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Department of Labor and Industries CONVEYANCE <br /> Elevator Section <br /> PO Box 44480 INSTALLATION <br /> Olympia WA 98504-4480 4 5zATepAx <br /> Phone:(360)902-6130 APPROVAL BY <br /> FAX(360)902-6132g <br /> www.Lni.wa.gov/TradesLicensing/Elevators �y1889�°y BUILDING OFFICIAL <br /> ➢ This form brings to your department's attention that the conveyance listed below is <br /> proposed for installation in an existing building within your jurisdiction. <br /> ➢ Your approval of this form is required and must accompany the installer's Installation <br /> Application. <br /> ➢ Notify the installer if you have any regulations that would prohibit this installation. <br /> Do not approve this form. <br /> *Note To Building Officials: The elevator section will approve LULA(Limited Use <br /> Limited Application Elevators) for existing buildings, on a case by case basis. <br /> A LULA elevator does meet the minimum cab size requirements for new construction <br /> required to be accessible, per WAC 296-96. <br /> If you have any questions,please contact us at the address or telephone number above. <br /> Indicate the equipment being installed. <br /> ❑ Inclined Wheelchair Lift <br /> El Vertical Wheelchair Lift The travel shall not exceed 14 ft. ASME A18.1 Rule 2.7.1. <br /> ❑✓ Inclined Chair Lift <br /> ❑ Limited use/limited application (LULA) elevator *Does NOT meet accessibility <br /> requirements for new construction. <br /> All conveyances must be installed per code. Any deviation from the code shall require a <br /> variance from the Department of Labor and Industries Elevator Section prior to a permit being <br /> issued. <br /> Name and License#of Installer of Conveyance Telephone Number <br /> Advantage Elevator #ADVANES929WJ Office:425-806-6044 ext.2 <br /> Building name where conveyance is located Telephone Number/Location Contact <br /> Second Baptist Church of Everett Hiller Payne 425-478-2663 <br /> Street Address City, State,Zip code <br /> 2801 Virginia Ave. Everett,WA 98201 <br /> Approved ❑Not approved <br /> ACKNOWLEDGED BY: � �i <br /> Title t4 mber <br /> /CJ'i ' all' 1`G► q l one Oz 7Date Prr a e of building official C/0.75- <br /> gna e buildin official <br /> J402Cd 7.-0‘7 <br /> F621-056-000 conveyance installation approval by building official 05-2010 <br />