Hot Work Permit Request

Hot Work Permit Form

  • Please tell us who will do the work:

    Note: Hot Work Permits must be submitted 72 hours in advance of work to be done.

  • Tell us about the work itself:

  • Date Format: MM slash DD slash YYYY
  • :
  • (not to exceed a week from start date)
    Date Format: MM slash DD slash YYYY
  • :

  • Verify all of the following:

    Check all boxes

  • Please indicate if your work will require detector heads to be covered. PROTECTION MUST BE REMOVED AT THE END OF EACH WORK DAY.

  • I attest that the above precautions are sufficient to prevent fire and unintended fire alarms, as well as to assure the health and safety of workers, bystanders, and building occupants. I understand that my company may be responsible for any fines incurred due to false alarms.

  • Enter your name. This verifies that you have personally surveyed the work area and will stop work if the above conditions are not met.

  • PLEASE PRINT THIS FORM PRIOR TO SUBMISSION for your records. You will also receive a copy of your submission via email. Please print and post this email at the work site. Scroll down, complete the "CAPTCHA", and press "Submit" to notify EHS and Facilities Management. If you have any questions, call EHS at 303-273-3316.