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?                                    Dwelling - 1a
Site area (m )2
                                   6.4 ha                           Floor area (m2)          289m2