Fillable WTL.permit Wind Tower Lift Permit Application (Office of the Chief Information Officer)

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WTL.permit Wind Tower Lift Permit Application (Office of the Chief Information Officer)

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The WTL.permit Wind Tower Lift Permit Application (Office of the Chief Information Officer) form is 2 pages long and contains:

  • 1 signature
  • 73 check-boxes
  • 126 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Office of the Chief Information Officer

BROWSE OFFICE OF THE CHIEF INFORMATION OFFICER (IA) FORMS

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Iowa Division of Labor
Elevator Safety
150 Des Moines Street
Des Moines, IA 50309-1836
Phone: 515-725-5612/515-725-5608
Fax: 515-242-5076
elevators@iwd.iowa.gov
www.iowaelevators.gov
FOR OFFICE USE ONLY
Date approved: By:
WT Permit #:
Date received: Check #:
Please type or print clearly. No installation or alteration shall begin until a permit has been issued. Submit a complete
application package in order to prevent delays. New installations require 2 copies of the project details set forth in 875 IAC
71.5. Plans must be submitted on 11”x17” paper. A single electronic plan submittal shall be made with sufficient resolution to
not lose detail when enlarged. A building code analysis document must also be submitted. Each lift to be installed must be
listed on the Wind Tower Lift Identification page.
Fee Schedule
$500.00 per wind tower – This fee includes the initial inspection, the first year operating permit and the issuance of a single
installation permit for all of the identical wind tower lifts installed in identical wind towers in a single wind farm as the result of
one construction contract. Make checks payable to: Elevator Safety.
Wind farm name
County
Total # of lifts covered
by this app:
Wind farm address
City
State
Zip
Wind farm owner’s name
Wind farm owner’s address
Same as wind farm address
City
State
Zip
Wind farm billing address
Same as wind farm address
City
State
Zip
Construction trailer location
Jobsite contact name
Jobsite contact phone number
Jobsite contact email address
Manufacturer
Manufacturer contact name
Manufacturer contact phone number
Wind Tower Lift
Permit Application
Rated speed
Fpm m/s
Capacity
Fpm m/s
Training required
Yes No
Personal gear permissible
Yes No
Manufacturer serial number
Attached list with additional serial numbers
Manufacturer model name
Special instructions
02.21.2020
600-016
I certify that the information on this form and the attachments is true and accurate to the best of my knowledge.
Name of individual filling out form
Phone number
Email address
Signature
Date
click to sign
signature
click to edit
Winder Tower Lift Identification
#
Permit number
(do not fill out)
Tower ID
Latitude (GPS coordinates)
Longitude (GPS
coordinates)
$500.00 fee
paid
1
Yes No
2
Yes No
3
Yes No
4
Yes No
5
Yes No
6
Yes No
7
Yes No
8
Yes No
9
Yes No
10
Yes No
11
Yes No
12
Yes No
13
Yes No
14
Yes No
15
Yes No
16
Yes No
17
Yes No
18
Yes No
19
Yes No
20
Yes No
21
Yes No
22
Yes No
23
Yes No
24
Yes No
25
Yes No
26
Yes No
27
Yes No
28
Yes No
29
Yes No
30
Yes No
31
Yes No
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WTL.permit Wind Tower Lift Permit Application (Office of the Chief Information Officer)

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Completed 20 July 2020

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