Form BCA-BE-COWAQS01

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THE BUILDING CONTROL ACT)
PARTICULARS OF RESIDENT TECHNICAL OFFICER FOR

ACCEPTANCE AS SITE SUPERVISOR

Commissioner of Building Control
Building and Construction Authority
5 Maxwell Road #02-00
Tower Block, MND Complex
Singapore 069110 / INSTRUCTIONS
1 *Delete accordingly
2 Tick the appropriate box
3 Indicate “NA” in any space not applicable
4 Please use BLACK INK to complete the form
5 Follow other directions as indicated
I hereby submit my particulars as a Resident Technical Officer for the purpose of Section 10 of the Building Control Act.
My particulars are as follows:-
A / Personal Particulars
1 Full Name (in block letters):
*Mr/Mrs/Miss/Mdm: ______
(Underline surname)
2 Identification No: ______Nationality: ______
*(Singapore NRIC/PR/Malaysia IC/Passport)
3 Date and Place of Birth:______Written/Spoken Language______
4 Telephone No: ______(Home) ______(Office/Pager/HP)
5 Home Address: ______
______
______
B / Eligibility
#Entry Qualification:
1 Degree from any local/foreign university: ______
(Date of Degree:______)
2 Diploma from any local/foreign polytechnic in
Civil Engineering or Structural Engineering: ______
(Date of Diploma:______)
3 Others : ______
(To attach “CERTIFIED TRUE COPY” of your full transcript of Diploma/Degree)

# To attach a “CERTIFIED TRUE COPY” of your Diploma/Degree certificate and full transcript endorsed by the Professional Engineer.

Note: It is an offence to make or produce to the Commissioner of Building Control any document, declaration, certificate, report, record or notice which is false in a material particular.

BEV/B3_RTO_Sep 2007 Page 1 of 3

C / Current Employment
1 Current Employer - a) Professional Engineer
b) Developer/Builder
2 Name of Current Employer : ______
D / Details of Past Site Supervision & Experience [See APPENDIX 1]
E / Resident Technical Officer Declaration
I hereby declare that all the particulars and information given in this form and the appendices attached are true and accurate.
______
Signature of Resident Technical Officer Date
F / Professional Engineer's Declaration
I have personally checked and verified the above and the Resident Technical Officer's academic qualification and declare that he possesses the required practical experience and qualifications as prescribed (see APPENDIX 1). I am fully aware that I shall be liable for an offence if I make or produce any information, which is false in a material particular.
______
Professional Engineer's Stamp and Signature Date

Note: It is an offence to make or produce to the Commissioner of Building Control any document, declaration, certificate, report, record or notice which is false in a material particular.

BEV/B3_RTO_Sep 2007 Page 1 of 3

APPENDIX 1

DETAILS OF PAST SITE SUPERVISION EXPERIENCE

Applicant’s Name : ______

Date
(From & To) / Title and Cost of Project, Title of position held and describe in detail types of structural works supervised and degree of responsibilities in each engagement
(If space below is insufficient use next page) / Duration of
Site supervision & Name of the supervising professional engineer (PE)
(Months/Name of PE) / Name & Address of
Employer / Use this margin for
verification by
*Professional Engineer
(Sign & Stamp)
Total (Years & Months)

+ To be endorsed by Professional Engineer in the Civil or Structural Engineering discipline.

Note: It is an offence to make or produce to the Commissioner of Building Control any document, declaration, certificate, report, record or notice which is false in a material particular.

BEV/B3_RTO-Appendix 1_Sep 2007 Page 3 of 3