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FOrm 2 - updated - 53 Rene Street
Attached to the e-mail Operational Works Application OPW22/0172 - DA Form 1 & 2 - Civil Plans 1 of 2 - 53-57 Rene Street, Noosaville - Operational Works.
DA Form 2 — Building work details Approved form (version 1.2 effective 7 February 2020) made under Section 282 of the Planning Act 2016. This form must be used to make a development application involving building work. For a development application involving building work only, use this form (DA Form 2) only. The DA Forms Guide provides advice about how to complete this form. For a development application involving building work associated and any other type of assessable development (i.e. material change of use, operational work or reconfiguring a lot), use DA Form 1 - Development application details and parts 4 to 6 of this form (DA Form 2). Unless stated otherwise, all parts of this form must be completed in full and all required supporting information must accompany the development application. One or more additional pages may be attached as a schedule to this development application if there is insufficient space on the form to include all the necessary information. This form and any other form relevant to the development application must be used to make a development application relating to strategic port land and Brisbane core port land under the Transport Infrastructure Act 1994, and airport land under the Airport Assets (Restructuring and Disposal) Act 2008. For the purpose of assessing a development application relating to strategic port land and Brisbane core port land, any reference to a planning scheme is taken to mean a land use plan for the strategic port land, Brisbane port land use plan for Brisbane core port land, or a land use plan for airport land. Note: All terms used in this form have the meaning given under the Planning Act 2016, the Planning Regulation 2017, or the Development Assessment Rules (DA Rules). PART 1 — APPLICANT DETAILS Applicant name(s) (individual or company full name) Cee Contact name (only applicable for companies) Ln~anSa, Postal address (PO Box or street address) Ze (82. oy Suburb State Cokes Postcode Country Contact number Email address (non-mandatory) Mobile number (non-mandatory) Fax number (non-mandatory) Applicant's reference number(s) (if applicable) PART 2 — LOCATION DETAILS 2) Location of the premises (complete 2.1 and 2.2 if applicable) Note: Provide details below and attach a site plan for any or all premises part of the development application. For further information, see DA Fete MCL (PaaS ENCe LW OLED 2.1) Street address and lot on plan Bl Street address AND lot on plan (ai! ots must be listed), Or [7] Street address AND lot on plan for an adjoining or adjacent property of the premises (appropriate for development in water but adjoining or adjacent to land e.g. jetty, pontoon. All lots must be fisted). Queensland Government
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Page 2
Unit No. Street No. Street Name and Type Suburb
B-37 Res sree Pookie (ee
Postcode Lot No. Plan Type and Number (e.g. RP, SP) Local Government Area(s)
4566 ZR SP oh 221 NSc-
2.2) Additional premises
(J Additional premises are relevant to this development application and the details of these premises have been
attached in a schedule to this development application
(J Not required
3) Are there any existing easements over the premises?
Note: Easement uses vary throughout Queensland and are to be identified correctly and accurately. For further information on easements and
how they may affect the proposed development, see the DA Forms Guide
(J Yes ~ All easement locations, types and dimensions are included in plans submitted with this development
application
(No
PART 3 —- FURTHER DETAILS
4) Is the application only for building work assessable against the building assessment provisions?
(] Yes — proceed to 8)
[No
5) Identify the assessment manager(s) who will be assessing this development application
6) Has the:local government agreed to apply a superseded: planning scheme for this development application?
(11 Yes -— a copy of the decision notice is attached to this development application
(1 The loca! government is taken to have agreed to the superseded planning scheme request — relevant documents
attached
C1 No
7) Information request under Part 3 of the DA Rules.
L l agree to receive an information request if determined necessary for this development application
(J | do not agree to accept an information request for this development application
Note: By not agreeing to accept an information request I, the applicant, acknowledge:
¢ that this development application will be assessed and decided based on the information provided when making this development
application and the assessment manager and any referral agencies relevant to the development application are not obligated under the DA
Rules to accept any additional information provided by the applicant for the development application unless agreed to by the relevant
parties.
« Part 3 of the DA Rules will still apply if the application is an application listed under section 11.3 of the DA Rules.
Further advice about information requests is contained in the DA Forms Guide.
8) Are there any associated development applications or current approvals?
C1 Yes — provide details below or include details in a schedule to this development application
LI No
List of approval/development Reference Date Assessment manager
application
CD Approval
CJ Development application
(1 Approval
(J Development application
. Page 2
DA Form 2 — Building work details
Version 1.2— 7 February 2020
Page 3
9) Has the portable long service leave levy been paid? (1 Yes — a copy of the receipted QLeave form is attached to this development application (11 No - |, the applicant will provide evidence that the portable long service leave levy has been paid before the assessment manager decides the development application. | acknowledge that the assessment manager may give a development approval only if | provide evidence that the portable long service leave levy has been paid (_] Not applicable (e.g. building and construction work is less than $150,000 excluding GST) Amount paid Date paid (dd/mm/yy) QLeave levy number (A, B or E) $ 10) Is this development application in response to a show cause notice or required as a result of an enforcement notice? (J Yes — show cause or enforcement notice is attached [] No 11) Identify any of the following further legislative requirements that apply to any aspect of this development application (J The proposed development is on a place entered in the Queensland Heritage Register or in a local government's Local Heritage Register. See the guidance provided at www.des.qld.gov.au about the requirements in relation to the development of a Queensland heritage place Name of the heritage place: Place ID: PART 4 — REFERRAL DETAILS 12) Does this. development application include any building work.aspects that have any referral requirements? (J Yes — the Referral checklist for building work is attached to this development application No ~ proceed to Part 5 13) Has any referral agency provided a referral response for this development application? (1 Yes - referral response(s) received and listed below are attached to this development application No Referral requirement Referral agency Date referral response Identify and describe any changes made to the proposed development application that was the subject of the referral response and this development application, or include details in a schedule to this development application (if applicable) PART 5 — BUILDING WORK DETAILS [4 Tick if the applicant is also the owner and proceed to 15). Otherwise, provide the following information. Name(s) (individual or company full name) Contact name (applicable for companies) Postal address (P.O. Box or street address) Suburb State » Page3 DA Form 2 - Building work details Version 1.2— 7 February 2020
Page 4
Postcode Country Contact number Email address (non-mandatory) Mobile number (non-mandatory) Fax number (non-mandatory) Ld Tick if a builder has not yet been engaged to undertake the work and proceed to 16). Otherwise provide the following information. Name(s) (individual or company full name) Contact name (applicable for companies) QBCC licence or owner — builder number Postal address (P.O. Box or street address) Suburb State Postcode Contact number Email address (non-mandatory) Mobile number (non-mandatory) Fax number (non-mandatory) 16) Provide details about the proposed building work What type of approval is being sought? Development permit C Preliminary approval b) What is the level of assessment? [+f Code assessment O Impact assessment (requires public notification) c) Nature of the proposed building work (tick all applicable boxes) C1 New building or structure C1 Repairs, alterations or additions (1 Change of building classification (involving building work) (J Swimming poo! and/or pool fence [J Demolition [J Relocation or removal d) Provide a description of the work below or in an attached schedule. Prop. Devewau + Modification +o Sewer] Stormwater t hater mfrasipybivnes e) Proposed constructidn/materials DD Double brick Steel C1 Curtain glass External walls 0 Brick veneer (J Timber C Aluminium CJ Stone/concrete (1 Fibre cement (1 Other (J Timber C1 Steel C1 Aluminium Frame CJ other Floor (1 Concrete (1 Timber D Other . UO Slate/concrete O Tiles C Fibre cement Roof covering UO Aluminium CJ Steel CJ Other f) Existing building use/classification? (if applicable) : Page 4 DA Form 2 — Building work details Version 1.2— 7 February 2020
Page 5
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. P*} Relevant plans of the proposed works are attached to the development application 17) What is the monetary value of the proposed building work? $ 0 18) Has Queensland Home Warranty Scheme Insurance been paid? C1 Yes — provide details below EH 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 [¥] Yes This development application includes a material change of use, reconfiguring a lot or A Yes operational work and is accompanied by a completed Form 1 — Development (I Not applicabt application details ot applicable Relevant plans of the development are attached to this development application ed Yes Note; Relevant plans are required to be submitted for all aspects of this development application. For further 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 si By making this development application, | declare that all information in this development application is true and correct 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: If 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 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
Page 6
PART 7 ~ FOR COMPLETION BY THE ASSESSMENT MANAGER -— FOR OFFICE USE ONLY Date received: [sd 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: (1 Double brick C] Steel (J Curtain glass External walls (1 Brick veneer (] Timber [1] Aluminium C1 Stone/concrete (1 Fibre cement C1 Other (1 Timber (Steel CZ Aluminium Frame EJ other Floor 1 Concrete Ci Timber OD Other . LD Slate/concrete OTiles L Fibre cement Roof covering OO Aluminium UO Steel CO 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 (m?) Page 6 DA Form 2 — Building work details Version 1.2— 7 February 2020