Hot Work Permit Application

Hot Work Permit Application

Project Information

Permit Type*

Select

Start Date of Hot Work Activity*

End Date of Hot Work Activity*

Location (Nearest Building #)

Select or enter value

Scope of Work*

Please describe the scope of work.

Applicant Name*

Department/College*

Contact Phone Number*

Contact Email*

Permit Status will be sent to this email address.

Name of Person (Fire Watch Duties)*

Start Time (Fire Watch)

End Time (Fire Watch)

Required Precautions Checklist

Available fire sprinklers, hose streams and extinguishers are in service?*

Yes

Hot Work Equipment in good repair?*

Yes

Within 35 Feet (11 meters) of Work

Flammable liquids, dust, lint and oily deposits removed?*

Yes

Explosive atmosphere in area eliminated?*

Yes

Floors swept clean of combustibles?*

Yes

Combustibles floors wet down, covered with damp sand, metal or fire-resistive tarpaulins?*

Yes

Remove other combustibles or protect with fire-resistive tarpaulins suspended beneath work to collect sparks?*

Yes

All wall and floor openings covered?*

Yes

Work on Walls or Ceilings

Construction noncombustible and without combustible covering?*

Yes

Combustibles moved away from other side of walls?*

Yes

Work on Enclosed Equipment

Equipment cleaned of all combustibles?*

Yes

Containers purged of flammable vapors?*

Yes

Fire Watch

Fire Watch to be provided during and for 30 minutes after work in all areas?*

Yes

Supplied with appropriate extinguisher(s)?*

Yes

Trained in the use of equipment and in sound fire alarm?*

Yes

Other Precautions Taken

Please provide an explanation for all items marked "NO".

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