Form 1 Application for a Building Permit

FORM 1

Regulation 24

Building Act 1993

Building Regulations 2018

APPLICATION FOR BUILDING PERMIT
To: Andrew Herbig (Impact Building Approvals)
From*
* Pursuant to Section 248 of the Building Act 1993, a person must not act on behalf of an owner of a building or land for the purpose of making any application, appeal or referral under this Act or the regulations unless the person is authorised in writing by the owner to do so. Penalty: 120 penalty units.
*ACN/*ARBN (Provide if applicant is a company)
Postal address of applicant*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applicant email*
example@example.com
Address for serving or giving of documents*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Indicate if the applicant is a lessee or licensee of Crown land to which this application applies*

YesNo
Contact Name*

PrefixFirst NameLast Name
Contact Phone*
Please enter a valid phone number.Format: 0000-000-000.

Lessee responsible for building work
Indicate if a lessee of the building, of which parts are leased by different persons, is responsible for the alterations to a part of the building leased by that lessee*

YesNo

Builder
Builder name
Builder is a company (ie. Body Corporate)*

YesNo
Telephone
Please enter a valid phone number.Format: 0000-000-000.
*ACN/*ARBN
Builder practitioner registration number
Postal address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
[If the builder is carrying out domestic building work under a major domestic building contract, attach an extract of the major domestic building contract showing the names of the parties to the contract in relation to the proposed building work and a copy of the certificate of insurance (if applicable).]
Upload extract of major domestic building contract

Cancelof
*Natural person for service of directions, notices and orders (if builder is a body corporate)
Name*

PrefixFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: 0000-000-000.

Social housing
Does any of the building work include the construction of social housing as referred to in regulation 281B?*

YesNo
[Indicate ‘Yes’ if the building work, which is the subject of this application, includes the construction of social housing or if other building work, which is the subject of a related staged building permit, includes the construction of social housing.]

Emergency recovery
Does any of the building work include the construction of a dwelling that was destroyed or damaged in an emergency referred to in regulation 166J (b) of the Building Regulations 2018?*

YesNo
[Indicate ‘Yes’ if the building work, which is the subject of this application, includes the construction or repair of a dwelling within the same municipal district as the destroyed or damaged residential dwelling.]

Cost of building work

Note: All costs specified in an application are to be inclusive of GST.
Building Permit Application made by*