WORK PERMIT

Control No. :

Tenant Name : GREGAN 101 CORPORATION Type of Work:

Floor / Unit No. : 3rd and 5th floor Major Works Minor Works
Name of Contractor : JESSECARE Category:
Name of Supervisor : JASON ASISTIN Civil Mechanical
Work Schedule : SATURDAY Electrical Plumbing
Time of Work : 9AM to 4PM Electronics Others PEST CONTROL

List of Authorized Personnel Work Description

LEO DOBLE GENERAL PEST CONTROL WORKS
JOSHSAM MIMAY GENERAL PEST CONTROL WORKS
JUNAR MEDINA GENERAL PEST CONTROL WORKS
MARK VALDULLA GENERAL PEST CONTROL WORKS
JOSE AIREL TENORIA GENERAL PEST CONTROL WORKS

Provide attachment(s) if necessary

OTHER REQUIREMENTS COMPLIANCE REMARKS

Contractor Induction / Safety Briefing
Complete Scope of Work
Bar Schedule/Gantt Chart
Job Hazard Statement Form
Hot Works Permit
Fire System Isolation Request Form
Gate Pass
Plan (Layout, Installation Details, etc.)

Requested by: Noted by: Reviewed by: Approved by:

_______________________ __JOHANN CHRISTIAN P. BALINGIT___ _______________________ _______________________

Contractor Tenant Representative Property Engineer Property Manager

Important Reminders:
1. All activities in the building must have an Approved Work Permit at least one (1) day for minor works and three (3) days for major works
prior to the actual Work Schedule.
2. Fully accomplish the Work Permit Form in duplicate copies (Admin/Security and Tenant) signed by the Contractor and Tenant's Authorized
Representative.
3. Maximum validity of the Work Permit is seven (7) days.
4. Submission/Approval of Work Permit is Monday to Friday from 9:00AM to 11:00AM and 2:00PM to 5:00PM at the Reception Area.
5. The Contractor's Supervisor/Authorized Representative must be present at the work area at all times. Absence of the Contractor's
Supervisor/Authorized Representative shall mean revocation of the Work Permit. Workers will be asked to vacate the area.
6. Workers are prohibited to use the Passenger Elevators.
7. Compliance to Building House Rules and Fit Out Guidelines is a must.
8. Supervisor and workers must log IN upon entry or log OUT prior to exit and present valid ID in exchange of "Worker ID" at Service Entrance
(Back Door Area).
9. Workers must display their "Worker ID" at all times and must be in their proper complete uniform.

CTP ALPHA TOWER

Block 2 Lot 7 Investment Dive, Madrigal Business Park
Brgy. Ayala Alabang, Muntinlupa City 1781
 JOB HAZARD STATEMENT FORM

Tenant Name : Work Permit No. :

Floor / Unit No. : Date :
Name of Contractor : Representative :

Scope of Works / Activity:

Hot Works Manual Handling Handling Hazardous Materials
Confined Work Space Fit-out Control Others :
Works at Height Works with Pressurized System
Noisy Works Handling with Sharps

Item No. Job Step Potential Hazard Controls Person-in-Charge

Note: This form should be completed by an authorized person (e.g. Project Manager, Engineer)

Prepared by: Reviewed by: Noted by:

_______________________________ _______________________ _______________________

Contractor Authorized Representative Property Engineer Property Manager

CTP ALPHA TOWER

Block 2 Lot 7 Investment Dive, Madrigal Business Park
Brgy. Ayala Alabang, Muntinlupa City 1781
 HOT WORKS PERMIT
Control No. :
Permit Status: Approved Disapproved
Tenant Name : Work Schedule :
Floor / Unit No. : Scheduled Time :
Name of Contractor :

To be filled up by Contractor (Hot Works Permit is to be used when work/activity requires welding, grinding, etc. within CTP ALPHA TOWER premises)
Expected
Work/Activity Description Time Start Time of
Completion

Does the work requires any isolation of impairment to the buildings Fire Protection System? Yes
(If Yes, please accomplish the attached Fire System Isolation Request Form)

Initial Checks Yes No

1. Fire Sprinkler System in service.
2. Fire Extinguishers are provided by the Contractor in the work area AT ALL TIMES.
3. Barriers/Curtains to be set up to prevent direct eye contact by other person with the arc of flame.

4. All Oxy-acetylene units must be trained in the use of fire fighting equipment and the location and operation of all
essential services on the relevant level of building.

5. Persons undertaking works are trained in the use of fire fighting equipment and the location and operation of all
essential services on the relevant level of building.

6. Ensure that:
Floors swept clean of combustibles within 10m of work area.
Combustible floors wet down, covered with damp sand or other shields within 10m of work area.
All combustible material of flammable liquids moved from work area.
All wall and floor openings are covered.
Spark retardant covers are suspended between works to collect sparks.
7. For works on walls and ceilings, ensure that:
The construction is non-combustible.
Combustibles are moved from the other side of the wall.
8. For works on enclosed equipment (e.g. tanks, containers, duct, dust collectors,etc.).
Ensure that no flammable gasses, dusts, liquids, etc. are present.
Clean all dust, rubbish, etc. out of the area before undertaking works.
9. All Personal Protective Equipment has been provided to all workers.
I certify that above conditions have been faithfully and honestly checked and carried out before work has commenced.

Contractor - Printed Name and Signature Date Time

Page 3 of 7
 HOT WORKS PERMIT
Control No. :
Final Checks Yes No

1. The work area and all adjacent areas where sparks may spread were inspected after works was completed,
ensuring no fire conditions were present.

2. The work area has been cleaned and cleared to prevent any hazards (trip, slip, fire, etc.).
3. Property Management /Security has been notified that Hot Works has been completed.
I certify that above checks have been faithfully and honestly carried out on completion of hot works.

Contractor - Printed Name and Signature Date Time

To be filled up by Property Management Staff/Security

Initial Checks Condition Found
1. Isolation of Smoke Detectors within the hot works area.
2. All items in the following Contractor's Initial Checklist have been checked and signed off.

3. The contractor must provide a written Safe Work Method Statement and Security attached to Hot Works Permit
before permit is approved.

All the above items have been carried out and checked and is recommended for approval.

Property Management Staff / Security Date Time

Approved by:

Property Manager Date Time

Final Checks Yes No

1. The work area and all adjacent areas where sparks may spread were inspected after works was completed,
ensuring no fire conditions occurred.

2. Hot Works was completed within estimated time.

3. De-isolation of Smoke Detectors within the hot works area.
I certify that above checks have been faithfully and honestly carried out on completion of hot works.

Contractor - Printed Name and Signature Date Time

CTP ALPHA TOWER

Block 2 Lot 7 Investment Dive, Madrigal Business Park
Brgy. Ayala Alabang, Muntinlupa City 1781

Page 4 of 7
WORKS PERMIT

activity requires welding, grinding, etc. within CTP ALPHA TOWER premises)
Actual
Time of
Completion

No

Comments

Page 5 of 7
WORKS PERMIT

Comments

Remarks

Comments

Page 6 of 7
 FIRE SYSTEM ISOLATION
Control No. :

This form is to be used when any isolation or impairment to the building fire system (e.g. Sprinkler, Hydrant, Smoke
Detector, Electrical Wiring Interconnect System) is carried out within CTP ALPHATOWER.

Tenant Name : Work Schedule :

Floor / Unit No. : Scheduled Time :
Name of Contractor :

To be filled up by Fire Protection System Contractor

Expected Actual
Reason / Description of Impairment Time Start Time of Time of
Completion Completion

Does this isolation or impairment due to Hot Works? Yes No

(If yes, please attach HOT WORKS PERMIT With Control No. _________________________ )

Check which Fire Protection Equipment is being impaired.

Smoke Detector Diesel / Electric Pump Transponders Fire Hydrant
Heat Detector Fire Indicator Panel Fire Hose Reel Emergency Warning Evacuation System

Requested by: Noted by: Reviewed by: Approved by:

_______________________ _______________________ _______________________ _______________________

Fire Pro. System Contractor Tenant Representative Property Engineer Property Manager

To be filled up by Fire Protection System Contractor (to be inspected by Property Management)

Isolated Zones :
No. of Fire Protection System Device Isolated :
Date of Isolation :
Time of Isolation :
Time of De-Isolation :
Fire Protection System Testing/Checking after De-isolation Remarks:
Normal
With Alarms / Malfunction / Defect
Specify :

Prepared by: Checked by: Reviewed by: Noted by:

_______________________ _______________________ _______________________ _______________________

Fire Pro. System Contractor Multi-Skilled Technician Property Engineer Property Manager

CTP ALPHA TOWER

Block 2 Lot 7 Investment Dive, Madrigal Business Park
Brgy. Ayala Alabang, Muntinlupa City 1781