Variance Request This form is used by elevator companies to request a variance. All requests for variance will need photos of the condition to support request consideration. Please forward your confirmation email with photo attachments to firstname.lastname@example.org . Current Start Preview Complete Indicates required field Requestor Requestor First Name Requestor Last Name Requestor Position/Title Email Company Company Name Email Phone Format: xxx-xxx-xxxx Company Street Address Company Street Address 2 Suite #, Apt #, etc. City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Project Address Project/Building Name Physical Street Address City/Town County - Select -AlamanceAlexanderAlleghanyAnsonAsheAveryBeaufortBertieBladenBrunswickBuncombeBurkeCabarrusCaldwellCamdenCarteretCaswellCatawbaChathamCherokeeChowanClayClevelandColumbusCravenCumberlandCurrituckDareDavidsonDavieDuplinDurhamEdgecombeForsythFranklinGastonGatesGrahamGranvilleGreeneGuilfordHalifaxHarnettHaywoodHendersonHertfordHokeHydeIredellJacksonJohnstonJonesLeeLenoirLincolnMaconMadisonMartinMcDowellMecklenburgMitchellMontgomeryMooreNashNew HanoverNorthamptonOnslowOrangePamlicoPasquotankPenderPerquimansPersonPittPolkRandolphRichmondRobesonRockinghamRowanRutherfordSampsonScotlandStanlyStokesSurrySwainTransylvaniaTyrrellUnionVanceWakeWarrenWashingtonWataugaWayneWilkesWilsonYadkinYancey NCDOL State ID# *If submitting for multiple state numbers, please separate by commas Code Section Reason Variance Requested Status message Pursuant to 13 NCAC 15 .0107, the Director of the N.C. Department of Labor, Elevator and Amusement Device Bureau may at his/her discretion grant exceptions from the requirements of the Elevator Safety Act of North Carolina. Thus, after reviewing your request, it is the decision of the Director that this variance be approved or denied if determined that the exception requested will or will not provide equivalent safety to the original design or device pursuant to 13 NCAC 15 .0107. Please note the validity of this electronic variance request is contingent upon the requestor’s adherence with the provisions contained in this original variance and additional documentation provided as submitted and stamped approved. Any deviations from the original request will prompt a revocation of the permission granted by the N.C. Department of Labor, Elevator and Amusement Device Bureau.