Occupational safety tool

Permit to Work

Pick the work type and print the permit. Pre-start checks come from the same library the risk assessment uses, each carrying the clause it comes from.

Type of work

Permit type

Cold Work Permit

Work at Height

CoP 21.0

📋 A permit is required for this work by its TYPE, not by its risk score. A low-risk task of this type still requires one.

Permit details

Fill what you can now; the rest is written at the workface.

Pre-start checks

Every box must be verified at the workface before work begins — not ticked in the office.

  • A cold work permit issued before starting.[CoP 21.0]
  • Guardrail at least 950 mm, toe board 150 mm, and no gap exceeding 470 mm.[CoP 23.0 cl.3.11.2]
  • The area below the work barricaded and passage beneath excluded.[CoP 22.0]
  • Harness and lanyards inspected before use, with anchor points identified and adequate.Good practice
  • Weather and wind conditions suitable for work at height.Good practice

Signatures

Permit holder / person in charge of the work

Authorized Person (issuing)

Permit Control Manager

⚠️ The Authorized Person and the permit holder must be two different people (CoP 21.0 cl.3.5.2). One person signing both lines invalidates the permit.

Permit closure / hand-back

Signed when the work stops — completed, suspended or the permit expires.

  • Work area left clean, tools removed, guards and isolations restored
  • Area handed back to the operating authority

Closed by (Authorized Person)

safepass.ae · Working template — not an authority-approved form
ℹ️

This form applies the pre-start checks and the roles named in Code of Practice 21.0 and its related codes. It is a working template, not an approved project form — your employer or client may mandate their own, and the competent authority judges the work against the edition in force.