2. DA Form 2 · 51901.3604.02

                                            ☐ Stone/concrete                      ☑ Fibre cement                      ☑ Other
                                            ☑ Timber                              ☐ Steel                             ☐ Aluminium
 Frame
                                            ☑ Other
 Floor                                      ☑ Concrete                            ☐ Timber                            ☑ Other
                                            ☐ Slate/concrete                      ☐ Tiles                             ☐ Fibre cement
 Roof covering
                                            ☐ Aluminium                           ☑ Steel                             ☐ Other
 f) Existing building use/classification? (if applicable)

 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?                      200000.00

 18) Has Queensland Home Warranty Scheme Insurance been paid?
 ☐ Yes – provide details below
 ☑ No
 Amount paid                                            Date paid (dd/mm/yy)                             Reference number
 $                                                                                                       Not Applicable


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
 operational work and is accompanied by a completed Form 1 – Development
                                                                                                                  ☐ Yes
 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   ☑ Yes
 information, see DA Forms Guide: Relevant plans.
 The portable long service leave levy for QLeave has been paid, or will be paid before a ☐ Yes
 development permit is issued
                                                                                         ☑ Not applicable
 20) Applicant declaration
 ☑ By making this development application, I declare that all information in this development application is true and
 correct
 ☑ 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:


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                                                                                                        DA Form 2 – Development Application details
                                                                                                                      Version 1.1— 22 JUNE 2018