Application for Construction Occupation Licence Individual 
Drainer
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 builder licence to provide building 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.

Privacy Notice 
The personal information on this form is provided to Access Canberra of the ACT Government to enable the processing of your application. If all or some of the personal information is not collected, Access Canberra 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 Access Canberra. The Information Privacy Policy Annex contains information in regard to what information Access Canberra 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 Access Canberra, and how you may complain about an alleged breach of the Territory Privacy Principles. The Information Privacy Policy can be found at http://cmd.act.gov.au/legal/privacy_statement.  

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 AF2016‐58 approved by Ben Green, Deputy Construction Occupations Registrar on 27 June 2016 under
section 128 of the Construction Occupations (Licensing) Act 2004 and revoke AF 2015-116.	

Section B — Existing Drainer Licence
Have you previously held or do you currently hold an ACT Drainer licence?

 Yes – licence number				Expiry date					 

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

Section C — Occupation class and functions

A Drainer is an entity that provides, has provided or proposes to provide a drainage service. A sanitary drainage service is the doing or supervision of sanitary drainage work. For the definition of sanitary drainage work see the Water and Sewerage Act 2000.  

What class of licence are you applying for?

 Sanitary Drainer — 	licence authorises sanitary drainage work without supervision.

 Journeyperson Drainer —	licence authorises sanitary drainage work under supervision of licensee with an Advanced Sanitary Drainers licence

 Operative Drainer —	licence authorises sanitary drainage work under supervision of licensee with an Advanced Sanitary Drainers licence
Section D —	Evidence of qualifications/eligibility — Advanced Sanitary
	Drainer 
Complete this section only if you are applying for an Advanced Sanitary Drainer 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:

 	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
 	CPCPDR4011B – Design and size sanitary drainage systems
 	CPCPDR4012B – Design and size stormwater drainage systems
 	CPCPDR4013B – Design and size domestic treatment plant disposal systems

 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 Drainer licence for over 12 months.

 Yes — please provide licence number				expire date 			
 No — please note that you may not be eligible for a licence.

Experience:	12 months full-time experience in draining while licensed as a Journeyperson Drainer under the supervision of a licensed Advanced Sanitary Drainer.

 Yes — please provide details of the supervisor below and attach a copy of the reference from the licensed Advanced Sanitary Drainer. Please note that this supervisor will be contacted to verify any written reference provided. 

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

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

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:

 	CPC32408
 	CPC32411
 	CPC32412
 	CPC32413

  	and the Drainage Stream was 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 — Operative Drainer
Complete this section only if you are applying for an Operative Drainer licence.  

Qualification:	a Certificate II in Drainage issued within five (5) years prior to making the application.  

 Yes — please attach a certified copy of the qualification.

 No — please note that you may not be eligible for a licence.
Section E — 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 F — Licence History Declarations

1.	Have you previously held a Drainer 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 Drainer, in Australia or overseas, currently suspended or cancelled?  

 Yes — you must attach details     							 No 

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

 I have read and understand the above statement. 

5.	Has your Drainer 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 drainage services that are 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 drainage services I may perform under my Drainers licence must comply with all relevant legislation, codes and standards. 

 I have read and understand the above statement.

Please note: Drainage 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 G — 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 information/documents provided in support of the application, is/are accurate, true and correct.

2.	 I authorise and consent:

a)	to the Construction Occupations Registrar and 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 an electrician or otherwise regarding matters relevant to this application.

b)	to receive 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 H — Payment Details
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.  
View the Access Canberra Website for licence application fee and charges.

Section I — Lodgement and Contact Information
Access Canberra Environment Planning and Land Shopfront
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 8096 
Email: cwpl@act.gov.au