FOrm 2 - updated - 53 Rene Street

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