Permit Request • CampusOptics

Safety is the priority when it comes to something as dangerous as operating cranes on and around the University of Akron. It takes time to prepare for these events and usually involves several departments. It is best to schedule any lifts with at least 7-10 days' notice, but emergencies do occur that will shorten this time.

Requester Info

Email Address* Required

Phone Number* Required

First Name* Required

Last Name* Required

Permit Date & Time

Start Date* Required

Start Time* Required

Expiration Date* Required

Expiration Time* Required

Location

Name* Required

Additional Location Details

Crane Lift Safety Checklist

Requester Info:* Required

First Name ** Required

Last Name ** Required

Email Address ** Required

Phone Number ** Required

Permit Date & Time:* Required

Start Date ** Required

Start Time ** Required

Expiration Date ** Required

Expiration Time ** Required

Hot Work Permit: * Required

General Information* Required

Project Name/Location: * Required

Date of Operation: [Start Date]* Required

Date of Operations: [End Date]* Required

Crane Type: [e.g., Mobile Crane, Tower, Boom Truck, etc.]* Required

Crane Make/Model: [Insert Details]* Required

Maximum Lift Capacity: [Insert Capacity]* Required

Crane Operator: [Full Name, License No.]* Required

Crane Company Name: [Insert Company Name]* Required

Scope of Work* Required

Description of Work: [Brief summary of lifting operation, [e.g. lifting HVAC units]* Required

Estimated Number of Lifts: [Insert Number]* Required

Maximum Lift Weight: [Insert Weight]* Required

Lift Radius: [Insert Distance, if known]* Required

Has Capital Planning been notified* Required

Condition of Ground in the setup area* Required

Will emergency vehicle access be impeded, or FDC/hydrants blocked* Required

Any overhead or underground hazards:* Required

Any electrical hazards:* Required

Will lift exceed the 75% chart at any time? If yes this is a high hazard lift and will require additional review and PE approval* Required

Setup Time [Estimated]* Required

Contractor has contacted the city for a permit if any city street or lane is to be closed (7 days notice)* Required

Can building access and exit points, in the lift zone be blocked to prevent someone from walking into the lift zone? ADA access blocked? Any fire exits blocked? (List room numbers to be closed)* Required

Sidewalk and partial lane will be blocked:* Required

Can the buildings upper floor(s) be cleared/closed below lift area? (Need to verify area is clear before starting lift)* Required

Site Control: Safety equipment needed, spill kit, barricades, signage...etc..?* Required

Contact UA Parking for any disruptions to parking lots for lift staging. May arrange for cones and barricades in advance for shutting lots/spaces down* Required

Contact PFOC (OOPS ticket, work orders, utility coordination, tree trimming)* Required

Contact EOHS or PFOC Safety Officer (Will review safety plan but must be notified for any changes, or accidents)* Required

Submit Safety Plan: * Required

Add Supporting Documents

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

Files

UA Crane Lift Permit Request

Requester Info

Permit Date & Time

Fire Watch Date & Time

Location

Crane Lift Safety Checklist

Add Supporting Documents