Template

Permit to Work Authorization Checklist

by Brandon Van Laar, from the Community

20+

Use this Permit to Work authorization checklist to review the scope of work, assess risks, and verify the right controls before a job begins. Capture job or permit number, site, date, preparer, and the person being reviewed. Perform a field risk assessment with the crew, confirm required permits, walk the area, and check PPE. Validate lockout tagout details, locks and tags, and confirm the reviewer recommends authorization. Record signatures and note if retraining is required.

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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
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 Spot Audit Checklist
This Spot Audit Permit to Work checklist helps verify onsite compliance with PTW procedures. Inspect permit boards and usage, confirm a valid permit exists for work in progress, and check issuer authorization and completeness. Ensure risk assessments are present and controls are followed at the job site. Capture findings and provide feedback to workers, supervisors, and managers to strengthen safety performance.
by Scott Denny, from the Community
Downloads: 30+
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Template
Pre-Task Confined Space Checklist and Permit
Use this pre-task confined space checklist and permit to conduct a thorough pre-entry review for permit-required confined spaces. Confirm job scope, hazards and risk assessment, isolation and lockout, ventilation and lighting, signage and access, communications methods, and atmospheric monitoring with calibration and logging. Select required equipment and PPE, and complete emergency and rescue planning details. Includes team briefing plus entrant and supervisor sign-off to verify training, conditions, and authorization before work begins.
by WPN Facilities, from the Community
Downloads: 10+
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Template
Graham Roofing Permit to Work Template
Use this Roofing Permit to Work template to manage high-risk roof activities with clear authorization and communication. Capture permit details, location, dates, and responsible persons (Authorised Person and Competent Person). Identify hazards and required controls, define timescales and expiry, and maintain an operatives sign-on with confirmation they have read and understood RAMS and permit procedures. Include pre-start checks, completion notes, issue descriptions, and close the job with AP and CP signatures for full traceability.
by Chris Blair, from the Community
Downloads: 0
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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

10+

Get

Template

Permit to Work Spot Audit Checklist

This Spot Audit Permit to Work checklist helps verify onsite compliance with PTW procedures. Inspect permit boards and usage, confirm a valid permit exists for work in progress, and check issuer authorization and completeness. Ensure risk assessments are present and controls are followed at the job site. Capture findings and provide feedback to workers, supervisors, and managers to strengthen safety performance.

by Scott Denny, from the Community

30+

Get

Template

Pre-Task Confined Space Checklist and Permit

Use this pre-task confined space checklist and permit to conduct a thorough pre-entry review for permit-required confined spaces. Confirm job scope, hazards and risk assessment, isolation and lockout, ventilation and lighting, signage and access, communications methods, and atmospheric monitoring with calibration and logging. Select required equipment and PPE, and complete emergency and rescue planning details. Includes team briefing plus entrant and supervisor sign-off to verify training, conditions, and authorization before work begins.

by WPN Facilities, from the Community

10+

Get

Template

Graham Roofing Permit to Work Template

Use this Roofing Permit to Work template to manage high-risk roof activities with clear authorization and communication. Capture permit details, location, dates, and responsible persons (Authorised Person and Competent Person). Identify hazards and required controls, define timescales and expiry, and maintain an operatives sign-on with confirmation they have read and understood RAMS and permit procedures. Include pre-start checks, completion notes, issue descriptions, and close the job with AP and CP signatures for full traceability.

by Chris Blair, from the Community

Get

Permit to Work Authorization Checklist

About author

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