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. + . <br /> . , , ��O - Department of Administration <br /> : •. - <br /> Building Codes and Standsrds Division,408 Metro Squsre Building,121 7'�Place East,St.Paul,MN SSiOI-2181 <br /> Voice:651-296-4639;Fax:651-297-1993;TTY: 1-800-627-3529 and ask for 651-296-9929 <br /> Building Official Review of Wheelchair Platform Lift Installation <br /> The purpose of this form is to provide the Elevator Safety Section of the Building Codes and Standazds <br /> Division with a standardized application process for wheelchair platform lift installation.The form on the <br /> reverse side of this page is to be completed by the local building official or, in non-code areas of the state, ' <br /> the Building Code$and Standards Division's Regional Representative.In most cases,a site visit and the <br /> lift installer's drawings will be necessary to complete the form. <br /> Our goal is to obtain basic accessibility, building code and safety information concerning a proposed <br /> . wheelchair lift installation. Such information is beyond the scope of the permit process for the lifting <br /> device.A pefmit for the install�tion of the actual lifting device will be issued by the elevatot safety <br /> section of the division.This fortn is intended to provide supplemental information pertaining to the• <br /> overall appropriateness of the proposed lift installation.These issues are irrespective of the mechanical <br /> issues of the lifting device which will be reviewed by the elevator safety section. <br /> Completion of this form will provide the division with an overall picture of the proposed installation and <br /> allow the division to determine if the proposed lift i�viil provide access to the area in an appropriate and <br /> safe manner r�vhile maintaining general exiting of the facility. <br /> Each permit application submitted to the division for the installation of a wheelchair platform lift must be <br /> accompanied by a completed Building Official Review form.Questions concerning this form shoutd be <br /> directed to the E1eVgtor Safety Section at 651-297-708L <br /> This is to verify that I have reviewed the proposed installation of a platform lift located at: <br /> , <br /> � and that the proposed installation is,� acceptable_ not recommended based on the attached <br /> criteria. <br /> LYC.C OM �N I Z6o <br /> Name of Building Official(print) Certification Number �� <br /> � '21� -C�Z <br /> Signed Date <br /> �a C3 0 � G � G'�,s►� ` 6 a�, V�l� ss�z 3 - <br /> Add�ess <br /> �JS2-ZK �? • KGoC� � Z- ZYS • Y!o/6 <br /> Phone Fax ' � <br /> ; <br />