General Work Permit

Unit Name: Al Hazm Reference No.:

Contractor (Company Name) : Today’s Date: D /M /Y

Tenant Representative: Designation: Signature:

Contact Number: Start Date: D /M /Y

Email Address: Expiry Date: D /M /Y

Location/Unit #: Start Time: End Time:

To be filled out by Work Permit Applicant

Hot Work Permit Needed Yes No Working After Trading Hours ✔ Yes No

Isolation Permit Needed Yes No Confined Space Permit Needed Yes No

Type of Work: ( ☒ Tick box related to category )

✔ Access after Trading Hours
Deliveries
✔ Maintenance and Repairs
Inventory
Fire Alarm Testing
Modification to Store Marketing
Pest Control Services Roof Access
Mechanical Utility Shutdown (Please specify):
Electrical Hoarding Relocation
Specialty Leasing Other (Please specify):

Work Description:

To be filled out by Al Hazm Officials

Careful Not to activate fire alarm Use Loading dock No Noisy works Protect affected Mall areas
Protect MEP services Working in Mall common areas
□ Call: Prior to starting any works

To be filled out by Al Hazm Officials

Approved Rejected Postponed
Approved with Comments Cancelled Supporting Documents Attached

Remarks: * Please Ensure your working area is clean and clear of any debris after completion of work.

* Hard Copy of Permit should be posted and readily available on site for viewing.

Approved by:
Reviewed by: Designation: ________

Date: D /M /Y

Rev.0