Image (11).jpg · OPW14/0226

Question 12

* The portable long service leave levy need not be paid when the application is made, but the Building and
Construction Industry (Portable Long Service Leave) Act 1991 requires the levy to be paid before a development
Permit is issued.

* Building and construction industry notification and Payment forms are available fram any Queensiand post office or
agency, on request from QLeave, or can be completed on the QLeave website at www.gleave.qid.gov.au. For
turther information contact QLeave on 1800 803 481 or visit www.qleave.qid.gov.au.

Privacy—The information collected in this form will be used by the Department of State Development, Infrastructure
and Planning (DSDIP), assessment manager, referral agency and/or building certifier in accordance with the
Processing and assessment of your application. Your personal details should not be disclosed for a purpose outside of
he IDAS process or the provisions about public access to planning and development information in the Sustainable
Planning Act 2009, except where required by legislation (including the Right to Information Act 2009) or as required by
Parliament. This information may be stored in relevant databases. The information collected wil be retained as.
required by the Public Records Act 2002.

 

OFFICE USE ONLY

Date received Reference numbers

NOTIFICATION OF ENGAGEMENT OF A PRIVATE CERTIFIER

To Council. | have been engaged as the private certitier for the
building work referred to in this application

BSA Certification license Building
number classification/s

 

 

 

 

 

 

Date of engagement | Name

 

 

 

 

 

QLEAVE NOTIFICATION AND PAYMENT (For completion by assessment manager or private certitler if
applicable.)

 

Date receipted
form sighted by
assessment
manager

Name of officer
who sighted the
form

QLeave project Amount paid

Description of the work RurnBer @) Date paid

 

 

 

 

 

 

 

 

 

The Sustainable Planning Act 2009 is administered by the Department of State Development, Infrastructure and
Planning. This form and all other required application materials should be sent to your assessment manager and any
referral agency.

Department of State Development, infrastructure and Planning
PO Box 15009 City East Qld 4002
tel 13 QGOV (13 74 68)

[email protected]. gov au IDAS form 1—Apniication details

Version 3.0—1 July 2013
www.dsdip.gid.gov.au SiON diuly