AF EXOWN Page 1 of 2
Last Updated: 10/01/2018
Revision: 2
AF EXOWN- Notification of Building
Work- Owner Decided Exemptions
This form provides notification to the Territorial Authority in relation to building work that has been
completed under a Building Act Schedule 1 exemption. The objective of this form is to provide a
record that is saved on the Councils property file, which can assist with any compliance enquiries or
future sales of your property.
This record provides formal notification that the owner has decided:
1. The building work meets all the requirements of the Building Code
2. The building work is exempt work under Building Act 2004 Schedule 1 clause
_________________ (owner to specify relevant clause)
A Notification Fee of $65 (incl. GST) is required to be paid at time of notification.
This notification will be recorded on the property file held by the Territorial Authority and will be
available for inclusion in a Land Information Memorandum.
The Building
Street Address:
Legal Description of land
where building is located:
Valuation Number:
Year of Construction:
Current, lawfully
established use:
Owner/Agent Information
Name:
Postal Address:
Phone Number:
Email:
Evidence of ownership
attached
Certificate of Title
Agreement for Sale and Purchase
Lease Agreement
Other document
AF EXOWN Page 2 of 2
Last Updated: 10/01/2018
Revision: 2
AF EXOWN- Notification of Building
Work- Owner Decided Exemptions
Project Information:
Please provide sufficient description of building works to enable scope of building work to be fully understood)
Description of building
works:
Estimated value of work
(incl GST):
Intended life of project:
Person(s) undertaking
the building work:
Provide details of any
proposed new use:
Territory Authority Disclaimer
The Territorial Authority makes no representation that the building works have been completed in
accordance with the description given by the owner :
It has not inspected the proposed/completed work
It has not checked the accuracy of the documents attached to this notification or approved in any
way the decision/s made by the owner relating to this notification.
It has not checked compliance with any other legislation as this remains the responsibility of the
owner
Owner/Applicant
Signature:
Date:
Documentation Checklist
Yes
N/A
Copies of plans: site, foundations, floorplan, elevations etc.
Copies of specifications
Producer Statements (PS1, PS2 etc.)
Photographs
Other:
Please submit AF EXOWN form and supporting attachments through the QLDC Sharefile portal
click to sign
signature
click to edit
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome