In Case of Fire Call Public Safety: 278-6000 or 911 Revised August 2017
Sacramento State University
Welding, Cutting, or Hot Work Permit
Before starting hot work, review all safety precautions.
Can this job be avoided or is there a safer way?
This permit is required for temporary operations involving open flame or producing heat and/or
sparks: welding, cutting, brazing, grinding, soldering, or using a torch to thaw piping or heat
material. The permit applies only to this job, in the area specified, during the time and date noted.
1. Complete precaution & safeguard
checklist at right.
2. Complete this permit form and issue to
person performing hot work procedure.
3. Verify fire watch.
Precaution & safeguard checklist
Fire extinguisher available.
Hot work equipment in good repair.
Hazardous energy locked out per Lock out
Tag out procedures.
Requirements within 35 ft. of work:
Flammable liquids and combustible material
removed from area.
Floors swept and overhead structure cleaned
of dust, lint and debris.
Fire-resistive covers and metal shields
provided as needed.
All floor and wall openings covered and or
Walls/ceilings: remove combustibles away
from opposite side or adjacent structures.
Work on enclosed/confined equip:
Adequate ventilation is provided.
Atmosphere checked with gas detector.
Purge any flammable vapors.
Confined Space Permit obtained, if required.
Fire watch:
Trained and equipped Fire Watch provided
during operations and at least 30 minutes after.
Special instructions:
Hot work performed by:
University Employee
Work order no.:
Work to be performed:
Person performing work/dept.:
Supervisor signature: (obtain prior to job)
I have verified that the above location has been inspected and the
required precautions & safeguards have been taken. Permission
is authorized only for the work described above.
Notification Requirements:
Public Safety/Electrical Shop (
if smoke detectors are
Building Occupants
(possible odors):
EH&S (Special Hazards):
(Cannot Exceed
24 hrs.)
Date: Time:
Permit / Work
Date: Time:
Final check
Employee signature:
Supervisor signature: