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Industrial Commission of Arizona
Protection of life, health, safety, and welfare of Arizona's workforce

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      • Self-Insurance and Tax Office
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    • Labor Department
    • Legal Division
    • Medical Resource Office (MRO)
    • Special Fund Division
  • News and Events
    • Public Notices
    • News and Events
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    • Resources for Employees
    • Resources for Employers
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    • Resources for Medical Providers
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  • Application for Permit to Install or Alter Elevator Form

Application for Permit to Install or Alter Elevator Form

Instructions

Contractors must submit this form prior to each installation or alteration of elevators, dumbwaiters, escalators, moving walks, workman’s hoists, material hoists, manlifts, moving walks, and stage or orchestra lifts, as defined in the Arizona Elevator Act, A.R.S. Title 23, Chapter 2, Article 12.

This form must be completed in its entirety.  Failure to do so may cause a delay in processing. It can be submitted online or it can be submitted to ADOSH by mail, fax, or hand-delivery.

For additional information or assistance you may contact the ADOSH Elevator Section directly at 602-542-3313 or ADOSH toll free at (855) 268-5251.

 

Printer-Friendly Form

PDF icon Notice of Installation-20200414.pdf

Related Forms

Report a Fatality or Severe Injury Form
Notice of Alleged Safety or Health Hazards Form
Discrimination / Whistleblower Complaint Form
Consultation Request Form
ADOSH Training Request Form
Application for Permit to Install or Alter Elevator Form
Request for Boiler Repair Form
Request for Boiler Certificate Form
Compliance Assistance Request Form
VPP Pre-Screening Form
SHARP Application Form

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Contact Us:

Phoenix Office
800 W. Washington Street
Phoenix AZ 85007
602-542-4661

 

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Contact Us:

Tucson Office
2675 E. Broadway Blvd
Tucson AZ 85716
520-628-5188

 

 

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