Doc# 1146281 Page 1 of 3 BA Form 103A
Application for a discretionary
exemption from building consent
Section 1, Part 1.2, Building Act 2004
Version: 3
Date: July 2020
Send or deliver your application to: Web: www.timaru.govt.nz
Building Services, Timaru District Council, Telephone: (03) 687 7236
2 King George Place, PO Box 522, Timaru 7940 Email: building@timdc.govt.nz
A. THE BUILDING (project location)
Street or road address:
Legal description:
(state legal description as at the date of
application and, if the land it proposed to
be subdivided, include details of relevant lot
numbers and consent no)
Valuation number: Zone:
Lot: DP:
Section:
Building name:
(if applicable)
Current, lawfully established use:
B. OWNER
Name of owner: (include title)
Contact person: (if different from owner)
Mailing address:
Street address / registered office:
Contact details: Landline number: Mobile number:
Daytime number: After hours number:
Facsimile number: Email address:
C. THE KEY PERSONNEL (person(s) who will do the work:
Include registration number or Licensed Practitioner Number ‘LPN’
Designer: Name: Reg or LPN no:
Builder: Name: Reg or LPN no:
Plumber: Name: Reg or LPN no:
Drainlayer: Name: Reg or LPN no:
Structural engineer: Name: Reg or LPN no:
Electrician: Name: Reg or LPN no:
