Regulations > Construction Regulations, 2014 > Annexures > Annexure 1 : Application for a Permit to do Construction Work

[In terms of Regulation 3(2) of Construction Regulations, 2014]

This application must be submitted with the following documents:

1. Health and Safety specification.

2. Health and Safety plan.

3. Baseline risk assessment.

1.	Name, postal address and telephone numbers of the client:


2.	Details of the Agent
	a.	Title, Surname and Initials
	b.	Identity number / Passport Number
	c.	Registration number with SACPCMP
	d.	Office Tel. number and/or Mobile number
	e.	Postal address

3.	Name, postal address and telephone numbers of the appointed principal contractor:


4.	Name, postal address and telephone numbers of designer of the project:


5.	Name, postal address and telephone numbers of the following persons:
	a.	Construction Manager:
	b.	Construction Health and Safety Manager:
	c.	Construction Health and Safety Officer:
6.	Exact physical address of the construction and site office:

7.	Nature of construction work:


8.	Expected commencement date:
9.	Expected completion date:
10.	Estimated maximum number of persons on the construction site:

11.	Planned number of contractors on site accountable to principal contractor:
12.	Name (s) of contractors appointed:




13.	Signature of Client/Client's Agent
14.	Signature of the Principal Contractor

FOR OFFICE ONLY

Authorization/

Unique No.

LABOUR CENTRE

OFFICIAL APPROVAL STAMP

15.

Date of application :

16.

Submitted documents prescribed in Construction Regulation 5(4)

CR 5(1)(a)

CR 5(1)(b)

CR 5(1);

(C-S)

17.

Result of the application (Please Tick "☑" Approved ☐ Declined ☐

Reason for declining the application:

19.

Signature of the Supervisor

20.

Signature of revoking Officer / Inspector

Occupational Health and Safety Act, 1993 (Act No. 85 of 1993)