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Scaffold Permit1

This scaffold permit document provides details for a scaffolding project, including the project name and location, duration, purpose (erection or dismantling), scaffold type (mobile or fixed), scope of work, dimensions, supervisor and erector names and details, safety equipment requirements, and approval signatures. It outlines safety protocols for working at the edge or with cantilevers, maximum number of workers, material types, tagging colors for safety status, and notes about unauthorized alterations facing penalties.

Uploaded by

Mohd Obaidullah
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We take content rights seriously. If you suspect this is your content, claim it here.
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177 views2 pages

Scaffold Permit1

This scaffold permit document provides details for a scaffolding project, including the project name and location, duration, purpose (erection or dismantling), scaffold type (mobile or fixed), scope of work, dimensions, supervisor and erector names and details, safety equipment requirements, and approval signatures. It outlines safety protocols for working at the edge or with cantilevers, maximum number of workers, material types, tagging colors for safety status, and notes about unauthorized alterations facing penalties.

Uploaded by

Mohd Obaidullah
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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SCAFFOLD PERMIT

Project Name : ___________________ Date issued : _________________


Location : ___________________ Duration Period : _________________

Purpose : Erection For use Dismantling

Type of Scaffold : Mobile Scaffold Fixed Scaffold

Scope of Work : ___________________________________________________________________________

Dimension:

Names Card No. Position Company Signature Training Fit to work


Supervisor :

Erectors :

YES NO

Will the scaffold be erected at the edge?

Any cantilever will be erected on the scaffold?

How many labors intended to use the saffold at one time?


Tube &
What is the type of materials to be used to install the scaffold? Pin Lock Caplock Coupler

Scafftags:
Personal Protective Equipment YES NO

Safety Shoes Green (Safe to Use)


Helmet
Gloves Red (Unsafe to Use)
FBH
Mask Yellow (Under Erection
Glass or Dismantling)

REMARKS : ____________________________________________________________________________

Checked and Issued by: Noted by:

_______________________ ____________________

Canceled by: Date : _________


Reason : _________________________________________________

P.O. Box Doha, Qatar SAF 002 /Rev 0/ Fax: +974


SCAFFOLD PERMIT

_______________________ _________________________________________________

Note: Any unauthorized personnel who will be caught removing or altering components of scaffold shall be penalized.

P.O. Box Doha, Qatar SAF 002 /Rev 0/ Fax: +974

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