02.3 - Da Form 2 - S63 · OPW18/0008

PART 7 – FOR OFFICE USE ONLY - FOR COMPLETION BY THE ASSESSMENT
MANAGER

 Additional building details required for the Australian Bureau of Statistics
 Existing building use/classification? (if applicable)
 New building use/classification?
 Site area (m2)                        1099                         Floor area (m2)


 Additional information required by the local government
 Confirm proposed construction materials:
 External walls                       Brick Veneer, Other
 Frame                                Timber                        ☐                            ☐
 Floor                                 Concrete, Timber
 Roof covering                        Steel

 Date received:                               Reference numbers:

 For completion by the building certifier
 Classification(s) of approved building work              QBCC Insurance receipt         QBCC Certification Licence
                                                          number                         number
 1a & 10a & 10b & 10b



 Notification of engagement of alternate chosen assessment manager
 Prescribed assessment manager
 Name of chosen assessment manager
 Date chosen assessment manager engaged
 Contact number of chosen assessment manager
 Relevant licence number(s) of chosen assessment
 manager

The Planning Act 2016, the Planning Regulation 2017 and the DA Rules are administered by the Department of
Infrastructure, Local Government and Planning. This form and all other required development application materials should
be sent to the assessment manager.




                                                                                                                         Page 6
                                                                                      DA Form 2 – Development Application details
                                                                                                        Version 1.0—3 July 2017