20170526 - DA Form 2 · 51901.3589.03

PART 7 – FOR OFFICE USE ONLY - FOR COMPLETION BY THE ASSESSMENT
MANAGER

  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)


  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


  Date received:                              Reference numbers:     20170526

  For completion by the building certifier
  Classification(s) of approved building work               QBCC Insurance receipt           QBCC Certification Licence
                                                            number                           number



  Notification of engagement of alternate chosen assessment manager
  Prescribed assessment manager                                   N/A
  Name of chosen assessment manager                               N/A
  Date chosen assessment manager engaged                          N/A
  Contact number of chosen assessment manager                     N/A
  Relevant licence number(s) of chosen assessment                 N/A
  manager

The Planning Act 2016, the Planning Regulation 2017 and the DA Rules are administered by the Department of
Infrastructure, Local Government and Planning. This form and all other required development application materials should
be sent to the assessment manager.




                                                                                                                             Page 6
                                                                                          DA Form 2 – Development Application details
                                                                                                            Version 1.0—3 July 2017