Hot Work Permit Request

Request Date

MonthDayYear
Date
Hour Minutes
Submitted By

First NameLast Name
Submitter Email
example@example.com
Hot Work Permit Request
Hot Work Request #
Temporary Hot Work Permit (THWP): Specific date/time/location/scope; valid for one shift/day; reissue if extended.Hot Work Area Permit (Area Permit): For a DHWA; valid up to 6 months with periodic inspections and PAI re‑validation if conditions change.
Project Information
Building*
Floor*
Near/Room (Please be specific)*
Site Map Link
Work Order #
Department or Contractor
Work Details
Brief Description of Work*
Date Work to be Done*

MonthDayYear
Date
Start Time*
Anticipated End Time
Please pick a different Anticipated End Time as it cannot be within 5 minutes after the Start Time.
Start Date of Permit

MonthDayYear
Date
End Date of Permit

MonthDayYear
Date
Comments/Notes
Responsible Parties
Requestor*

First NameLast Name
Requestor Email*
example@example.com
requestor test
Supervisor*

First NameLast Name
Operators (All operators must be listed)*
Fire Watch*

First NameLast Name
Fire Watch Email Address*
example@example.com
Attachements
As Applicable, such as JHA/THA; SDS; site sketch/photos; roofing checklist; PRCS permit; impairment plan; equipment pre-use inspection; contractor training roster

Cancelof
Notification
Upon approval, you will receive an email with a pdf copy of the permit which you can print if needed. Also, you will receive a link to the HotWork Tag for use that day to complete and close out the HW request.

**This paragraph will be defined more.**
YesNo
Reason for Denial
Notes or Comments
Should be Empty:

Hot Work Permit Request

Project Information

Work Details

Responsible Parties

Attachements

Notification