DA Form 2

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 Unit No.             Street No.          Street Name and Type                                 Suburb
                      17                  The Esplanade                                        Sunshine Beach
 Postcode             Lot No.             Plan Type and Number (e.g. RP, SP)                   Local Government Area(s)
 4567                 678                 RP48111                                              Noosa Council
 2.2) Additional premises
 ☐ Additional premises are relevant to this development application and the details of these premises have been
   attached in a schedule to this development application
 ☒ Not required


 3) Are there any existing easements over the premises?
 Note: Easement uses vary throughout Queensland and are to be identified correctly and accurately. For further information on easements and
 how they may affect the proposed development, see the DA Forms Guide
 ☐ Yes – All easement locations, types and dimensions are included in plans submitted with this development
   application
 ☒ No


PART 3 – FURTHER DETAILS
 4) Is the application only for building work assessable against the building assessment provisions?
 ☐ Yes – proceed to 8)
 ☒ No

 5) Identify the assessment manager(s) who will be assessing this development application
 Noosa Council

 6) Has the local government agreed to apply a superseded planning scheme for this development application?
 ☐ Yes – a copy of the decision notice is attached to this development application
 ☐ The local government is taken to have agreed to the superseded planning scheme request – relevant documents
    attached
 ☒ No

 7) Information request under Part 3 of the DA Rules
 ☒ I agree to receive an information request if determined necessary for this development application
 ☐ I do not agree to accept an information request for this development application
 Note: By not agreeing to accept an information request I, the applicant, acknowledge:
 ●​ that this development application will be assessed and decided based on the information provided when making this development
      application and the assessment manager and any referral agencies relevant to the development application are not obligated under the DA
      Rules to accept any additional information provided by the applicant for the development application unless agreed to by the relevant parties.
 ●​ Part 3 of the DA Rules will still apply if the application is an application listed under section 11.3 of the DA Rules.
 Further advice about information requests is contained in the DA Forms Guide.


 8) Are there any associated development applications or current approvals?
 ☐ Yes – provide details below or include details in a schedule to this development application
 ☒ No
 List of approval/development               Reference                               Date                          Assessment manager
 application
 ☐ Approval
 ☐ Development application
 ☐ Approval
 ☐ Development application



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 9) Has the portable long service leave levy been paid?
 ☐ Yes – a copy of the receipted QLeave form is attached to this development application
 ☐ No – I, the applicant will provide evidence that the portable long service leave levy has been paid before the
   assessment manager decides the development application. I acknowledge that the assessment manager may
   give a development approval only if I provide evidence that the portable long service leave levy has been paid
 ☒ Not applicable (e.g. building and construction work is less than $150,000 excluding GST)
 Amount paid                        Date paid (dd/mm/yy)                    QLeave levy number (A, B or E)
 $


 10) Is this development application in response to a show cause notice or required as a result of an enforcement
 notice?
 ☐ Yes – show cause or enforcement notice is attached
 ☒ No

 11) Identify any of the following further legislative requirements that apply to any aspect of this development
 application
 ☐ The proposed development is on a place entered in the Queensland Heritage Register or in a local
   government’s Local Heritage Register. See the guidance provided at www.des.qld.gov.au about the
   requirements in relation to the development of a Queensland heritage place
 Name of the heritage place:                                          Place ID:


PART 4 – REFERRAL DETAILS

 12) Does this development application include any building work aspects that have any referral requirements?
 ☐ Yes – the Referral checklist for building work is attached to this development application
 ☒ No – proceed to Part 5


 13) Has any referral agency provided a referral response for this development application?
 ☐ Yes – referral response(s) received and listed below are attached to this development application
 ☐ No
 Referral requirement                                         Referral agency                     Date referral response



 Identify and describe any changes made to the proposed development application that was the subject of the
 referral response and this development application, or include details in a schedule to this development application
 (if applicable)




PART 5 – BUILDING WORK DETAILS

 14) Owner’s details
 ☒ Tick if the applicant is also the owner and proceed to 15). Otherwise, provide the following information.
 Name(s) (individual or company full name)        Christian Seymour
 Contact name (applicable for companies)          Adapt Development Management (Tiani Boulton)
 Postal address (P.O. Box or street address)      PO Box 7618
 Suburb                                           Sippy Downs
 State                                            QLD


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Postcode                                             4556
Country                                              Australia
Contact number                                       0404 924 160
Email address (non-mandatory)                        [email protected]
Mobile number (non-mandatory)
Fax number (non-mandatory)

15) Builder’s details
☒ Tick if a builder has not yet been engaged to undertake the work and proceed to 16). Otherwise provide the
following information.
Name(s) (individual or company full name)
Contact name (applicable for companies)
QBCC licence or owner – builder number
Postal address (P.O. Box or street address)
Suburb
State
Postcode
Contact number
Email address (non-mandatory)
Mobile number (non-mandatory)
Fax number (non-mandatory)

16) Provide details about the proposed building work
What type of approval is being sought?
☒ Development permit
☐ Preliminary approval
b) What is the level of assessment?
☒ Code assessment
☐ Impact assessment (requires public notification)
c) Nature of the proposed building work (tick all applicable boxes)
☒ New building or structure                                                   ☐ Repairs, alterations or additions
☐ Change of building classification (involving building work)                 ☒ Swimming pool and/or pool fence
☒ Demolition                                                                  ☐ Relocation or removal
d) Provide a description of the work below or in an attached schedule.
Refer to cover letter.
e) Proposed construction materials
                                      ☐ Double brick                ☐ Steel                        ☐ Curtain glass
External walls                        ☐ Brick veneer                ☒ Timber                       ☒ Aluminium
                                      ☒ Stone/concrete              ☒ Fibre cement                 ☐ Other
                                      ☒ Timber                      ☐ Steel                        ☐ Aluminium
Frame
                                      ☐ Other
Floor                                 ☒ Concrete                    ☒ Timber                       ☐ Other
                                      ☒ Slate/concrete              ☐ Tiles                        ☐ Fibre cement
Roof covering
                                      ☐ Aluminium                   ☐ Steel                        ☐ Other
f) Existing building use/classification? (if applicable)


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 Class 1a, 10a, 10b
 g) New building use/classification? (if applicable)
 Class 1a, 10a, 10b
 h) Relevant plans
 Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide:
       Relevant plans.
 ☒ Relevant plans of the proposed works are attached to the development application

 17) What is the monetary value of the proposed building work?
 TBC

 18) Has Queensland Home Warranty Scheme Insurance been paid?
 ☐ Yes – provide details below
 ☒ No
 Amount paid                   Date paid (dd/mm/yy)                                         Reference number
 $


PART 6 – CHECKLIST AND APPLICANT DECLARATION

 19) Development application checklist
 The relevant parts of Form 2 – Building work details have been completed                                         ☒ Yes
 This development application includes a material change of use, reconfiguring a lot or                           ☐ Yes
 operational work and is accompanied by a completed Form 1 – Development
 application details                                                                                              ☒ Not applicable

 Relevant plans of the development are attached to this development application
 Note: Relevant plans are required to be submitted for all aspects of this development application. For further   ☒ Yes
 information, see DA Forms Guide: Relevant plans.
 The portable long service leave levy for QLeave has been paid, or will be paid before                            ☐ Yes
 a development permit is issued (see 9)                                                                           ☒ Not applicable


 20) Applicant declaration
 ☒ By making this development application, I declare that all information in this development application is true and
   correct
 ☒ Where an email address is provided in Part 1 of this form, I consent to receive future electronic communications
   from the assessment manager and any referral agency for the development application where written
   information is required or permitted pursuant to sections 11 and 12 of the Electronic Transactions Act 2001
 Note: It is unlawful to intentionally provide false or misleading information.
 Privacy – Personal information collected in this form will be used by the assessment manager and/or chosen
 assessment manager, any referral agency and/or building certifier (including any professional advisers which may be
 engaged by those entities) while processing, assessing and deciding the development application.
 All information relating to this development application may be available for inspection and purchase, and/or
 published on the assessment manager’s and/or referral agency’s website.
 Personal information will not be disclosed for a purpose unrelated to the Planning Act 2016, Planning Regulation
 2017 and the DA Rules except where:
 ●​ such disclosure is in accordance with the provisions about public access to documents contained in the Planning
      Act 2016 and the Planning Regulation 2017, and the access rules made under the Planning Act 2016 and
      Planning Regulation 2017; or
 ●​ required by other legislation (including the Right to Information Act 2009); or
 ●​ otherwise required by law.
 This information may be stored in relevant databases. The information collected will be retained as required by the
 Public Records Act 2002.



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

 Date received:                                Reference numbers:



 For completion by the building certifier
 Classification(s) of approved building work

 Name                                                       QBCC Certification Licence     QBCC Insurance receipt
                                                            number                         number



 Notification of engagement of alternative 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


 Additional information required by the local government
 Confirm proposed construction materials:
                                        ☐ Double brick                  ☐ Steel                  ☐ Curtain glass
 External walls                         ☐ Brick veneer                  ☐ Timber                 ☐ Aluminium
                                        ☐ Stone/concrete                ☐ Fibre cement           ☐ Other
                                        ☐ Timber                        ☐ Steel                  ☐ Aluminium
 Frame
                                        ☐ Other
 Floor                                  ☐ Concrete                      ☐ Timber                 ☐ Other
                                        ☐ Slate/concrete                ☐ Tiles                  ☐ Fibre cement
 Roof covering
                                        ☐ Aluminium                     ☐ Steel                  ☐ Other


 QLeave notification and payment
 Note: For completion by assessment manager if applicable
 Description of the work
 QLeave project number
 Amount paid ($)                                                    Date paid (dd/mm/yy)
 Date receipted form sighted by assessment manager
 Name of officer who sighted the form


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




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                                                                                               DA Form 2 – Building work details
                         ​                                                  ​                    ​Version 1.2— 7 February 2020