technical referee report - building surveyor (limited)

1

TECHNICAL REFEREE FORM

© State of Victoria, Victorian Building Authority 2017 (published September 2017)

Part M: Technical Referee Report – Building Surveyor (Limited) work

Limited to inspecting all classes of building up to three storeys in height and with a floor area of up to 2000 square metres

THIS DOCUMENT MUST BE COMPLETED BY THE PERSON PROVIDING THE REFERENCE

What is a Technical Referee Report?

An applicant applying for registration in a category and class of building practitioner must have recent experience in carrying out that work under supervision in accordance with relevant standards. The Technical Referee Report provides information about the applicant’s work, when it was performed, and the applicant’s role in performing that work. It is prepared by a person who has directly supervised the applicant in performing that work.

The report is used to help determine whether the applicant has sufficient experience to be considered for registration as a building practitioner.

Who can provide a Technical Referee Report?

If the report relates to work performed in Victoria, the referee should be registered in the category of, Building Surveyor (Limited) or Building Surveyor (Unlimited). In relation to inspections of building work carried out in Victoria, the referee may be registered in the category of Building Inspector (Limited) or Building Inspector (Unlimited).

If the report relates to work undertaken outside Victoria, and that work must be performed by registered persons, then the referee should be

licensed or registered (or equivalent) in the category of building practitioner for which they are providing the Technical Referee Report.

If the report is about work performed interstate or overseas, and it does not require a person to be licensed or registered, then the referee can be a person who has employed or contracted the applicant to undertake the work.

In addition, the referee must have directly observed the applicant carrying out the work that is listed in the report.

What are my responsibilities as a Technical Referee?

As a Technical Referee, you must:

provide an accurate and true reference

NOT give any false or misleading statement or information

be willing to be contacted by the Victorian Building Authority to confirmor explain further the work that the applicant performed

sign and date the Technical Referee Report Declaration.

Technical Referee Report for Building Surveyor (Limited) work - /44

2


Technical Referee Report – Building Surveyor (Limited)

Limited to inspecting all classes of building up to three storeys in height and with a floor area of up to 2000 square metres

THIS DOCUMENT MUST BE COMPLETED BY THE PERSON PROVIDING THE REFERENCE

STEP 1. Use this form to give your details and the details of the person for whom you’re providing the reference.

DETAILS OF THE TECHNICAL REFEREE

Given name:

Surname:

Date of birth:

Company name of your employer:

Address:

Contact number:

Are you registered as a building practitioner in Victoria in any of the categories at right, or in an equivalent registration/licence category outside of Victoria? If yes, please tick.

If no, are you registered in other categories of building practitioner in Victoria? Please specify them.

☐ Registered in Victoria ☐ Registered/licensed outside Victoria

☐ Building Inspector (Limited) ☐ Building Surveyor (Limited)

☐ Building Inspector (Unlimited) ☐ Building Surveyor (Unlimited)

☐ Other building practitioner (please specify)


3


DETAILS OF THE APPLICANT FOR WHOM YOU ARE PROVIDING THE TECHNICAL REFEREE REPORT

First name:

Last name:

TYPE OF EMPLOYMENT (Tick the relevant box/es)

PERIOD OF EMPLOYMENT: FROM – TO (Month/Year) PERIOD WHEN YOU SUPERVISED THE APPLICANT: FROM – TO (Month/Year)

Full time

Part time (please also include average number of hours employed per month)

Casual (please also include average number of hours employed per month)

Building practitioner number for each registration you hold (including interstate and overseas registration/ licence numbers):

DETAILS OF APPLICANT’S EMPLOYER

Name of company that employed the applicant when you supervised them:

ABN:

Address:

Contact number:


4


STEP 2. Complete the following table 1 and table 2.

Complete table 2 ONLY IF:

the applicant is not currently registered in Victoria as a BuildingSurveyor (Limited), Building Inspector (Limited) or Building Inspector(Unlimited), or

the applicant is currently registered in Victoria as a Building Inspector(Limited), but you are not authorised to inspect all classes of buildingand/or buildings up to three storeys and/or buildings with a floor area upto 2000 square metres.

In column 1 of both tables

Tick each area of work that the applicant undertook under your supervision, otherwise leave blank.

Note: For the applicant to have carried out building surveyor work under your supervision, you must be authorised to carry out the work, and the applicant must have carried out the work in your presence and at your direction.

In columns 2 and 3 of both tables

Fill in information about:

how many times the applicant performed each area of workunder your supervision

the applicant’s exact responsibilities in undertaking each areaof work.

Remember

Provide information about work the applicant undertook that yousupervised. Do not include information about any work that you didnot supervise personally.

Please include as much detail as possible, this statement will be usedto work out whether the applicant has enough relevant experience forregistration.

You must not (under section 246 of the Building Act 1993) give anyfalse or misleading statement or information in your report.

The report will be returned if it is incomplete or doesn’t have enoughdetail, and you may be asked to provide for more information.


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Table 1. Your supervision of the applicant’s building surveying work for buildings of all classes up to three storeys in height and with a floor area of up to 2000 square metres

Column 1 Column 2 Column 3

Did you supervise the applicant carrying out the following types of work? (Tick the box) How many times did they do

this work under your supervision?

What were the applicant’s exact responsibilities?

You may write ‘as above’ if you need to repeat the applicant’s responsibilities for multiple items in column 1

Assisted a registered building surveyor to assess an application for a building permit to:

construct a Class 1a building without a basement ☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 1a building with a basement ☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 2 or 3 building of Type C Construction with a floor area of up to 500 square metres

☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 2 or 3 building of Type C Construction with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 5

☐ 6 – 10

☐ 11+


6


construct a Class 2 or 3 building of Type B Construction with a floor area of up to 500 square metres

☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 2 or 3 building of Type B Construction with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 2 or 3 building of Type A Construction with a floor area of up to 500 square metres

☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 2 or 3 building of Type A Construction with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 5, 6, 7 or 8 building of Type C Construction with a floor area of up to 500 square metres

☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 5, 6, 7 or 8 building of Type C Construction with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 5

☐ 6 – 10

☐ 11+


7


construct a Class 5, 6, 7 or 8 building of Type B Construction with a floor area of up to 500 square metres

☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 5, 6, 7 or 8 building of Type B Construction with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 9 building of Type C Construction with a floor area of up to 500 square metres

☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 9 building of Type C Construction with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 9 building of Type B Construction with a floor area of up to 500 square metres

☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 9 building of Type B Construction with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 5

☐ 6 – 10

☐ 11+


8


construct a Class 9 building of Type A Construction with a floor area of up to 500 square metres

☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 9 building of Type A Construction with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 10a structure ☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 10b structure being a swimming pool (including pool safety barriers)

☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 10b structure being a fence ☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 10b structure being a retaining wall ☐ 1 – 5

☐ 6 – 10

☐ 11+


9


construct a Class 10b structure being a free standing wall

☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a Class 10b structure being a mast or antenna

☐ 1 – 5

☐ 6 – 10

☐ 11+

construct a class 10c structure being a private bushfire shelter

☐ 1 – 5

☐ 6 – 10

☐ 11+

alter an existing building where the proposed alterations, together with any other alterations completed or permitted within the previous three years, represent more than half the original volume of the building

☐ 1 – 5

☐ 6 – 10

☐ 11+

alter an existing Class 2, 3, 5, 6, 7, 8 or 9 building where the proposed alteration would adversely affect any exit or path of travel to an exit

☐ 1 – 5

☐ 6 – 10

☐ 11+

demolish or remove an existing Class 1 building ☐ 1 – 5

☐ 6 – 10

☐ 11+


10


demolish or remove an existing Class 2, 3, 5, 6, 7, 8 or 9 building

☐ 1 – 5

☐ 6 – 10

☐ 11+

Building permits

Confirmed if the report and consent of a relevant service authority had been obtained in support of an application for a building permit to construct a building over an easement vested in that service authority

☐ 1 – 5

☐ 6 – 10

☐ 11+

Confirmed if the report and consent of the chief officer (of the Metropolitan Fire Brigade or the Country Fire Authority) had been obtained in support of an application for a building permit that involved prescribed fire safety matters if those matters did not meet the deemed-to-satisfy provisions of the Building Code of Australia

☐ 1 – 5

☐ 6 – 10

☐ 11+

Considered whether protection work may be required to ensure an adjoining property is not affected by proposed building work

☐ 1 – 5

☐ 6 – 10

☐ 11+

Carried out an assessment of whether proposed protection works are appropriate

☐ 1 – 5

☐ 6 – 10

☐ 11+


11


Made a written recommendation to the relevant building surveyor about the appropriateness of proposed protection work

☐ 1 – 5

☐ 6 – 10

☐ 11+

Carried out an inspection of building work to assess whether required protection works were in place

☐ 1 – 5

☐ 6 – 10

☐ 11+

Prepared a written request to an applicant for a building permit requesting further information or documents in support of the application

☐ 1 – 5

☐ 6 – 10

☐ 11+

Prepared a written request to an applicant for a building permit requesting they amend the application (including design or other supporting documentation)

☐ 1 – 5

☐ 6 – 10

☐ 11+

Made a written recommendation to the relevant building surveyor to grant or refuse an application for a building permit, and the reasons for the recommendation

☐ 1 – 5

☐ 6 – 10

☐ 11+

Prepared a written notice to an applicant advising them of the relevant building surveyor’s decision to refuse the application for a building permit, and the reasons for the decision

☐ 1 – 5

☐ 6 – 10

☐ 11+


12


Prepared a building permit in the prescribed form for the relevant building surveyor to issue

☐ 1 – 5

☐ 6 – 10

☐ 11+

Provided a copy of a building permit, plans and other documents prescribed by the regulations to the applicant within seven days of the permit being issued

☐ 1 – 5

☐ 6 – 10

☐ 11+

Provided a copy of a building permit, plans and other documents prescribed by the regulations to the relevant council within seven days of the permit being issued

☐ 1 – 5

☐ 6 – 10

☐ 11+

Prepared a monthly return to the VBA on behalf of a building surveyor on building permits issued; building work that has commenced, been completed or abandoned; and any building work that lapsed in the previous month

☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


13



☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


14



☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


15



☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


16



☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


17



☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


☐ 1 – 5

☐ 6 – 10

☐ 11+


18


Building permit levy

Calculated the cost of the building permit levy to be paid by the applicant for the building permit

☐ 1 – 5

☐ 6 – 10

☐ 11+

Prepared a written notice to the applicant for a building permit, advising of the building permit levy payable

☐ 1 – 5

☐ 6 – 10

☐ 11+

Maintained records of amounts of the building permit levy received by a building surveyor and paid to the VBA

☐ 1 – 5

☐ 6 – 10

☐ 11+

Prepared a monthly return to the VBA on behalf of a building surveyor, setting out building permit levy amounts received and forwarded to the VBA

☐ 1 – 5

☐ 6 – 10

☐ 11+


19


Certificates of final inspection

Prepared a certificate of final inspection for the relevant building surveyor in the prescribed form

☐ 1 – 5

☐ 6 – 10

☐ 11+

Provided a copy of a certificate of final inspection and approval dates for mandatory inspections to the relevant council within seven days of the relevant building surveyor issuing the certificate

☐ 1 – 5

☐ 6 – 10

☐ 11+

Occupancy permits required by a building permit

Assisted the relevant building surveyor to assess an application for an occupancy permit required by a building permit

☐ 1 – 5

☐ 6 – 10

☐ 11+

Made a written recommendation to the relevant building surveyor to grant or refuse an application for an occupancy permit required by a building permit, and the reasons for the recommendation

☐ 1 – 5

☐ 6 – 10

☐ 11+

Prepared a written notice to an applicant advising them of the relevant building surveyor’s decision to refuse the application for an occupancy permit required by a building permit, and the reasons for the decision

☐ 1 – 5

☐ 6 – 10

☐ 11+


20


Prepared an occupancy permit required by a building permit in the prescribed form for the relevant building surveyor to issue

☐ 1 – 5

☐ 6 – 10

☐ 11+

Provided a copy of the occupancy permit, certificate of final Inspection and approval dates for the mandatory inspections to the relevant council within seven days of the relevant building surveyor issuing the occupancy permit

☐ 1 – 5

☐ 6 – 10

☐ 11+

Provided a copy of the occupancy permit required by a building permit to the applicant within seven days of the relevant building surveyor issuing the occupancy permit

☐ 1 – 5

☐ 6 – 10

☐ 11+

Provided the occupancy permit to the owner of the land/structure within seven days of the relevant building surveyor issuing the occupancy permit

☐ 1 – 5

☐ 6 – 10

☐ 11+

Temporary occupation of buildings

Assisted a building surveyor to assess an application to occupy temporarily a building for which an occupancy permit appropriate to the use of the building is not or cannot be issued

☐ 1 – 5

☐ 6 – 10

☐ 11+


21


Made a written recommendation to a building surveyor to grant or refuse an application for temporary occupation of a building, and the reasons for the recommendation

☐ 1 – 5

☐ 6 – 10

☐ 11+

Prepared a written notice to an applicant advising them of a building surveyor’s decision to refuse the application for temporary occupation of a building, and the reasons for the decision

☐ 1 – 5

☐ 6 – 10

☐ 11+

Prepared an approval for temporary occupation of a building in writing for a building surveyor to issue, specifying conditions (if any) and the period for which it applies

☐ 1 – 5

☐ 6 – 10

☐ 11+

Provided a copy of the approval of temporary occupation of a building to the relevant council within seven days of the building surveyor issuing the approval

☐ 1 – 5

☐ 6 – 10

☐ 11+

Provided a copy of the approval of temporary occupation of a building to the owner of the building within seven days of the building surveyor issuing the approval

☐ 1 – 5

☐ 6 – 10

☐ 11+


22


Enforce safety and building standards

Prepared a building notice to be served on an owner of a building or land on which building work is being or is proposed to be carried out.

☐ 1 – 5

☐ 6 – 10

☐ 11+

Assessed (on behalf of the relevant building surveyor) representations made by the person served with a building notice in relation to carrying out building work, protection work or other work

☐ 1 – 5

☐ 6 – 10

☐ 11+

Made a recommendation to the relevant building surveyor to cancel or amend a building notice after considering representations made by the owner

☐ 1 – 5

☐ 6 – 10

☐ 11+

Prepared a building order in the prescribed form for the relevant building surveyor to make, requiring the owner to carry out building work, protection work or other work

☐ 1 – 5

☐ 6 – 10

☐ 11+

Prepared a building order in the prescribed form for the relevant building surveyor to make, requiring the owner to stop building work

☐ 1 – 5

☐ 6 – 10

☐ 11+


23


Assessed a request from an owner who is required to comply with a building order to amend or cancel the building order

☐ 1 – 5

☐ 6 – 10

☐ 11+

Carried out an inspection of building work to assess whether a building order has been complied with

☐ 1 – 5

☐ 6 – 10

☐ 11+

Made a recommendation to the relevant building surveyor to amend or cancel a building order

☐ 1 – 5

☐ 6 – 10

☐ 11+

Prepared a referral to the VBA on behalf of the relevant building surveyor when a person failed to comply with a building order made by the relevant private building surveyor

☐ 1 – 5

☐ 6 – 10

☐ 11+

(Please continue)


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Table 2. Fill out this table to tell us about your supervision of the applicant’s inspections of building work for buildings of all classes up to three storeys in height and with a floor area of up to 2000 square metres if:

the applicant is not currently registered as a Building Inspector (Limited) or Building Inspector (Unlimited) in Victoria, or

the applicant is currently registered as a Building Inspector (Limited) in Victoria, but is not authorised to inspect all classes of building and/or buildingsup to three storeys in height and/or buildings with a floor area up to 2000 square metres.

Column 1 Column 2 Column 3

Did you supervise the applicant carrying out the following types of work? (Tick the box) How many times did they do

this work under your supervision?

What were the applicant’s exact responsibilities?

You may write ‘as above’ if you need to repeat the applicant’s responsibilities for multiple items in column 1

Carried out an inspection of building work before a footing is placed for the following classes and types of building

Class 1a building without a basement ☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 1a building with a basement ☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 2 or 3 building of Type C Construction with a floor area of up to 500 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+


25


Class 2 or 3 building of Type C Construction with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 2 or 3 building of Type B Construction with a floor area of up to 500 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 2 or 3 building of Type B Construction with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 2 or 3 building of Type A Construction with a floor area of up to 500 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 2 or 3 building of Type A Construction with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 2 or 3 building with a basement ☐ 1 – 10

☐ 11 – 20

☐ 21+


26


Class 5, 6, 7 or 8 building of Type C Construction with a floor area of up to 500 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 5, 6, 7 or 8 building of Type C Construction with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 5, 6, 7 or 8 building of Type B Construction with a floor area of up to 500 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 5, 6, 7 or 8 building of Type B Construction with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 5, 6, 7 or 8 building with a basement ☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 9 building of Type C Construction with a floor area of up to 500 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+


27


Class 9 building of Type C Construction with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 9 building of Type B Construction with a floor area of up to 500 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 9 building of Type B Construction with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 9 building of Type A Construction with a floor area of up to 500 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 9 building of Type A Construction with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 9 building with a basement ☐ 1 – 10

☐ 11 – 20

☐ 21+


28



☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+

Class 10b structure being a swimming pool (including pool barriers)

☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 10b structure being a fence ☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 10b structure being a retaining wall ☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 10b structure being a free standing wall ☐ 1 – 10

☐ 11 – 20

☐ 21+


29


Class 10b structure being a mast or antenna ☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 10c structure being a private bushfire shelter

☐ 1 – 10

☐ 11 – 20

☐ 21+

Carried out an inspection of building work before an in situ reinforced concrete member nominated by the relevant building surveyor is poured for the following classes and types of building


☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


30



☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


31



☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


32



☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


33



☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


34


Class 10b structure being a private bushfire shelter

☐ 1 – 10

☐ 11 – 20

☐ 21+

Carried out an inspection of building work on completion of the framework for the following classes and types of building


☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


35



☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


36



☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


37



☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


38


Carried out an inspection of building work on completion of all building work for the following classes and types of building


☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


39


Class 2 or 3 building of Type A with a floor area of up to 500 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


40



☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 9 building of Type B Construction and with a floor area of up to 500 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+

Class 9 building of Type B Construction and with a floor area of more than 500 and up to 2000 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+


41



☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 1 – 10

☐ 11 – 20

☐ 21+


42



☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+


☐ 11 – 20

☐ 21+

Class 10c structure being a private bushfire shelter

☐ 1 – 10

☐ 11 – 20

☐ 21+

Carried out an inspection of protection work in relation to an adjoining property before or during the carrying out of building work

Carried out an inspection of protection work for an adjoining property for building work in relation to any class of building and with a floor area of up to 500 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+


43


Carried out an inspection of protection work for an adjoining property for building work in relation to any class of building with a floor area of more than 500 square metres but less than 2000 square metres

☐ 1 – 10

☐ 11 – 20

☐ 21+

Prepared inspection records and directions to fix building work for buildings up to three storeys in height and with a floor area of up to 2000 square metres

Prepared a written inspection record of building work inspected

☐ 1 – 10

☐ 11 – 20

☐ 21+

After inspecting building work, reported to the relevant building surveyor on building work that fails to comply with the Building Act 1993, building regulations and building permit issued in relation to the building work

☐ 1 – 10

☐ 11 – 20

☐ 21+

Gave an oral direction to fix non-compliant building work (to the builder and/or the person who was apparently in charge of the site on which the building work was being carried out), when authorised to do so by the relevant building surveyor

☐ 1 – 10

☐ 11 – 20

☐ 21+

Assisted the relevant building surveyor in preparing a written direction to fix building work

☐ 1 – 10

☐ 11 – 20

☐ 21+


44


Remember: The information provided in this form must be true and correct. It is an offence under section 246 of the Building Act 1993 to give false or misleading information in relation to an application for registration, and this offence carries a maximum penalty of 120 penalty units.

I declare that the information contained in this form is complete and true to the best of my knowledge. And I understand that the VBA may make enquiries to verify any of the information I have given on this form, and I consent for the information provided in this form to be shared with any other third party for that purpose.

Referee name

Referee signature

Date


(must be a handwritten signature)

technical referee report - building surveyor (limited)

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