Application for a Building Permit CHECKLIST

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					     Builder:                                                                    Category:

     Address:                                                                   Phone No:
                                                                                                                                                          Application for a Building Permit
                                                                                                                                                      To Permit Authority, Clarence City Council, 38 Bligh Street Rosny Park 7018
                                                                                   Fax No:

     Accreditation No:                                                       Email address:
     Documents and certificates provided:                                                                                          The personal information on this form is required by Council under the Building Act 2000. We will only use your
  The following specified documents and certificates are provided with this application -                                          personal information for this and other related purposes. If this information is not provided, we may not be able to deal
                                                                                                                                   with this matter. You may access and/or amend your personal information at any time. How we use this information is
                               Document or certificate description:                                  Prepared by:                  explained in our Privacy Policy, which is available at or at Council offices.
                                                                                              (accreditation No. if applicable)
            •     Certificate of Title, Schedule and Plan (1)                                                                      This checklist is provided to assist applicants in ensuring that all the information required is included with the
            •     Certificate of Likely Compliance (3)                                                                             application. Your application will be dealt with promptly, however, approval will be delayed and the permit may
            •     Site plans (3), Drainage plan & specifications if required                                                       be refused if all the information is not provided or other relevant approvals have not been obtained at the time of
            •     Architectural Plans (3)
            •     Outline Plan and procedure of demolition works if applicable (3)                                                 Before Council as the Permit Authority may consider granting a Building Permit the following information must
            •     Details of proposed work for the protection of                                                                   be provided:
                  persons or property (3)
            •     Owner Builder Statement if the builder is an owner builder (3)                                                  1.   Planning Permit
            •     All documents referred to on the Certificate of                                                                      Details for planning approvals obtained in respect to the proposed building work or evidence that a
                  Likely Compliance (3)                                                                                                planning permit is not required.
            •     Copy of Plumbing Permit/Special Plumbing Permit                                                                      IMPORTANT INFORMATION: If your proposed development or its use requires a
            •     Other Permits if required.                                                                                           permit under the Land Use Planning and Approvals Act 1993 and this has not been
                                                                                                                                       obtained prior to the lodgement of your Building Application your application may
                                            OWNER/AGENT DECLARATION:                                                                   be refused. You are urged to discuss your proposal with Council’s planning staff
   I certify that:-                                                                                                                    prior to lodgement of the application to ensure that any planning scheme
   •    All the information listed in the attached Checklist is provided with this application;                                        requirements have been met.
   •    The building practitioners involved in the proposed building work and identified in this application hold the
        appropriate accreditation required to undertake that work; and
   •    The building work will be carried out in accordance with the Building Act, the Building Regulations 2004 and the          2.   Plumbing Permits
        Building Code of Australia.                                                                                                    Where the proposed building work includes plumbing work separate applications for a Plumbing Permit and
                                               Name: [print]                         Signed                            Date            a Special Plumbing Permit (if applicable) must be completed and Permits issued.
Owner / Agent:                                                                                                                         (Please ask a Building Officer for relevant forms and fee details).
(Delete one not applicable)

                                                                                                                                  3.   On-site Waste Water Management System
                   TIMEFRAME CONSENT FOR CONSIDERATION OF BUILDING APPLICATION:                                                        Where the proposed building work includes the installation of or an alteration to an on-site waste water
                                                                                                                                       management system a separate consent is required to be obtained from Council’s Environmental Health
   The Building Act 2000 requires that the Permit Authority (Clarence City Council) determine this application for a                   Officer prior to the lodgement of the building application.
   Building Permit within 7 days of its lodgement or within a time agreed to by the applicant.
                                                                                                                                       (Please ask a Building Officer for relevant forms and fee details).
   I understand that:-
       • a building permit cannot be granted unless:
               o all the required information is provided with this application;                                                  4.   Historic Cultural Heritage Act 1995
               o all planning, plumbing, and special plumbing permits are in place; and                                                An approval may be required from the Tasmanian Heritage Council where the proposed building works
               o if required, a permit under the Historic Cultural Heritage Act is in place.                                           affect the historic cultural heritage significance of a registered place or a place within a heritage area.
       • if this application is refused a new application and fee will or may be required.                                             IMPORTANT INFORMATION: If the provisions of the Historic Cultural Heritage Act
       • prior Building Permits                                                                                                        1995 apply to the building work you are urged to ensure that the proposal is
   As these other permits may require additional time for assessment I consent to extend the time to determine this                    approved or exempted by the Tasmanian Heritage Council prior to the lodgement
   application to 7 days from the date when all required permits have been granted or when advice that these permits                   of your application.
   have been granted has been given by me to the Permit Authority.
                                                                                                                                  5.   Other Relevant Approvals
   I also agree that:-
                                                                                                                                       Other relevant approvals may be required under Tasmanian legislation in respect to your proposed building
        • the documents provided with this application may be copied and used by the Permit Authority for the
            purposes of assessing this application; and
        • I will advise the Permit Authority in respect to permits required from other organisations (ie other than the
                                                                                                                                       IMPORTANT INFORMATION: If the provisions of the Aboriginal Relics Act 1975, the
            Clarence City Council) when these permits have been granted and provide copies of these other permits                      Threatened Species Protection Act 1995 or the Forest Practices Act 1985 or other
            upon request.                                                                                                              acts apply to the building work you are urged to ensure that your proposed
                                               Name: [print]                         Signed                            Date            building work is also approved by the relevant State Government agency.
Owner / Agent:
(Delete one not applicable)
                                                                                                                                  6.   Stability of the Site
                                                                                                                                       A Site Stability Report prepared and signed by a suitably qualified person that indicates the stability of the
                                                               Page 4 of 4
                                                                                                                                       site is suitable for the proposed works.
                                                                                                                                                                                            Please turn the page for further information
                                                                                                                                                                                           Page 1 of 4
7.   Certificate of Title (These can be obtained from any Service Tasmania office)                                                                                                                                                                              Sect 70
                                                                                                                                                        Application for a Building Permit
             Search Page showing details of owners, mortgagees, Registered Agreements and other dealings
             Sealed Plan, Plan or Diagram showing the property location, lot number and boundaries                                           To Permit Authority, Clarence City Council, 38 Bligh Street Rosny Park 7018
                                                                                                                                                                                                                                                               Form           2
         •   Schedule of Easements, Agreements or Transfer (where noted on the Search Page)
                                                                                                                       OFFICE USE ONLY:
8.   Application fees must be paid at the time of lodgement.
     Fees are determined by the cost of the building work and the classification of the building and will include
     the State Government levies (Training Levy under the Building and Construction Industry Training Fund Act         IMPORTANT INFORMATION: Before you submit this application please ensure that all the documentation
     1990 for building work valued greater than $5,000 and the Building Permit levy under the Building Act 2000        detailed in the “Checklist for an Application for a Building Permit” is attached. Applications are requested to
     for building work valued greater than $5,000).                                                                    be submitted in person.
     (Please ask the Building Officer for relevant forms and fee details).                                              Applicant / Owner details:
                                                                                                                       Note: Only an owner or agent of the owner may make an application
9.   Completed Application for a Building Permit                                                                        Owner:
     The application must be signed and dated by the owner or the authorised agent for the owner (Refer to the
     bottom of this page and to page 4 of this form).                                                                   Address:                                                                                         Phone No:

     IMPORTANT INFORMATION: A written authority from the owner is required or the                                                                                                                                           Fax No:
     owner’s agent is to complete the authorisation - Refer to the bottom of this page
     for authorisation.                                                                                                 Owner builder:          Yes:          (X if applicable)                 Email address:

10. Housing Indemnity Insurance (Certificate of Insurance under the Housing Indemnity Act 1992)
         •   A certificate is required if building work is valued at $12, 000 or greater and the applicant is not an    Address:                                                                                                  Phone No:
             owner builder                                                                                                                                                                                                           Fax No:
         •   If the applicant is an Owner Builder and the property is sold within 6 years of completion then the
             person is required by the Housing Indemnity Act 1992 to get insurance to cover the residual period         Note: Agents to be authorised in writing by the owner                   Email address:

11. Certificate of Likely Compliance                                                                                    Details of building work:
         •   A Certificate of Likely Compliance issued by an accredited Building Surveyor is to be provided with
             the application accompanied by a complete set of certified plans and drawings and referenced               Address:                                                                                                                  Lot No:
             documents. The Certificate (including all conditions and all referenced plans drawings and
                                                                                                                                                                                                                                  Certificate of title No:
             documents are to be endorsed in ink by the Building Surveyor.
         •   (For details of the plans and documents required refer to page 4 of this form.)                            Type of work:
                                                                                                                                                                                                                     (new building / alteration / addition / repair /demolition /
                                                                                                                                                                                                                     removal / re-erection / other)

12. Consent to building over services or easements                                                                      Use of building:                                                                             (main use)         Building class:
     Details of any proposal to build over or within a metre of an existing drain, within or over a service
     easement. Provide a copy of any related consents from the appropriate authority.                                   Housing Indemnity Details:
13. Cost of works statement                                                                                             Insurer                                                                                               Policy No:
     Where no contract price exists, statement of cost of works from the Building Surveyor must be provided.
                                                                                                                        Other details:
 If you need assistance or further information please contact a Building Officer on 6245-8600.
                                                                                                                        Area: m2                        existing building floor:                     new floor:                                     land:

                                                                                                                        Material:              floor:                    walls:                              roof:                                frame:

                                                   AGENT AUTHORISATION:                                                 Value of work: $                                     contract price:          estimate:          (X one applicable.)
 I/We_____________________________________________________________________(owners name/s)                               [inclusive of GST]                                                                               No. of dwelling units:
 being the owner/s of ________________________________________________(address of property)
 hereby authorise ___________________________________________________________(name of agent)                            Building practitioner details:
 to act as agent in respect to this application for a Building Permit.
 Signed ________________(owner/s)                   Dated_______________                                                Surveyor:

                                                                                                                        Address:                                                                                         Phone No:
                                                   AGENT DECLARATION                                                                                                                                                        Fax No:

                                                                                                                        Accreditation No:                                                  Email address:
 I/We_____________________________________(Agent of the owner) Have authority from the owner to
 lodge this application for a Building Permit with the Clarence City Council.                                           Designer:                                                                                         Category:

 Signed __________________________________(Agent)                    Dated__________________                            Address:                                                                                         Phone No:

                                                         Page 2 of 4                                                                                                                                                        Fax No:

                                                                                                                        Accreditation No:                                                  Email address:
                                                                                                                                                                                               Page 3 of 4

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Description: Application for a Building Permit CHECKLIST