Pasco County
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Hot Works Permit

  1. HOT WORKS PERMIT
    Per OSHA 1910.252, if the required precautions in this permit cannot be met, hot works is NOT PERMITTED.
  2. If exact address is not available, use nearest address.
  3. What task(s) are being performed?
  4. TYPE OF HOT WORKS OPERATION*
  5. FIRE WATCH CHECKLIST
    Fire watch personnel may not perform other jobs or duties which detract them from their primary responsibility.
  6. Fire watch provide; continuously during work, breaks, and during shift changes*
  7. Fire watch is equipped with suitable fire extinguishers*
  8. Fire watch employee trained in the use of fire suppression equipment*
  9. Fire watch required for adjoining rooms/areas, above, and below*
  10. RESCUE SERVICES NOTIFICATIONS
  11. Pasco County Fire Rescue Dispatch*
  12. Note: Immediately call 911 if an emergency occurs.
  13. Jeffrey Brockman O: 813-929-2755 x6907 C: 727-277-4781
    Safety Manager | Public Infrastructure
  14. Hot Works Authorization
    I understand and certify that this Hot Works Permit has been authorized and the information contained herein is accurate. All team members have been trained in accordance with OSHA 1910.252. This permit is not valid unless ALL sections are completed. The permit is valid only for the duration of this job.
  15. Leave This Blank:

  16. This field is not part of the form submission.