Link opens Instructions for Completing Form UCC-22 in PDF format  Instructions for Completing Form UCC-22 (REV 10-05):
Application for Alteration Permit: Lifting Devices

PAGE 1:

Part A:

Building Code and Responsible Party Numbers: Department Certificates of Operation list two numbers, one is the “Responsible Party” (which tells us who the building owner is) and the other is the “Building Code” (which will tell us the street location of the building). We want both numbers. In most cases, these numbers are identical.
 
State Equipment Number: This is the number assigned to this particular lift. It should appear on the certificate. Also, if there are multiple lifts, the equipment number should be painted on each piece of equipment in the machine room. In buildings with multiple lifts, be leery about relying strictly on information from the certificate that is in the car. In many cases, elevator cars do not have the correct certificate of operation posted in them!

Part B:

Building owner’s name and contact information. This must be filled out completely.

Part C:

The location and name of the building where the lift is installed should include not only the mailing address, but also the name of the political subdivision (Borough, City or Township) and the county. Competed in entirety.
 
Use and occupancy: we need to know what the building code use is for this building, for example, residential-motel.
 
Indicate if there is a basement.
 
Stories: include the basement as a story.

Part D:

Select the type of lift. If you do not see the specific type of lift listed, you must check "Other" and write in the type of lift as defined in the ASME codes. Examples: Other: Special Purpose Personnel Elevator, Other: Rack and Pinion, etc.
 
If you select a Freight Lift or a Combination Passenger/Freight, you must also select the class of loading A, B or C. If you check C, you must also circle 1 or 2 or 3.

Part E:

Select the type of drive. If you do not see the specific type of drive listed, you must check Other and write in the type of drive as defined in the ASME codes. Example: Other: Rack and Pinion

Part F:

If you are changing any of the information in this section, include the changes under the “New” heading. If no change has been made to the original information, please write “NA” next to the item (under the “New” heading).
  1. Capacity, per the definition in the ASME §1.3, is the weight that the lift is designed to handle.

    Net Inside Platform Area is the useable square footage inside the car. This is the dimension that is used to calculate the allowable capacity of the lift. Measure this according to ASME § 2.16.

  2. Car Speed Up and Down must be listed. This is to be calculated per the definitions “rated speed” and “operating speed in the down direction” in ASME §1.3.

  3. Travel, per the definition in ASME §1.3, is the vertical distance traveled between bottom and top terminal landings.

    No. of Stops (Landings) is the number of floors at which the lift stops.

  4. No. of Openings is the number of openings front and rear per the definition in ASME §1.3. For example: 7 front and 3 rear

    Platform size: List the outside dimensions of the platform. See “Car Platform” in the ASME definitions.

  5. Gross weight is the total weight of the car, including the sling, platform, safeties and all auxiliary equipment attached to the car.

  6. Floor Designations: list the floors as they will be identified in the building. For example: LL-G-1 thru 5, or SB–B-G–1 thru 6.

PAGE 2:

Part G:

  1. Top Car Clearance for Electric Elevators: The shortest vertical distance between the top of the car crosshead, or the distance which any sheave or any other equipment mounted in or on the crosshead projects above the top of the car crosshead, whichever is greater, or, between the top of the car where no crosshead is provided and the nearest part of the overhead structure of any other obstruction, when the car floor is level with the top terminal landing. When determining top car clearance, you must use the formulas referred to in §§2.4.6, 2.47, 2.48, & 2.4.10.

    Top Car Clearance for Hydraulic Elevators: The shortest vertical distance within the hoistway between the crosshead or any other object on the car top that is higher than the crosshead and the top of the hoistway or the horizontal plane of the lowest obstruction at the top of the hoistway (i.e., the hoist beam). This measurement must be taken when the car is at its maximum upward movement (on the stop ring). Refer to §§3.4.4 through 3.4.8.

    Top CWT (Counterweight) Clearance: The shortest vertical distance between any part of the counterweight structure and the nearest part of the overhead structure or any other obstruction in the overhead.

    • For Electric Elevators: When determining top counterweight clearance, refer to §2.4.9.

    • For Hydraulic Elevators: When determining top counterweight clearance, refer to §3.4.6.

    Bottom Car Clearance: The clear vertical distance from the pit floor to the lowest structural or mechanical part, equipment, or device installed beneath the car platform, except guide shoes or rollers, safety jaw assemblies, and platform or guards, when the car rests on its fully compressed buffers.

    • For Electric Elevators: When determining bottom car clearance and refuge space, refer to §2.4.1.

    • For Hydraulic Elevators: When determining bottom car clearance and refuge space, refer to refer to §3.4.1.

  2. Top Car Refuge for Electric Elevators: An unobstructed horizontal area of not less than 5.4 sq. ft. must be provided on top of the car enclosure for refuge. It shall not be less than 24 inches on any side. The minimum vertical distance between the top of the car enclosure and the overhead structure or other obstruction at the top of the hoistway must be at least 43 inches. See §2.4.12.

    Top Car Refuge for Hydraulic Elevators: An unobstructed horizontal area of not less than 5.49 sq. ft. must be provided on top of the car enclosure for refuge. It shall not be less than 24 inches on any side. The minimum vertical distance between the top of the car enclosure and the horizontal plane described by the lowest point in the overhead structure must be at least 43 inches, when the car has reached its maximum upward movement. See §3.4.7.

    Bottom Refuge Space for Electric Elevators: The area a person can go to for safety in the event of an emergency. This space must meet the minimum area spelled out in §2.4.1. It is important to also follow §2.4.1.6 regarding striping any area that does not meet the minimum requirements for refuge spaces.

    Bottom Refuge Space for Hydraulic Elevators: The area a person can go to for safety in the event of an emergency. This space must meet the minimum area spelled out in §3.4.1.3. It is important to also follow §3.4.1.6 regarding striping any area that does not meet the minimum requirements for refuge spaces.

  3. Bottom Car Runby: There is a minimum and maximum distance permitted. It is the distance between the car buffer striker plate and the striking surface of the car buffer, when the car floor is level with the bottom terminal landing. This is the distance spelled out for Electric Elevators in §§ 2.4.2 thru 2.4.4 and for Hydraulic Elevators in §§3.4.2 and 3.4.3.

    Top Car Runby for Hydraulic Elevators: The distance the elevator car can run above its top terminal landing before the plunger strikes its mechanical stop. Refer to §§3.4.2 and 3.4.3.

  4. Bottom Counterweight Runby: The distance between the counterweight buffer striker plate and the striking surface of the counterweight buffer when the car floor is level with the top terminal landing.

    • For Bottom Counterweight Runby for Electric Elevators: Refer to §§2.4.2 and 2.4.4.

    • For Bottom Counterweight Runby for Hydraulic Elevators: Refer to §3.4.6.

  5. State the number of cables, chains, or other means of suspension. Only steel wire rope is permitted for elevator cars. Other types of lifts (such as Vertical Reciprocating Conveyors) may use other means of suspension. If an elevator is to use anything other than steel wire ropes a variance must be obtained.

    The Factor of Safety must be provided for an individual rope, chain or other type of suspension means.

  6. Interlocks are required unless specifically exempt by the code. If a “Labeled” interlock is not used, you must explain why. For example, you might state: “§12.3.1 permits combination mechanical locks and electrical contacts on a specific type of freight elevator at specific landings.”

    Note: VRCs require interlocks - see Advisory on VCRs.

  7. If the work you are doing affects either the structural or fire resistive properties of the building, you must have a building plan approval before the work is done. One way to check if a building approval is needed is to follow the code references. If any of them make the statement “you must comply with the building code”, you should assume that an approval from a Building Code Official is necessary. If a building plan approval is required and you do not complete Part L, your permit will be returned.

  8. If the answer to the preceding question is “Yes,” we need to know if the building plan approval included the work on the lifting device(s) associated with this alteration permit. In many cases, there is substantial alteration/renovation work being done to a building. This usually involves much more than the work associated with the elevator alteration. We want to make sure the elevator renovations that involve the structure were also included in the building approval.

  9. If the answer to either of the two preceding questions is “Yes,” you must provide the building approval information requested in Section L.

  10. Indicate the amount of voltage supplied to the disconnect and the controller. Verify that the electric service is three-phase.

Part H:

Follow the instructions on the application. You must provide a complete description of the scope of the work and you must cite the correct §8.6.3 or §8.7 references.
 
Controller changes have presented a particular problem. When doing a controller change, please report it in the following manner: In addition to listing the general section for a controller change (Electric Elevators: §8.7.27.4 and Hydraulic Elevators: §8.7.3.31.5), the application must state if there is a change in motion (Electric Elevators: §8.7.27.5 and Hydraulic Elevators: § 8.7.3.31.6) or a change in operation (Electric Elevators: §8.7.27.5 and Hydraulic Elevators: §8.7.3.31.6).
 
Check the definitions for clarification on what constitutes motion and operation changes. Per those definitions, list the type of controller being removed and the type being installed. You must use the terms as they are defined in the ASME A17.1 2000 –2002 Addenda.
 
Section 8.6.3.7 gives examples of devices that are required to be Listed/Certified. We want to know which devices you are replacing, so we can check to verify that they are properly labeled.

Parts I and J:

Provide complete contact information for the general contractor and the elevator company responsible for the installation of the lift.

Part K:

The name and contact information provided here should be for the person who can provide additional information. Also, your permit submission will be returned (either approved or for corrections and additional information) to this address.

PAGE 3:

Part L:

Provide the building name and street address.
 
The drawing number requested is from the elevator plan and the architectural/engineering plans. This number must match the elevator drawings being submitted to the Elevator Division for review. Having the design professional reference this number will verify that the design professional did in fact design the building around the design and specifications on the elevator plans. This will eliminate potential conflicts at the time of the final inspection. See advisories regarding this subject.
 
You must provide information regarding plan approval for the building in which the lifting device(s) will be installed.
 
If the building plan was approved by the Department of Labor & Industry (under either the Fire and Panic regulations or the Uniform Construction Code), include all the information requested in the appropriate sections.
 
If a local government has jurisdiction for the building, include all of the municipality approval information. It is important that we receive the name and phone number of the Building Code Official, in the event that we have any questions regarding the building approval. Since many municipalities are using third-party agencies (as opposed to their own employees) to enforce the UCC, having this information will facilitate contacting the appropriate person and our approval of your application. Provide this information in the appropriate section.
 
Note: Do not confuse the City of Philadelphia’s Department of Licenses and Inspections (L&I) with the Pennsylvania Department of Labor & Industry. If the City of Philadelphia approved the building, this should be listed in the municipality approval section.

Applicant Signature Box:

The name of the person filling out and submitting the application (not the design professional) should be printed here, and the same person should sign and date the form. Note that, on page 2, a different individual can be designated to receive a copy of the approved application.
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