Template

Low Voltage Permit to Work

by Phillipa Gregory, from the Community

10+

This low voltage permit to work template helps organizations plan and authorize electrical tasks safely. Capture permit details, scope of work, location, dates, and special conditions. Document access control and safety precautions including lock off, safe isolation, proving dead and test instruments used, earthing, and warning notices. The form includes declarations for the authorized person issuing the permit and the competent person accepting it, with names, positions, signatures, and timestamps. A closure section confirms work completion and withdrawal of personnel and equipment. Developed with reference to BS7671, this template supports consistent control of electrical work but should be reviewed for suitability to your site and jurisdiction.

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Confirm accountability and compliance with a digital log

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This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
LV Electrical Permit to Work
Use this LV Electrical Permit to Work template to control and document low voltage electrical activities under a safe system of work. The checklist covers isolation from all energy sources, lockout and caution signage, proving dead with approved test equipment, earthing and cable identification, and warning signage on adjacent live equipment. It includes sections for authorisation by an authorised person, acceptance by a competent person, time extensions, completion, and permit closure, helping teams coordinate contractors and inform landlords or affected parties.
by Luke Penrose, from the Community
Downloads: 10+
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Electrical Work Permit Template
This Electrical Work Permit template helps teams plan and authorize electrical tasks safely. Capture permit numbers, work location and validity, and whether it combines with confined space or hot works permits. Verify trained and competent personnel, a current risk assessment, earthing, points of isolation, key retention, caution notices, and safety locks. Record authorization by the responsible contractor and site manager, plus worker sign-on/sign-off. Conclude with permit closure, confirming all equipment is returned and areas are left safe, including any controls left in place.
by Jeffrey Harders, from the Community
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Hospital Permit To Work Template
This Permit To Work template helps hospitals authorize and control contractor and maintenance activities. It captures permit details, contractor and competent person information, work scope and location, and RAMS submission and approval. It links associated high risk permits including hot works, working at height, confined spaces, isolated and live equipment. The form includes approvals, declarations, signatures, and clear acceptance of responsibilities. It guides permit clearance and closure, and verifies completion, safety, and any fire stopping measures such as sleeves, collars, covers, and sealants. Security checks confirm permits returned and closed.
by Stephen Dawson, from the Community
Downloads: 10+
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Template
Electrical Testing and Inspection Permit
This Electrical Testing and Inspection Permit template helps control and authorize electrical work on site. It guides permit issuers and holders through key checks such as panel labeling, presence of covers and guards, isolation and lockoff of incomplete circuits, signage in work areas, and photographic evidence of panel condition. It captures RAMS review and approval, key sign-out, permit holder details, and contact time stamps. The workflow includes declaration of responsibility, signatures for receipt and clearance, confirmation that areas are locked off and keys returned, and formal cancellation. Clear responsibilities for the permit holder emphasize restricting access, maintaining key control, housekeeping, communication with other permit holders, and returning the permit and keys to the authorized person at the permit office upon completion.
by Aaron Lee, from the Community
Downloads: 0
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Low Voltage Permit to Work

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