Permit Request • CampusOptics

This is the Hot Work Permit Form. This form must be completed before hot work activity. You must receive approval from EHS before hot work commences.

Requester

Email Address* Required

Phone Number* Required

First Name* Required

Last Name* Required

Start Date* Required

Start Time* Required

Expiration Date* Required

Expiration Time* Required

Campus, Building, or Outdoor Area* Required

Additional Location Details

Hot Work be performed in the next 72 hours?* Required

Type of Hot Work Activity* Required

Scope of Hot Work Activity* Required

Contractor Company Name/NSU Physical Plant Work Unit* Required

Hot Work To be Performed By* Required

Name of Person Conducting the Hot Work* Required

Phone number of on-site contact* Required

Outside business hours?* Required

Organize a work area Fire Watch* Required

Fire System Impairment?* Required

NSU SOC Dispatch notified?* Required

Post Work Fire Watch organized?* Required

Is a building wide Fire Watch needed?* Required

Contact Fire Life Safety Manager* Required

Add files to upload as supporting documentation along with your permit request.

Files