Waimakariri District Council
1 of 8 Application for Certicate of Acceptance
APPLICATION FOR
CERTIFICATE OF ACCEPTANCE
Under The Building Act 2004, Section 97
C/A No.
THE BUILDING
1. Site address:
(Street / Road / Township)
2.
Legal description of the land where the building is located:
Lot:
DP: Valuation Number:
3. Building Name (if applicable):
4. Location of building within site:
(Only applicable to multi-development sites)
5.
Number of levels: 6. Unit/Level No.:
7. Floor area m
2
- Existing: New: Total:
8. Current lawfully established use:
(i.e. use on any previous consent for the existing building)
9.
Year building rst constructed:
(Only applicable to existing buildings, approximate date is acceptable, eg 1920’s)
THE AGENT
PLEASE NOTE - Authorisation is required from the owner to act as agent.
16.
Agent’s name:
(Company or Organisation name if applicable)
1 7.
Contact person:
18. Mailing address:
19. Street address / Registered office:
20. Mobile: Landline:
Email:
THE OWNER
10. Owners name:
(Company or organisation name if applicable)
11.
Contact person:
12. Mailing address:
13. Street address / Registered office:
14. Mobile: Landline:
Email:
15. The following evidence of ownership is attached to this application:
Council to provide (additional charge of $15)
Private Bag 1005, Rangiora 7440
Phone 0800 965 468 (0800 WMK GOV)
Fax 03 313 4432 -
waimakariri.govt.nz
Copy of Certificate of Title OR
(Current within 1 month of being issued and must include a deposited plan [diagram])
Signed copy of Sale and Purchase Agreement
(If Certificate of Title is not issued)
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Waimakariri District Council
2 of 8 Application for Certicate of Acceptance
APPLICATION
2 1. The Certicate of Acceptance should be sent to Owner Agent
22. I wish to receive my approved documentation in the following format:
PLEASE NOTE - If Hard copy please confirm if you wish to pick it up from the council or have it posted.
Hard copy:
(post) OR (pick-up) OR Email OR USB
23. All consent related invoices/refunds to be billed and sent to:
Owner Agent
Or other
(If other please complete below)
Company name:
(If applicable)
Contact person:
Mailing address:
Mobile:
Landline:
Email:
PLEASE NOTE - Any refunds are to the receipted name unless written authorisation has been received from the receipted person or company.
PROJECT
24. Description of work (ie dwelling, alteration/addition)
25. Specify the intended use of the building (e.g. residential)
26. All building work carried out under this Certicate of Acceptance was completed on:
2 7. Did the building work result in a change of use of this building?
Yes
No
If yes provide details
28. Are hazardous substances stored in the building?
Yes
No
29. Intended life of the building:
Indenite but not less than 50 years
Or specied as
years
30. List Building Consents previously issued for this building (if any):
(i.e. is this project being constructed in stages? Is this consent for a relocated or transportable building?)
3 1.
Estimated value (incl GST) $
(i.e. the estimated aggregate of the values of all goods and services to be supplied for the building work and includes GST).
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3 of 8 Application for Certicate of Acceptance
REASONS WHY A CERTIFICATE OF ACCEPTANCE IS REQUIRED
The owner, or the owner’s predecessor in title, carried out building work for which a building consent was
required, but a building consent was not obtained because (explain in detail below):
A building consent could not practicably be obtained in advance because the building work had to be carried out
urgently (delete one of the following):
(a) for the purpose of saving or protecting life or health or preventing serious damage to property as follows
(explain in box below):
(b) in order to ensure that a specied system was maintained in a safe condition or made safe as follows (explain
in box below):
The building consent authority that granted the building consent is unable or refuses to issue a code compliance
certicate in relation to the building work, and no other building consent authority will agree to issue a code
compliance certicate for the building work:
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4 of 8 Application for Certicate of Acceptance
RESTRICTED BUILDING WORK
Does the building work include any restricted building work?
Yes
No
If Yes, provide the following details of all Licensed Building Practitioners who will be involved in carrying out or
supervising the restricted building work (if these details are unknown at the time of the application, they must be
supplied before the work begins).
LICENCE CLASS
LICENSED BUILDING
PRACTITIONER NUMBER
(or registration number if treated as
being licensed under section 291 of
the Building Act 2004)
NAME
CARPENTRY
EXTERIOR PLASTERER
BRICKLAYER
BLOCKLAYER
ROOFER
FOUNDATIONS
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5 of 8 Application for Certicate of Acceptance
KEY PERSONNEL
BUILDER
Name:
Reg. No.:
Address:
Phone No.:
Fax No.:
Email:
DESIGNER(S)
Name:
Reg. No.:
Address:
Phone No.:
Fax No.:
Email:
CERTIFYING DRAINLAYER
Name:
Reg. No.:
Address:
Phone No.:
Fax No.:
Email:
CERTIFYING PLUMBER
Name:
Reg. No.:
Address:
Phone No.:
Fax No.:
Email:
CERTIFYING GASFITTER
Name:
Reg. No.:
Address:
Phone No.:
Fax No.:
Email:
REGISTERED ELECTRICIAN
Name:
Reg. No.:
Address:
Phone No.:
Fax No.:
Email:
STRUCTURAL ENGINEER
Name:
Reg. No.:
Address:
Phone No.:
Fax No.:
Email:
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6 of 8 Application for Certicate of Acceptance
ATTACHMENTS
The following documents are attached to this application:
Site plans (One copy to scale, clean and unstamped usually 1:100 or 1:50)
Must include:
North orientation arrow
Distance from all boundaries
Show all other buildings on property (size if possible)
Distance from any hazards (ie water race/open drains)
Floor plans (One copy to scale, usually 1:100 or 1:50)
Photographs of building work
Certicates from the people who carried out the work.
You are required to supply certicates from ALL the trades involved in your project.
Such certicates should include the following information:
Name, address, and contact phone numbers
Registration number (where applicable)
Project site address, and scope of work
Name of the tradesperson who carried out the work
A statement conrming which NZ Building Code Clauses that the work complies with
The Certicate must be signed and dated by the tradesperson responsible for the work
Certicates that relate to the energy work (Electrical and Gastter).
Evidence that specied systems are capable of performing to the performance standards
set out in the submitted documents (Installers certication).
Certificate of Title (current within one month of being issued).
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OWNER / AGENT AUTHORISATION
I request that you issue under Section 97 of the Building Act 2004, a Certicate of Acceptance for the building work
described in this application.
PLEASE NOTE - By entering your name in the box below you are giving your authority for the application to proceed.
Name: Date:
I am the
Owner
Agent
Note: If acting on behalf, by entering your name above you hereby declare that you are authorised to act as Agent for
the Owner.
NB: Ensure Agent Authorisation section is completed - see below.
AGENT AUTHORISATION
(TO BE AUTHORISED BY OWNER)
PLEASE NOTE - By entering your name in the box below you are giving your authority for this application to proceed.
I authorise
to act as Agent on my behalf for this
Certicate of Acceptance application under Section 97 of the Building Act 2004.
Name (Owner): Date:
TERMS OF TRADE
I/We understand that:
Building Consents shall be paid for when the consent is collected or if the consent is not collected within three months after the date
of consent being granted, the work done to date portion i.e. admin and processing costs of the account will be due and payable. The
balance of the invoice will be payable when the consent is collected.
All other accounts shall be paid by the 20th day of the month following the month in which the invoice is issued.
I/We agree to pay according to these terms for any goods or services you supply to us. Failure to meet these Terms of Trade may
result in any credit arrangement being withdrawn with any balance becoming payable within seven days. Should failure to meet the
terms of trade result in debt recovery and/or legal proceedings, any costs whatsoever incurred in the collection of the debt including
debt collector’s fees and commissions and legal costs, charges and expenses on a solicitor and own client basis will be added to
the account and will be payable by me/us.
OFFICE USE ONLY
Further information required? Yes No
Date of acceptance: Officer:
OFFICE USE ONLY
Amount paid: $
Date:
Officer:
Date payment processed:
Receipt
Officer:
Fee paid on application Deposit invoice sent
Waimakariri District Council
8 of 8 Application for Certicate of Acceptance
IMPORTANT INFORMATION
All the relevant information on this form is required to be provided under the Building Act 2004 and/or Resource Management Act 1991
for the Waimakariri District Council to assess your application. Under these Acts this information has to be made available to members
of the public if requested. The information contained in this application may be made available to other units of the Council.
You have
the right to access the personal information held about you by the Council which can be readily retrieved. You can also request that the
Council correct any personal information it holds about you.
APPLICATION INFORMATION
Under certain circumstances a Territorial Authority may, on application, issue a Certicate of Acceptance for work already done.
This does not apply to building work carried out prior to 1 July 1992.
A Territorial Authority may issue a Certicate of Acceptance only if it is satised, to the best of its knowledge and belief and on
reasonable grounds, that, insofar as it could ascertain, the building work complies with the Building Code.
The above does not relieve a person from the requirement to obtain a Building Consent for building work (excluding building work
described under Schedule 1 of the Building Act 2004).
A Certificate of Acceptance will be issued within 20 working days from application, provided all the information required
has been supplied. The Certificate of Acceptance will be based on the supplied documents. All work listed in the
Certificate of Acceptance documentation must have been carried out to the satisfaction of the Building Consent Authority.
This will be determined through inspections.
COMPLIANCE CHECK
Where applicable a Compliance Check is undertaken to ensure your building work complies with the District Plan.
CERTIFICATE OF ACCEPTANCE FEES
A Certicate of Acceptance carries a non-refundable deposit of $515. To see Council’s full Schedule of Fees & Charges visit
waimakariri.govt.nz. All work for the issue of a Certicate of Acceptance over and above this value will be charged and invoiced
additionally in the same way as for a Building Consent application, ie levies, inspections, administration etc as described in
Section 97 of the Building Act 2004.
LEVIES PAYABLE
Under the Building Act 2004 s53, s55 s402 Council are authorised to collect levies for the MBIE (Building Levy Order 2005) and BRANZ
(Building Research Levy Act 1969). Levies are only payable on building works where the construction value exceeds a prescribed amount.
Building Act 2004 – http://www.legislation.govt.nz/act/public/2004/0072/latest/whole.html
Building Levy Order 2005 – http://www.legislation.govt.nz/regulation/public/2005/0033/latest/whole.html#DLM313989
Building Research Levy Act 1969 - http://www.legislation.govt.nz/act/public/1969/0023/latest/whole.html
INSPECTIONS
During the processing, inspections might be necessary to assess the work that has been undertaken.
All inspections are subject to to a separate charge.
RESOURCE CONSENT
Your application will be assessed by the Planning Unit of the Council to determine whether your project complies with the relevant
District Plan requirements.
If it is determined that the completed building work is in breach of the District Plan you may need to apply for a Resource Consent.
This will be a separate process additional to this application for Certicate of Acceptance.
It is recommended that you phone the
Planning Unit on 0800 965 468 to discuss the process.
AGENCY
The owner may authorise an agent to submit an application on their behalf.
The Agent will be the rst point of contact for all communications with the Council/Building Consent Authority regarding this
application under Sections 97 and 99 of the Building Act 2004. They will receive all correspondence and must be authorised by
the Owner - see page 7.
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