Application for Construction Occupation Licence Individual
Plumber
Construction Occupations (Licensing) Act 2004, s128 and s17	

This approved form is to be used for individuals applying under the Construction Occupations (Licensing) Act 2004 to the Construction Occupations Registrar for a Plumbing licence to provide plumbing services in the ACT.  This application will not be considered unless it is complete and all supporting documentation provided.

All supporting documentation must:
•	be originals or certified true copies of original documents where relevant; and
•	be in English. If original documents are not in English, you must provide a certified copy of the original document and an official translation of the document.

For detailed information on eligibility criteria please refer to Plumbers Licensing  

Privacy Notice 
The personal information on this form is provided to the ACT Environment and Planning Directorate (EPD) to enable the processing of your application. If all or some of the personal information is not collected EPD cannot process your application. The personal information you provide may be disclosed to the other ACT Government Directorates, and third parties external to the ACT Government, as required by specific legislations administered by EPD. The Information Privacy Policy Annex contains information in regard to what information EPD collects and to whom it is disclosed. The policy also contains information about how you may access or seek to correct your personal information held by EPD, and how you may complain about an alleged breach of the Territory Privacy Principles. The EPD Information Privacy Policy can be found on the EPD website, under the “About Us” menu. 

Section A — Personal Details
Title 		 Surname 									 

Given Names							Date of Birth	    /	  /	

Business Address											 

Suburb 					State				Postcode 		

Residential Address										 

Suburb 					State				Postcode 		
	
Postal Address 											           

Suburb 					State				Postcode 		

Phone Number (Business Hours) 				Fax 					

Mobile Number* 				Email*							

*Please note that under S170 of the Construction (Occupations) Licensing Act 2004 it is a requirement to provide a valid mobile telephone number and email address. 

I understand that it is a requirement under law that should my licence be issued I must notify the Construction Occupations Registrar of any changes to my details within two weeks of the change?  

 I understand

Approved form AF2014‐121 approved by David Middlemiss, Construction Occupations Registrar on 7 October 2014 under
section 128 of the Construction Occupations (Licensing) Act 2004.	
Section B — Existing Plumber Licence
Have you previously held or do you currently hold an ACT Plumber licence?

 Yes – licence number				Expiry date					 

 No – proceed to Section C — Occupation class and functions.

If the licence expired within the last five years, do you wish to apply for the same licence again?

 Yes – proceed to Section F – Evidence of Financial Resources. 

 No – proceed to Section C — Occupation class and functions.
Section C — Occupation class and functions
A plumber is an entity that provides, has provided or proposes to provide a plumbing service. A plumbing service is the doing or supervision of sanitary plumbing work or water supply plumbing work. 

What class of plumbing licence are you applying for?

 Sanitary Plumber 	—licence authorises sanitary plumbing work without supervision.

 Water Supply Plumber	— licence authorises water supply plumbing work including fire sprinkler work for class 1 and 2 buildings in relation to pipework of 25mm diameter or less, but not including backflow prevention device  test work within the meaning of section 21 of Construction Occupations (Licensing) Regulation 2004.

 Journeyperson Plumber  	— licence authorises sanitary plumbing work under the supervision of a licensee with sanitary plumbing licence. 

 Fire Sprinkler Fitter 	— licence authorises fire sprinkler work and work on a fire hydrant or fire hose connection point. 

Journeyperson Fire Sprinkler Fitter	— licence authorises fire sprinkler work and work on a fire hydrant or fire hose connection point, under the supervision of a licensee with fire sprinkler fitter licence.

Section D — Evidence of qualifications/eligibility — Sanitary Plumber 
Complete this section only if you are applying for a Sanitary Plumber licence.  

Qualification:	provide evidence of completion, or partial completion, of one of the following Certificate IV qualifications in Plumbing and Services issued within five (5) years prior to making the application: 

•	CPC40912
•	CPC40911
•	CPC40909
•	CPC40908

The Certificate IV, or partial Certificate IV, must include all the following units of competency, or their superseded equivalent:

•	CPCPWT4011B - Design and size heated and cold water services and systems
•	BSBSMB401A - Establish legal and risk management requirements of small business
•	CPCCBC4012B - Read and interpret plans and specifications
•	CPCPCM4011A - Carry out work-based risk control processes
•	CPCPSN4011B - Design and size sanitary plumbing systems
•	CPCPCM4012A - Estimate and cost work

 Yes — please attach a certified copy of the qualification or units of competency.

 No — please note that you may not be eligible for a licence.

Requirement:	currently holds, or has held within 12 months prior to application, a Journeyperson Plumber licence for over 12 months.

Experience:	12 months full-time experience in plumbing work while licensed as a Journeyperson Plumber under the supervision of a licensed Sanitary Plumber.
	
 Yes — please provide details of the supervisor below and attach a copy of the reference from the licensed Sanitary Plumber. 

 No — please note that you may not be eligible for a licence.
Supervisor (Licensee) Name				Licence Number	 			

Section D — Evidence of qualifications/eligibility — Water Supply Plumber

Complete this section only if you are applying for a Water Supply Plumber licence.   

Qualification:	provide evidence of completion, or partial completion, of one of the following Certificate IV qualifications in Plumbing and Services issued within five (5) years prior to making the application:

•	CPC40912
•	CPC40911
•	CPC40909
•	CPC40908

the Certificate IV in Plumbing and Services, or partial Certificate IV in Plumbing and Services, must include all the following units of competency, or the superseded equivalent:
•	CPCPWT4011B - Design and size heated and cold water services and systems
•	BSBSMB401A - Establish legal and risk management requirements of small business
•	CPCCBC4012B - Read and interpret plans and specifications
•	CPCPCM4011A - Carry out work-based risk control processes
•	CPCPCM4012A - Estimate and cost work

 Yes — please attach a certified copy of the qualification or units of competency.

 No — please note that you may not be eligible for a licence.

Requirement:	currently holds, or has held within 12 months prior to application, a Journeyperson Plumbers licence for over 12 months.

Experience:	12 months full-time experience in water services and general plumbing work while licensed as a Journeyperson Plumber under the supervision of a licensed Sanitary or Water Supply Plumber.
	
 Yes — please provide details of the supervisor below and attach a copy of the reference from the licensed Sanitary or Water Supply Plumber. 

 No — please note that you may not be eligible for a licence.
Supervisor (Licensee) Name				Licence Number	 			

Section D — Evidence of qualifications/eligibility —Journeyperson Plumber
Complete this section only if you are applying for a Journeyperson Plumber.   

Qualification:	provide evidence of completion of one of the following Certificate III qualifications in Plumbing issued within five (5) years prior to making the application:

•	BCP30103
•	CPC32408
•	CPC32411
•	CPC32412
•	CPC32413

 and the Water Stream, Sanitary Stream and Roofing Stream were completed to attain this qualification.

 Yes — please attach a certified copy of the qualification including transcripts.

 No — please note that you may not be eligible for a licence.

Section D — Evidence of qualifications/eligibility — Fire Sprinkler Fitter
Complete this section only if you are applying for a Fire Sprinkler Fitter licence.   

Qualification:	provide evidence of completion of the following units of competency from the Certificate IV in Plumbing and Services CPC40912 issued within five (5) years prior to making the application:

•	CPCPWT4011B - Design and size heated and cold water services and systems
•	CPCCBC4012B – Read and interpret plans and specifications
•	CPCPCM4011A – Carry out work based risk control processes
•	CPCPCM4012A – Estimate and cost work
•	BSBSMB401A – Establish legal and risk management requirements of small business

 Yes — please attach certified copies.

 No — please note that you may not be eligible for a licence.

Requirement:	currently holds, or has held within 12 months prior to application, a Journeyperson Plumbers licence for over 12 months.
	
Experience:	12 months full-time experience in fire sprinkler fitting while licensed as a Journeyperson Fire Sprinkler Fitter under the supervision of a licensed Fire Sprinkler Fitter.
	
 Yes — Please provide details of the supervisor below and attach a copy of the reference from the licensed Fire Sprinkler Fitter. 

 No — please note that you may not be eligible for a licence.
Supervisor (Licensee) Name				Licence Number	 			
Section D — Evidence of qualifications/eligibility — Journeyperson Fire Sprinkler Fitter
Complete this section only if you are applying for a Journeyperson Fire Sprinkler Fitter licence.   

Qualification:		provide evidence of successful completion of, or completion of an apprenticeship that includes, a Certificate III in Fire Protection CPC32813 issued within five (5) years prior to making the application.

 Yes — please attach a certified copy.

 No — please note that you may not be eligible for a licence.

Section E – Endorsement
The Construction Occupations Registrar may endorse a licence holder (in addition to what the scope of licence already authorises) if satisfied that licensee can safely and competently perform the additional works.
Please indicate what you wish to be endorsed for:

																								

*Please note that additional information may be required for endorsements to undertake specialist building work at the discretion of the Construction Occupations Registrar. You will be notified if additional information is required. 

Do you have additional qualifications or training relevant to each endorsement above?

 Yes – please attach evidence of any additional qualifications/training 	 

 No 

The Construction Occupations Registrar will take into consideration any demerit activity or disciplinary action recorded against the applicant under the Construction Occupations (Licensing) Act 2004.
Section F — Evidence of Financial Resources
Evidence of financial resources is required to help demonstrate your ability to fulfil contractual obligations when providing construction services.  Failure to provide information below may result in your licence being refused. 

Do you have access to financial resources adequate to complete works performed under the licence applied for?  

  Yes – please skip the next question 				

 No – complete next question

If ‘No’ to the above, do you wish to only operate as an employee under the licence applied for?

 Yes – I understand a condition may be imposed on the licence if issued  

 No —if you do not wish to have a licence restricted to employee only, then you must ensure you have        financial resources as requested above or you may be ineligible for a licence.
Are you currently, or previously have been, deemed bankrupt or personally insolvent? 

 Yes – please attach details and official documentation of bankruptcy/insolvency     		  No

I understand that it is a requirement under law that should my licence be issued, I must notify the Construction Occupations Registrar should I become bankrupt or personally insolvent. 

  I have read and understand the above statement.

Section G — Licence History Declarations
1.	Have you previously held a Plumber licence elsewhere in Australia or overseas? 

 Yes —provide details below of most recent licence/s (attach an additional page if required)  	  No

	State/Territory/Country ___________________________Expiry date:   ______/______/______  

2.	Is your licence as a Plumber, in Australia or overseas, currently suspended or cancelled?  

 Yes — you must attach details     							 No 

3.	Have you previously had a Plumber licence cancelled, refused or suspended in Australia or overseas?      

 Yes — you must provide comprehensive details in an attachment to this application		  No

4.	I understand that I must notify the Construction Occupations Registrar if my Plumber licence is cancelled, refused or suspended in Australia or overseas. 

 I have read and understand the above statement. 

5.	Has your Plumber licence ever been subject to conditions, undertakings, limitations or restrictions in Australia or overseas?  

 Yes — you must provide comprehensive details in an attachment to this application		 No

6.	Are you disqualified under the Construction Occupations (Licensing) Act 2004, or a corresponding prior Act, from applying for licence, or being licensed, in a construction occupation? 

  Yes – you must provide comprehensive details in an attachment to this application		 No

7.	Have you ever been, or are you currently, the subject of complaints, occupational discipline, demerit activity or rectification orders whilst licensed under the Construction Occupations (Licensing) Act 2004, a corresponding prior Act, or the law of another jurisdiction in Australia or overseas, where those proceedings were not finalised?    

  Yes – you must provide comprehensive details in an attachment to this application		 No

8.	Have you been convicted or found guilty of a criminal offence* that involves fraud, dishonesty or violence and is punishable by imprisonment of 1 year or more? 

 Yes — you must provide comprehensive details in an attachment to this application 		 No
and a recent criminal history check  (issued in the last three months).				
*Please note: Spent convictions under the Spent Convictions Act 2000 do not need to be included in this declaration

9.	I understand that it is a requirement under law that should my licence be issued I must notify the Construction Occupations Registrar if I am convicted of such an offence in the future.  

 I have read and understand the above statement.

10.	I understand that it is a requirement under law that should my licence be issued I must not perform any licensable plumbing service that is outside the scope of what the licence authorises.  

 I have read and understand the above statement. 

11.	I understand that it is a requirement under law that should my licence be issued  I must give evidence to clients of the insurance I hold as a licensed individual in relation to any relevant licensable construction service I intend to undertake prior to providing the services.

  I have read and understand the above statement.

12.	I understand that it is a requirement under law that should my licence be issued I must only advertise licensable construction services with my full name (as it appears on the licence) and my individual licence number.*  

 I have read and understand the above statement.

*Please note: It is an offence to advertise licensable construction services as an individual without including the above.

13.	I understand that it is a requirement under law that should I be granted a licence, all licensable plumbing services I may perform under my Plumbers licence must comply with all relevant legislation, codes and standards. 

 I have read and understand the above statement.

Please note: Plumbing work may be audited by the Construction Occupations Registrar in the ACT for compliance against the relevant laws. Individual licence holders identified performing non-compliant services may be subject to occupational discipline or other licensing action.
Section H — Consent and Application Declaration
I, ________________________________________________________________________________________,
 			Insert name, address and occupation of person making the declaration

make the following declaration:

1.	I declare:

a)	that I make this application to the Construction Occupations Registrar for a construction occupations licence and that all statements, and the documents/information provided in support of the application, are accurate, true and correct.

2.	 I authorise and consent:

a)	to the Construction Occupations Registrar and Environment and Planning Directorate to make enquiries of, and exchange information with, the relevant regulatory authorities of any Australian State or Territory, or other country, regarding my construction occupation licence and practice as a plumber or otherwise regarding matters relevant to this application.

b)	to receiving information from the Construction Occupations Registrar relevant to my construction occupation licence or the construction industry electronically.

3.	I acknowledge:

a)	that the Construction Occupations Registrar and EPD may validate documents provided in support of this application or wish to confirm my identity.

b)	that failure to complete all relevant sections of this application and enclose all supporting documentation may result in this application not being accepted or additional fees being applied as per the statutory instrument authorising fees to be taken under the Construction Occupations (Licensing) Act 2004

c)	that the Construction Occupations Registrar has the legal right to refuse my application if not satisfied that I am eligible to hold a licence or impose a condition on my  licence if it is deemed necessary or desirable to protect the public.

4.	Should I be issued with a construction occupation licence I undertake:

a)	to comply with the Construction Occupations (Licensing) Act 2004 (and it’s operational Acts) and the codes, standards and guidelines relevant to my construction occupation licence when providing, or offering to provide, a relevant construction service.

5.	 I believe that the statements (1 - 4) in this declaration are true and correct.

Signature of Applicant 							Date 			  

Section I — Payment Details
View the fees and charges booklet for licence applications for more information.

Upon lodgement of your application you will be required to pay an application assessment fee. This fee is non‑refundable. You will be provided with a notice of decision in relation to your application. If your application is approved a licence term fee will be payable prior to the issue of your licence. Please note that additional fees may apply if you submit an incomplete application without required supporting documents. 
Section J — Lodgement and Contact Information
Environment and Planning Directorate website

Customer Service Centre 
GPO Box 1908, Canberra City 2601 
16 Challis Street, Dickson ACT 2602 
Business Hours: 8.30am to 4.30pm weekdays (excluding Public Holidays) 
Phone: (02) 6207 1923 

Email: epdcustomerservices@act.gov.au