APPLICATION FORM BA1

Application for building permit – certified

Building Act 2011, section 14, 16 Reference number
PERMIT AUTHORITY
Building Regulations 2012, regulation 4, 16
USE ONLY

Permit authority

1. Property this application relates to

Property street Unit no Street no Level Lot no

address (provide lot
number where street
number is not Street name Street type Street suffix
known)
Suburb State Postcode

Certificate of title Volume Folio

(if known)

Local government area (if different

from permit authority)

Is this lot vacant? Yes No

2. Details of building work

Project name (if any)

Description of the
building(s) and
building work
Main use of
building(s)

Building Code of Main BCA class

Australia (BCA)
class of the
building(s) (refer to
the certificate of Secondary BCA Third BCA class (for
design compliance) class (for multi- multi-purpose
purpose buildings) buildings)

Type of work New building/structure Alteration/addition Refurbishment/fit out

Relocation of a
Change of use/conversion
building to this site

Form approved by the Building Commissioner on 30 June 2016 Page 1 of 5

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Type of building or Swimming pool/spa Garage Patio

incidental structure
(if a Class 10) Carport Shed Fence/wall

Retaining wall Water tank Other

Number of dwellings relocated

TO this site from another site

Type of structure Detached (free standing) Attached to another structure

Number of storeys of the

Number of residential dwellings
highest building (above
to be created
ground)

Number of basement storeys of the Estimated value of building

$
building (below ground) work (including GST)

2 2
Floor area to be created (m ) Site (lot) area (m )

Floor Exterior walls Roof cover Wall frame

What are the main
materials used in the
Concrete Brick (double) Tiles Brick/block
building work?
Timber Brick (veneer) Concrete Concrete
Steel Concrete/stone Fibre cement Timber
Other Fibre cement Steel Steel
Timber Aluminium Aluminium
Curtain glass Other Other
Steel
Aluminium
Other
If ‘other’ please
specify

Intended owner of Private sector Is this application for a stage Yes

the completed Government sector of a multi-stage building No
building project?

Is an alternative solution to a building standard

Yes No
proposed for the building work?

Form approved by the Building Commissioner on 30 June 2016 Page 2 of 5

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3. Owner details

Where there are multiple owners, please attach a list with the names and signatures of each owner. If each of those
owners requires a copy of the building permit, please also provide forwarding details for each owner.

Owner’s name

Street address Unit no Street no Level Lot no

(provide lot number
where street number Street name Street type Street suffix
is not known)

Suburb State Postcode Country (if not Australia)

OR
PO Box no
PO Box address

Suburb State Postcode Country (if not Australia)

Email address

Phone no Fax
Phone/fax

Owner’s signature* Date

*If you are authorised to sign on behalf of the owner, please provide your written legal authorisation with your
application. Owner’s signature is not required for Class 1 or Class 10 buildings or incidental structures with
applications lodged before 31 December 2018.

4. Builder details

Builder’s name

Street address Unit no Street no Level Lot no

(provide lot number
where street number Street name Street type Street suffix
is not known)

Suburb State Postcode Country (if not Australia)

OR
PO Box no
PO Box address

Suburb State Postcode Country (if not Australia)

Email address

Phone no Fax
Phone/fax

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Type of builder Registered building contractor (provide registration number below)

Approved owner-builder (attach owner-builder approval from the Building Services
Board and provide owner-builder approval number below)
Public Authority
Other (building work under $20,000, or where registered building contractor not
required)
Registration number Registration / approval number (if relevant)
or owner-builder
approval number
Name (print)
Builder’s signature

Signature Date

5. Applicant details

Who is the
applicant? Owner Builder Other
(Tick one box)

If ‘Other’ was selected above, complete the following details:

Applicant’s name

Street address Unit no Street no Level Lot no

(provide lot number
where street number Street name Street type Street suffix
is not known)

Suburb State Postcode Country (if not Australia)

OR
PO Box no
PO Box address

Suburb State Postcode Country (if not Australia)

Email address

Phone no Fax
Phone/fax

Form approved by the Building Commissioner on 30 June 2016 Page 4 of 5

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6. Statement by applicant

I understand that a building permit cannot be granted unless:

1. All the prescribed information is provided with this application, including a certificate of design compliance
signed by a registered building surveyor.
2. In accordance with section 20 of the Building Act 2011 and regulation 18 of the Building Regulations 2012:
• all relevant prescribed authorities have been obtained and have been or are being complied with;
and
• all prescribed notifications have been given.

Provide evidence of compliance with approvals given.

3. For Class 2 to Class 9 buildings only, where required by the regulations: In accordance with section 20 of
the Building Act 2011 and regulation 18 of the Building Regulations 2012, the plans and specifications
specified in the certificate of design compliance have been given to the FES Commissioner.
4. All consents or court orders have been obtained if part of a building or incidental structure is proposed to
be placed beyond the boundaries of the works land.
Does the proposed work encroach on other land? Yes No
If yes, has consent or a court order been obtained? Yes No

Attach a copy of each consent (form BA20) or court order obtained.

5. All consents or court orders have been obtained if the building work may adversely affect land beyond the
boundaries of the works land.
Does the proposed work adversely affect other land? Yes No
If yes, has consent or a court order been obtained? Yes No

Attach a copy of each consent (form BA20) or court order obtained.

6. If the proposed building work is for a Class 1 or Class 10 building or incidental structure that includes
alternative solutions to building standards, details have been provided with this application.

Provide details of each alternative solution not shown

on the plans and specifications.

Applicant’s Name (print)

signature
Signature Date

Form approved by the Building Commissioner on 30 June 2016 Page 5 of 5