Items 1 and 2: contact and issuing office
Name and telephone number of the emergency contact, and the office issuing the permit.
GSA1755
Permit for Welding, Cutting, or Brazing
GSA Form 1755, Permit for Welding, Cutting, or Brazing, is a General Services Administration form. Its footer reads GSA FORM 1755 (REV. 6-91), and GSA hosts it in its forms library, where its page lists the authority or regulation PBS 5900.2C.
The instructions on the back say: A permit must be issued prior to starting welding, cutting, or brazing, regardless of GSA Service involved. They say all such work shall adhere to the relevant OSHA Standards (29 CFR 1910, or 29 CFR 1926), that every item on the form must be completed, and that the lack of signatures or any item not completed voids the permit.
The form records the emergency contact, the issuing office, the location, date and times of the work, the hazards, protective equipment and emergency precautions, the person doing the work and the fire watch, and signatures for the prework inspection, the permit issuance and the post-work checkup. You can fill it out free in your browser on this page and download the result without an account.

Name and telephone number of the emergency contact, and the office issuing the permit.
Building name and specific location within the building, the date of work, and the start and stop times, a.m. or p.m.
The special nature of the work, the anticipated hazard due to the work (safety, health, fire), and the protective clothing and equipment required for the work.
The name of the person performing the work, the name of the fire watch at the site, and emergency precautions, including the type of required fire extinguisher.
Signature, name and title, and date for the prework site inspector and for the person issuing the permit.
The signature of the post-work checkup inspector and the date.
The instructions say every item on the form must be completed, and that the lack of signatures or any item not completed voids the permit.
For items 1A and 1B, the instructions say to fill in the emergency name and telephone number in red (preferred).
Enter the date, start time and stop time in items 4A to 4C. The form says the permit is not valid 30 minutes prior to the end of the scheduled work shift.
The person performing the work and the fire watch each initial beside their names in items 8 and 9. Item 7 also covers screens and barricades for the protection of others.
The form says the prework inspection is on the date of work before starting the operation, and the inspector ensures all combustibles are removed, covered, or protected.
The form says the checkup is 30 minutes after completion of work, to ensure the area is free of hazardous conditions. The completed permit then goes back to the issuing authority.
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
Upon completion of the work, or when the expected stop time is reached, whichever comes first, the form says the completed permit is returned to the issuing authority for filing.
For a confined space entry task, the form says a copy is posted next to GSA form 3625, Permit for Confined Space Entry, both clearly posted outside the confined space, and that prior approval from the regional Safety Environmental Management Office is mandatory.
The form points to OSHA Standards 29 CFR 1910 or 29 CFR 1926, and to 29 CFR 1910, Subpart Q, for the person performing the work and the fire watch.
The form says the issuance of the permit in no way relieves a contractor of responsibility for an accident resulting from negligence with the work.
The footer reads GSA FORM 1755 (REV. 6-91). GSA's page gives a current revision date of 06/1991 and the authority or regulation PBS 5900.2C. The PDF prints no OMB number or privacy statement.
Item 2 names it. The form says the completed permit is returned to the issuing authority for filing when the work is done or the expected stop time is reached, whichever comes first.
Named in item 8, and initials beside the name to show knowledge and understanding of the form, its purpose and the safety precautions per OSHA Standard 29 CFR 1910, Subpart Q.
Named in item 9, with initials for the duties of a fire watch per 29 CFR 1910, Subpart Q. The form says the fire watch will not be the same person performing the work.
Signs item 11. The form says the supervisor in charge of the GSA employee performing the work or the Contracting Officer's representative conducts the inspection.
The instructions for item 12, Permit Issued By, say it is approved by the facility manager or authorized representative.
Signs and dates item 13 after the checkup, which the form says is conducted 30 minutes after completion of work.
The item instructions on the back name these roles.
The agency’s own page for Form GSA1755.
The official blank form, to print or fill by hand.
No tool matches that search.
The footer names the General Services Administration and reads GSA FORM 1755 (REV. 6-91). GSA's page lists PBS 5900.2C as the authority or regulation.
The instructions say a permit must be issued prior to starting welding, cutting, or brazing, regardless of GSA Service involved.
The form says the fire watch will not be the same person performing the work.
The form says the supervisor in charge of the GSA employee performing the work or the Contracting Officer's representative conducts it, on the date of work before starting the operation.
It says the permit is not valid 30 minutes prior to the end of the scheduled work shift, and the completed permit is returned to the issuing authority at completion or at the expected stop time, whichever comes first.
The form says a copy is posted next to GSA form 3625, Permit for Confined Space Entry, outside the confined space, and that prior approval from the regional Safety Environmental Management Office is mandatory.
The form says the lack of signatures or any item not completed voids the permit.