Application to Install Elevator/Manlift/Dumbwaiter

BWC/ISD/T6

Republic of the Philippines

Department of Labor and Employment

CORDILLERA ADMINISTRATIVE REGION

APPLICATION TO INSTALL ELEVATOR/MANLIFT/DUMBWAITER

1. Owner/Establishment : ______

2. Address:______

3. Owner/Manager:______

4. Building where Elevator/Manlift/Dumbwaiter is to be installed:______

______No. of stories______

5. Name and signature of person to supervise installation:______

______

(Board of Mechanical Engineering Reg. No. Licensed No.)

6. When building was erected ______installation is an addition______

addition erected, when?______

6 A. Elevator; Check whether ______Passenger or ______Freight.______

S P E C I F I C A T I O N

7. Type:______

(Traction, drum, double-belt, hydraulic, plunger)

Motive power:______

(Hand, electric, direct-connected, steam, line-shaft)

8. Height of lift _____Feet ______inches, from ______floor to ______floor______

9. Location of hoisting machine ______No. of hoistway landings______

10. Capacity ______Weight of car complete ______Speed _____ft./min.______

11. Inside dimensions of car: ______Construction of car frame:______

12. Car enclosure: Material ______No. of sides _____ height _____ Thickness______

13. Top on car ______Grilles ______Mesh ______Solid ______

Self-closing hinges section 18” in depth full width of car ______

(Yes or No)

14. Emergency exit in car: ______Location ______Size ______

Emergency switch in car: ______

15. Number of opening in car ______No. of compartments in car ______

16. Gates on car at ______sides; type ______

Height ______; contacts ______Emergency release ______

17. Distance between controller and handle on car gate ______on

Hoistway gate or door. ______

18. electric light in car ______Car gate or door tracks countersunk

19. Clearance between edge of car platform and landing sill ______

Edge of car platform and door used at landing sill ______

20. Overhead clearance: Distance of run-by of car at upper limit of travel ______

______

21. Number of hoist cables ______Material ______

Diameter ______Roping 1 to 1 ______2 to 1 ______

22. Any cables outside of hoistway ______; guarded 7’0 from floor______

23. Number of counterweight cables: Car ______Drum ______

24. Diameter of smallest sheeves: Hoisting ______; counterweight ______

Compensating ______

25. Distance between top of counterweight and overhead beams when buffers are

completely compressed ______

______

26. Pit buffers: Type ______; compression ______

Counterweight buffers: Type ______; Compression ______

27. Number of counterweight sections ______Weight of each section ______

Counterweight section and frames through-bolted ______

28. Counterweight guard: Entire travel ______; height from pit ______

Under clearance ______; compensating chains ______

29. Control: Automatic push button ______; constant-pressure push button ______

Switch ______Hand cable ______; self-centering ______

30. Current: A.C. _____ D.C. ______Reverse-phase relay to shunt type ______

______

31. Car guide rails ______Dimensions ______

(Steel or wood)

32. Counterweight guide rails ______Dimensions ______

(Steel or wood)

33. Brake: Electromechanical ______; Mechanical ______

Self-locking ______

34. Terminal limit stops ______

(on car) (in hoistway) (On machine) (On operating device)

35. Slack cable stop ______

Partition between adjacent pits ______; height ______

36. Rope lock ______type ______locking device for safety lift loads ______

37. Speed Governor: Type ______Location ______

Safety Switch: On governor ______; on safety ______

38. Car safeties: Location ______; gradual ______

(Crosshead Bottom) (Clamp)

instantaneous (Roll, Rachet, Cam) ______

39. Automatic speed retarder ______Counterweight safeties______

40. Platform under overhead sheaves and open spaces over hoistway ______

Material ______Solid ______Thickness ______

41. Skylight ______Exterior window above platform ______

Exterior window immediately below platform ______

42. Width of flooring beyond contour of machine ______handrail______

43. Distance from floor to center to bow on top of car (trap-door installation) ______

______

44. Signals ______Type ______

______

Name & Signature of Owner/Manager

______

Establishment

EVDL No. ______

Plan Fee: ______

OR No. ______

Date: ______

Date Received: ______

Received by: ______

Note:

The detailed working drawings of the elevator/manlift/dumbwaiter, the hoistway and

installation plans shall accompany this application and shall be prepared, signed and sealed by

a PROFESSIONAL MECHANICAL ENGINEER