Template

Working at Height Permit Template

by Simon Lancashire, from the Community

30+

Create a clear, auditable record before starting any work at height. This permit template covers risk assessments, supervisor and company sign-off, exclusion zones, rescue planning, communications equipment, and required PPE. It includes checks for certified harnesses, lanyards, safety helmets, protective clothing, respiratory equipment, non-sparking tools, PAT-tested equipment, ladder certificates, Scafftag status, and weather considerations such as anemometer readings. It also documents issue, acceptance, shift changes, and final clearance to ensure safe, compliant operations.

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

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
Working at Heights Permit Template
This working at heights permit template helps you authorize and control work at elevation. Capture issuer and recipient details, start and end times, location, and a clear scope of work. Verify a Safe Work Checklist or Work Planning Form, confirm rescue plans, and check training requirements. Include PPE and equipment checks for ladders, scaffolding, EWP, harnesses, lanyards, and communications. Assess conditions such as weather, traffic, power lines, and signage. Record completion or suspension and clear the work area.
by vic copling, from the Community
Downloads: 0
Get
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
Work at Height Permit to Work
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.
by Luke Penrose, from the Community
Downloads: 0
Get
Template
Work Permit for Confined Space Entry
This Confined Space Work Permit template helps teams control entry into confined spaces with a structured approval process. It covers site details, start and finish times, isolation from hazards (fumes, electrical, pressurized gas or liquids, steam/heat), and any additional permits required (hot works, working at height, electrical). The form captures atmospheric testing results and required safety precautions including breathing apparatus, lifeline, eye and protective clothing, dust respirators, non-sparking tools, and ventilation. Authorization, contractor acceptance, post-completion sign-off, and formal permit cancellation are included to ensure proper oversight and compliance.
by kkennedy@ace-express.com, from the Community
Downloads: 0
Get

Working at Height Permit Template

About author

You might also like

Working at Heights Permit Template

Permit to Work at Height

Work at Height Permit to Work

Work Permit for Confined Space Entry

You might also like

Working at Heights Permit Template

Permit to Work at Height

Work at Height Permit to Work

Work Permit for Confined Space Entry