Victorian Numbered Regulations Victorian Numbered RegulationsSch. 2
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Form 1 |
Application for a building permit |
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Form 2 |
Building permit |
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Form 3 |
Building permit levy return |
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Form 4 |
Building work commencement, completion or permit lapse return |
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Form 5 |
Protection work notice |
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Form 6 |
Protection work response notice |
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Form 7 |
Application for occupancy permit |
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Form 8 |
Occupancy permit |
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Form 9 |
Certificate of final inspection |
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Form 10 |
Annual essential safety measures report |
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Form 11 |
Certificate of compliance—Design |
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Form 12 |
Certificate of compliance—Inspection |
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Form 13 |
Building infringement notice |
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FORM 1
Form 1
Building (Interim) Regulations 2005
APPLICATION FOR A BUILDING PERMIT
To (Building surveyor)
From
Owner*/Agent of owner*
* delete if inapplicable
Postal address
Postcode
Address for serving or giving of documents
Postcode
Indicate if the applicant is a lessee or licensee of Crown land to which this application applies o †
† tick if applicable
Contact person Telephone
Ownership Details (only if agent of owner listed above)
Owner
Postal address
Postcode
Contact person Telephone
Property details
Number Street/road City/suburb/town Postcode
Lot/s LP/PS Volume Folio
Crown allotment Section Parish County
Municipal district Allotment area (for new dwellings only) m 2
Land owned by the Crown or a public authority o †
† tick if applicable
Builder (if known)
Form 1
Name Telephone
Postal address Postcode
Building practitioners 1 and/or architect
(a) to be engaged in the building work 2
Name Category/Class Registration No.
Name Category/Class Registration No.
(If a registered domestic builder carrying out domestic building work attach details of the required insurance)
(b) who were engaged to prepare documents forming part of the application for this permit 3
Name Category/Class Registration No.
Name Category/Class Registration No.
Nature of building work *
|
Construction of a new building o Demolition of a building o Extension to an existing building o Re-erection of a building o Other o |
Alterations to an existing Removal of a building o Change of use of an existing |
Proposed use of building 4
* Tick if applicable or give other description
Owner-builder 5 (if applicable)
I intend to carry out the work as an owner-builder. [Yes/No]
Cost of building work
Is there a contract for the building work? [Yes/No]
If yes, state the contract price $
If no, state the estimated cost of the building work
(including the cost of
labour and materials) and
attach details of the method of estimation
$
Stage of building work
Form 1
If application is to permit a stage of the work—
Extent of stage
Cost of work for this stage $
Signature
Signature of owner or agent Date
Note 1: Building practitioner means—
(a) a building surveyor; or
(b) a building inspector; or
(c) a quantity surveyor; or
(d) an engineer engaged in the building industry; or
(e) a draftsperson who carries on a business of preparing plans for building work or preparing documentation relating to permits and permit applications; or
(f) a builder including a domestic builder; or
(g) a person who erects or supervises the erection of prescribed temporary structures; or
(h) a person responsible for a building project or any stage of a building project and who belongs to a class of people prescribed to be building practitioners—
but does not include—
(i) an architect; or
(j) a person (other than a domestic builder) who does not carry on the business of building.
Note 2: Include building practitioners with continuing involvement in the building work.
Note 3: Include only building practitioners with no further involvement in the building work.
Note 4: The use of the building may also be subject to additional requirements under other legislation such as the Liquor Control Reform Act 1998 and the Dangerous Goods Act 1985 .
Note 5: If an owner-builder there are restrictions on the sale
of the building under section 137B of the Building Act 1993 . Section 137B
prohibits an owner-builder from selling a building on which domestic building
work has been carried out within 6½ years from the completion of the
relevant building work unless they have satisfied certain requirements
including obtaining compulsory insurance. The Building Commission maintains a
current list of domestic insurance providers.
Form 1
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FORM 2
Form 2
Building (Interim) Regulations 2005
Issued to
Owner*/Agent of owner*
Postal address
Postcode
Address for serving or giving of documents
Postcode
Contact person Telephone
* Delete if inapplicable
Ownership details (only if agent of owner listed above)
Owner
Postal address
Postcode
Contact person Telephone
Property details (include title details as and if applicable)
Number Street/road City/suburb/town Postcode
Lot/s LP/PS Volume Folio
Crown allotment Section Parish County
Municipal District
Builder
Name Telephone
Address
Postcode
Details of building practitioners and architects
a) to be engaged in the building work 1
Name Category/Class Registration No.
Name Category/Class Registration No.
Form 2
b) who were engaged to prepare documents forming part of the application for this permit 2
Name Category/Class Registration No.
Name Category/Class Registration No.
Details of domestic building work insurance 3 ( delete if inapplicable)
The issuer or provider of the required insurance policy is
( insert name of policy issuer or provider )
Details of relevant planning permit ( delete if inapplicable )
Planning permit No. Date of grant of planning permit
Nature of building work
*Construction of a new building, extension, alteration, change of use, demolition, removal or re-erection of a building
* Circle whichever is applicable
Stage of building work permitted Cost of building work $
Total floor area of new building work in m 2
Building classification
Part of building BCA Classification
Part of building BCA Classification
Inspection requirements
The mandatory notification stages are—
Occupation or use of building
An occupancy permit/certificate of final inspection* is required prior to the occupation or use of this building
* Circle whichever is applicable
If an occupancy permit is required, the permit is required for the whole/part* of the building in respect of which the building work is carried out.
* Circle whichever is applicable
Form 2
Commencement and completion
This building work must commence by
This building work must be completed by
Relevant building surveyor
Name Registration No.
Business/council name Address
Permit No. Date of issue of permit
Signature
Note 1: Include building practitioners with continuing involvement in the building work.
Note 2: Include only building practitioners with no further involvement in the building work.
Note 3: Domestic builders carrying out domestic building work forming part of this permit (where the contract price for that work is more than $12 000) must be covered by an insurance policy as required under section 135 of the Building Act 1993 .
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FORM 3
Building (Interim) Regulations 2005
Form 3
Month: Year:
Part A: ( to be completed for each building permit issued during the month )
Permit details
Permit No: Date of Issue:
Application Date:
Owner name: Telephone No.
Owner address:
Postcode
Owner builder (Y/N):
Property details
Lot/s Number
Street/road
City/suburb/town
Postcode
Municipal district
Private, or Local, State or Commonwealth Government land ownership:
( indicate which is applicable )
Description of building work
Nature of building work:
BCA classification(s):
Use of the building:
Allotment area (m 2 ):
Total floor area of new building work (m 2 ):
No of storeys: Floor material:
External wall material:
Roof cladding material: Frame material:
Existing dwellings: Dwellings demolished:
New dwellings:
Form 3
Cost of building work
Total estimated cost or contract sum of the project ($):
Cost of building work applicable to this permit ($):
Estimated cost or contract sum of domestic
building work applicable to this
permit ($):
Levy amount
General levy amount ($):
*HIH levy amount ($):
Total levy amount ($):
Part B: ( to be inserted after the last permit levy details for that month have been included )
TOTAL OF LEVY AMOUNTS RECEIVED FOR MONTH:
Total of general levy amounts ($):
*Total of HIH levy amounts ($):
Total ($):
Part C: ( to be inserted at the end of the levy return )
I certify that the information provided in this levy return is complete and correct.
Name: Registration No.
Signature:
Date:
* Leave blank if inapplicable
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FORM 4
Form 4
Building (Interim) Regulations 2005
BUILDING WORK COMMENCEMENT, COMPLETION OR PERMIT LAPSE RETURN
Month Year
|
Building Permit Number |
Commencement date* |
Occupancy Permit/ Certificate of Final Inspection Number (if applicable) |
Date of Occupancy Permit/ Certificate of Final Inspection |
Date project abandoned or permit lapsed (if applicable) |
| | | | | |
| |
||||
I certify that the above information is complete and correct.
Name
Signed
Registration number
Date
* Estimated commencement of building work or date of first inspection.
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FORM 5
Form 5
Building (Interim) Regulations 2005
To
Adjoining owner
Postal address
Postcode
Relevant building surveyor
Postal address
Postcode
Contact person Telephone
From
Owner/agent
Postal address
Postcode
Contact person Telephone
In accordance with section 84 of the Building Act 1993 , I give notice of my intention to carry out the following building work on my land and request your agreement to the proposed protection work.
Details of proposed building work
Property details
Number Street/road City/suburb/town
Lot/s LP/PS Volume Folio
Crown allotment Section Parish County
Municipal District
Adjoining property details
Number Street/road City/suburb/town
Lot/s LP/PS Volume Folio
Crown allotment Section Parish County
Municipal District
Details of proposed protection work and program
Form 5
Nature, location, time and duration of protection works:
Signature
Signature of owner or agent
Date
NOTE: Under section 85 of the Building Act 1993 , the adjoining owner must respond to a notice under section 84 of that Act by giving to the owner within 14 days a notice under section 85 of that Act—
(i) agreeing to the proposed protection work; or
(ii) disagreeing with the proposed protection work; or
(iii) requiring more information.
Failure to respond will be taken as agreement to the proposed protection work.
In the case of (ii) and (iii) above, a copy of the notice under section 85 of that Act must also be given to the relevant building surveyor. (See regulations 602(4) and 602(5) and Form 6).
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FORM 6
Form 6
Building (Interim) Regulations 2005
PROTECTION WORK RESPONSE NOTICE
To
Owner or agent
Postal address
Postcode
Relevant building surveyor
Postal address
Postcode
From
Adjoining owner
Postal address
Postcode
Contact person Telephone
Address of property where building work is to be carried out (from Form 5)
Number Street/road City/suburb/town
Address of my adjoining property
Number Street/road City/suburb/town
Response
In accordance with section 85 of the Building Act 1993 , I hereby respond to the notice served on me by the owner under that section and—
(i) agree to the proposed protection work o
(ii) disagree with the proposed protection work for
the
following reasons o
(iii) request the following further information o
Signature
Signature of adjoining owner or agent
Form 6
Date
NOTE : The notice under section 85 of the Building Act 1993
must be given to the owner or agent within 14 days of being served with a
notice under section 84 of that Act and in the case of (ii) or (iii) must also
be given to the relevant building surveyor who must determine the matter under
section 87 of the Building Act 1993 .
(See regulations 602(4) and 602(5)).
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FORM 7
Form 7
Building (Interim) Regulations 2005
APPLICATION FOR OCCUPANCY PERMIT
To
Relevant building surveyor
From
Owner or agent Telephone
In accordance with section 42 of the Building Act 1993 , I hereby apply for an occupancy permit for the building at—
Property details
Number Street/road City/suburb/town
Lot/s LP/PS Volume Folio
Crown allotment Section Parish County
Municipal District
Building practitioners and architects who were engaged in the building work 1
Name Category/Class Registration No.
Name Category/Class Registration No.
Use applied for
Part of building Intended use BCA Class
Part of building Intended use BCA Class
Signature of owner or agent
Date
Note 1: Include building 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.
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FORM 8
Form 8
Building (Interim) Regulations 2005
Property details
Number Street/road City/suburb/town Postcode
Lot/s LP/PS Volume Folio
Crown allotment Section Parish County
Municipal District
Building details*
Part of building Use BCA Class
Allowable floor loading No. of people deemed accommodated
Part of building Use BCA Class
Allowable floor loading No. of people deemed accommodated
* Complete this portion only if an occupancy permit is required under Division 1 of Part 5 of the Building Act 1993 .
Places of Public Entertainment**
Place of Public Entertainment Type of temporary structure
Public entertainment to be conducted Class of public entertainment
Period of operation of this permit
** Complete the applicable parts of this portion only if an occupancy permit is required under Division 2 of Part 5 of the Building Act 1993 .
Conditions
Occupation is subject to the following conditions—
(1) Essential safety measures
Essential safety measures must be maintained in accordance with the maintenance requirements set out in the following table—
|
Essential safety measure |
BCA or other provision to which essential safety measure has been installed and is to operate |
Frequency and type of maintenance required |
| | | |
| | | |
(2) Other conditions ( delete if not applicable )
Form 8
Approved location for display of occupancy permit
For a building or place of public entertainment that has a required essential safety measure the approved location for display of this permit and the annual essential safety measures report (if applicable) is
Suitability for occupation
The building or part of a building to which this certificate applies is suitable for occupation.
Relevant building surveyor
Name Registration No.
Signature
Occupancy Permit No.
Date of inspection
Date of issue
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FORM 9
Form 9
Building (Interim) Regulations 2005
CERTIFICATE OF FINAL INSPECTION
Property details
Number Street/road City/suburb/town Postcode
Lot/s LP/PS Volume Folio
Crown allotment Section Parish County
Municipal District
Description of building work
Part of building Permitted use BCA Class
Part of building Permitted use BCA Class
Approved location for display of certificate of final inspection
For a building or place of public entertainment, which has a required essential safety measure, the approved location for display of this certificate and the annual essential safety measures report (if applicable) is
Directions
All directions under Part 4 of the Building Act 1993 have been complied with.
Relevant building surveyor
Name Registration No.
Signature
Certificate No.
Date of inspection
Date of issue
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FORM 10
Form 10
Building (Interim) Regulations 2005
ANNUAL ESSENTIAL SAFETY MEASURES REPORT
Property Address
Building/s or part of building
Classification of building/s or part of building
This report is in relation to occupancy permit no. ( insert no .) issued ( insert date ) or maintenance determination dated ( insert date ) and is required to be prepared before each anniversary of the date of that occupancy permit or maintenance determination.
Maintenance personnel details
The following personnel carried out maintenance on the essential safety measures in this building during the preceding 12 months.
|
Essential safety measure |
Name |
Address |
| | | |
| | | |
Details of any inspection report provided under section 227E of the Building Act 1993
Compliance
I hereby state that I have/the owner has* taken all reasonable steps to ensure that—
* Delete as applicable
(i) each essential safety measure is operating at the required level of performance; and
(ii) each essential safety measure has been maintained in accordance with the occupancy permit or maintenance determination and will fulfil its purpose; and
(iii) since the last annual essential safety measures report
there have been no penetrations to required fire-resisting construction, smoke
curtains and the like in the building, other than those for which a building
permit has been issued; and
Form 10
(iv) since the last annual essential safety measures report there have been no changes to materials or assemblies that must comply with particular fire hazard properties, other than those for which a building permit has been issued; and
(v) the information contained in this report is correct.
Signature
Owner*/agent of owner*
* Ddelete if inapplicable
Date
NOTES
1. The owner must ensure that this annual safety measures report is displayed at an approved location in accordance with regulation 1211 of the Building (Interim) Regulations 2005. The penalty for non-compliance is a maximum of 10 penalty units.
2. The owner must ensure that this annual essential safety measures report and records of maintenance checks, service and repair work are kept on the premises for inspection by the municipal building surveyor or chief officer at any time on request. The penalty for non-compliance is a maximum of 10 penalty units.
3. Under section 240 of the Building Act 1993 an owner of a building or land may in writing authorise another person to make any application, appeal, referral or representation under this Act on behalf of the owner. Under section 248(1) of the Building Act 1993 , it is an offence for a person to do those things unless they are so authorised.
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FORM 11
Form 11
Building (Interim) Regulations 2005
CERTIFICATE OF COMPLIANCE—DESIGN
To
Relevant building surveyor
Postal address
Postcode
From
Building practitioner Category/Class
Postal address
Post code
Property details (if applicable)
Number Street/road City/suburb/town
Lot/s LP/PS Volume Folio
Crown allotment Section Parish County
Municipal District
Compliance
I did*/did not* prepare the design and I certify that the part of the design described as
* Delete whichever is not applicable
complies with the following provisions of the Regulations**
** Includes BCA and relevant standards.
Design documents
Drawing Nos. Prepared by Date
Specifications Prepared by Date
Computations Prepared by Date
Test reports Prepared by Date
Other documentation Prepared by Date
Form 11
Signature
Registration No.
Name of building practitioner
Date
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FORM 12
Form 12
Building (Interim) Regulations 2005
CERTIFICATE OF COMPLIANCE—INSPECTION
To
Relevant building surveyor
Postal address
Postcode
From
Building practitioner Category and class Registration No.
Postal address
Postcode
Property details
Number Street/road City/suburb/town
Lot/s LP/PS Volume Folio
Crown allotment Section Parish County
Municipal District
Compliance
I certify that the part of the building work described as
has been inspected by me and complies with the following provisions of the Act or regulations*
* Includes BCA and relevant standards.
Prescribed temporary structures
In the case of a prescribed temporary structure this certificate relates to occupancy permit number
Inspection date
Date of inspection of building work
Signature
Name of building practitioner
Form 12
Registration No.
Date
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FORM 13
Form 13
Building (Interim) Regulations 2005
To
Name and address of owner, occupier or person carrying out building work who is alleged to have committed a prescribed offence.
Identification of building
Address of building or information required to identify the building where the prescribed offence allegedly occurred.
Nature of prescribed offence
Prescribed penalty for the prescribed offence
Additional steps (if any) required to expiate the prescribed offence
Period within which additional steps (if any) must be taken
Period for payment of prescribed penalty
Required manner and place of payment of penalty
Name, business address and signature of authorised officer
Date of issue
NOTES
1. The authorised officer may withdraw the infringement notice at any time (other than as described in Note 2) within 28 days after notice is served by serving a withdrawal notice and if the authorised officer withdraws the infringement notice the authority may either take no action, or may take other action including bringing the matter before a court.
2. The infringement notice cannot be withdrawn if within the required time any required additional steps have been taken and the penalty paid.
3. If any required additional steps have been taken and the
penalty has been paid within the required time the offence will be expiated
and no conviction for the offence will be recorded. However, the authorised
officer may serve a summons where failure to expiate an offence occurs.
Form
13
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