D17129101DAForm2-Buildingworkdetails.pdf

 g) New building use/classification? (if applicable)


 h) Relevant plans
 Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide:
       Relevant plans.
     Relevant plans of the proposed works are attached to the development application

 17) What is the monetary value of the proposed building work?
 $350,000

 18) Has Queensland Home Warranty Scheme Insurance been paid?
    Yes – provide details below
    No
 Amount paid                    Date paid (dd/mm/yy)                                        Reference number
 $


PART 6 – CHECKLIST AND APPLICANT DECLARATION

 19) Development application checklist
 The relevant parts of Form 2 – Building work details have been completed                                         X Yes
 This development application includes a material change of use, reconfiguring a lot or                           X Yes
 operational work and is accompanied by a completed Form 1 – Development
 application details                                                                                                 Not applicable

 Relevant plans of the development are attached to this development application
 Note: Relevant plans are required to be submitted for all aspects of this development application. For further   X Yes
 information, see DA Forms Guide: Relevant plans.
 The portable long service leave levy for QLeave has been paid, or will be paid before                               Yes
 a development permit is issued (see 9)                                                                              Not applicable


 20) Applicant declaration
 X By making this development application, I declare that all information in this development application is true and
    correct
 X Where an email address is provided in Part 1 of this form, I consent to receive future electronic communications
    from the assessment manager and any referral agency for the development application where written
    information is required or permitted pursuant to sections 11 and 12 of the Electronic Transactions Act 2001
 Note: It is unlawful to intentionally provide false or misleading information.
 Privacy – Personal information collected in this form will be used by the assessment manager and/or chosen
 assessment manager, any referral agency and/or building certifier (including any professional advisers which may
 be engaged by those entities) while processing, assessing and deciding the development application.
 All information relating to this development application may be available for inspection and purchase, and/or
 published on the assessment manager’s and/or referral agency’s website.
 Personal information will not be disclosed for a purpose unrelated to the Planning Act 2016, Planning Regulation
 2017 and the DA Rules except where:
 • such disclosure is in accordance with the provisions about public access to documents contained in the Planning
      Act 2016 and the Planning Regulation 2017, and the access rules made under the Planning Act 2016 and
      Planning Regulation 2017; or
 • required by other legislation (including the Right to Information Act 2009); or
 • otherwise required by law.
 This information may be stored in relevant databases. The information collected will be retained as required by the
 Public Records Act 2002.




                                                                                                                                              Page 5
                                                                                                                     DA Form 2 – Building work details
                                                                                                                       Version 1.2— 7 February 2020


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g) New building use/classification? (if applicable)

 

 

h) Relevant plans
Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide:
Relevant plans.

LJ Relevant plans of the proposed works are attached to the development application

 

 

 

 

17) What is the monetary value of the proposed building work?
$350,000

 

18) Has Queensland Home Warranty Scheme Insurance been paid?

LJ Yes — provide details below

L] No

Amount paid Date paid (dd/mm/yy) Reference number

$

 

 

 

 

 

 

 

 

PART 6 — CHECKLIST AND APPLICANT DECLARATION

 

19) Development application checklist
The relevant parts of Form 2 — Building work details have been completed X Yes

This development application includes a material change of use, reconfiguring a lot or xX Yes
operational work and is accompanied by a completed Form 1 — Development CINot licabl
application details eee

 

 

Relevant plans of the development are attached to this development application

Note: Relevant plans are required to be submitted for all aspects of this development application. For further X Yes

information, see DA Forms Guide: Relevant plans.

The portable long service leave levy for QLeave has been paid, or will be paid before [_] Yes

a development permit is issued (see 9) LJ Not applicable

 

 

 

20) Applicant declaration

X By making this development application, | declare that all information in this development application is true and
correct

X Where an email address is provided in Part 1 of this form, | consent to receive future electronic communications
from the assessment manager and any referral agency for the development application where written
information is required or permitted pursuant to sections 11 and 12 of the Electronic Transactions Act 2001

Note: It is unlawful to intentionally provide false or misleading information.

Privacy — Personal information collected in this form will be used by the assessment manager and/or chosen

assessment manager, any referral agency and/or building certifier (including any professional advisers which may

be engaged by those entities) while processing, assessing and deciding the development application.

All information relating to this development application may be available for inspection and purchase, and/or

published on the assessment manager’s and/or referral agency’s website.

Personal information will not be disclosed for a purpose unrelated to the Planning Act 2016, Planning Regulation

2017 and the DA Rules except where:

e such disclosure is in accordance with the provisions about public access to documents contained in the Planning
Act 2016 and the Planning Regulation 2017, and the access rules made under the Planning Act 2016 and
Planning Regulation 2017; or

e required by other legislation (including the Right to Information Act 2009); or

e otherwise required by law.

This information may be stored in relevant databases. The information collected will be retained as required by the

Public Records Act 2002.

 

 

 

 

Page 5
DA Form 2 — Building work details
Version 1.2— 7 February 2020