Republic of the Philippines

Department of Labor and Employment

National Capital Region

APPLICATION TO INSTALL ELEVATOR / MANLIFT / DUMBWAITER

1. Name of Establishment: _________________________________________________________________________

2. Address: _____________________________________________________________________________________
3. Owner / Manager: _____________________________________________________________________________
4. Building where Elevator/Manlift/Dumbwaiter is to be installed: _________________________________________
__________________________________________ No. of Stores: ______________________________________
5. Name (print) and Signature of person to supervise installation:
_______________________________________________________________________________
________________________________________________ _____________________________________
(Board of Mechanical Engineer Reg. No.) (License No.)
6. When was the Building erected _______________________ Installation is an addition _______________________
6. A. Elevator: Check whether ______________________ Passenger or ____________ Freight _________________

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

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 Hoisting landings: ________________________
10. Capacity: ________________ Weight of Car complete: _____________ Speed: __________ ft. /min. __________
11. Inside dimension 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 of Car at __________________________________ Slides; Types _________________________________
Height: _____________________; Contacts: ____________________Emergency release ___________________
17. Distance between controller and handle on Car gate: _______________________________________ on hoistway
Gate or Car _________________________________________________________________________________
18. Electric light in Car ___________________________________________________________________________
19. Clearance between edge of Car platform and landing sill ______________________________________________
Edge or Car platform and door used at landing sill __________________________________________________
20. Overhead clearance: Distance of run-by of Car at upper limit of travel ___________________________________
___________________________________________________________________________________________
21. Number hoist cable: ______________________________________ 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 sheaves: Hoisting _______________________ Counterweight ________________________
Compensating _______________________________________________________________________________
25. Distance between top of counterweight and overhead beams when buffers are completely compressed
_______________________________________________________________________________________________
26. Pit buffer: Type __________________________; Compression ___________________________________
Counterweight buffer: 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: Eletromechanical ______________________; Mechanical ________________________________
Self-locking __________________________________________________________________________
34. Terminal limit stops ______________________________________________________________________
(on car) (in hoistway) (on machine) (on operating device)
Slack cable stop ______________________________________________________________________________
35. Hoistway pit: Distance lowest landing to bottom pit __________________________________________________
partition between adjacent pits _____________________________; Height ______________________________
36. Rope lock __________________ Type ____________________ Locking device or safe 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 _______________________________________________________
43. Distance from floor to center to bow on top of car (trap-door installation)
____________________________________________________________________________________________
44. Signals __________________________________________ Type ______________________________________

_____________________________________________
Name (print) & Signature of Owner/Mgr.
_____________________________________________
Name of Establishment

EVDL No. ________________________________

Plan Fee _________________________________
O.R. 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.