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Alleged Safety Or Health Hazards (DOSH Complaint Form)

Employees use this form to report work place conditions which jeopardize workers safety and health.



Form
F418-052-000

Alt Language(s):
Español
 
Alleged Safety Or Health Hazards (DOSH Complaint Form) Spanish - Presuntos Riesgos de Salud y Seguridad (Formulario de Queja de DOSH)

Employees use this complaint form to report work place conditions which jeopardize workers safety and health.



Form
F418-052-999

Alt Language(s):
Inglés
 
Application for Amusement Ride or Air Supported Structure Operating Permit

To apply for a decal for an amusement ride or air supported structure.



Form
F500-010-000
 
Application for Electrical Contractors License

Application used to get an electrical contractors license



Form
F500-018-000
 
Electrical/Telecommunications Contractor's Bond to the State of WA
Used to show proof of a bond in the State of Washington.

Form
F500-019-000
 
Electrical/Telecommunications Contractor Assignment of Savings Account
This is used to assign ownership interest to a savings account that is held by L&I for one year after a contractor's license has expired or after the contractor ceases business in Washington State.

Form
F500-020-000
 
Request for Duplicate or Replacement License or Certificate

To request a duplicate or replacement of your Washington state electrical license or certificate.



Form
F500-032-000
 
Affidavit of Experience

This affidavit is used to record the hours of a trainee's electrical experience with direct supervision under a Washington certified journeyman, master or specialty electrician.



Form
F500-043-000
 
Request for Change of Address

Used by electrical licensee to notify L&I of an address change.



Form
F500-044-000
 
Administrator / Electrician / Master Electrician Certificate Renewal

To renew your electrical certificate. Fee varies depending on renewal type.



Form
F500-045-000
 
Application to Establish an Account and Access to L&I's Electrical Permit & Inspection System (EPIS) with L&I's Miscellaneous Accounts
To request access to L&I's EPIS - Miscellaneous Accounts

Form
F500-054-000
 
Electrical Installation Variance Application

To apply for a variance which is an allowable deviation from specific requirements of a National Electrical Code section, or the WAC 296-46B where the proposed alternate methods will maintain equivalent safety.



Form
F500-063-000
 
Application for Amusement Ride Inspector Certification

Application to be certified as an amusement ride inspector.



Form
F500-065-000
 
Affidavit for Amusement Rides
Affidavit of experience to apply for cetification as a Amusement Ride Inspector.

Form
F500-066-000
 
Electrical Education Course Application

Used to get approval of a course as an electrical continuing education class. This application must be received by L&I at least 30 days before the course is offered.



Form
F500-068-000
 
Reassignment of Savings Account or Time Deposit - Electrical Contractor

A reassignment is permitted only when (1) the Electrical Contractor (assignor) changes the name of the business; (2) the Electrical Contractor transfers the funds to a new account; or (3) the financial institution changes the account number.



Form
F500-072-000
 
Investigation Report
To notify L&I on any electrical work that you think is illegal.

Form
F500-076-000
 
Electrical / Telecommunication Contractor's License Renewal Notice

This form is used to notify you that your license will expire and for you to use to renew your license.



Form
F500-077-000
 
Account Deposit for Contractor's or Miscellaneous Account Holder's

Used to deposit money into your L&I account (Electrical).



Form
F500-080-000
 
Electrical Inspection Witness Statement
Used to gather information from a person who was a witness to electrical work that is being investigated by L&I.

Form
F500-087-000
 
Application for Master Electrician Certification Examination

Use this form to apply for the master electrician exam.



Form
F500-088-000
 
Electrical Continuing Education Instructor Application

An application to receive approval from L&I to instruct electrical continuing education courses.



Form
F500-090-000
 
Contractor Electrical Work Permit Application

This application is used to apply for a valid electrical permit from L&I. 4 pages.



Form
F500-093-000
 
Property Owner Electrical Work Permit Application

This application is used to apply for a valid electrical permit. 5 pages.



Form
F500-094-000
 
Application for Telecommunications Contractor's License

Application used to get an telecommunications contractors license.



Form
F503-008-000
 
Change Assignment of Administrator/Master Certificate

To assign or unassign your status as an administrator or master.



Form
F503-009-000
 
Non-Compliance Report - Boiler & Pressure Vessel Inspection
Used by L&I inspectors when a boiler or pressure vessel does not pass inspection. You can only mail or fax this form to L&I. E-mailed forms are NOT accepted.

Form
F620-012-000
 
Shop and Field Inspection Report
Used by L&I inspectors when they inspect boilers.

Form
F620-027-000
 
Boiler / Pressure Vessel Water Heater Installation or Reinstallation Permit
This form is filled out by the installer, contractor and/or owner who wants to install or reinstall a boiler.

Form
F620-032-000
 
Application for Certificate of Competency as an Inspector of Pressure Retaining Items
To apply for a certificate of competency as an Inspector of Pressure Retaining items. You can only mail or fax this form to L&I. Emailed forms are not accepted. NOTE: Applications MUST be received no later than 30 days prior to the exam date. Incomplete applications WILL NOT be accepted.

Form
F620-040-000
 
Boiler/Pressure Vessel Clearance Variance Request
To request a clearance variance on a boiler or pressure vessel. You can only mail or fax this form to L&I. E-mailed forms are not accepted.

Form
F620-041-000
 
Rental Boiler Operating Permit - Good at this Location Only
To request a permit to use a rental boiler at one location only.

Form
F620-042-000
 
Historical Boilers Inspection Guideline
Inspection sheet for boiler inspectors. 4 pages.

Form
F620-043-000
 
Incident Report Boiler or Pressure Vessel
Used for the reporting of incident with boilers or a pressure vessels.

Form
F620-044-000
 
Elevator Installation Variance Application

Property owner or elevator company can apply for a variance to install an elevator. 4 pages.



Form
F621-048-000
 
Elevator Information Update

This form is required by L&I before they can process any changes to the ownership, physical or mailing address.



Form
F621-050-000
 
Elevator Five-Year Safety Test Report

This report is used by L&I for its five-year safety inspection of an elevator.



Form
F621-051-000
 
Hydraulic Overpressure Test

To be submitted when a valve is changed or a seal is broken.



Form
F621-052-000
 
If Family Members Work for You, Know Your Obligations (English/Thai)

Fact sheet: Provides an overview and resources to know your obligations when you have family members working for you. Relatives, including children, must be treated as employees with the same rights as any other paid worker in the state of Washington.



Publication
F101-077-303

Alt Language(s):
English/中国的
English/한국의
English/русский
English/Español
English/Việt
 





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