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APPLICATION FOR CONSTRUCTION CERTIFICATE

PART 1 – APPLICANT As the applicant, I / we hereby appoint Tony Truong from KUDOS BUILDING CERTIFICATION as the Principal Certifying Authority (PCA) for the building work identified in Part 3 of this application form.

Name:

Note: The applicant must be a person who has the benefit of the development consent. An applicant must not be by a person who will carry out the building work or subdivision work unless that person(s) owns the land is to be carried out.

Company:

Address:

Contact details: Mobile: Signature:

Email: Date:

PART 2 – OWNER CONSENT As owner of the land to which this application relates to I consent to this application. I also consent for KUDOS BUILDING CERTIFICATION staff to enter the land to carry out inspections relating to this application.

Name: Note: Where the works are being carried out in strata titled building the consent of the Body Corporate must be provided.

Note: If the owner is a company, an authorised director must sign the form.

Company:

Address:

Contact details: Mobile: Signature: Insert Seal of Body Corporate here if applicable Email: Date:

PART 3 – DESCRIPTION OF DEVELOPMENT Detailed description is required for the proposed works.

Description of development:

Address of development:

Building name: XXX

Lot & DP: Shop number: XXX

Address: XXX XXX

Miscellaneous: Cost of works (incl. GST): XXX Classification(s): XXX

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PART 4 – DEVELOPMENT CONSENT DETAILS

DA no.: XXX

Date: XXX

Council: XXX

PART 5 – NOTICE OF COMMENCEMENT OF BUILDING WORK A Notice of commencement under Section 81A of the Environmental Planning and Assessment Act 1979

Date work is to commence:

NOTE: The person having benefit of the Part 4a Certificate shall give at least 2 working day(s) notice of intention to commencement of works.

PART 6 – PRINCIPLE CONTRACTOR

Name: NOTE: Without the Principle Contractor’s details we will not accept the application form

Company:

Address:

Contact details:

PART 7– DOCUMENTS TO ACCOMPANY APPLICATION FOR CDC

The following documentation is submitted with the CDC application

Copies of plans, elevations and sections. List of any existing and proposed fire safety measures.

Copies of specifications. Evidence that Long Service Levy has been paid.

Owner’s consent. Applicant’s signature.

ABS schedule is completed. Evidence of Home Building Act requirements satisfied.

PART 8 – PROPOSED FIRE SAFETY SCHEDULE

Fire Safety Measures Standard of Performance

Access panels, doors and hoppers to fire resisting shaft BCA C3.13 & AS1905.1-2005, AS1905.2-2005

Automatic fail safe devices BCA D2.21

Automatic fire detection and alarm system BCA E2.2, Spec E2.2a & AS1670.1-2004, AS3786-1993

Automatic fire suppression system BCA E1.5, Spec E1.5 & AS2118.1-1999

Automatic fire suppression system (Residential) BCA E1.5, Spec E1.5 & AS2118.4-1995

Emergency lighting BCA E4.2, E4.4 & AS2293.1-2005

Emergency Lifts BCA E3.4 & AS1735.2-2001

Sound systems & intercom systems for emergency purposes

BCA E4.9 & AS1670.4-2004

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Fire Safety Measures Standard of Performance

Exit signs BCA E4.5, E4.6, E4.8 & AS2293.1-2005

Exit signs (non-illuminated) BCA Clause E4.7

Fire blankets AS2444-2001

Fire control centres and rooms BCA E1.8 & Spec E1.8

Fire dampers BCA C3.12, C3.15 & AS/NZS1668.1-1998, AS1668.2-1991

Fire doors BCA Spec C3.4 & AS1905.1-2005

Fire hydrant systems BCA E1.3 & AS2419.1-2005

Fire seals protecting openings in fire resisting components of the building

BCA C3.12, C3.15 & Spec C3.15

Fire shutters BCA C3.4 & Spec C3.4

Fire windows BCA Spec C3.4

Hose reel system BCA E1.4 & AS2441-2005

Lightweight construction BCA C1.8 & Spec C1.8

Mechanical air handling system BCA E2.2, Spec E2.2b & AS/NZS1668.1-1998

Perimeter vehicular access BCA Clause C2.4

Portable fire extinguishers BCA E1.6 & AS2444-2004

Pressurising system BCA Clause E2.2 & AS/NZS1668.1-1998

Required automatic exit doors BCA C3.4, C3.7 & C3.8

Smoke detectors and heat detectors BCA E2.2, Spec E2.2a & AS3786-1993

Smoke & heat vents BCA E2.2 & Spec E2.2c

Smoke exhaust system BCA E2.2, Spec E2.2b & AS/NZS1668.1-1998

Smoke dampers BCA E2.2

Smoke doors BCA Spec C3.4

Solid-core doors BCA C3.11

Standby power systems BCA Spec G3.8

Wall wetting sprinkler and drencher systems BCA C3.4

Warning and operational signs EPA Regulation (reg 183)

BCA E3.3 (lifts)

BCA C3.6 sliding doors

Zone smoke control system BCA E2.2 & AS/NZS1668.1-1998

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FIRE SAFETY MEASURES STANDARD OF PERFORMANCE

Fire blankets AS2444-2001

Fire control centres and rooms BCA E1.8 & Spec E1.8

PART 9 – AUSTRALIAN BUREAU OF STATISTICS SCHEDULE Note: Only required to be completed with Class 1a dwelling only.

All new buildings

Gross site areas (m2)

Gross floor area (m2) of new building

Number of storeys (including underground floors)

Residential buildings only

Number of dwellings to be constructed

Number of pre-existing dwellings on site

Numbers of dwellings to be demolished

Will the new dwellings(s) be attached to other new building?

Will the new building(s) be attached to existing dwellings?

Does the site contain a dual occupancy?

Materials – Residential buildings

Walls □ Brick (double)(11) □ Brick (veneer)(12) □ Concrete or store (20)

□ Fibre cement (30) □ Timber glass (40) □ Timber glass (50) □ Steel (60) □ Aluminium (70) □ Other (80) □ Not specified (90)

Roof □ Tiles (10) □ Concrete or slate (20) □ Fibre cement (30) □ Steel (60) □ Aluminium (70) □ Other (80) □ Not specified (90)

Frame □ Timber (40) □ Steel (60) □ Aluminium (70) □ Other (80) □ Not specified (90)

Floor □ Concrete or slate (20) □ Timber (40) □ Other (80) □ Not specified (90)

PART 10 – NOTES FOR COMPLETING APPLICATION FOR A CONSTRUCTION CERTIFICATE

Does the application relate ONLY to a FIRE LINK CONVERSION? Yes No

Does the development involve SUBDIVISION WORK? Yes No

Does a Residential Flat Development design verification required from a qualified designer? Yes No

Has the Fire Commissioner granted an exemption under clause 188 EP&A Regulation from compliance with any specified Category 3 fire safety provision?

Yes No

Is any long service payment levy payable under s.34 of the Building and Construction Industry Long Service Payments Act 1986?

Yes No

Does the application involve a BASIX affected development, or a BASIX optional development for which a BASIX certificate has been obtained?

Yes No