General permit example
Completed permits for common jobs: both sheets, filled in and cancelled. Read one, download it, then issue your own from the blank.
Get the blankChoose a permit
- Torch-on felt on a flat roofA propane torch on the roof of an occupied office, with a fire watch to the two-hour check.2 pages, checked 2 November 2026
- Welding a steel beam in a basementMIG welding during a refurbishment, with fume extraction and the office above checked too.2 pages, checked 2 November 2026
- A new drain in a yard, near live servicesHand digging near a cable and a gas pipe, over two days, with inspections after rain.2 pages, checked 2 November 2026
- Entering a foul manhole to join a drainTwo people in a 2.4 m manhole, with gas tests, a top person and a winch at the surface.2 pages, checked 2 November 2026
- A night fit-out in a bank branchA shopfitting team replacing a reception desk and two partitions after closing, with one intruder alarm zone off and security on site.2 pages, checked 2 November 2026
- A roof survey behind a barrierA surveyor and an assistant on a large flat felt roof with roof lights and an open edge, inside a barrier set and struck on the same permit, with wind readings throughout.2 pages, checked 2 November 2026
- Changing a sub-main boardA board with two incomers and a generator inlet, with both firms locked on through a lock-out box, proved dead before the permit was issued.2 pages, checked 2 November 2026
General permit example
A night fit-out in a bank branch
A shopfitting team replacing a reception desk and two partitions after closing, with one intruder alarm zone off and security on site.
What to change
- Your site and exact location
- Your own six precautions, written for this job
- Who issues it and who accepts it
- The COSHH box: clear here because the only adhesive is water-based with no hazard code
Sources
Checked
The same sheet as text
Worked example of a made-up job. Not a permit.
Sheet 1: Permit to Work
Hollins & Reed Contracting Ltd
- Permit no.HR-0421
- SiteHigh street bank branch
- Exact locationBanking hall, reception end
Details
- ContractorHollins & Reed
- Issued toPriya Shah
- Valid from19/10/26 18:30
- Valid to20/10/26 05:30
- RAMS refHR-RAMS-11
The work
- Work to be doneTake out the old reception desk and two partitions. Fit the new ones from drawing HR-D-05.
- Plant and equipmentHand tools, cordless drivers, sack truck. Panels arrive cut to size: no cutting in the hall.
Hazards
- ServicesYes
- HeightNo
- Confined spaceNo
- Hot workNo
- LiftingNo
- TrafficNo
- COSHH substancesNo
- OtherYes
Precautions
- Intruder alarm zone 2 isolated, fire alarm stays onDone: yes. By: Alarm engineer
- Power to the old desk isolated and proved deadDone: yes. By: Bank's electrician
- Exits and the rear corridor kept clear all nightDone: yes. By: Reece Ollerton
- Security told who is in, and their number on this permitDone: yes. By: Dan Hollins
- No hot work: the bank allows none on this permitDone: yes. By: Dan Hollins
- Waste out by the rear door only, door shut after each tripDone: yes. By: Joe Penketh
What is isolated
- Intruder alarm zone 2How: Bypassed at the panel. Locked: no. Tag: A1. Proved by: Alarm engineer
- Desk ring circuitHow: Way 9, breaker locked off. Locked: yes. Tag: E1. Proved by: Bank's electrician
People on this permit: name
- Priya ShahCompany: Hollins & Reed. Briefed: yes
- Reece OllertonCompany: Hollins & Reed. Briefed: yes
- Joe PenkethCompany: Hollins & Reed. Briefed: yes
Other conditions
- One night, 18:30 to 05:30. Not finished by 05:00: stop, make safe, ring the duty manager. Intruder zone 2 bypassed 18:15, desk circuit proved dead 18:20, both before issue.
- Other hazard: out of hours, one security officer alone. Security 0161 496 0178. Check in at 18:30, at 00:00 and on leaving. Nobody past the counter line.
- Asbestos: none in the desk or partitions on the bank's register. Anything unexpected in the walls, stop and ask.
Sign-off
- Issued: precautions checkedName: Dan Hollins. Signature: signed. Date: 19/10/26. Time: 18:25
- Accepted: permit understoodName: Priya Shah. Signature: signed. Date: 19/10/26. Time: 18:28
Sheet 2: Permit to Work
Hollins & Reed Contracting Ltd
- Permit no.HR-0421
- SiteHigh street bank branch
- Exact locationBanking hall, reception end
Cancellation
- Work stopped at04:50. New desk and both partitions fitted.
- Area checkedHall swept and walked at 05:00. Exits clear. Rear door shut, checked by security.
- Equipment removedTools and waste out of the rear door by 04:58.
Handback
- Isolations removedDesk circuit back on at 05:05, by the bank's electrician. Intruder alarm zone 2 reinstated and tested at 05:10, by the alarm engineer.
- Area returned toThe bank's duty manager, 05:10
- NotesChecked in with security 18:30, 00:00, 05:06. The bank's electrician connected and tested the new desk sockets before switching back on.
Sign-off
- Extended: new end timeName: Not extended
- Cancelled: area checkedName: Dan Hollins. Signature: signed. Date: 20/10/26. Time: 05:08
- Handed back: area returnedName: Dan Hollins. Signature: signed. Date: 20/10/26. Time: 05:10
What a completed permit shows
- Who issued it and who accepted
- What was checked first, and what did not apply
- The record while it ran (fire watch, gas tests, inspections)
- How it was cancelled and handed back
Two ways to run your permits
Keep the day’s record
Note each permit issued and cancelled in Site Diary, with photos of the area.
Open Site DiaryPermit to work example questions
Are these real permits?
No. Every job, company, person and address here is made up, and so is every reading. They show what goes in each box.
Can I issue one of these as it is?
No. A permit is written for one job, one place, one time. Issue your own from the blank, after checking the place yourself.
What makes a permit invalid?
It covers only the job, the place and the time written on it. If the time runs out or the work changes, stop, then extend it or issue a new one once it is checked as safe. HSE: HSG250.
How long does a hot work fire watch last?
At least an hour of continuous watching after the hot work ends, then at least one more check two hours after the end. HSE: HSG168.
Where is the blank?
On the permit to work template page. Add your logo, then print it or download it.