Energized Electrical bWorkb Authorization bFormb 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling out the 'Location/Space' section. Enter the building name, specific location, date, issue time, and expiration date/time.
  3. In the 'Work to be Performed' section, provide a detailed description of the project and location, list personnel performing the work, and justify why the circuit/equipment cannot be de-energized.
  4. The 'Safety Precautions' section must be completed by a qualified person. Fill in details for shock risk assessment including voltage exposure and approach boundaries.
  5. Complete the arc flash risk assessment by identifying PPE category and arc flash boundary. List safe work practices and required PPE items.
  6. Confirm safety agreement by checking 'Yes' or 'No', then provide names and signatures of personnel doing the work.
  7. Ensure notification is completed by confirming if personnel who may be impacted have been informed.
  8. Check any additional permits required for your work type before obtaining necessary approvals from responsible parties.
  9. Finally, document work completion with date and time once electrical work is finished.

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The circuits and equipment to be worked on shall be disconnected from all electric energy sources. Control circuit devices, such as push buttons, selector switches, and interlocks, may not be used as the sole means for deenergizing circuits or equipment.
An energized work permit is required when working within the restricted approach boundary or when the employee interacts with the equipment and conductors or circuit parts are not exposed but an increased likelihood of injury from an exposure to an arc flash hazard exists.
Qualified employees only. Only qualified employees may work on or with exposed energized lines or parts of equipment. Only qualified employees may work in areas containing unguarded, uninsulated energized lines or parts of equipment operating at 50 volts or more.
These projects are generally limited to low-voltage or simple tasks that dont pose docHub electrical hazards. It includes: Installing or replacing light bulbs, fixtures, and ceiling fans (provided you are not altering the electrical wiring). Installing a new electrical outlet or switch (same type and amperage).
An EEWP is necessary based on a persons proximity to an exposed energized part. This is true whether someone is working on, near, or within the restricted approach boundary or interacting with the equipment.

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An EEWP is necessary based on a persons proximity to an exposed energized part. This is true whether someone is working on, near, or within the restricted approach boundary or interacting with the equipment. It applies to your employees, contractor employees, and anyone else in the vicinity.

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