Hot Work Permit Request Form

A Hot Work Permit is required for any temporary operation 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 Welding.

Instructions :

Complete the form by checking the boxes to indicate if the proper precautions have been taken.
Fill in the name of person performing hot work, date, type & nature of job, location of job, & jobsite supervisor.
Click on the “Submit” button below. The permit will then be sent to EH&S (Fire Safety Division or Safety Management Division) for review and approval. If submitting a handwritten request, please bring to EH&S for approval.
If all precautions have been met, you will receive an approved and signed hot work permit in your email. For handwritten request, pick up the approved permit from the EH&S building 24 hours after submitting the permit.

After picking up or printing the approved permit, ensure that the job's supervisor signs the permit, and post the permit on the jobsite for the duration of the job . After the job is completed, file the completed permit in department files.

A Hot Work Permit is required for any temporary operation 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 Welding. Instructions : Complete the form by checking the boxes to indicate if the proper precautions have been taken. Fill in the name of person performing hot work, date, type & nature of job, location of job, & jobsite supervisor. Click on the “Submit” button below. The permit will then be sent to EH&S (Fire Safety Division or Safety Management Division) for review and approval. If submitting a handwritten request, please bring to EH&S for approval. If all precautions have been met, you will receive an approved and signed hot work permit in your email. For handwritten request, pick up the approved permit from the EH&S building 24 hours after submitting the permit. After picking up or printing the approved permit, ensure that the job's supervisor signs the permit, and post the permit on the jobsite for the duration of the job . After the job is completed, file the completed permit in department files.
* Required fields
* Required Precautions Checklist : Available sprinklers, hose streams, and fire extinguishers are in service and operable. Hot Work equipment is in good repair. Requirements within 35 feet (11 meters) of work: Flammable liquids, dust, lint and oily deposits are removed. Explosive atmosphere in area is eliminated. Floors are swept clean. Combustible floors are wet down, and covered with damp or fire-resistive sheets. Other combustibles are removed when possible. Otherwise, fire-resistive tarpaulins or metal shields are used. All wall and floor openings are covered. Fire resistive tarpaulins are suspended beneath work. Work on walls or ceilings: Construction is noncombustible and without combustible covering or insulation. Combustibles on other side of walls are moved away. Work on enclosed equipment: Enclosed equipment is cleaned of all combustibles. Containers have been purged of flammable liquids/vapors. Fire Watch/Hot work area monitoring: Fire Watch will be provided during and for at least 30 minutes after work, including any breaks. Fire Watch is supplied with suitable fire extinguishers and fire fighting equipment. Fire Watch is trained in the use of fire extinguishing equipment and in sounding emergency alarm. Other Precautions Taken:
* Hot Work is being performed by : UC Irvine employee Contractor under UC Irvine supervision * Name of Person performing Hot Work: * Trained: Yes No * Person performing Fire Watch: * Company/Department: * Job's start date: * Location/Building/Floor/Room: * Nature of Job: I verify the above location has been examined and that the precautions checked on the Required Precautions Checklist have been taken to prevent fire, and permission is granted to perform this work. * Supervisor's email (a copy of this application will be forwarded to your supervisor):