Work Permit Application

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Under IAA General Ordinance No. 3-2014, all construction, remodeling, additions, alterations, utility work, safety, environmental, or security work (hereinafter sometimes referred to individually and/or collectively as “Work”), of any kind or nature whatsoever, on property owned or leased by the Indianapolis Airport Authority (“IAA”), shall require a “work permit” issued by the IAA (the “Permit”). A Permit will be issued only to the entity, or an authorized representative of the entity, initiating the Work (the “Authorized Representative”).

Contractor/Tenant Details

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Organization's Legal Name*

If applying as an individual, please enter your first and last name or type "N/A"

Organization Position/Title

First or Single Name*

Last Name

Business Phone Number*

Extension

Secondary Phone Number

Extension

Email Address*

Organization's Legal Address*

If applying as an individual, please enter your home address

City/Town*

Province/State*

Postal/Zip Code*

Emergency Contact (24/7) Details

Same as Contractor/Tenant

First or Single Name

Last Name

Business Phone Number

Extension

Secondary Phone Number

Extension

Email Address

Owner Details

Organization Name

Organization Position/Title

First or Single Name

Last Name

Business Phone Number

Extension

Secondary Phone Number

Extension

Email Address

Date / Time

Special Instructions:

The Authorized Representative must submit the Application (along with detailed plans) to IAA at least two (2) weeks prior to the desired start date. The IAA’s Work Permit Committee (the “Committee”) reviews work permit applications daily (as needed), and Applications can be submitted daily in order to get on the agenda for review. However, with respect to emergency repairs (e.g., major equipment replacements or repairs requiring immediate attention), the Work Permit Application (the “Application”) shall be submitted to the IAA by no later than 5:00 p.m. of the next business day (Monday-Friday).

Start Date*

Please select the date.

End Date*

Please select the date.

Location(s)

RIGHT CLICK a point for a location, and multiple points to create a segment.

Road Jurisdictions	Main Roads	Estimated Price	Conditions

Possible conflicts

Possible conflicts were detected. Note that items adjacent to the specified location(s) may be listed.

A collection of events/permits that may conflict with the entered locations.
Id	Type	Reason	Location	Start Date	End Date

Work Permit Details

Estimated Cost:

Location of Proposed Work (Building #, Room #, Concourse, address, etc.)

Scope of Work:

Impairing Fire Protection Systems:

All work that will involve impairing the Fire Protection System requires a special “Red Tag Permit”. This tag is issued by calling the Building Maintenance Request line at 317-487-5158 or email inspectionservices@ind.com. This permit shall be obtained 24 hours prior to work being performed. This work may require a shut-down of alarm systems, approved ventilation to the outside, possession of an appropriate fire extinguisher, a stand-by person on fire watch and work on “premium” time. In addition, the “fire watch person” will be expected to have the Airport emergency telephone number (911) in their possession and be able, in an emergency, to explain exactly their location. System shutdown will only occur once weekly. Advance scheduling is suggested.

Hot Works (i.e. Welding and Cutting):

You can apply for Hot Work Application HERE. If you select "Yes" below, complete the application and upload it in the File Upload section at the end of this form. All hot work requires a special “Yellow Hot Work Permit” issued by the IAA Planning and Development Department and can be obtained by calling 317-487-5159 or email inspectionservices@ind.com. This should be obtained 24 hours prior to start of work. This work may require a shut-down of alarm systems, approved ventilation to the outside, possession of an appropriate fire extinguisher, a stand-by person on fire watch and work on “premium” time. In addition, the “fire watch person” will be expected to have the Airport emergency telephone number (911) in their possession and be able, in an emergency situation, to explain exactly their location.

Electrical:

29 CFR Part 1926, Subpart K

Lockout/Tag out:

29 CFR Part 1926, Subpart K
Please identify electrical panels and substations (if applicable) to this permit in the text box below. You must notify IAA through the Building Maintenance Service Request line by calling 317-487-5158, (for terminal substation work). A minimum of 48 hours’ notice is required prior to utility disruption.

Electrical Panels

Substations

Scaffolding:

29 CFR Part 1926, Subpart L

Fall Prevention:

29 CFR Part 1926, Subpart M

Cranes & Hoists:

29 CFR Part 1926, Subpart N

Excavations & Trenching:

29 CFR Part 1926, Subpart P

Confined Spaces:

29 CFR Part 1910, Subpart J
Attach your Confined Space Plan to this application below. Contractor is required to notify the Airport Control Center at (317) 487-5089 prior to and upon completion of confined space activities.

Handling Hazardous Materials:

29 CFR Part 1910, Subpart H

Work Including Toxic and/or Hazardous Substances:

29 CFR Part 1910, Subpart Z

Project Security Plan:

You can apply for Security Plan HERE. A detailed security plan will need to be submitted if the proposed work is in a secured area. The project security plan should reflect that all contractors are aware of and will abide by the 6 to 1 ratio, 500 foot in line of sight rule.

Handling of Refrigerants, Section 608, Clean Air Act:

40 CFR Part 82, Subpart F

Data Cabling:

All Data cabling must meet EIA/TIA cabling standards. Routing of data cabling path must be indicated on drawing, which should be submitted below.

List all sub-contractors working on job:

Please indicate which documents will be sent in with the Work Permit Application:

Certificate(s) and document(s) to be uploaded in File Upload section at the end of this form.

Insurance Certificate
City Permit
Airspace Approval (7460 if above 25')
State Plan Review
Safety Plan
IAA/FAA Locates - Written Confirmation

Insurance expiry date

Please select the date.

Waiver of Subrogation:

Yes

Endorsement of Schedules:

Yes

Is there a Storm Water Pollution Prevention Plan (SWPPP)?

Office Use Only

This section can only be filled out by staff.

Staff file to be attached to certificate (PDF File Only)

Project Number:

Project Name/Description

Inspector

Note

Priority

File is Open or Closed

Extension 1

Please select the date.

Extension 2

Please select the date.

Extension 3

Please select the date.

File Uploads

Insurance Certificate(s)

Please note the COI Guidelines for both the COI-Owner: IAA and COI-Owner: Tenant.

Confined Space Plan:

Attach your Confined Space Plan to this application here. Contractor is required to notify the Airport Control Center at (317) 487-5089 prior to and upon completion of confined space activities.

Drawing of Data Cabling

All Data cabling must meet EIA/TIA cabling standards. Routing of data cabling path must be indicated on drawing.

City Permit

Airspace Approval (7460 if above 25')

State Plan Review

IAA/FAA Locates - Written Confirmation

Safety Plan

Hot Work Form

Please complete the template and upload the completed file to the designated field.

Template Sample

Additional Files

Work Permit Application

PREVIEW ONLY. You must register and log in to service to make application.

Please read carefully:

Contractor/Tenant Details

Emergency Contact (24/7) Details

Owner Details

Date / Time

Location(s)

Possible conflicts

Work Permit Details

Office Use Only

File Uploads

PREVIEW ONLY. You must register and log in to service to make application.

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