Original source · versioned page text
D17129101DAForm2-Buildingworkdetails.pdf
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 ($) Date paid (dd/mm/yy)
Date receipted form sighted by assessment manager
Name of officer who sighted the form
Additional building details required for the Australian Bureau of Statistics
Existing building use/classification? (if applicable)
New building use/classification?
Site area (m2) Floor area (m2)
Page 6
DA Form 2 – Building work details
Version 1.2— 7 February 2020
[OCR of page images]
PART 7 — FOR COMPLETION BY THE ASSESSMENT MANAGER -— FOR OFFICE
USE ONLY
Date received: [i Reference numbers: |
For completion by the building certifier
Classification(s) of approved building work
Name QBCC Certification Licence QBCC Insurance receipt
number number
Notification of engagement of alternative assessment manager
Prescribed assessment manager
Name of chosen assessment manager
Date chosen assessment manager engaged
Contact number of chosen assessment manager
Relevant licence number(s) of chosen assessment
manager
Additional information required by the local government
Confirm proposed construction materials:
LJ Double brick CJ Steel LJ Curtain glass
External walls C1 Brick veneer (J Timber (J Aluminium
L Stone/concrete L] Fibre cement J Other
Timber CJ Steel (J Aluminium
Frame FJ Other
Floor 1 Concrete (J Timber LJ Other
. LJ Slate/concrete LJ Tiles L] Fibre cement
Roof covering Aluminium C Steel CF Other
QLeave notification and payment
Note: For completion by assessment manager if applicable
Description of the work
QLeave project number
Amount paid ($) _| Date paid (dd/mmiyy) _|
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 (m?) Floor area (m2)
Page 6
DA Form 2 — Building work details
Version 1.2— 7 February 2020
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