工程变更申请书模板范文

工程变更申请书

模板一：通用工程变更申请书

项目名称：	申请编号：
申请日期：	变更类型：□设计变更 □施工变更 □材料变更 □工艺变更 □其他：_________
申请单位/部门：	申请人：
联系电话：	涉及专业：
变更发生阶段：	变更优先级：□低 □中 □高

一、变更原因描述

（请详细说明导致此次变更的根本原因，例如：现场实际情况与图纸不符、原设计存在缺陷、新规范要求、业主方提出新需求、材料供应困难、技术优化建议等。请提供具体证据或背景说明。）

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二、原设计/施工方案简述

（详细描述原定项目的哪些部分受到此次变更的影响，包括但不限于：原设计图纸编号、版本，涉及构件、材料、工艺、施工方法等。请务必清晰地说明原有状态。）

三、变更内容详细描述

（详细描述变更前后状态对比，包括：涉及的结构、材料、设备、施工方法、操作流程等。请提供具体参数、编号、型号、规格等信息。若涉及图纸变更，请注明最新修订图纸的图号、版本号、修订日期，并作为附件提交。此处描述应足够清晰，使得审批人员能够明确了解变更内容。）

变更前状态：

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变更后状态及预期效果：

（详述变更后将采用的新的结构、材料、设备、施工方法、操作流程等。同时，说明这些变更将带来哪些积极效果，如提高安全性、改善质量、缩短工期、降低成本、解决技术难题、满足新的法规要求等。）

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四、对项目的影响评估

请评估并说明此次变更可能对项目质量、进度、成本、安全等方面带来的影响（请使用量化数据或具体说明）：

质量影响：

□无影响 □正面影响（请说明：________________________）

□负面影响（请说明可能导致的质量问题及应对措施：_________________________）

进度影响：

□无影响 □工期提前 ______天 □工期延误 ______天（请说明受影响的工序、原因及具体时间节点调整：__________________________）

成本影响：

□无影响 □成本增加 ______元 □成本减少 ______元（请提供详细的成本增减估算清单：材料费、人工费、机械费、管理费等，并说明依据：__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

五、对项目的影响评估（续）

安全影响：

□无影响 □正面影响（请说明：________________________）

□引入新风险（请说明具体风险点及建议的安全防范和应急措施：__________________________）

环境影响：

□无影响 □正面影响（请说明：________________________）

□负面影响（请说明可能导致的环保问题及应对措施：_________________________）

合同/法律影响：

□无影响 □可能导致合同条款修订 □可能涉及法律风险（请说明：__________________________）

六、建议处理方案

（请详细阐述针对此次变更，您建议的实施方案，包括技术细节、施工步骤、材料选用、质量控制要点、安全措施等。如有多个可选方案，请列出并说明推荐方案的理由。）

七、风险评估及应对措施

（分析此次变更可能带来的风险，并提出应对措施。例如：技术风险、进度风险、成本超支风险、安全风险、环保风险等。请说明如何控制这些风险。）

八、附件清单

（例如：变更后的图纸或草图，图号：______，版本：______，日期：______）
（例如：现场照片，编号：______）
（例如：相关技术说明/计算书，文件号：______）
（例如：材料/设备选型对比表）
（例如：成本估算明细表）
（其他相关支持性文件）

九、审批意见

部门/人员	审批意见（同意/不同意/退回修改）	签字/盖章	日期	备注
技术负责人
工程部经理
采购部经理
成本部经理
质安部经理
项目经理
业主/监理单位
总工程师
公司高层

模板二：重大工程变更申请书（含详细经济与进度评估）

项目名称：	申请编号：
申请日期：	变更类型：□设计重大变更 □施工方案重大变更 □材料/设备重大变更 □其他：_________
申请单位/部门：	申请人：
联系电话：	涉及专业：
变更发生阶段：	变更优先级：□高 □紧急
变更提案发起人：	提案日期：

一、变更概述与原因分析

（详细阐述此次重大变更的背景、目的、以及导致变更发生的根本原因。请进行深入分析，例如：因地质勘察结果与预期严重不符、关键设备性能无法满足要求、国家或行业强制性新标准出台、业主方对核心功能提出根本性调整、重大安全隐患必须立即消除等。明确此次变更的必要性和紧迫性。）

二、变更内容与技术要求（详细说明）

| 原技术文件/标准/设计 | 变更后要求 |

| 变更原因（请清晰阐述，可附图示、图片、文件编号等作为支撑）： |

| 变更内容描述（具体变更细节，包括相关文件或图纸编号，变更的精确范围和影响）： |

| 预期变更效果（定性和定量描述，对项目的积极影响）： |

三、对项目各项指标的详细评估

1. 进度影响评估

原计划工期	受影响工序	预计变更开始日期	预计变更完成日期	变更导致工期变化	关键路径影响评估	对项目总工期影响
____天	__________	_______	_______	□缩短 ___天	□是	□无影响
				□延长 ___天	□否	□缩短 ___天
				□无变化		□延长 ___天

进度分析与应对措施：

（详细说明变更对项目进度的具体影响，包括是否会影响关键路径，如何调整现有施工计划，是否需要加班赶工，或采取其他加速措施以弥补延误。请附更新的进度计划或关键里程碑计划。）

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2. 经济影响评估

3. 质量影响评估

对最终产品质量的提升/下降：

（详细描述变更是如何影响产品的性能、可靠性、耐用性、安全性等核心质量指标。如果提升，请说明原理；如果下降，请说明控制措施。）

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四、质量、安全与环保影响评估

质量影响：

（分析此次变更对项目整体质量体系的影响。例如：是否影响产品性能、质量标准、是否引入新的技术工艺流程，若有，应详细说明如何确保质量控制。对质量保证的提升或风险，以及相应的管理措施。）

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安全与环境影响：

（评估变更是否增加新的安全风险或对现有风险产生何种影响，以及对环境的潜在影响。说明已识别的风险、评估方法、缓解措施以及应急预案。请提供具体的安全操作规程修订、环保措施增补等说明。）

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五、附件清单（请确保提供的附件与以上各项相符）

变更涉及图纸/方案修订版（图号、版本、修订日期）：____________________________________
受影响的原图纸/文件（图号、版本、发布日期）：____________________________________
详细的成本增减估算表及计算依据：_______________________________________________
更新的进度计划/工期评估报告：_________________________________________________
质量控制方案/安全风险评估报告：_______________________________________________
现场照片/视频证据：_________________________________________________________
与业主/监理沟通记录：_______________________________________________________
其他相关支持性文件：_______________________________________________________

六、会签与审批流程

部门/人员	会签意见（需注明是否同意变更及原因，如有异议请详细说明）	签字/盖章	日期
技术部
工程管理部
采购部
成本控制部
质量安全部
计划部
合同法务部
项目经理
业主方代表
监理方代表
总工程师
公司总经理/高层
最终审批结论：	□批准实施 □不批准 □退回修改，理由：__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

模板三：紧急工程变更申请书

关于_______项目的紧急工程变更申请

项目名称：	申请编号：
紧急发生时间：	申请日期：
申请单位/部门：	申请人：
联系电话：	变更类型：□设计 □施工 □材料 □安全隐患排除 □其他：_________
紧急变更影响范围：□局部 □区域性 □全线/全面（请圈选）