Hot Works Permit

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Acknowledgement Required

I confirm that this request to obtain a Hot Works Permit complies with Relevant Legislation and Curtin University Policies.
I have inspected the workplace, and have determined and put into place appropriate control measures to minimise health, safety and operational risks, and I agree to accept full responsibility for these risks.
I have read and understood the following:
Contactor Safety Handbook
Hot Works Permit Guide

I accept and acknowledge all of the above.

Documents Required

Only standard document types accepted. Please name files appropriately.
NOTE - Combined document filesize limit is only 15MB.

1. Attach a Location Plan

2. Attach a Services Plan / Survey Infomation

3. Attach a Work Methodology

4. Attach a Risk Management Plan

Permit Request Details The Curtin project number or project name

Brief Description of Works:
(inc. building number, area and/or other specific location details)

Permit Request Duration Start date

End date

Your Details Your Company's name

Your name

Your email address. We send important administration notices to this address

Your contact number

Curtin Permit Manager Details Your Curtin Permit Manager name

The information gathered from this form will be sent to this Curtin email address

Your Curtin Permit Manager phone number

On-Site Contact The Site Contact's name

The Site Contact's job title

The Site Contact's contact number

I confirm that all of the supporting documentation and information contained in this access permit request is complete and accurate.