Application for Approval of Structural Plans

LODGEMENT OF CERTIFICATE OF LIFT MAINTENANCE AND TESTING

Building Maintenance and Strata Management (Lift & Building Maintenance) Regulations.

COMMISIONER OF BUILDINGS IMPORTANT: BUILDING MANAGEMENT DEPARTMENT Please read the attached Explanatory Notes before completing this BUILDING PLAN AND MANAGEMENT DIVISION form. BUILDING AND CONSTRUCTION AUTHORITY Use CAPITAL LETTERS only to fill in all of the fields. 52 JURONG GATEWAY ROAD #10-01 SINGAPORE 608550

This form may take you 10 minutes to fill in. You will need the following information to fill in the form: Particulars of Building (I) Particulars of Lift(s) (IV) Particulars of Lift Owner (II) Confirmation of lodgement (V) Particulars of Lift Maintenance Contractor (III)

((Tick the appropriate box) *NEW LIFT(S) *RE-COMMISSIONING OF LIFT(S)

I PARTICULARS OF BUILDING

1) Name of Building (if any) :

2) Official Address(as approved by Inland Revenue Authority of Singapore): *Hse/Blk No. :

*Road Name :

*Postal Code :

3) *Development Type : (Tick the appropriate box)

Commercial

Industrial

Institutional and others

Residential (Landed)

Residential (Non-landed)

Others (Please specify) ______

For Office Use

File Ref. No. : Appln No. :

* MandatoryII PARTICULARS Field OF LIFT OWNER

BPMV_BMD_BMS/SF-1 Page 1 of 6 Version 1.7 [Jan 2015] 1) *Name of lift owner:

2) *UEN/NRIC/FIN No: (Delete as appropriate)

3) Postal Address : *Hse/Blk No. :

*Road Name :

Building Name (if any) :

* Level/Unit No.: -

*Postal Code:

4) * Telephone No. : Or Handphone No:

5) Fax No. :

6) *Email Address. :

III PARTICULARS OF LIFT MAINTENANCE CONTRACTOR

1) *Name of Lift Maintenance Contractor

2) *Frequency of periodic maintenance : (Tick the appropriate box)

Weekly Fortnightly Monthly

Others (Please specify) ______

* MandatoryIV PARTICULARS Field OF LIFT(S)#

BPMV_BMD_BMS/SF-1 Page 2 of 6 Version 1.7 [Jan 2015] 1) *Size of Lift (LxBxH) : ______mm ______mm ______mm

2) *Maximum Load : ______kg

3) *Capacity : ______persons

4) *Type and Lift number of the lift (s): (Tick the appropriate box) Passenger Lift / No: ______Fire Lift / Goods Lift / No: ______Home Lift / No: ______Passenger No: ______Car Lift / No: (Handicap)Lift / No: ______Fire (Handicap) Lift / ______Stair / Chair Lift / No : No : ______Observation Lift (Bubble lift) / No: ______Platform Lift / No: ______

5) *Ma nufa cture r :

V CONFIRMATION OF LODGEMENT OF THE FOLLOWING:

I confirm that the information provided above are true and accurate to the best of my knowledge. I have also attached the following documents together with this lodgement

(Tick the appropriate box)

1) Certificate of Lift Maintenance & Testing

2) Form BPD_CSC04 or BPMV BMD BMS/C2

3) Lift Location plan

4) Letter of approval from BCA (For lift not complying with SS CP2: 2000)

5) Lodgment Fee : $______

______Name of Applicant

______Signature of Applicant

Date: ______

BPMV_BMD_BMS/SF-1 Page 3 of 6 Version 1.7 [Jan 2015] # Use separate sheet if necessary * Mandatory Field

BPMV_BMD_BMS/SF-1 Page 4 of 6 Version 1.7 [Jan 2015] EXPLANATORY NOTES

(A) GENERAL

1. This form is to be used only for new / re-commissioning of lifts. Application for renewal should be made via the electronic lift lodgement system. 2. For lodgement of more than one lift, only lifts in the same address may be lodged in a single form. 3. The lift number of the lift(s) should be numerical eg 1, 2, 3, etc or alphabetical eg A, B, C, etc or alpha-numerical eg P1, P2, P3, etc. 4. An acknowledgement of your lodgement will be sent to you by post.

(B) DOCUMENTS

Please submit the following documents:

(a) Certificate of Lift Maintenance and Testing, (b) One copy of lift location plan showing the location(s) and the numbering of lift(s). (applicable to new application) (c) One copy of Form BPD_CSC04 - Certificate of Supervision of Installation of Escalator(s)/Lift(s) or BPMV BMD BMS/C2 - Certificate of Supervision of Major Alterations or Replacement of Lift(s) (d) Letter approval from BCA for non SS CP2: 2000 compliance lift.

NOTE:  All lift location plans must be in either A3 or A4 size.

(C) VALIDITY

The Certificate of Lift Maintenance and Testing is valid up to the last day of the month 12 months from the date of lodgement.

(D) LODGEMENT FEE

Each lodgement of lift(s) in the same address shall be accompanied by the following fees:-

 $20 per lift for first 10 lifts; and  $10 per lift for each lift in excess of 10

BPMV_BMD_BMS/SF-1 Page 5 of 6 Version 1.7 [Jan 2015] ______Company Stamp

BPMV_BMD_BMS/SF-1 Page 6 of 6 Version 1.7 [Jan 2015]