICC Continuing Education renewal process will go into effect.
Please refer to the Renewal Information Bulletin which can be found on the ICC website. Additional information can also be found at
www.iccsafe.org/FAQS.
Total Number of CEUs Required
(% from ICC and/or PPN)*
Renewal Fees
Member
Renewal Fees
Non-Member
1
1.5 (0.3)
$75
$87.50
2 through 5
3.0 (0.6)
$87.50
$100
6 through 10
4.5 (0.9)
$100
$112.50
11 or more, or Master Code Professional
4.5 (0.9)
$112.50
$125
$93.75
$125
Number of Certifications Being Renewed
Reinstatement Fee
* CBO or CFM requires 6.0 CEUs
Full payment must be submitted with all applications.
Method of Payment:
□ Check/Money Order
(Payable to ICC)
Renewal fee $________ + Paper application fee $ 15 = Total: $_________
□ Visa
□ MasterCard
□ American Express
□ Discover
Name as it appears on credit card: __________________________________ Signature: _______________________________________
Credit Card No: _________________________________________________ Expiration (Mo/Yr)
Continuing Education/
Professional Development Activity
Date Completed
Provided by
(school, code organization, etc.)
Contact Hours/
CEUs
Preferred Provider
Course number
1.
2.
3.
4.
5.
6.
Attach a separate sheet of paper for additional listings, if necessary. Documentation must be retained for three (3) years from date of renewal
request and submitted upon an audit request. DO NOT submit documentation with this form.
————— Continued on other side —————
CEUs Required per Certification Category
1.5 CEUs required for each certification, unless otherwise noted.
Residential Inspection
Special Inspector
Legacy
__ B1 Residential Building Inspector
__ E1 Residential Electrical Inspector
__ P1 Residential Plumbing Inspector
__ M1 Residential Mechanical Inspector
__ R5 Residential Combination Inspector
__ 49 Reinforced Concrete Special Inspector
__ 48 Reinforced Concrete Special Inspector Associate
__ 34 Plumbing Inspector UPC
__ 44 Mechanical Inspector UMC
__ 50 Combination Inspector—Uniform Codes
__ 56 Combination Dwelling Inspector—Uniform Codes
__ 57 Light Commercial Combination Inspector—Uniform
Codes
__ F1 Fire Prevention Inspector I—NFPC
__ F2 Fire Prevention Inspector II—NFPC
__ N7 Building Fire Protection Inspector
__ N8 Building Fire Protection Plans Examiner
__ 97 Elevator Inspector
__ 85 Structural Steel & Welding Special Inspector
__ 88 Reinforced Concrete Special Inspector—Legacy
__ 89 Prestressed Concrete Special Inspector—Legacy
__ EA Commercial Energy Inspector w/ASHRAE 90.1
__ EB Commercial Energy PE w/ASHRAE 90.1
__ G2 IgCC Commercial Inspector
__ G3 IgCC Commercial Inspector w/ASHRAE 189.1
__ G4 IgCC Plans Examiner
__ G5 IgCC Plans Examiner w/ASHRAE 189.1
Commercial Inspection
__ B2 Commercial Building Inspector
__ E2 Commercial Electrical Inspector
__ P2 Commercial Plumbing Inspector
__ M2 Commercial Mechanical Inspector
__ C5 Commercial Combination Inspector
Plans Examiner
__ B3 Building Plans Examiner
__ E3 Electrical Plans Examiner
__ P3 Plumbing Plans Examiner
__ M3 Mechanical Plans Examiner
__ R3 Residential Plans Examiner
__ RF Residential Fire Sprinkler Inspector/PE
__ C3 Combination Plans Examiner
Energy Inspection/Plans Examiner
__ 77 Commercial Energy Inspector
__ 78 Commercial Energy Plans Examiner
__ 79 Residential Energy Inspector/Plans Examiner
__ CE Commercial Energy Inspector/Plans Examiner
with ASHRAE 90.1
Green
__ GC IgCC Inspector/Plans Examiner w/ASHRAE 189
__ G1 Green Building—Residential Examiner
Fire
__ 66 Fire Inspector I
__ 67 Fire Inspector II
__ F3 Fire Plans Examiner
__ FM Certified Fire Marshal (CFM)
__ CA Commercial Fire Alarm Inspector
__ CN Commercial Fire Alarm Plan Examiner I
__ CR Commercial Fire Alarm Plans Examiner II
__ CF Commercial Fire Sprinkler Inspector
__ CP Commercial Fire Sprinkler Plans Examiner
Note: Holding certification or renewing certification in the
“General” Inspection category does not qualify you to
automatically receive certification in the “Residential” and/
or “Commercial” Inspection categories.
NOTE: ACI Field Technician Grade 1 must be current for 48 or 49
__ 92 Prestressed Concrete Special Inspector
__ S1 Structural Steel and Bolting Special Inspector
__ S2 Structural Welding Special Inspector
__ 86 Spray-applied Fireproofing Special Inspector
__ 84 Structural Masonry Special Inspector
__ EC Soils Special Inspector
__ MI Master of Special Inspection
Code Enforcement
__ 14 Permit Technician
__ 21 Accessibility Inspector/Plans Examiner
__ 75 Zoning Inspector
__ 64 Property Maintenance and Housing Inspector
__ C1 Coastal and Floodplain Construction Inspector
__ DR Disaster Response Inspector
__ FG Fuel Gas Inspector
General Inspection
__ B5 Building Inspector
__ E5 Electrical Inspector
__ P5 Plumbing Inspector
__ M5 Mechanical Inspector
__ C8 Combination Inspector (Bldg, Elect, Plbg, Mech)
Code Official and Code Specialist
__ T6 Permit Specialist (PS)
__ CB Certified Building Official (CBO)
__ B6 Certified Building Code Official (CBCO)
__ E6 Certified Electrical Code Official (CECO)
__ P6 Certified Plumbing Code Official (CPCO)
__ M6 Certified Mechanical Code Official (CMCO)
__ H6 Certified Housing Code Official (CHCO)
__ F6 Certified Fire Code Official (CFCO)
__ G8 Energy Code Specialist
** Requires current Property Maintenance and Housing
Inspector and Zoning Inspector certification to renew; no
additional CEUs required
*** Requires current Property Maintenance and Housing
Inspector or Zoning Inspector certification, and Legal/
Management module to renew; no additional CEUs
required
State-specific and Specialty
__ N2 New Jersey Commercial Plumbing Inspector
__ N3 New Jersey Plumbing Plans Examiner
__ MR Minnesota Residential Plumbing Inspector
__ MC Minnesota Commercial Plumbing Inspector
__ FR Florida Roofing Inspector
__ L1 Louisiana Residential Plumbing Inspector
__ L2 Louisiana Commercial Plumbing Inspector
__ L3 Louisiana Plumbing Plans Examiner
__ I1 California Commercial Building Inspector
__ I2 California Commercial Electrical Inspector
__ I3 California Commercial Plumbing Inspector
__ I4 California Commercial Mechanical Inspector
__ I5 California Commercial Combination Inspector
__ I6 California Building Plans Examiner
__ I8 Combination Inspector—California Codes
__ J1 California Residential Building Inspector
__ J2 California Residential Electrical Inspector
__ J3 California Residential Plumbing Inspector
__ J4 California Residential Mechanical Inspector
__ J5 California Residential Combination Inspector
__ 76 ICC/AACE Code Enforcement Officer **
__ 73 ICC/AACE Code Enforcement Administrator ***
AFFIDAVIT OF APPLICANT
I hereby certify that I am the person indicated on this form, that all the information I have given herein is true and complete to the best of my
knowledge, and that any false statement will be cause for voiding this application. I understand that supporting documentation must be retained
for three years.
Signature: ______________________________________________________________ Date: ______________________________________
Printed Name: ___________________________________________________________
Return this completed application in its entirety along with the appropriate fees to:
International Code Council
Certification Renewals
Western Regional Office
3060 Saturn St., Ste. 100
Brea, CA 92821-1732
PLEASE ALLOW FOUR TO SIX WEEKS FOR PROCESSING OF YOUR RENEWAL APPLICATION.