Template

Work at Height Permit to Work

by Luke Penrose, from the Community

Use this permit to plan and control work at height. The template captures site and contractor details, scope of work, and required control measures such as barriers, access limitations, ladder condition, plant setup, falling object protection, weather checks, housekeeping, and RAMS attachments. It documents authorization by an approved person, acceptance by the competent person, time extensions, and final completion and closure to ensure the area is left safe and equipment returned to service.

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With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

Community

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
Permit to Work at Height
This Permit to Work at Height template guides supervisors and contractors through planning and authorization of work at height. It covers equipment suitability and inspection, fall-arrest systems, edge protection, PPE, barriers, and overhead service checks. The form captures approvals, issue, acceptance, clearance, and closure to ensure work is controlled from start to finish. Use it to confirm competent persons, record work details, apply site-specific conditions, and maintain compliance with safe systems of work.
by Stephen Dawson, from the Community
Downloads: 10+
Get
Template
Permit to Work - Hot Works
This Permit to Work for Hot Works template supports a safe system of work for welding, cutting, grinding, and other ignition-producing tasks. It captures site and contractor details, a description of the work, and the validity window. Mandatory precautions include isolating fire alarms and suppression, clearing combustibles, confirming utility isolations, providing firefighting equipment, establishing a way to raise the alarm, attaching RAMS, and maintaining safe egress. It formalizes authorization by an approved person, acceptance by the competent person, and records fire watch details. It also provides sections for time extensions, completion, and permit closure to ensure the area is left safe.
by Luke Penrose, from the Community
Downloads: 10+
Get
Template
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+
Get
Template
Permit to Work for Mechanical System Isolations
Use this Permit to Work template to plan and control mechanical system isolations. Capture precautions, barriers, risk assessments, method statements, and emergency procedures. Record authorizations, acceptance by the competent person, time extensions, and completion details to ensure equipment is safely returned to service. Aligns with Safe Systems of Work and helps keep unauthorized personnel out of high-risk areas.
by Luke Penrose, from the Community
Downloads: 10+
Get

Permit to Work at Height

This Permit to Work at Height template guides supervisors and contractors through planning and authorization of work at height. It covers equipment suitability and inspection, fall-arrest systems, edge protection, PPE, barriers, and overhead service checks. The form captures approvals, issue, acceptance, clearance, and closure to ensure work is controlled from start to finish. Use it to confirm competent persons, record work details, apply site-specific conditions, and maintain compliance with safe systems of work.

by Stephen Dawson, from the Community

10+

Get

Template

Permit to Work - Hot Works

This Permit to Work for Hot Works template supports a safe system of work for welding, cutting, grinding, and other ignition-producing tasks. It captures site and contractor details, a description of the work, and the validity window. Mandatory precautions include isolating fire alarms and suppression, clearing combustibles, confirming utility isolations, providing firefighting equipment, establishing a way to raise the alarm, attaching RAMS, and maintaining safe egress. It formalizes authorization by an approved person, acceptance by the competent person, and records fire watch details. It also provides sections for time extensions, completion, and permit closure to ensure the area is left safe.

by Luke Penrose, from the Community

10+

Get

Template

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

10+

Get

Template

Permit to Work for Mechanical System Isolations

Use this Permit to Work template to plan and control mechanical system isolations. Capture precautions, barriers, risk assessments, method statements, and emergency procedures. Record authorizations, acceptance by the competent person, time extensions, and completion details to ensure equipment is safely returned to service. Aligns with Safe Systems of Work and helps keep unauthorized personnel out of high-risk areas.

by Luke Penrose, from the Community

10+

Get

Work at Height Permit to Work

About author

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