Client / Job Detail
(can be printed, or filled out electronically)
Project Details
ACT / unit / block / section
NSW / unit / lot / DP
address
suburb / state / postcode
Applicant Details(note: all documents will be sent to this person)
name
postal address
suburb / state / postcode
mob / phone
email
Owners Details
All owners must be listed. Owner 1, considered contact person.
owner 1 / owner 2
owner 3 / owner 4
company / abn/acn
postal address
suburb / state / postcode
mob / phone
email
Billing Details – please advise who to bill: 1. ACT Govt Levies and 2. Certification fees
applicant / owner / builder
Builders Details
licence holders name as it appears on licence card
licence number / class / expiry
If the builder is a company or partnership, provide details of the nominee who will supervise the building work.
nominee
licence number / class / expiry
postal address
suburb / state / postcode
mob / phone
email
Required documents to be supplied
ACT / NSW
  • full set of working drawings with specifications
/
  • full set of council approved plans with specifications

  • full set of DA Approved plans (if applicable)
/
  • copy of the relevant council’s development consent conditions / documents

  • ACTPLA Notice of Decision (if applicable)
/
  • engineer’s structural details / soil classification

  • engineer’s structural details / SITE classification
/
  • if development over $50k - BASIX certificate

  • energy rating certificate (completed by a licenced assessor)
/
  • copy of builder’s license or owner builder’s license

  • copy of builder’s license or owner builder’s license
/
  • if a licensed builder and value of work exceeds $20k - copy of building owner’s home warranty insurance

  • if a licenced builder and value of work is over $12k - copy of building owner’s home warranty insurance
/
  • receipt for long service levy payment over $25k

  • asbestos survey certificate (if applicable)
/
  • asbestos survey certificate (if applicable)

  • demolition waste management plan (if applicable)
/
  • demolition waste managementplan (if applicable)

  • form 7A and form 7B for any DA exempt construction, demolition or additions to existing residence (see link a. below)

  • evidence of a building sign must be erected seven daysprior to issue of Building Commencement Notice (see link b. below). Our details: ABN 60110603850 Licence: 2010979 PH:61622632

  • copy of ACT builders licence card

a)

b)

OFFICE USE ONLY

Application Sought
ACT / building approval only / exempt DA & building approval / other
NSW / construction certificate / occupation certificate / other
Proposed Development
single dwelling / alteration & additions / pool
multi dwelling / commercial / fitout
Demolition / other
estimate cost of building work / (including GST)
Description of work – OFFICE USE ONLY
Describe each item of building work in this building approval / BCA Occupancy Class / BCA Const.
Type / Area (m2) / No.of Storeys / Cost of Works (refer to building cost guide)
Application received
date received

ACCEPTANCE OF FEE PROPOSAL

Including Select Structure P/L TERMS OF ENGAGEMENT

SELECT STRUCTURE P/L REFERENCE:
(Select’s Office Use Only)
PROJECT DETAILS:
(Select’s Office Use Only)
FEE PROPOSAL / As per quotation emailed:
ACCEPTANCE OF FEE PROPOSAL / Yes No
COMPANY / NAME FOR INVOICE:
(Who we will be billing) / Applicant / Owner / Builder
(circle appropriate contact as per listed in client detail information)
BILLING ADDRESS: / Applicant / Owner / Builder
(circle appropriate contact as per listed in client detail information)
COMPANY ABN (or ACN) / Applicant / Owner / Builder
(circle appropriate contact as per listed in client detail information)
CONTACT PERSON:
(For all accounts enquiries) / Applicant / Owner / Builder
(circle appropriate contact as per listed in client detail information)
NAME:
SIGNATURE:
DATE:

· office 0402 467 897 · mobile 0418 265 453 ·

· certifier ACT 2010979 / NSW BPB1140 · ABN 60 110 603 850 ·

· · · PO Box 1508, Unit 1/16 Geelong St Fyshwick ACT 2609 ·