Contractor

Job Name:
Name:
Contractor
Job Address:
Contact:
Job City and Contractor
State Phone #:
Elevator Data
Class of
Loading:
Car Capacity: Elevator Type: □Hydraulic □Traction
Power Supply □Power
Operation: Wall Construction: □Masonry □Drywall
(v & Hz)
□Manual
Hoistway □NEMA 1 □NEMA 4 Class ____, Group ____
Machine
Room
□NEMA 1 □NEMA 4 Class ___, Group ____
Conditions: □NEMA 4X □NEMA 7/9 Division ______
Conditions: □NEMA 4X □NEMA 7/9 Division ______

IMPORTANT! Please indicate the location of Elevator Counterweight (if any) and
any other obstructions not shown. Please also indicate the location of all Car and
Hall Push Buttons.

ADDITIONAL OPENINGS
Floor # Front/Rear Floor Height Opening Height
□ Front □Rear
□ Front □Rear
□ Front □Rear
□ Front □Rear
□ Front □Rear
□ Front □Rear

Hoistway Survey Sheet General Information & Layout

COURION
3044 Lambdin Avenue - St. Louis, MO 63115
(800) 533-5760 or (314) 533-5700 - (314) 533-5720 (fax)
sales@couriondoors.com - www.couriondoors.com
Entrance Wall Car Gate Survey Form
and Framing Dimensions Required from both sides for 2-Sided Car