Amended DA Form 2

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