Application for Construction Occupation Licence Individual  
Owner Builder
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 an owner builder licence 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 Owner Builders Licensing on the www.planning.act.gov.au website.

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 AF2014‐140 approved by David Middlemiss, Construction Occupations Registrar on 7 November 2014 under
section 128 of the Construction Occupations (Licensing) Act 2004 and revokes AF2014-120.	
Section B — Owner Builder 

An Owner Builder licence authorises the licensee to undertake building work (other than specialist building work) in relation to a Class 1, 2 or 10a building that is, or is to be, the licensee’s main home or ancillary to it. 

An Owner Builder licence cannot be issued for demolition work, asbestos removal work or swimming pool construction work.
Section C — Site Details 

Block 			Section 				Suburb					 

Section D — Description of Building work

Description of Building Work: 									

												
Section E —Appointed Building Certifier and Building Approval Details

Building Certifier Name: 						Licence Number			

Building Approval Issue Date:					

Please attach a copy of the building approval to this application ensuring that the Building Approval stamp is clear and the type of work being undertaken is clear.  A Building Approval must be obtained from a Private Certifier prior to submitting this application.

Section F —Evidence of qualifications/eligibility – BCA Class 1 or 2 Dwelling

Complete this section only if you are applying for an Owner Builder licence to construct a building that is classified as a Class 1 or 2 building under the Building Code of Australia.

Requirement

Requirement Type:	An Owner Builder course certificate issued after 1 January 2009, or;

Requirement Type:	An ACT Class A, B or C Builder’s licence or interstate equivalent. 

 Yes	— please attach certified copies of requirements to this application.

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

Section F —Evidence of qualifications/eligibility – BCA Class 10a Structure

Complete this section only if you are applying for an Owner Builder licence to construct a structure that is classified as a class 10a structure under the Building Code of Australia.

Requirement

Requirement Type:	An Owner Builder course certificate issued after 1 January 2009, or;

Requirement Type:	Relevant experience in carrying out building work that satisfies the Construction Occupations Registrar that the applicant is capable of satisfactorily carrying out the building work that is the subject of the owner builders licence application.  

 Yes	— please attach certified copies of requirements to this application.

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

Section G — Licence History Declarations

1.	Are you a lessee of the land where the proposed construction is to take place?

 Yes	 

 No — Please note you may not be eligible for a licence only an individual lessee of the land can be issued with an Owner Builder licence.
2.	Have you previously held an Owner Builder licence in the ACT within the last five years?

 Yes — You may not be eligible for a licence.  Owner Builder licences cannot be issued to an individual who has been granted an Owner Builder licence within the last five years prior to making this application unless it was for the same parcel of land.

 No 	 
3.	Is the building work in relation to your main home or ancillary to that home?

 Yes	

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

Section H — Consent and Application Declarations

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 information/documents 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 (EPD) 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 Builder 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 occupations 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 (lessee)						Date 	       /           /    	  

All other lessees of the land where the building work is to be undertaken must authorise this application for an Owner Builder licence:

Name 																
Signature							 Date 	       /           /    	

Name 																
Signature							 Date 	       /           /    	  

Name 																
Signature							 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 www.planning.act.gov.au 

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