Building Act 1993

BUILDING INTERIM REGULATIONS 2017

Regulation 1002

Form 5

APPLICATION FOR OCCUPANCY PERMIT

Class 1a or 1b

To
Relevant building surveyor – Dean Bertuch, David Thacker, Jo van Loon & Peter Phillips, Chris Biviano &
Greg Stepien
From
Owner or Agent / / Telephone

Property /project details

In accordance with section 42 of the Building Act 1993, I hereby apply for an occupancy permit for the building at:-

Project Address / Post code
Municipality /
Building practitioners1 and/or architects
Include practitioners who were involved in the building work and who were not known or not listed at time of completion of application for building permit.
Name Category/Class Registration No.
Name Category/Class Registration No.
Name Category/Class Registration No.
Use applied for
Part of building/Unit - / Intended use Dwelling / BCA Class 1a
Signature
Signature of owner or agent / / Date
The following certificates are to be provided at the time of final inspection to the Relevant Building Surveyor and are required prior to the issue of the occupancy permit (tick relevant included certificates/statements):
Certificate of Compliance Plumbing Works – Sanitary, hot and cold water, roof, septic tank (where applicable)
Statement from window manufacturer or glazier that glass installed in the building complies with AS 1288 - 2006
Statement from Shower Screen manufacturer that glass installed complies with AS 1288 - 2006
Certificate of Compliance Electrical Installation
Details of Solid Fuel Heater appliance and method of installation
Certificate of compliance in respect of termite protection
Confirmation of the on site compliance plate/sticker being installed in respect of the termite protection method
Statement of compliance with the Energy rating report - please complete separate statement as per attached
Certificate to use from the Council in relation to the installation of septic tank or waste water treatment plant
In the case that more than one contractor has been involved in the works then a certificate from each contractor is required to be submitted.

First Floor, 126 Torquay Road, Grovedale, 3216

P 03 5241 2559 F 03 5241 2563 E

Culberon Pty Ltd A.B.N 51 132 434 541 trading as BSA Building Surveyors

BSA Building Surveyors

Energy Efficiency Compliance Statement

To /
Relevant Building Surveyor /
From /
Builder / Owner Builder /
Project Details /
Project type /
Project address /
Building Permit No /
I certify that the energy efficiency measures listed below as relevant to this project have been provided in accordance with in Building Code of Australia volume 2 Part 3.12 and the approved building permit documents:
Building fabric - wall, ceiling and floor insulation rating and installation
Building sealing , window and door seals, exhaust fans, vent baffles, light caps etc
Windows and glazing, construction and installation (see note 1 below)
Electrical lighting and heating installations (see note 2 below)
Solar hot water system
Water tank to toilet facilities
Central heating ducting and piping
Electric resistance space heating
Swimming pool / spa heating and pumping
Please indicate P items relevant to this project
Signed / / Dated
Name / Reg. No
Builder / Owner builder

Notes

1  Windows - the window manufacturer will need to provide written confirmation that the window supplied comply with

(a)  AS2047-1999 Windows in Housing,

(b)  AS1288-2006 Glass in Buildings

(c)  The energy rating report / building permit documents.

2  Electrical compliance relates to the number of light fittings, dimmers if applicable and the rating (wattage) of the lights installed, also heating appliance as approved in the building permit documents. A compliance statement from the electrician is also acceptable.

First Floor, 126 Torquay Road, Grovedale, 3216

P 03 5241 2559 F 03 5241 2563 E

Culberon Pty Ltd A.B.N 51 132 434 541 trading as BSA Building Surveyors