Permit Request • CampusOptics

Submit this form to CapU Safety in advance of the first planned workday.

This form is initiated by the Contractor requesting building access.
Provide all requested information on the permit request.
This request will be reviewed and verified by CapU Safety prior to approval for access.
Upon approval, CapU Safety will authorize the request and the CapU Liaison will inform the requesting contractor.
All contractor keys must be signed out from Security.
Roof access will only be provided upon receipt of a Roof Access Permit.
All contractors must attend a site orientation prior to starting work and annually thereafter.
Contractors will sign in and out with security each day that they are on campus.
Attach copies of hazard/risk assessments, safe work procedures, training certificates and other safety documents below.

PLEASE CONTACT YOUR CAPU LIAISON FOR ADDITIONAL INFORMATION

Requester

Email Address* Required

Phone Number* Required

First Name* Required

Last Name* Required

Start Date* Required

Start Time* Required

Expiration Date* Required

Expiration Time* Required

Campus, Building, or Outdoor Area* Required

Additional Location Details

Project Name* Required

Scope of Project Work* Required

CapU Liason* Required

CapU Liaison Cell* Required

Contractor Company Name* Required

Office* Required

Site Supervisor* Required

Site Supervisor Cell* Required

Add files to upload as supporting documentation along with your permit request.

Files