Hot Work Permit

This hot work permit is required for operations involving open flames or producing heat and/or sparks. This includes, but is not limited to: brazing, cutting, grinding, soldering, thawing pipe, torch-applied roofing, and cadwelding. This permit must be completed and approved prior to any hot work operation, and posted on-site during same. This permit is for one (1) day only.

TO BE FILLED OUT BY THE PROJECT MANAGER/CONTRACTOR OF JOB.

For questions regarding this permit contact the ODU Office of Fire Prevention at 757-683-5166.

Page 1 of 2 - Project and Staff Information

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Hot Work Being Done By Hot Work Being Done By First Last
Select One

Select One ODU Employee Contractor
Phone Number Phone Number * - ### - ### ####
Hot Work Project
Work Order Number
Submitted Date Submitted Date / MM / DD YYYY
Expected Start Date Expected Start Date / MM / DD YYYY
Expected Start Time Expected Start Time : HH MM AM/PM
Expected Stop Date Expected Stop Date / MM / DD YYYY
Building Name *
Floor/Location
Nature of Job/Object
ODU Project Manager *
I verify the above location has been examined, the precautions checked on the Required Precautions Checklist have been taken to prevent fire, and permission is authorized for work.

Contractor Supervisor Name/Facilities Staff Name *
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Phone Number Phone Number * - ### - ### ####
Hot Work Technician Name *
Phone Number Phone Number * - ### - ### ####
I have reviewed all requirements; area is safe for Hot work.
Date Date / MM / DD YYYY
Time Time : HH MM AM/PM
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
All guidelines have been followed and hot work is complete.
Date Date / MM / DD YYYY
Time Time : HH MM AM/PM
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Fire Alarm Technician Name if Applicable
Phone Number Phone Number - ### - ### ####
Fire detection disabled.
Date Date / MM / DD YYYY
Time Time : HH MM AM/PM
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Fire detection reactivated.
Date Date / MM / DD YYYY
Time Time : HH MM AM/PM
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

Hot Work Permit

Hot Work Permit

Page 1 of 2 - Project and Staff Information