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HOT WORK PERMIT

We, the undersigned, agree to observe the restrictions for hot works on site and have received a briefing on the restrictions
for work in the affected area, the emergency egress requirements and any special conditions which have been identified as
necessary in the maintenance of health, safety and welfare at the works.

NAME (PRINT) ROLE (PRINT) SIGNATURE

PERMIT CANCELLATION ON COMPLETION OF WORKS*
The work has been completed and materials cleared away from all areas adjacent to the working area including floors,
ceilings and partitions have been inspected and have been found to be in fire safe condition.

NAME (PRINT) ROLE (PRINT) SIGNATURE DATE TIME
SITE SUPERVISOR

60 MINUTES AFTER COMPLETION OF WORKS*
The work area and all areas adjacent to the working area including floors, ceilings and partitions have been inspected and
have been found to be in a fire safe condition. This permit is cancelled; any further hot works will require a new permit.

NAME (PRINT) ROLE (PRINT) SIGNATURE DATE TIME
SITE SUPERVISOR

*To be completed by Site Supervisor

17160 Hot Works Brochure 28pp A5.indd 18 13/03/2018 16:30