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Site and construction · SI-01

Permit to Work

A free printable general permit to work — the job, the hazards, the controls you write yourself, everyone covered, and a handback section.

First page of the Permit to Work — Put a controlled job in writing: what is being done, what has to be true before it starts, who is covered and when it was handed back.
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2 pages. Choose your paper size — both versions are laid out identically, so neither one gets shrunk to fit.

Print it and write on it

Fill it in type and save

The fillable versions have real form fields — open them in any PDF reader, type into them and save. Printing help.

What this sheet is for

Put a controlled job in writing: what is being done, what has to be true before it starts, who is covered and when it was handed back.

Who it is for

Site managers, facilities teams, farms, workshops, landlords supervising contractors, and anyone controlling work by others on their premises.

How to use it

  1. Write the controls for this job. A permit filled from a template is a formality.
  2. Describe the location precisely — 'the roof' has caught people out.
  3. Everyone doing the work signs to accept the permit before starting.
  4. Set a validity time and stick to it; re-issue rather than extend by memory.
  5. Complete the handback. An open permit is an unsafe area nobody has checked.

What is on the sheet

2 pages, in this order:

Page 1

Printed under the title: A general permit to work: what the job is, who authorised it, who is covered, and when it was handed back.

The controls are written by you, for this job. Who may authorise and carry out this work, what training and certification they need, what must be recorded and how long it must be kept differ by country and by workplace. This sheet names no scheme, sets no criteria and satisfies no regulation on its own — check what applies where you are.

Write-on lines: Permit number · Site · Date · Valid from · Valid to · Exact location of the work · Company or team · The work, described precisely

Hazards identified for this job — written for this job, not ticked from a list

Ruled lines

Controls required before work starts — written by the person authorising, for this job

Ruled lines

Page 2

Also confirmed

  • Others affected have been told
  • Isolation confirmed and proved
  • Access and egress agreed
  • Emergency arrangements explained
  • Equipment inspected before use
  • Area signed and barriered

People covered by this permit

Table, 4 rows: Name · Company · Role · Signed on accepting the permit · Time in · Time out

Issue

Write-on lines: Issued by (print) · Position · Signature · Time

Handback and cancellation

Write-on lines: Work complete or suspended · Area left safe and clear · Equipment removed · Handed back by · Accepted by · Date · Time

Ruled lines: Anything the next shift should know

Questions

Does using this permit make my site compliant?

No, and it does not claim to. It is a blank pro-forma. Whether a permit system is required, what it must contain and who may issue one differ by country and by workplace — establish that first, then use whatever form fits it.

Related sheets

Hot Work Permit

Control work that makes heat, flame or sparks, and record the after-check that catches the fire that starts once everyone has gone home.

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Confined Space Entry Permit

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Risk Assessment Form

Record a risk assessment you have carried out yourself, in a layout that captures the part people forget: who is doing the further action, by when, and when it gets reviewed.

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