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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
 
Extension Request

This form is to request a time extension from an unforeseen circumstances for overdue corrections for conveyances.



Form
F621-053-000
 
Test of Escalator Safety Devices

A licensed elevator mechanic shall perform this test once a year and mail a copy to L&I.



Form
F621-055-000
 
Conveyance Installation Approval by Building Official

Used by the installer to notify L&I that a conveyance is proposed for installation in a buildiing.



Form
F621-056-000
 
New Elevator Installation Checklist

Checklist for the elevator company/contractor to complete before the call L&I for an elevator inspection. Includes DEc 2010 letter on ASME checklists.



Form
F621-057-000
 
Owner Requested Red Tag Form

Used by the owner for red tagging a unit that is to be placed or to remain out of service.



Form
F621-063-000
 
Request for Duplicate Elevator Certificate

Used to request a duplicate elevator license or a duplicate operating permit for a conveyance.



Form
F621-065-000
 
Application for Licensure as an Elevator Mechanic

This is an application for certification as an Elevator Mechanic and is NOT a license to perform work. A contractor's license is still required by L&I.



Form
F621-067-000
 
Temporary Licensed Elevator Mechanic

This temporary license is limited to the mechanical and electrical operation, construction, installation, alteration, maintenance, inspection, relocation and repair of conveyances.



Form
F621-068-000
 
Licensed Elevator Contractor (LC) Operation

Contractors who install, construct, repair, alter or maintain elevators need to be licensed by the Elevator Program through L&I and with L&I's contractor registration program.



Form
F621-069-000
 
Mobile Cranes/Derricks Worksheet for Construction Industry

Mobile Cranes/Derricks Worksheet for Construction Industry



Form
F416-043-000
 
Cranes, Derricks and Material Handling Devices Worksheet for Maritime Industry

Use this form for the inspection of cranes, derricks and materials handling devices on waterfront operations



Form
F416-051-000
 
License Requirements for Elevator Mechanics and Contractors
Fact sheet: Explains licensing and testing requirements for mechanics who work on elevators and for contractors who install, repair or maintain elevators.

Publication
F621-070-000
 
Application for Accreditation Cranes/Derricks and other Material Handling Devices

Application to become an accredited crane certifier.



Form
F416-063-000
 
Elevator Continuing Education Course Application

This is used to apply for approval of elevator related continuing education courses.



Form
F621-077-000
 
Notice of Deficiencies (Crane/Derrick Certification Examination)
Use this form for noting any deficiencies of cranes, derricks, material handling devices, spouts, suckers and similar equipment.

Form
F416-054-000
 
Elevator Continuing Education Instructor Application

Application to become an instructor for elevator related courses.



Form
F621-078-000
 
Plan Approval Request - Recreational Vehicles and Recreational Park Trailers

Plans to build recreational vehicles or park trailers need approval from L&I. This form is used as part of the approval process.



Form
F622-006-000
 





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