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04i26/20E3 06:22 20E6238E66 AMERICAN ELEVATOR PAGE 02 <br />Washington State Department of Labor & Industries <br />Elevator Section <br />PO Box 44480 <br />Olympia, Washington 98504-4480 <br />Phone (360) 902-6130 <br />Fax (360) 902-6132 <br />Dear Building Official: <br />This form brings to your department's attention that the comreyanae listed below is proposed for <br />installation in an existing building within your jurisdiction. Your approval of this form is required <br />and will accompany the installer's Installation Application. If you have any regulations that <br />would prohibit this Installation, please notify the Installer, and do not approve this form. <br />Incined Wheelchair Lift <br />Vertical Wheelchair Lift (the travel shall not exceed 12 it nor penetrate a floor. ASME A17.1 Rule <br />2000.7a. <br />Inclined Onair Lift <br />Limited usejlimihed application (WLA) elevator* (does NOT meet accessibility requirements) <br />All conveyances shall be installed to code. Any deviation from the code shall require a variance from the <br />Department of Labor and Industries Elevator Section prior to a permit being issued. <br />1,e5i— G,4rheol/ <br />Location name (for conveyance) <br />936 9194'(,~ F0!/ER <br />Street Address <br />(arrows a100 <br />Telephone Number <br />(46Z6') -259- 1139 <br />Telephone Number <br />E!/fgg Z:Z . ZdA a 4e d 1 <br />// y City, State, Zip code <br />A OWLEI)GF,O BY. L7 Approved ❑ Not appraved <br />"L �i nil iL El'L <br />Signature of Building Official Please print name of official <br />Title Dale Telephone Number <br />* NOTE TO BUILDING OFFICIAL: The elevator section will approve LULA elevators in existing <br />churches and private dubs that are not required tube a cessillile per WAC-51-40-LIDS and 51- <br />40-1109. If this application Is for a LULA installation In any other type of building, please notify <br />the Elevator Technical Specialist or the Chief Elevator Inspector before approving this <br />application. <br />If you have any questions, please contact us at the lettemead address or telephone number. <br />