FMD-F-11-02.14.1.
4
Work Permit x
Hot Work Permit x
TENANT/UNIT/ESTABLISHMENT: _________________________ BUILDING: __________________________
AUTOMATION OF SWING GATE
WORK TO BE DONE (SPECIFY) _______________________________________________________________
8:00 AM
DATE (S):_______________________ TIME (from) ______________________ 5:00 PM
(to) ____________________
PERSONNEL TO BE ADMITTED INTO THE PREMISES:
SERAFIN ESTALANE
PROJECT Engineer/Supervisor: __________________________________ 0915-4632870
Contact No. _____________________
0917-7747775
SMART RYE AUTOMATICS Emergency No. _____________________
Name of Contractor / Company: _______________________________
PERSON-IN-CHARGE: SERAFIN ESTALANE
________________________________ ________________________________
________________________________ ________________________________
LIST OF POWER TOOLS / EQUIPMENT QUANTITY CHARACTERISTIC
WELDING MACHINE
___________________________________ 1
______________________ _____________________________
GRINDING TOOLS
___________________________________ 2
______________________ _____________________________
MISCELLANEOUS TOOLS
__________________________________ 1 LOT
______________________ ____________________________
FOR HOT WORK PERMIT:
JUN ISOLE
Fire watch Personnel: _______________________________ MARK MAGCAWAS
Welder: _________________________________
1
Portable Fire Extinguisher (QTY): _________ N/A
(Oxygen-Acetylene) Welder: _____________________________
Prepared by: SERAFIN ESTALANE
__________________________________ CONSTRUCTION SUPERVISOR
Designation : _____________________________
Contractor
I hereby certify that all works to be done within the duration of this permit will be in accordance with the
HOUSE RULES & REGULATIONS/CONSTRUCTION GUIDELINES set by ALI/APMC. I have understood all
provisions and rules in the pre-work SAFETY ORIENTATION as conducted by the Admin personnel.
MANAGER/ TENANT/OWNER: CONTRACTOR REPRESENTATIVE/ PROJECT LEADER:
______________________________ SERAFIN ESTALANE
________________________________
PRINTED NAME & SIGNATURE PRINTED NAME & SIGNATURE
APPROVED BY: ____________________________ ASSISTED BY: MOD ___________________________
COMMENTS: _______________________________________________________________________________
___________________________________________________________________________________________
Received by: _____________________________________ 11/20/23
Date Received: ___________________________
PRINTED NAME & SIGNATURE
INSPECTED BY:
_______________________________ ________________________________
Guard on Duty PM / TA
(To record workers time of entry / exit and ( For inspection the ff. Morning )
equipment at logbook )
1. Dedicated fire watch personnel must be at job site 30 minutes before and after scheduled hot work.
2. At least one (1) 20 lb. ABC fire extinguisher should be available at the work area.
3. There should be no combustible materials and if there are, they should be covered with metal sheet or non-
combustible cover. Appropriate ventilation should be provided when working with flammable gas.
4. The contractor and the project Engineer/ supervisor shall make sure that there will be no damage to the
surrounding area.
5. Any damage to the surrounding area caused by negligence shall be charged to the contractor.
6. Contractor must clean up the area after work.
7. Hot Work Permit should be filed everyday for the whole duration of the work.
* Accomplish this form in two copies: (1) Tenant’s/Establishment Copy and (2) Security/APMC Copy *
TERMS AND CONDITIONS
1. All work permits shall be accomplished and submitted one week prior to work commencement, in case of
urgent/emergency works; APMC PM/TA shall have the discretion for approval.
2. Workers shall accomplish a “Signed” Job Hazard Analysis (JHA) (under their company logo) that will
cover all activities stated in this permit and shall be submitted to the APMC PM/TA prior to Work/ Hotwork
Permit application or for urgent cases, prior to the commencement of work . Absence of JHA means non-
approval of work mobilization.
SAMPLE FORM:
ACTIVITY: AUTOMATION OF SWING GATE
ACTIVITY PROCEDURE / HAZARDS / IMPACT CONTROL MEASURES to
STEPS of the PROCEDURE Implement for the HAZARD
Electrical works Electrocution Electrical isolation / tagging system
Welding works Fire / eye injury Follow procedure and use PPE
Grinding works Finger / eye injury Follow procedure and use PPE
3. All works to be done shall not cause damage to exceed utility capacities of the leased area or building and
shall comply with pertinent government and safety regulations in accordance with the ALI/APMC House
Rules and Regulations and Construction Guidelines.
4. Painting or spraying shall be done when building is non-operational and air-conditioning is off. The
Property Manager has the right to confiscate the materials and equipment which are used for painting or
spraying.
5. Any work to be done that affects the adjacent tenants / common areas would be subjected for work
stoppage.
6. If the merchants/ workers continue to defy, work stoppage or orders from the PM, APMC / PM have the
right to confiscate materials or equipment to effect the stoppage.
7. Tampering of Work permits without the authorization of PM and other authorized representatives will
automatically render the work permit void.
8. Damages caused by construction works or any procedures of the like will not render ALI/ APMC liable.
9. Any person who shall be caught smoking within the building construction area shall be banned entry to
Building and shall be fined as specified on the Construction Guidelines.
10. Use of common utility has corresponding charges to be determined by the Property Manager.
Rev.03
