Community Safety Operations

Application to Assess/Reassess

Special Fire Services and/or Alternative Solution Design

Assessment / Re-assessment / QFRS Job No:
B.A. Number: / D.A. Number:

Please fill in all sections below marked with a hash (#). The QFRS is unable to process this application unless ALL sections are complete and all requested documentation has been provided.

# APPLICANT DETAILS
Contact Person:
Company Name:
Postal Address: / Post Code:
Email Address:
Telephone: / Fax: / Mobile:
Signature:
# INVOICING DETAILS
Invoice to be charged to*
Name:
Company:
Customer Order Reference: (if applicable)
* Fees are charged in accordance with the Fire andRescue Service Act1990 and the Building Fire Safety Regulation 2008.
Postal Address: / Post Code:
Telephone: / ABN:
Authorised By: / Signature:
# BUILDING CERTIFIER DETAILS
Name: / BSA License Number:
Company:
Postal Address: / Post Code:
Email Address:
Telephone: / Fax: / Mobile:
# FIRE ENGINEER DETAILS
Name: / RPEQ Number:
Company: / BSA Fire Safety Professional Number:
Postal Address: / Post Code:
Email Address:
Telephone: / Fax: / Mobile:
# NATURE OF BUILDING APPLICATION
Building Approval / Fit out of Building / Change of Class / Use
This application includes an Alternative Solution ** component
Referral Agency Response Before Application to Building Certifier
Temporary Structure
Special Structure
Marina

CSO 020 Authorised By: Executive Manager, Fire Safety Command Version: 1/6/2011

ADDITIONAL INFORMATION
Change from DTS assessment to Alternative Solution assessment
Change from Alternative Solution assessment to DTS assessment
** If Alternative Solutions, what are the specific Alternative Solutions components:
# PREMISES DETAILS
Lot: / Plan: / Parish: / County:
Lot: / Plan: / Parish: / County:
Lot: / Plan: / Parish: / County:
Premises Name:
Premises Address:
Premises Suburb: / Post Code:
Existing Use: / Class (Select): 1b, 2, 3, 4, 5, 6, 7a, 7b, 8, 9a, 9b, 9c
Proposed Use: / Class (Select): 1b, 2, 3, 4, 5, 6, 7a, 7b, 8, 9a, 9b, 9c
Floor Area Existing (m2): / New / Additional (m2): / Total (m2):
No. of Storeys: / Rise in Storeys: / Effective Height:
(exact metres)
Size of Largest Fire Compartment (m2): / Type of Construction: / A B C
SPECIAL FIRE SERVICES TO BE ASSESSED (Please tick):
Fire Hydrants / Sprinklers
Fire Mains / Wall-Wetting Sprinklers
Fire Detection and Alarm Systems*** / Fire Control Centre
Smoke Exhaust Systems / Emergency Lifts
Air Handling System for Smoke Control / Special Automatic Fire Suppression Systems
Stairwell Pressurisation / Services required under the BCA, clause E1.10
Smoke and Heat Venting / Vehicular Access for Large Isolated Buildings
Sound systems & intercom systems for emergency purposes (formerly EWIS) / Special provisions under conditions imposed under the Building Act 1975 Section 79

***Assessment will be in accordance with the QFRS Fire Alarms and Building Design guidelines (supporting documentation is required). See: further information.

The completedApplication to Assess / Re-assess Special Fire Services and / or Alternative Solution Designshould be forwarded to QFRS with the following documents:

  • IDAS Form 1 – Application Details
/
  • Fire Engineering Brief (FEB)

  • IDAS Form 2 – Building work requiring assessment against the Building Act 1975
/
  • Fire Engineering Report (FER)

  • Building Application Drawings
/
  • A report addressing the six ‘performance recommendations’ detailed in the QFRS Fire Alarm and Building Design Guidelines for the Reduction of Unwanted Alarms (if required)

Fordetails regarding privacy and other uses and disclosures of your personal information, refer to the Department of Community Safety’s Information Privacy Plan, available on the Department’s website

By signing this application, the applicant acknowledges:

  • That in the event of a default of non payment of any invoices from the QFRS to the stated invoice recipient the applicant will be held liable for remittance.
  • The QFRS receives written correspondence from the invoice recipient advising that they wish to cease current arrangements; all invoices outstanding and issued henceforth will be to the applicant.
  • The applicant will notify the QFRS in writing within 14 days of any nomination of any alternative invoice recipient.

QFRS OFFICE USE ONLY
QFRS Job No. ______/ CSO PhysicalFolder No. ______/ Receipt No. ______

CSO 020 Authorised By: Executive Manager, Fire Safety Command Version: 1/6/2011