Safety Standards Division Application for Permit to Alter/Do Major Repair on Elevator or Escalator

              INSTRUCTIONS FOR COMPLETING OKLAHOMA ELEVATOR PERMITS
The Oklahoma Elevator Permit which follows should be completed using your computer keyboard by typing the information into the first page online. All subsequent pages will be automatically filled in with the information. After all three pages have been printed, you must sign them all and submit to: Oklahoma Department of Labor Safety Standards Division 3017 North Stiles, Suite 100 Oklahoma City, OK 73105 You are also required to submit all plans in hardcopy.
Types of Driving Machines
Drum
Traction
Geared
Gearless
Hydraulic
Direct Acting
Roped
Rack And Pinion
Screw-Column
Spiralift
List of Elevating Devices
P
=
Passenger Elevator
F
=
Freight Elevator
SPP
=
Special Purpose Personnel Elevator
VPL
=
Vertical Platform Lift
IPL
=
Inclined Platform Lift
SC
=
Stairway Chairlift
PH
=
Personnel Hoist (ANSI A10.4)
BM
=
Belt Manlift (ASME A90.1)
CODES/DATA FOR USE IN COMPLETING THE FOLLOWING PERMIT
Revised 01/10/11
The Oklahoma Department of Labor will not discriminate against any individual or group because of race, sex, religion, age, national origin, color, marital status, disability, or political beliefs. If you need help with reading, writing, hearing, etc., under the Americans with Disabilities Act, you may make your needs known to this agency.
STATE SERIAL NUMBER
PERMIT NUMBER
PERMIT APPROVED BY
COUNTY
LOCATION (ADDRESS)
CITY
BILLING INFORMATION (OWNER OR DESIGNATED AGENT)
ELEVATOR LOCATION (BUILDING NAME)
BILLING ADDRESS
CITY
CONTRACTOR'S COMPANY NAME AND BRANCH OFFICE (CITY)
CONTRACTOR'S LICENSE NUMBER
TYPE OF ELEVATOR
VOLTAGE
CAPACITY
RISE IN FEET
LIST EACH SPECIFIC ALTERATION AS LISTED IN ASME A17.1 SECTION 8.7
OFFICE USE ONLY
INSPECTOR'S COMMENTS
This form is issued under authority of 59 O.S. § 3020 et seq. You must complete this form and return it to the above address if you want to alter or do a major repair on an elevating device.
Section 3021 B.1. A person, firm or corporation shall not install, alter or do a major repair on an elevator without first having obtained a permit from the department. A permit shall be issued only to a person, firm or corporation licensed by the director as an elevator contractor. Permit applications shall be made on forms furnished by the department.
380:70-11-8. An altered, including major repairs, or relocated elevator shall not be placed into service until it has been inspected.
ZIP CODE
ZIP CODE
STATE
MANUFACTURED BY
POWERED BY
MACHINE TYPE
PASSENGER
FREIGHT
ESCALATOR
OTHER
TRACTION
DRUM
SPROCKET
HYDRAULIC
OTHER
A.C.
D.C.
MANUFACTURER'S NUMBER
LBS
FLOORS TRAVELED
NO. CAR ENTRANCES
FT
IN
SPEED
FPM
NO. OF HOISTWAY ENTRANCES
CONTRACTOR'S SIGNATURE
DATE
INSPECTOR'S SIGNATURE
INSPECTOR NUMBER
DATE
COPY DISTRIBUTION: Pg 1 - Elevator Safety Division; Pg 2 - Field Inspector; Pg 3 - Contractor's PERMIT (Post on Jobsite After Approved by Division) PAGE 1
Application for Permit to Alter/Do Major Repair on Elevator or Escalator
Oklahoma Department of Labor
Safety Standards Division - Elevator Inspections
3017 N. Stiles, Suite 100
Oklahoma City, OK 73105
405-521-6100
DO NOT SUBMIT WITHOUT
STATE SERIAL NUMBER
DATE
HAND POWERED
ELECTRIC MOTOR
OTHER
PERMIT FORMS MUST BE SUBMITTED IN TRIPLICATE ELEVATOR PLANS MUST BE SUBMITTED IN HARDCOPY
Alteration
Repair
Both
Revised 01/10/11
The Oklahoma Department of Labor will not discriminate against any individual or group because of race, sex, religion, age, national origin, color, marital status, disability, or political beliefs. If you need help with reading, writing, hearing, etc., under the Americans with Disabilities Act, you may make your needs known to this agency.
STATE SERIAL NUMBER
PERMIT NUMBER
PERMIT APPROVED BY
COUNTY
LOCATION (ADDRESS)
CITY
BILLING INFORMATION (OWNER OR DESIGNATED AGENT)
ELEVATOR LOCATION (BUILDING NAME)
BILLING ADDRESS
CITY
CONTRACTOR'S COMPANY NAME AND BRANCH OFFICE (CITY)
CONTRACTOR'S LICENSE NUMBER
TYPE OF ELEVATOR
VOLTAGE
CAPACITY
RISE IN FEET
LIST EACH SPECIFIC ALTERATION AS LISTED IN ASME A17.1 SECTION 8.7
OFFICE USE ONLY
INSPECTOR'S COMMENTS
This form is issued under authority of 59 O.S. § 3020 et seq. You must complete this form and return it to the above address if you want to alter or do a major repair on an elevating device.
Section 3021 B.1. A person, firm or corporation shall not install, alter or do a major repair on an elevator without first having obtained a permit from the department. A permit shall be issued only to a person, firm or corporation licensed by the director as an elevator contractor. Permit applications shall be made on forms furnished by the department.
380:70-11-8. An altered, including major repairs, or relocated elevator shall not be placed into service until it has been inspected.
ZIP CODE
ZIP CODE
STATE
MANUFACTURED BY
POWERED BY
MACHINE TYPE
PASSENGER
FREIGHT
ESCALATOR
OTHER
TRACTION
DRUM
SPROCKET
HYDRAULIC
OTHER
A.C.
D.C.
MANUFACTURER'S NUMBER
LBS
FLOORS TRAVELED
NO. CAR ENTRANCES
FT
IN
SPEED
FPM
NO. OF HOISTWAY ENTRANCES
CONTRACTOR'S SIGNATURE
DATE
INSPECTOR'S SIGNATURE
INSPECTOR NUMBER
DATE
COPY DISTRIBUTION: Pg 1 - Elevator Safety Division; Pg 2 - Field Inspector; Pg 3 - Contractor's PERMIT (Post on Jobsite After Approved by Division) PAGE 1
DO NOT SUBMIT WITHOUT
STATE SERIAL NUMBER
DATE
ELECTRIC MOTOR
HAND POWERED
OTHER
PERMIT FORMS MUST BE SUBMITTED IN TRIPLICATE ELEVATOR PLANS MUST BE SUBMITTED IN HARDCOPY
405-521-6100
Oklahoma City, OK 73105
3017 N. Stiles, Suite 100
Safety Standards Division - Elevator Inspections
Oklahoma Department of Labor
Application for Permit to Alter/Do Major Repair on Elevator or Escalator
Revised 01/10/11
P E R M I T
The Oklahoma Department of Labor will not discriminate against any individual or group because of race, sex, religion, age, national origin, color, marital status, disability, or political beliefs. If you need help with reading, writing, hearing, etc., under the Americans with Disabilities Act, you may make your needs known to this agency.
STATE SERIAL NUMBER
PERMIT NUMBER
PERMIT APPROVED BY
COUNTY
LOCATION (ADDRESS)
CITY
BILLING INFORMATION (OWNER OR DESIGNATED AGENT)
ELEVATOR LOCATION (BUILDING NAME)
BILLING ADDRESS
CITY
CONTRACTOR'S COMPANY NAME AND BRANCH OFFICE (CITY)
CONTRACTOR'S LICENSE NUMBER
TYPE OF ELEVATOR
VOLTAGE
CAPACITY
RISE IN FEET
LIST EACH SPECIFIC ALTERATION AS LISTED IN ASME A17.1 SECTION 8.7
OFFICE USE ONLY
INSPECTOR'S COMMENTS
This form is issued under authority of 59 O.S. § 3020 et seq. You must complete this form and return it to the above address if you want to alter or do a major repair on an elevating device.
Section 3021 B.1. A person, firm or corporation shall not install, alter or do a major repair on an elevator without first having obtained a permit from the department. A permit shall be issued only to a person, firm or corporation licensed by the director as an elevator contractor. Permit applications shall be made on forms furnished by the department.
380:70-11-8. An altered, including major repairs, or relocated elevator shall not be placed into service until it has been inspected.
ZIP CODE
ZIP CODE
STATE
MANUFACTURED BY
POWERED BY
MACHINE TYPE
PASSENGER
FREIGHT
ESCALATOR
OTHER
TRACTION
DRUM
SPROCKET
HYDRAULIC
OTHER
A.C.
D.C.
MANUFACTURER'S NUMBER
LBS
FLOORS TRAVELED
NO. CAR ENTRANCES
FT
IN
SPEED
FPM
NO. OF HOISTWAY ENTRANCES
CONTRACTOR'S SIGNATURE
DATE
INSPECTOR'S SIGNATURE
INSPECTOR NUMBER
DATE
COPY DISTRIBUTION: Pg 1 - Elevator Safety Division; Pg 2 - Field Inspector; Pg 3 - Contractor's PERMIT (Post on Jobsite After Approved by Division) PAGE 1
DO NOT SUBMIT WITHOUT
STATE SERIAL NUMBER
DATE
ELECTRIC MOTOR
HAND POWERED
OTHER
PERMIT FORMS MUST BE SUBMITTED IN TRIPLICATE ELEVATOR PLANS MUST BE SUBMITTED IN HARDCOPY
405-521-6100
Oklahoma City, OK 73105
3017 N. Stiles, Suite 100
Safety Standards Division - Elevator Inspections
Oklahoma Department of Labor
Application for Permit to Alter/Do Major Repair on Elevator or Escalator
Revised 01/10/11