IDAS Form 1 · OPW15/0169

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 from any Queensland post office or
  agency, on request from QLeave, or can be completed on the QLeave website at www.qleave.qld.gov.au. For
  further information contact QLeave on 1800 803 481 or visit www.qleave.qld.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 will not be disclosed for a purpose outside of the
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 will be retained as
required by the Public Records Act 2002.


OFFICE USE ONLY
 Date received      06-Jul-15                           Reference numbers         20150300

NOTIFICATION OF ENGAGEMENT OF A PRIVATE CERTIFIER
 To      NOOSA COUNCIL                                  Council. I have been engaged as the private certifier for the
                                                        building work referred to in this application

                                                                    BSA Certification license         Building
Date of engagement Name
                                                                    number                            classification/s

06-Jul-15             Don Grehan, Pacific BCQ                       A739669                           1A


QLEAVE NOTIFICATION AND PAYMENT (For completion by assessment manager or private certifier if
applicable.)
                                                                  Date receipted
                                                                                  Name of officer
                        QLeave project Amount paid                form sighted by
Description of the work                                 Date paid                 who sighted the
                        number         ($)                        assessment
                                                                                  form
                                                                  manager
                                                    $


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.