APPOINTMENT OF A CERTIFIER 
APPLICATION FOR BUILDING APPROVAL  
Building Act 2004, S151

This form is to be completed by the Owner/s of the land to which the building work relates.

PART A	PROJECT DETAILS

Block	Section	Suburb	Unit No.

Street Address

Description of Building Works relevant to this application‐If more than 4 items please attach further details

Describe each item of building work in this building approval	BCA
Occupancy Class	BCA
Construction Type	Area (m2)	Number of Storeys	Cost of Works (refer to building cost guide)	
1						
2						
3						
4						

Applicable approved requirements and reasons why building approval is not prevented from being issued

Is all work exempt from development approval?

•	YES	Attach assessment for exempt development checklist (if applicable)
•	NO	Provide reason/s or description of work:   	

Description of Attachments compliant with Division 3.3 Building Act 2004
Please attach any additional documentation not listed below

•	Building Approval Plans
•	
Referrals, consultations & consents outcomes
•	
Asbestos Advice ‐ If documents accompanying building approval do not include an asbestos assessment report as per the Building Act 2004, the building approval must have an AA attached as per the Act

PART B	OWNER’S DETAILS – Please Print

All owners must be listed	Owner 1 will be considered the contact person in relation to this application

Company Details

ACN/ABN Number

Owner 1	Owner 2

Owner 3	Owner 4

Approved form AF2016‐80 approved by David Middlemiss, Construction Occupations Deputy Registrar on 02 August 2016 
under section 151 of the Building Act 2004 and revokes AF2014‐68

PART B continued	OWNER/S DETAILS – Please Print

Postal Address

Suburb	State	Postcode

Phone Number Business Hours	Mobile

EMAIL ADDRESS

PART C	APPOINTMENT OF CERTIFIER

As required under the Building ACT 2004 I/we herby advise that I/we the owner/s have appointed the person whose details appear below as the certifier in relation to the building works described in this form

Company Details

Name of Certifier	ABN/
ACN

Postal Address

Suburb	State	Postcode

Phone Number Business
Hours

Mobile

EMAIL ADDRESS

PART D	APPLICATION FOR BUILDING APPROVAL

I/we the Owner/s of the abovementioned property hereby apply under Section 26 of the Building Act 2004 to the certifier named above to issue a building approval for the building work described in this form. I/we have provided the certifier with information and documentation required to issue a building approval as specified in the Building (General) Regulation 2008.

PART E	AUTHORITY TO ACCESS BUILDING FILE

I/we hereby authorise the certifier to access the building file for the property which is the subject of this application for the purposes of obtaining information relevant to the issuing of a building approval and associated processes.

PART F	OWNER/S SIGNATURE/S

Ist Owner’s Signature	            Date

2nd Owner’s Signature	            Date

3rd Owner’s Signature	            Date

4th Owner’s Signature	            Date

NOTE: There are penalties for deliberately giving false and misleading information. The Planning and Land Authority or Minister may revoke an approval if satisfied that the approval was obtained by fraud or misrepresentation.

Approved form AF2016‐80 approved by David Middlemiss, Construction Occupations Deputy Registrar on 02 August 2016 
under section 151 of the Building Act 2004 and revokes AF2014‐68

APPLICATION FOR BUILDING APPROVAL REQUIREMENTS – Building (General) Regulations 2008

Where relevant the following information MUST be included in either the application or the plans accompanying the application for building approval: General Requirements
„	Estimated Cost of Works ‐as per Building (General) (Cost of Building Work) Determination 2011
„	if the proposed building work to be carried out at or near a street or place that is open to or used by the public the application must contain details of the precautions proposed to be taken to protect the safety of people using the street or place while the building work is carried out
„	the area of the parcel of land to which this application relates
„	the class of the building according to the intended use of the building as proposed to be erected or altered;
„	if applicable what fire‐resisting construction type (under the building code) the building as proposed to be erected or altered will be
Note: Fire‐resisting construction type may not be applicable if an alternative solution under the building code is used
„	for an application relating to the erection of a class 1 building the site classification of the parcel of land
„	for an application relating to the alteration of a class 1 building if the alteration will increase the building load carried by foundation material beyond the building load carried by the foundation before the alteration
„	the site classification of the parcel of land
„	for an application relating to the alteration of a building the class and type of fire‐resisting construction of the existing building classified under the building code and the materials used in the existing building
Note	Fire‐resisting construction type may not be applicable if an alternative solution under the building code is used
„	the number of storey’s of the building as proposed to be erected or altered;
„	the number of new dwellings (if any) created by the proposed building work;
„	the floor area of the proposed building or proposed new part of the building;
„	the materials to be used in the frame, floor, walls and roof of the proposed building or proposed new part of the building
„	if a performance requirement of the building code is to be complied with by use of an alternative solution under the code ‐
(i)	the performance requirement; and
(ii)	the alternative solution; and
(iii)	each assessment method used to show that the alternative solution complies with the performance requirement;
„	if the building code does not state a standard of work in relation to any part of the proposed building work and it is intended to carry out that part of the proposed building work in accordance with a standard of work stated in another document ‐
(i)	the nature of the proposed building work; and
(ii)	the title of the document; and
(iii)	each assessment method used to show that the proposed building work complies with the standard of work stated in the document.
Removal or demolition of building/s

„	Details of the methods to be used in carrying out the proposed building work, including a work plan stated or set out in AS 2601 (Demolition of structures), as in force from time to time;
„	the number of dwellings (if any) to be demolished.

Asbestos

„	The application must include a description of the method proposed to be used to remove the bonded asbestos sheeting from the building
„	the application must include the following information:
(i)	the method proposed to be used to remove the asbestos;
(ii)	the approximate amount and kind of asbestos to be removed;
(iii)	the equipment proposed to be used to remove the asbestos, including any personal protective equipment;
(iv)	details of a program, prepared in accordance with the asbestos removal code, for monitoring airborne asbestos to be followed during the removal.

Privacy Notice                                                                                                                                                                                                                                                                
The personal information on this form is provided to Access Canberra to enable the processing of your application. The collection of personal information is authorised by the Building Act 2004. 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 Australian Bureau of Statistics, ACT Revenue Office and the Taxation Office. The information may also be disclosed where authorised by law or court order, or where the Directorate reasonably believes that the use or disclosure of the information is reasonably necessary for enforcement‐related activities conducted by, or on behalf of, an enforcement body. Access Canberra’s Information Privacy Policy 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. Access Canberra Information Privacy Policy can be found at www.act.gov.au/accessCBR

CONTACT INFORMATION
  Email:
  ACTPLAedevlopmentBA@act.gov.au 

	Post:
Access Canberra
Building Services
Shopfront Mitchell 
GPO Box 158
Canberra, ACT 2601	In Person:
Please visit www.act.gov.au/accessCBR
Or call 132281 to find an 
Access Canberra Shopfront.	

	
Approved form AF2016‐80 approved by David Middlemiss, Construction Occupations Deputy Registrar on 02 August 2016 
under section 151 of the Building Act 2004 and revokes AF2014‐68