Template

Working at Height Permit to Work

by Harry Prajapati, from the Community

10+

Use this Working at Height Permit to Work template to control high‑risk tasks on roofs, ladders, scissor lifts, and boom lifts. The checklist captures job details, personnel and qualifications, and guides a full JSEA with hazards, controls, and a risk matrix. It prompts pre‑start checks, barricading, training verification, and equipment inspections. Built‑in sections cover tools used aloft, energy isolation and an isolation register, plus a detailed rescue plan with communications and emergency gear. Authorization, permit suspension, revalidation, and close‑out verification ensure safe completion and return to normal operations.

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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
Working at Height Checklist and Permit
This working at height checklist and permit helps you plan and control high risk tasks. Capture job details, assess hazards, and confirm training and area controls. Sections cover roof access, mobile elevating work platforms, fixed and tower scaffolds, forklift man riding cages, and ladders and stepladders. Verify licenses and inspections such as IPAF 3a and 3b, PASMA, and LOLER, monitor weather and wind, and prepare rescue plans. Includes validity times, acceptor sign off, and hand back to close out the permit. Use alongside a general permit to work.
by Darren Downing, from the Community
Downloads: 0
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Template
Safety Work Permit Template
This safety work permit template helps you control high risk work by formalizing request, review, and authorization. It guides supervisors and permit authorities through documenting the work activity, identifying high risk tasks such as hot work, confined space, excavation, plant isolation, work at heights, and live electrical work, and confirming risk assessments and controls are in place. Capture names, dates, approvals, and signatures, register the permit, and communicate scope and supervision requirements. Use it to verify controls before start of work, monitor hazards during the job, and close out with final sign off.
by Mohamed Elhassan, from the Community
Downloads: 10+
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Template
Permit to Work Checklist
Use this Permit to Work checklist to plan, authorize, and control high risk activities on site. It covers PPE requirements and verification, energy isolation and lockout tagout approvals, hot work controls with extinguishers, barricades, and post work fire watch, excavation planning and service locating, and working at heights training, equipment checks, and edge protection. Include inductions, worker counts, area lighting, hazard signage, and housekeeping. Close out by restoring alarms and isolations, cleaning the area, and confirming the site is safe to resume operations.
by Colin Handley, from the Community
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Template
Site Access and Work Permit
Use this work permit template to control site access and high‑risk activities for contractors. It includes work classification, hot work, confined space, working at heights, lockout/tagout, and excavation sections. Capture contractor and supervisor details, SWMS/JSA attachments, asbestos register confirmation, permit issuer, validity periods, and mandatory permit conditions. Conclude with completion certification to confirm the area is safe and normal operations can resume.
by Andrew Moar, from the Community
Downloads: 10+
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Working at Height Permit to Work

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