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SECTION 1 DWELLING & OTHER WORKS - NOT (Waimakariri District Council New Zealand)

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SECTION 1
Statutory Forms
- Inspec on List – By Council
- Building Consent Form (Form 5) – By Council
- Code Compliance Applica
on (Form 6) – By
Council
- Installa
on & PS3 Forms – By Council
- Applica
on Form
- LBP Design Cer
ficates
- Cer
ficate of Title or Sales & Purchase
Agreement
- PIM, Resource Consent – By Council
DWELLING & OTHER WORKS -
NOT COMMERCIAL
Waimakariri District Council
1 of 13
Building Consent/PIM Application for Dwellings & Other Work
BUILDING CONSENT AND/OR PIM APPLICATION
FOR DWELLINGS & OTHER WORK THAT DOES NOT FIT THE
CRITERIA FOR SPECIFIED MINOR WORKS FIXED FEE
NOT FOR COMMERCIAL PROJECTS
Under The Building Act 2004, Sections 33, 45 & Schedule 1, Part 1,
Section 2, BAA13
BC 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. Owner’s 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)
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)
215 High Street, Rangiora
Private Bag 1005, Rangiora 7440
Free Phone 0800 965 468
Email office@wmk.govt.nz
waimakariri.govt.nz
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APPLICATION
2 1. I request that the following (please select one) be issued for the Building Work described in this Application:
Project Information Memorandum (PIM) only
Building Consent for PIM No:
Building Consent with PIM
Building Consent without PIM (Compliance Check applies)
Exemption from the need for B/C
Amendment to Building Consent
(Refer Schedule 1, Part 1, Section 2, BAA13)
Building Consent for Above Ground Pool and/or Non-Exempt Small Heated Pool
22. I wish to receive my approved documentation in the following format:
PLEASE NOTE - If USB or Hard Copy please conrm if you wish to pick it up from the council or have it posted/couriered (couriered will incur
an additional cost).
Electronically via Sharele Transfer Portal
(
You must be set up and registered for this option)
USB:
(post) OR (pick-up) OR (courier)
Hard copy (on site):
(post) OR (pick-up) OR (courier)
PLEASE NOTE - One set of “On-site” hard copy consented documents must be available at all times for inspections.
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.
SPECIFY AND PROVIDE WITH APPLICATION
Building Element – Site information
APPLICANT TO COMPLETE OFFICE USE ONLY
Completed application form
Set of plans / specications (1 copy)
Certicate of Title / Sales & Purchase (1 copy)
ONLY FOR SWIMMING POOL:
Building Element – Drawn Information / Specications / Details
Site plan, showing location of pool and existing buildings, location of fence,
boundaries and existing waterways
Fence construction. Show the height, gates, self closing device, construction
type etc (see “A guide to pool fencing”)
Also show how any doors or windows that form part of the fence will comply
Brand and model of pool:
Size of the pool:
Drainage plan. Show discharge point
Producer statement (where applicable)
Installation instructions/manual
Show lling point for pool (tap) and backow protection
Waimakariri District Council
3 of 13 Building Consent/PIM Application for Dwellings & Other Work
GEOTECHNICAL REPORT
If a geotechnical report has been included in this application, please conrm that it has been uploaded to the
Canterbury Geotechnical database by providing its unique report reference number below.
Report number:
PROJECT INFORMATION MEMORANDUM
The following matters are involved in the project:
Subdivision
Alterations to land contours
New or altered connections to public utilities
New or altered locations and/or external dimensions of buildings
New or altered access for vehicles
Building work over or adjacent to any road or public place
Disposal of stormwater and wastewater
Building work over any existing drains or sewers or in close proximity to wells or water mains
Other matters known to the applicant that may require authorisations from the territorial authority:
PROJECT
25. Description of work (e.g. dwelling, alteration/addition). If an amendment, please provide a complete description of the nature of
the amendment.
Yes
No
26. Specify the intended use of the building (e.g. residential/show home)
27. Will the building work result in a change of use of this building?
If yes provide details
28. Will hazardous substances be 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. Is this a staged consent:
Yes
No
If staged, provide details
(e.g. Stage 1 of 3)
3 1.
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?)
32.
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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NOTES
Other notes or comments which you may wish to add, eg: Resource Consents
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Waimakariri District Council
Building Consent/PIM Application for Dwellings & Other Work
BUILDING CODE COMPLIANCE
The building work will comply with the building code as follows:
(If you are not sure what clauses are applicable, consult with your builder, designer or architect).
Clause
(Tick relevant clause numbers of Building Code)
Means of compliance
(Refer to the relevant compliance
document(s) or detail of alternative
solution in the plans and
specications; if not applicable, put
n/a
Waiver / modication required
(State nature of waiver or modication
of building code required; if not
applicable, put n/a)
B1 Structure
B2 Durability
C1 - C6 Protection from re
D1 Access routes
D2 Mechanical installations for access
E1 Surface water
E2 External moisture
E3 Internal moisture
F1 Hazardous agents on site
F2 Hazardous building materials
F3 Hazardous substances and processes
F4 Safety from falling
F5 Construction and demolition hazards
F6 Visibility in escape routes
F7 Warning systems
F8 Signs
F9 Means of restricting access to residential pools
G1 Personal hygiene
G2 Laundering
G3 Food preparation and prevention of contamination
G4 Ventilation
G5 Interior environment
G6 Airborne and impact sound
G7 Natural light
G8 Articial light
G9 Electricity
G10 Piped services
G11 Gas as an energy source
G12 Water supplies
G13 Foul water
G14 Industrial liquid waste
G15 Solid waste
H1 Energy efficiency
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Building Consent/PIM Application for Dwellings & Other Work
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
COMPLIANCE SCHEDULE
The specied systems for the building are as follows (specied systems are dened in regulations):
The following specied systems are being altered, added to, or removed in the course of the building work:
There are no specied systems in the building
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7
of 13
Building Consent/PIM Application for Dwellings & Other Work
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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Building Consent/PIM Application for Dwellings & Other Work
OWNER / AGENT AUTHORISATION
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
Building Consent application under Sections 33 and 45 of the Building Act 2004.
With respect to this Building Consent application, I authorise
to act
as Agent on my behalf for the application for Code Compliance Certicate under Section 92 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.
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DOCUMENTATION CHECKLIST
Applicants must mark all items provided with ☑ or leave blank if not applicable.
PIM
This section must be completed if you are applying for a PIM.
DO NOT complete this section if a PIM has already been issued.
The following documents are attached to this application:
Site plan, Floor plans, Elevations for proposed building
Certicate of Title, or Sales and Purchase Agreement if C/T is not issued. Current C/T required (current within one month
of application)
One copy of all information required (all plans to be dimensioned, scaled and accurate. Plans preferred size A3)
Application fee (as per Council Fees and Charges Schedule)
BUILDING CONSENT
(DO NOT complete this section if the Application is for a Project Information Memorandum only)
The following documents are attached to this application:
1 copy - building plans (site plans, oor plans, elevation plans. All plans to be dimensioned, scaled and accurate preferred
size A3)
1 copy of each - specications, producer statements, truss details (refer below)
1 copy - Certicate of Title or Sale and Purchase Agreement if C/T is not issued. Current C/T required (current within one
month of application)
Project Information Memorandum Development Contribution Notice (if applicable)
Certicate attached to Project Information Memorandum (Resource Management Act)
Certicate of design work from licensed building practitioner
Restricted building work - see page 5
Key personnel - see page 6
See page 5 for a schedule conrming the building work will comply with the Building Code
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Building Consent/PIM Application for Dwellings & Other Work
APPLICATION FORM (One copy)
Fully complete all sections
Means of Compliance with NZBC - designer to complete
Provide the correct legal description (Council can help with this)
Provide one copy of the current Certicate of Title, or Sales and Purchase Agreement - not
more than one month old
Give name and contact numbers of contact person (if not the owner)
State the project location (street address or location details as near as possible if no address)
Sign and date the form
Agent Authorisation (section completed where applicable)
Certicate/s of design work (LBP)
DESIGN BASIS (To be completed by the designer)
Please list the following basis for the building design:
Wind zone
Earthquake zone
Snow zone/altitude
Corrosion zone (if applicable)
Building is specically engineer-designed
Complies with NZS 3604:2011
Both specic design and NZS 3604:2011
DESIGN DOCUMENTS (One copy)
Weather tightness risk matrix
Truss design layout and Producer Statement
Bracing calculations / plan
H1 Energy efficiency calculations
SITE PLAN (One copy)
Overview of site showing legal boundaries as per current Title
Showing proposed and existing structures (including swimming pools)
Distances to boundaries
Proposed and existing site levels
North point
Utility infrastructure (sewer, water pipelines, septic tanks etc) where applicable
Water races, drains, topographic features
DRAINAGE LAYOUT (One copy to scale usually 1:100 or 1:50)
Foul water - showing waste pipes, sizes, grades, venting
Foul water to discharge point
Storm water - pipe sizes, grades, downpipe locations
Storm water drain to discharge point
FOUNDATION LAYOUT (One copy to scale usually 1:100 or 1:50)
Full foundation layout plan
For timber oors, show all pile layout, pile types and bracing location
Slab thickenings, shrinkage control joints and reinforcing rebates
OFFICE
USE ONLY
These have
been provided:
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Building Consent/PIM Application for Dwellings & Other Work
OFFICE
USE ONLY
These have
been provided:
FLOOR PLANS (One copy to scale usually 1:100 or 1:50)
Layout of all oors fully dimensioned. For alterations and/or additions provide both new
and existing oor plans
Doors and window positions and sizes
Layout of amenity areas (laundry etc)
Main structural beams that are not shown elsewhere
Lintel sizes
HWC location
Roof space access
Gas cylinder location
Room names
Location of smoke alarms
Location of heating unit (if applicable)
EXTERIOR ELEVATIONS (One copy to scale usually 1:100 or 1:50)
Elevations of all external walls showing claddings
Doors and windows showing opening sections
Show location of solar panels
Accurate ground levels existing and proposed
Suboor ventilation for timber oors
Show roof bracing on elevations if not shown elsewhere
CROSS SECTION AND CONSTRUCTION DETAILS (One copy to scale usually
1:50 or 1:20 for sections and 1:10 for details - minimum scale)
Roof lines, overhangs, oor levels, ground levels
Major vertical dimensions
Foundation, wall and roof structure materials
Upper level decks or balconies over lower level room must be fully detailed including the
stormwater disposal and overow precautions
Stairs, handrails and balustrade showing pitch and head clearances
Structural connections, posts to footings, beams to posts, trusses or beams to walls
Component xing information is to be provided for all structural and framing components
Foundation and footing details and reinforcing. Show height from nished oor to ground level
Pile details for timber oors
Floor bracing details
Timber grade and treatment
Damp proof membranes, building papers and insulation systems/materials
Flashing details and documents
Roof penetrations
Shower oor details and wall to shower base junction detail
Sealing to wet area xtures
Water splash prevention
All other building components that are not otherwise detailed or are unusual in any way
SPECIFICATION (One copy)
The specication must be for the project. We will not accept standard specications unless
they relate directly to the building and they cover the project accurately and fully. Multichoice
specications will not be accepted. A brief accurate specication is usually best.
Provide a written specication to cover all of the trades involved in the project. All materials used in
the project are fully specied including xings of all materials and components
The specication can be written on the drawings as long as all materials are fully covered
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12 of 13 Building Consent/PIM Application for Dwellings & Other Work
OFFICE
USE ONLY
These have
been provided:
IMPORTANT THINGS TO INCLUDE IN YOUR APPLICATION (One copy - where relevent)
The chartered professional engineer’s Producer Statement
The engineer’s monitoring schedule if the engineer chooses to do site monitoring
All structural calculations
Structural details showing connections and details of the components
Solar technical details and plumbing schematic
Log re and ue installation instructions.
If log re secondhand, engineer’s certication required
Current potable water test (current within 18 months)
Effluent disposal design & ECan’s copy of the submitted application form or approval
Wastewater system designs when required to be done by a chartered professional engineer such
as in a hazard zone
GEOTECHNICAL REPORT
Unique report reference number provided, if applicable
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
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13 of 13 Building Consent/PIM Application for Dwellings & Other Work
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
(a) Project Information Memorandum (PIM):
A PIM will be issued within 20 working days provided all the required information is supplied with the application.
Processing time is stopped whenever further information is required and starts again when the correct information is received.
It is not mandatory to apply for a PIM. Applicants can choose not to apply for a PIM when they consider that the information would
not be relevant for their building project.
A fee is required to accompany your PIM application (as per Council’s fees and Charges Schedule).
(b) Compliance Check:
Where a PIM is not sought, a Compliance Check will be undertaken to ensure your proposal complies with the District Plan.
(c) Building Consent (BC):
A Building Consent will be processed within a maximum allowable time of 20 working days provided all the information
required has been supplied. Processing time is stopped whenever further information is required and starts again when the correct
information is received.
Once the Building Consent has been granted, you will receive notification, which will include an invoice for the fees payable. Once
the fees are paid in full, your Building Consent will be issued. Work must not start until the Building Consent is issued, and any
Resource Consent requirements have been resolved.
A Building Consent lapses and is of no effect if the building work to which it relates does not commence within 12 months after the
date of issue of the Building Consent or any further period that the Building Consent Authority may allow.
(d) Combined Project Information Memorandum & Building Consent Applications:
Applications for a combined PIM/BC will only be accepted when sufficient information is provided to permit the Building Consent to
be processed.
If insufficient information is provided, then further information will be requested, or your application may be returned to you.
(e) If the applicant does not own the land, they must provide written approval from the owner to submit this application.
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 process of construction, inspections will be necessary to conrm all work complies with your approved Building Consent
documentation. Please phone the Council Building Unit on 03 311 8906 at least 48 hours in advance of requiring an inspection to ensure
that this can be arranged.
The inspections required will be set out in the Building Consent documentation issued by the Council. Failure to have a prescribed
inspection carried out may put the issue of the Code Compliance Certicate at risk.
All inspections including re-inspections are subjected to a separate charge, even if carried out on the same day.
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 your application does not comply with District Plan requirements you will need to either amend your proposal to comply or apply for a
Resource Consent. A Certicate will be attached to your Project Information Memorandum to notify that a Resource Consent is required
prior to building work commencing. It is recommended that you phone the Planning Unit on 0800 965 468 to discuss the process.
CODE COMPLIANCE CERTIFICATE
A Building Consent is not completed until it has been issued with a Code Compliance Certicate. The owner is required to complete a
separate application for a Code Compliance Certicate as soon as practicable after the building work is completed. In any event no later
than two (2) years after the granting of the Building Consent, Council is required to decide whether or not a Code Compliance Certicate
can be issued. If your project will not be completed within two years you will need to apply for a time extension*.
*Fees apply
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 33 and 45 and if authorised, the application for a Code Compliance Certicate under Section 92 of the Building Act 2004.
They will receive all correspondence and must be authorised by the Owner - see page 8. All amendments require new authorisation.
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Geotech, Engineer
Reports & Condions
PS1 & 2
- Calculaons
- A4 Details
SECTION 2
Truss Details &
Bracing Details
(Include Fixings of Gib & Ecoply)
- Design IT Calcs
- Hyspan etc.
SECTION 3
H1 Calculaons
Risk Matrix
SECTION 4
Specificaons
SECTION 5
Technical Informaon
(Manufacturer’s Informaon)
- Sepc Tank & Effluent Design incl.
fencing
- ECan Approval Documents
- Gas Fire
- Heang Unit
- Solar Panels
- Central Heang Systems
- A4 Details/Acceptable Soluon
Extract
- Well/Water Test
SECTION 6
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SECTION 1 DWELLING & OTHER WORKS - NOT (Waimakariri District Council New Zealand)

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Completed 29 July 2020

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