OPW15/0056 - IDAS Forms Part 1 of 2

   Question 12
   • The portable long service leave levy need not be paid when the application is made, but the Building and
      Construction tndustry (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 1800803481 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 should 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       ~                                      ~I      Reference numbers

   NOTIFICATION         OF ENGAGEMENT            OF A PRIVATE CERTIFIER

    To                                                                  Council. I have been engaged as the private certifier for the

             ----------------                                       I   building work referred to in this application

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




   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
                                                                                                       manaoer




   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 Old 4002
10113 oGOV (13 74 68)
[email protected]                                                                                          IDAS form 1-Application delails
                                                                                                                      Version 4.1-4 July 2014
www.dsdip.qld.gov.au