Application for Construction Occupation Licence Individual 
Building Surveyor
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 building surveyor licence to provide building surveying and certification 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 Error! Hyperlink reference not valid. 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 legislation 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 the Construction Occupations (Licensing) Act 2004 it is a requirement to provide a valid mobile telephone number and email address. 

Approved form AF2015‐10 approved by David Middlemiss, Construction Occupations Registrar on 19 March 2015 under
section 128 of the Construction Occupations (Licensing) Act 2004 and revokes AF2014-151.	

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
Section B — Existing licence
Have you previously or do you currently hold an ACT construction occupation licence?

 Yes — licence number				 expiry date				

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

Section C — Occupation class and functions

A building surveyor is an entity that provides, has provided or proposes to provide a building certification service, an exemption assessment service or a works assessment service.  A building certification service is the doing of building certification work under the Building Act 2004.  Exemption assessment work means undertaking an exemption assessment under the Building Act 2004. 
What class of building surveyor licence are you applying for?

 Principal Building Surveyor -	licence authorises the building certification work or, for a corporation, supervision of building certification work. 

 Principal Building Surveyor Employee -	licence authorises the building certification work as an employee of a principal building surveyor. 

 General Building Surveyor -	licence authorises building certification work or, for a corporation, supervision of building certification work, in relation to a building that is 3 storeys or lower and that has a floor area of 2,000m² or less. 

 General Building Surveyor Employee -	licence authorises building certification work in relation to a building that is 3 storeys or lower and that has a floor area of 2,000m² or less, as an employee of a principal or general building surveyor. 

 Principal Government Building Surveyor -  licence authorises building certification work. 

 Government Building Surveyor -	licence authorises building certification work in relation to a building that is 3 storeys or lower and that has a floor area of 2,000m² or less. 

Section D — Evidence of qualifications/eligibility – Principal Building Surveyor 

Complete this section only if you are applying for a principal building surveyor licence. 

Registration Type:	registration by the Institution of Engineers Australia on the national professional engineers register in the area of practice of “principal certifier-building (ACT)”; 

		OR

Accreditation Type:	accreditation as a “building surveyor” by the Australian Institute of Building Surveyors.

 Yes — please attach a certified copy of the registration or accreditation

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

Section D — Evidence of qualifications/eligibility – Principal Building Surveyor Employee

Complete this section only if you are applying for a Principal building surveyor employee licence. 

Registration Type:	registration by the Institution of Engineers Australia on the national professional engineers register in the area of practice of “principal certifier-building (ACT)”; 

	OR

Accreditation Type:	accreditation as a “building surveyor” by the Australian Institute of Building Surveyors.

 Yes — please attach a certified copy of the registration or accreditation

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

Employer

To be eligible for this class the employer must hold a principal building surveyor licence.

 Yes — please provide the details of your employer below and attach a statement from your employer confirming your employment.

  No — please note that you may not be eligible for a licence.
Name of principal building surveyor (employer)							
	
Licence number								 Expiry			

Section D — Evidence of qualifications/eligibility – General Building Surveyor 

Complete this section only if you are applying for a General Building Surveyor licence. 

Accreditation Type:	“assistant building surveyor” issued prior to 28 February 2011 by the Australian Institute of Building Surveyors; 

	OR

Accreditation Type:	“building surveyor limited” issued after 28 February 2011 by the Australian Institute of Building Surveyors

 Yes — please attach a certified copy of the registration or accreditation

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

Section D — Evidence of qualifications/eligibility – General Building Surveyor Employee

Complete this section only if you are applying for a general building surveyor employee licence. 

Accreditation Type:	“assistant building surveyor” issued prior to 28 February 2011 by the Australian Institute of Building Surveyors; 

OR

Accreditation Type:	“building surveyor limited” issued after 28 February 2011 by the Australian Institute of Building Surveyors

 Yes — please attach a certified copy of the registration or accreditation

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

Employer

To be eligible for this class the employer must hold at least a general building surveyor licence.

 Yes — please provide the details of your employer below and attach a statement from your employer confirming your employment.

  No — please note that you may not be eligible for a licence.
Name of principal or general building surveyor (employer)						
	
Licence number								 Expiry			

Section D — Evidence of qualifications/eligibility – Principal Government Building Surveyor 

Complete this section only if you are applying for a principal government building surveyor licence. 

Registration Type:	registration by the Institution of Engineers Australia on the national professional engineers register in the area of practice of “principal certifier-building (ACT)”; 

	OR

Accreditation Type:	accreditation as a “building surveyor” by the Australian Institute of Building Surveyors.

 Yes — please attach a certified copy of the registration or accreditation

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

Section D — Evidence of qualifications/eligibility – Government Building Surveyor 

Complete this section only if you are applying for a government building surveyor licence. 

Accreditation Type:	“assistant building surveyor” issued prior to 28 February 2011 by the Australian Institute of Building Surveyors; 

	OR

Accreditation Type:	“building surveyor limited” issued after 28 February 2011 by the Australian Institute of Building Surveyors

 Yes — please attach a certified copy of the registration or accreditation

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

Section E — Insurance Requirements

Note: If you are applying for a principal government building surveyor or government building surveyor you do not need to complete this section.

A building surveyor must have adequate Professional Indemnity insurance to be eligible for a licence.  The insurance certificate must state that the applicant is an insured person under the policy.  

If the insurance is in a company name then the insurance certificate must contain a clause stating that employees are covered, and a letter from a director must also be provided confirming that the applicant is an employee covered by the company’s insurance policy.  In these cases, the company must also hold a licence as a building surveyor in the ACT and the licence will be employee class. 

Insurance must also meet the minimum requirements as prescribed under section 17(4) of the Construction Occupations (Licensing) Regulation 2004 (the regulation).  

Section 17(4) of the regulation states ‘an applicant is adequately insured if the applicant has professional indemnity insurance that provides 
a)	indemnity against claims for breach of professional duty as a building surveyor; and 
b)	a minimum limit of indemnity of $1,000,000 for a single claim; and 
c)	a minimum limit of indemnity of $1,000,000 for the total of all claims made against the application during the period of cover; and 
d)	in addition to the indemnities mentioned in paragraphs (b) and (c), a minimum limit of indemnity for the costs and expenses of defending or settling a claim of 20% of the limit of the indemnity for the claim.’

 Yes — please attach a certified copy of the insurance certificate of currency, and if required, a copy of the insurance policy disclosure document. 

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

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. 

1.	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

2.	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

3.	Are you currently, or previously have been, deemed bankrupt or personally insolvent? 

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

4.	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 building surveyor 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 building surveyor, in Australia or overseas, currently suspended or cancelled?  

 Yes — you must attach details     							 No 

3.	Have you previously had a building surveyor 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 building surveyor licence is cancelled, refused or suspended in Australia or overseas.  

 I have read and understand the above statement. 

5.	Has your building surveyor 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 building certification services 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 certification services I may perform under my building surveyor licence must comply with all relevant legislation, codes and standards. 

 I have read and understand the above statement.

Please note: Building certification services 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 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 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 (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 building surveyor 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 							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