📍 When to use this template
- Before starting any lifting activity using a mobile crane, tower crane, hydra, or gantry crane.
- A new permit is required for each new lift plan, change in location, or at the start of each shift.
- Filled by the Site Engineer/Supervisor, checked by the Lifting Supervisor, and approved by the Site Safety Officer/Manager.
Sections & fields
Preview of the template structure. Download Excel to fill on site.
1Header / Project Information6 fields
Project Name
_____________
Contract Package No.
_____________
Location of Lift (Gridline/Area)
_____________
Permit Validity (From Time / To Time)
_____________
2Crane & Operator Details8 fields
Crane Type (e.g., Mobile, Tower, Hydra)
_____________
Crane Make & Model
_____________
Crane ID / Registration No.
_____________
Third Party Inspection (TPI) Certificate No. & Validity
_____________
Operator Name
_____________
Operator License No. & Validity
_____________
Rigger Name(s)
_____________
Signaller / Banksman Name
_____________
3Lift Details6 fields
Description of Load to be Lifted
_____________
Load Weight (in Tonnes)
_____________
Maximum Lifting Radius (in meters)
_____________
Crane Capacity at Max Radius (from Load Chart)
_____________
Safe Working Load (SWL) for this configuration
_____________
Number of Lifts Planned under this permit
_____________
4Lifting Gear & Tackles Checklist6 fields
Sling Type (Wire Rope / Webbing / Chain)
_____________
Sling SWL (Tonnes)
_____________
Shackle Type & SWL (Tonnes)
_____________
Spreader Beam / Lifting Beam SWL (if used)
_____________
TPI Validity of all lifting tackles
_____________
Visual Inspection of Tackles (No visible damage, wear, or defects)
_____________
5Pre-Lift Safety Checklist (Tick if OK)9 fields
Ground Condition Assessed (Firm & Level)
_____________
Outriggers Fully Extended on Proper Pads
_____________
Lift Area Barricaded & Warning Signage Posted
_____________
Clearance from Overhead Power Lines Confirmed
_____________
Weather Conditions Acceptable (Wind Speed, Visibility)
_____________
Load Secured & Balanced
_____________
Tag Lines Attached to Control Load Swing
_____________
Communication Method Established (Hand Signals / Radio)
_____________
Lift Plan / Method Statement Reviewed with Crew
_____________
6Authorization & Permit Closure6 fields
Prepared By (Name & Signature)
_____________
Checked By (Lifting Supervisor Name & Signature)
_____________
Approved By (Safety Officer Name & Signature)
_____________
Permit Closed By (Name & Signature)
_____________
Date & Time of Closure
_____________
Remarks on Completion / Any Issues Faced
_____________
💡 Sample filled excerpt
Section: Lift Details
Description of Load: 'Structural Steel Truss TR-04'
Load Weight (in Tonnes): '4.2 T'
Maximum Lifting Radius (in meters): '16 m'
Crane Capacity at Max Radius (from Load Chart): '5.5 T'
⚖ Compliance notes
- Fulfills requirements of the BOCW (Building and Other Construction Workers) Central Rules, 1998, specifically Rules 60-63 regarding Lifting Appliances and Gear.
- Provides documented evidence of risk assessment and safe system of work, essential for internal and external safety audits (e.g., ISO 45001).
- Serves as proof of compliance with safe lifting practices as per IS 15048 (Planning of Lifts) and IS 14473 (Use of Mobile Cranes).
- Mandatory record to be produced during inspections by the Directorate of Industrial Safety and Health (DISH) or other labour authorities.