CS19.3 Residential Building Consent Application and Processing Checksheet

Important Information for the Applicant

In accordance with the Building Act 2004 Section 49 (Grant of Building Consent), the Council must be “satisfied on reasonable grounds that the provisions of the building code will be met if the building work were to be completed in accordance with the plans and specification that accompanied the application”. This checklist is designed to assist the owner, agent and designer to identify the documentation content and level of design information that must be provided with your Building Consent application. The Applicant is required to use this checklist to ensure that their drawings, specifications and other relevant design documents are complete, accurate and are compliant with the New Zealand Building Code. When completing this form please ensure that all the fields within the orange coloured sections titled “Applicant to Complete”, are filled out. If any section or specific question is not applicable this can be indicated by selecting the ‘N/A’ box

This form is to be completed accurately, ensuring that all questions are answered appropriately, with the relevant plan or specification page number(s) identified. We recommend the applicant uses this checksheet as an aide during the design process as well as a checklist to verify they have all required information prior to uploading their Building Consent Application files onto the QLDC website File Transfer Portal (Sharefile). Please note that a suitable quality of documentation is required before QLDC will accept an application for processing and granting of a building consent. For further information on the quality of the documentation required please refer to the MBIE (Ministry for Building Innovation and Employment) guidance document: ‘Guide to applying for a building consent (residential building)”.

The time invested in the preparation of application documentation, including the completion of this checklist, will reduce the likelihood of unnecessary delays and requests for significant amounts of further information. Failure to provide complete documentation may result in the Building Consent Application being delayed due to RFI requests or refused outright.

Applicant to Complete Note: Where there is only a single design option for the QLDC district the Council Use Only checkboxes are prepopulated . All other fields must be populated by the applicant. Click here to enter text. Address: Building Consent Click here to enter text. Number: Click here to enter text. Description of work: ☐ Building Consent Application ☐ Amendment Date: Click here to enter text.

E2 Risk Score ☐ Res1 ☐ Res2 ☐ Res3 Building Category Highest score of all faces must be ☐ Com1 ☐ Com2 ☐ Com3 provided, even for internal alterations Click here to enter text. Processor Name Click here to enter text. (BCO)

Yes RFI Reasons for decision/comments Wind Region ☐ Lee Zone  A NZS 3604 Fig 5.1 Note: Applies to upper Lake Hawea area only ☐ ☐ Click here to enter text.

Earthquake zone ☐ 2 ☐ 3 ☐ 4 ☐ ☐ Click here to enter text. NZS 3604 Fig 5.4

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Snow Zone Click here to N5 Altitude ☐ <400 ☐SED ☐ ☐ NZS 3604 Fig 15.1 enter text.

B2 Exposure zone  B Click here to enter text. ☐ ☐ Click here to enter text. NZS 3604 Fig 4.2

Form 2: Application for Project Information Memorandum and/or Building Consent Applicant to Council Use Only Complete Reasons for Decisions / Yes N/A Description Yes N/A RFI comments Have all Click here to confirm the result sections of from Vetting Sheets CS4.1 and Form 2 been CS4.1R completed including signatures, LBP details, ☐ RBW details, ☐ ☐ an accurate description of the work, section 8 means of compliance, Proof of ownership (CT, Rates Account, ☐ Sale and ☐ ☐ Purchase agreement or Lease.) Letter from the owner appointing ☐ ☐ Agent where ☐ ☐ ☐ an agent is making the application. Fee calculator (completed by the applicant) & ☐ the value of ☐ ☐ work is accurate. Completed Certificates of ☐ ☐ Design Work ☐ ☐ ☐ (CODWs) Plans and specifications ☐ complete and ☐ ☐ demonstrate compliance

Restricted Building work (RBW): Applicant Council Use Only to CS19.3 Page 2 of 30 Last Updated: 13/09/2017 Revision: 6 CS19.3 Residential Building Consent Application and Processing Checksheet

Complete Reasons for Decisions / Yes N/A Description Yes N/A RFI comments LBP No: (Design): ☐ ☐ Memorandum ☐ ☐ ☐ Click here to enter text. (CODW) Provided LBP No: (Engineer): ☐ ☐ Memorandum ☐ ☐ ☐ Click here to enter text. (CODW) Provided Owner Exemption: ☐ ☐ Statutory ☐ ☐ ☐ Click here to enter text. declaration Form 2B, or Owner Exemption: ☐ ☐ Notice of ☐ ☐ ☐ Click here to enter text. owner-builder Form 2C

Means of Compliance Applicant to Council Use Only Complete Reasons for Decisions / Yes N/A Description Yes N/A RFI comments ☐ ☐ NZS3604:2011 ☐ ☐ ☐ Click here to enter text. Specific Engineering Design (SED) i.e AS/NZS ☐ ☐ 1170 ☐ ☐ ☐ Click here to enter text. Note: Please fill out details in following section NASH (National ☐ ☐ Association of ☐ ☐ ☐ Click here to enter text. Steel Framed Housing) NZS 4229 ☐ ☐ (Concrete ☐ ☐ ☐ Click here to enter text. Masonry) AS 4440 (Roof ☐ ☐ Trusses) ☐ ☐ ☐ Click here to enter text. BRANZ / BEAL Click here to enter text. ☐ ☐ appraisal. ☐ ☐ ☐ If Yes, please provide details:

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Click here to enter text. Codemark Certificate No: If Yes, please ☐ ☐ provide details: ☐ ☐ ☐ Click here to enter text. Click here to enter text. Other means of compliance: ☐ ☐ Click here to ☐ ☐ ☐ Click here to enter text. enter text.

Specific Engineering Design elements included in this application

☐ Foundations (pile) ☐ Floor (timber subfloor) ☐ Ventillation ☐ Swimming pool

☐ Foundations (strip) ☐ Floor (timber mid-floor) ☐ Barriers ☐ Solar water heating

☐ Masonry walls ☐ Wall framing ☐ Bracing ☐ Wastewater ☐ Lift / Cable car

☐ Floor (slab) ☐ Columns ☐ Beams ☐ Lintels ☐ Stormwater ☐ Conservatory

☐ Retaining walls ☐ Roof framing / bracing ☐ Solid fuel heater ☐ Cladding System

☐ Other: Click here to enter text.

General Applicant to complete Note: Where a specific (reference) has been provided this is a Compliance Council Use Only general reference to the subject of the item to be checked, and may Decision or may not be the specific means of compliance. Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Click to enter Siting dimensions on site plan provide Click here to enter text. Page/Doc No: ☐ sufficient information ☐ ☐ ☐

Minimum (floor and finished ground) levels ☐ shown on site plan/details (Ref NZS 3604 Fig ☐ ☐ ☐ Click here to enter text. 7.11 or E2/AS1 Fig 65)

Datum / contours sufficient to assess site ☐ drainage requirements can be satisfied ☐ ☐ ☐ Click here to enter text. Click to enter All building works shown on site plan (ensure Click here to enter text. Page/Doc No: ☐ any Schedule 1 works NOT included) ☐ ☐ ☐

Main access to building shown on site ☐ plan(required for Section D1 Access) ☐ ☐ ☐ Click here to enter text.

Ancillary Buildings: Retaining walls, outdoor Click here to enter text. ☐ fire, storage tanks ☐ ☐ ☐

Outbuildings: Garage, carport, shed, Click here to enter text. ☐ swimming pool ☐ ☐ ☐ CS19.3 Page 4 of 30 Last Updated: 13/09/2017 Revision: 6 CS19.3 Residential Building Consent Application and Processing Checksheet

Public & private drainage shown on site plan Click to enter Location, connections, cess pits (required for Click here to enter text. Page/Doc No: ☐ Sections E1 & G13) ☐ ☐ ☐

The following sections detail the questions that QLDC will evaluate as part of the processing of your building consent. These questions are aligned with the requirements of the NZ Building Code.

Please evaluate your design documentation against these requirements and where applicable, provide the document reference/page number from your plans/specifications that demonstrates the building code requirement has been satisfied.

B1 Structure: Landscape retaining walls

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions/ Comments or Page No. A Construction details specified i.e. footings, Click here to enter text. ☐ wall construction, height ☐ ☐ ☐ Drainage clear of public drains and Soakpit Click to enter ☐ design specified (ref Section E1 to ensure ☐ ☐ ☐ Click here to enter text. Page/Doc No: sump prior to entering stormwater system. Drainage medium, tanking and protection Click here to enter text. ☐ specified ☐ ☐ ☐ Click here to enter text. ☐ Surcharge correctly factored into design ☐ ☐ ☐

☐ Type A: PS1, PS2, PS3 & PS4

Masonry types: A, B or C ☐ Type B: PS1 & PS3 Click to enter (Ref Engineer’s design guidance statement) Page/Doc No: ☐ ☐ ☐ ☐ ☐ Type C: PS3 may be required.

☐ Other (NZS 4229): PS3 may be required. Click here to enter text. Click to enter Barrier specified (required for Section F4 Click here to enter text. Page/Doc No: ☐ safety from falling) ☐ ☐ ☐ Excavations potentially affecting neighbouring Click to enter properties mitigated (ref NZS 3604 Fig 3.1 & Click here to enter text. Page/Doc No: ☐ MBIE Schedule 1 Guidance doc Exemption ☐ ☐ ☐ 20.)

B1 Structure: Strip footings

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions/ Comments or Page No. A Click to enter Footings depth, size specified Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ ☐ Vertical and horizontal reinforcing / starters ☐ ☐ ☐ Click here to enter text. Size, c/s (ref NZS 3604 Figures 6.13, 6.14, CS19.3 Page 5 of 30 Last Updated: 13/09/2017 Revision: 6 CS19.3 Residential Building Consent Application and Processing Checksheet

6.15, and 6.15.a)

Steps in foundations (due to ground slope) Click here to enter text. ☐ (ref NZS 3604 Fig 6.12, NZS 4229 Fig 6.7) ☐ ☐ ☐

B1 Structure: Piles, pads and posts

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Click to enter Pile foundation plan: Depth, size, c/s, heights Click here to enter text. Page/Doc No: ☐ point loads (ref NZS 3604 Table 6.1) ☐ ☐ ☐ Click to enter Column and posts foundations / pads (ref Click here to enter text. Page/Doc No: ☐ NZS3604 section 9 table 9.1) ☐ ☐ ☐ Braced / Anchor piles, footing size, pile Click to enter height, connections (ref NZS 3604 Para 6.8 – Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ 6.9, Fig 6.6 – 6.10) Click to enter Driven piles SED (ref NZS 3604 Para 6.6 – Click here to enter text. Page/Doc No: ☐ 6.7, Table 6.2) ☐ ☐ ☐

B1 Structure: Masonry , concrete and retaining walls (foundation)

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Wall height: Minimum, maximum (ref NZS Click to enter 3604 Para 6.11, NZS 4229 Section 8 & Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Appendix A & B Click to enter Vertical reinforcing (starters) size, c/s Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Horizontal reinforcing (bond beam) size, c/s, ☐ block size ☐ ☐ ☐ Click here to enter text.

☐ Type A: PS1, PS2, PS3 & PS4

Masonry type – A, B or C ☐ Type B: PS1 & PS3 Click to enter (Ref Engineer’s design guidance statement). Page/Doc No: ☐ ☐ ☐ ☐ ☐ Type C: PS3 may be required.

☐ Other (NZS 4229): PS3 may be required. Click here to enter text. Click to enter Split level drainage, tanking, strapped, lined Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐

B1 Structure: Slab

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY

Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A

Click to enter Type: Slab-on-grade (ref NZS 3604 Section ☐ ☐ ☐ ☐ ☐ Slab-on-grade Page/Doc No: 7.5), raft (SED: PS1), suspended floor (ref SED & NZS 4229) ☐ Raft CS19.3 Page 6 of 30 Last Updated: 13/09/2017 Revision: 6 CS19.3 Residential Building Consent Application and Processing Checksheet

☐ Suspended Floor Click here to enter text. Click to enter Foundation edge details, starters (ref NZS Click here to enter text. Page/Doc No: ☐ 3604 Fig 7.13 – 7.16) ☐ ☐ ☐ Base preparation: sand, hard-fill 75mm min to 600mm max (Geotech Eng. investigation ☐ required if >600 = SED) (ref NZS 3604 Para ☐ ☐ ☐ Click here to enter text. 7.5.3) ☐ Slab (thickness) (ref NZS 3604 Para 7.5.8.2) ☐ ☐ ☐ Click here to enter text. ☐ Membrane (ref NZS 3604 Para 7.5.4) ☐ ☐ ☐ Click here to enter text. ☐ Reinforcing size, grade (ref NZS3604 7.5.8.3 ☐ ☐ ☐ Click here to enter text.

☐ Mesh (type) 500E (ref NZS 3604 Para 2.5 ☐ ☐ ☐ Click here to enter text.

Point loads pads / slab thickenings (ref NZS ☐ 3604 Para 7.5.11 & check Truss plan) ☐ ☐ ☐ Click here to enter text. Click to enter Plumbing pipes not running through point load Click here to enter text. Page/Doc No: ☐ pad or slab thickenings (X-check truss plan) ☐ ☐ ☐ Shrinkage control, free joints, internal corners, Click to enter max. length of slab (ref NZS 3604 Para Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ 7.5.8.6) & B1/AS1 Para 2.1.1) Click to enter Additions i.e. connection to existing slab (joint Click here to enter text. Page/Doc No: ☐ preparation & starters) ☐ ☐ ☐

B1 Structure: Subfloor Framing and Bracing

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Click to enter Subfloor bracing calculations, zone, demand, Click here to enter text. Page/Doc No: ☐ capacity (ref NZS 3604 Section 5.5) ☐ ☐ ☐ Subfloor bracing plan indicating type, location, Click to enter length, 5.0m c/s max, 4 bracing elements min, Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ evenly distributed (ref NZS 3604 Para 5.5.2.1) Click to enter 2-storey (height vs. width i.e. ref NZS3604 Click here to enter text. Page/Doc No: ☐ Para 5.5.3.2) ☐ ☐ ☐ Click to enter Diaphragms > 100 BUs, location, limitations Click here to enter text. Page/Doc No: ☐ (ref NZS 3604 Para 5.6.1 & 7.3) ☐ ☐ ☐ Click to enter Bearers: Size, c/s, span, point loads, C/L, Page/Doc No: ☐ loading, fixing to foundation walls (ref NZS ☐ ☐ ☐ Click here to enter text. 3604 Para 6.12) Joists: Size, c/s, span, point loads, C/L, ☐ loading, penetrations (ref NZS 3604 Para 7.1) ☐ ☐ ☐ Click here to enter text. Cantilever joist 2.4m max. height, support for ☐ L/B walls (ref NZS3604 Para 7.1.5) ☐ ☐ ☐ Click here to enter text. ☐ Lateral support mid-span, blocking, bracing ☐ ☐ ☐ Click here to enter text. lines (ref NZS 3604 Para 7.1.2)

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Flooring thickness, clearances, type (ref NZS ☐ 3604 Para 7.2) ☐ ☐ ☐ Click here to enter text. Base cladding type, support, access, Click to enter ventilation, crawlspace, vermin proofing, Click here to enter text. Page/Doc No: ☐ obstructions, large area, ltd x-flow (ref NZS ☐ ☐ ☐ 3604 Para 6.14) Provision for surface water runoff sloping Click to enter sites (ref NZS 3604 Para 3.6, 6.14.3, 6.14.5 & Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ 7.5.2.2)

B1 Structure: Mid-Floor

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Structure/load path, beams/posts, SED, Click to enter timber, steel, flitch, engineered timber, Click here to enter text. Page/Doc No: ☐ suspended concrete (ref NZS 3604 Para ☐ ☐ ☐ 7.1.3) Click to enter Joists C/L, floor load, penetrations, size, c/s, Click here to enter text. Page/Doc No: ☐ span, point loads (ref NZS 3604 Para 7.1) ☐ ☐ ☐ Click to enter Flooring Type, diaphragm (ref NZS 3604 Click here to enter text. Page/Doc No: ☐ Para 7.2 & 7.3.1) ☐ ☐ ☐

B1 Structure: Deck Construction (ground floor or external decks above ground floor)

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Click to enter Piles: size, depth, c/s, height (ref NZS 3604 Page/Doc No: ☐ Para 6.4) ☐ ☐ ☐ Click here to enter text. Bearers: size, span (ref NZS 3604 Table ☐ Section 6 A6.4) ☐ ☐ ☐ Click here to enter text.

Joists: 2.0kPa, size, span, c/s, cantilever, ☐ saddle flashings (ref NZS 3604 para 7.1) ☐ ☐ ☐ Click here to enter text.

Decking material slip resistance, type, fixings, ☐ FFL (ref NZS 3604 Para 7.4) ☐ ☐ ☐ Click here to enter text.

Stringer: size, span, fixings, air-gap (ref NZS ☐ 3604 Para 6.13) ☐ ☐ ☐ Click here to enter text.

Subfloor deck bracing if >2.0m in width (ref Click to enter NZS 3604 Para (ref NZS 3604 Para 7.4.2.2 & Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Table 5.8) Click to enter Slab / patio connection to slab, FFL (ref Click here to enter text. Page/Doc No: ☐ NZS3604 Para 7.5) ☐ ☐ ☐ Stairs and landings type, tread, riser, pitch, Click to enter openings, slip resistance, handrail (ref Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ D1/AS1)

B1 Structure: Barrier Design

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N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A

Click to enter Design standards e.g. AS1170; NZS4223; ☐ ☐ ☐ ☐ ☐ ☐ ☐ AS1170 NZS4223 Other Page/Doc No: Other Click here to enter text. Click to enter Barrier construction, SED, materials, fixings, Click here to enter text. Page/Doc No: ☐ openings, height ☐ ☐ ☐

☐ Loadings Indoors / outdoors / common areas ☐ ☐ ☐

Click to enter Glazing (PS1 covers all aspects of design and Click here to enter text. Page/Doc No: ☐ fixings) ☐ ☐ ☐

B1 Structure: Framing – Lower of two

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Click to enter Top plate: size, point loads (ref NZS 3604 Click here to enter text. Page/Doc No: ☐ Para 8.7.1) ☐ ☐ ☐ Bottom plate: size, fixings (ref NZS 3604 ☐ Para 8.7.2) ☐ ☐ ☐ Click here to enter text. Studs and trimmers: size, height, c/s, point ☐ loads (ref NZS 3604 Para 8.5 & 8.6) ☐ ☐ ☐ Click here to enter text. Click to enter Gable end framed for cladding (ref NZS 3604 Click here to enter text. Page/Doc No: ☐ Fig 8.2 & Table 8.4) ☐ ☐ ☐ Click to enter Uplift fixings detailed for studs (ref NZS 3604 Click here to enter text. Page/Doc No: ☐ Table 8.18) ☐ ☐ ☐ Lintels / beams: point loads, fixing details, ☐ size, span, uplift, C/L (ref NZS 3604 Para ☐ ☐ ☐ Click here to enter text. 8.6.1.1, Fig 8.8 & Table 8.10)

B1 Structure: Framing – Ground or Upper Floor

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Click to enter Top plate: size, point loads (ref NZS 3604 Click here to enter text. Page/Doc No: ☐ Para 8.7.1) ☐ ☐ ☐ Bottom plate: size, fixings (ref NZS 3604 ☐ Para 8.7.2) ☐ ☐ ☐ Click here to enter text. Studs and trimmers: size, height, c/s, point ☐ loads (ref NZS 3604 Para 8.5 & 8.6) ☐ ☐ ☐ Click here to enter text. Click to enter Gable end framed for cladding (ref NZS 3604 Click here to enter text. Page/Doc No: ☐ Fig 8.2 & Table 8.4) ☐ ☐ ☐ Click to enter ☐ Uplift fixings detailed for studs (ref NZS 3604 ☐ ☐ ☐ Click here to enter text. Page/Doc No: Table 8.18)

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Lintels / beams Point loads, fixing details, ☐ size, span, uplift, C/L (ref NZS 3604 Para ☐ ☐ ☐ Click here to enter text. 8.6.1.1, Fig 8.7 & Table 8.9)

B1 Structure: Wall Bracing (all floors)

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Click to enter Wall bracing calculations, wind zone, Click here to enter text. Page/Doc No: ☐ demand, capacity (ref NZS 3604 5.2 & 5.3) ☐ ☐ ☐ Click to enter Wall bracing plan indicating type, location, Click here to enter text. Page/Doc No: ☐ length ☐ ☐ ☐ Click to enter Bracing capacity external walls >100 BU, Page/Doc No: ☐ 50% demand, 15 BUs / m (ref NZS 3604 ☐ ☐ ☐ Click here to enter text. 5.4.3 & 5.4.7) Bracing capacity internal walls > 100 Bus, ☐ 50% total demand (ref NZS 3604 5.4.3 & ☐ ☐ ☐ Click here to enter text. 5.4.7) Location of bracing elements 6.0m c/s, evenly Click to enter distributed, wings, blocks, wet areas, split or Click here to enter text. Page/Doc No: ☐ discontinuous levels (ref NZS 3604 5.4.3 - ☐ ☐ ☐ 5.4.7 Dragon ties to extend brace lines to 7.5m > Click to enter 100 Bus, location (ref NZS 3604 8.3.3 & Fig Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ 8.1) Click to enter Ceiling diaphragm > 100 Bus, location, Click here to enter text. Page/Doc No: ☐ limitations (ref NZS 3604 Para 5.6 & 13.5) ☐ ☐ ☐

B1 Structure: Roof and Ceiling Framing

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Click to enter Roof type (pitch), pitched, trussed Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐

☐ PS1 required Click to enter Trusses Design Statement, software Page/Doc No: ☐ statement, truss layout ☐ ☐ ☐ ☐ CS7.2 completed Click here to enter text. Click to enter Roof bracing (ref NZS 3604 Para 10.4) Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Click to enter Rafter / ridge beam: size, span, support, Click here to enter text. Page/Doc No: ☐ fixings (ref NZS 3604 Section 10 & 15) ☐ ☐ ☐ Click to enter Skillion roof type, thickness, fixing (ref NZS Click here to enter text. Page/Doc No: ☐ 3604 Fig 10.3 & 10.7) ☐ ☐ ☐ Click to enter Purlin, tile batten, size, span, c/s, fixings (ref Click here to enter text. Page/Doc No: ☐ NZS 3604 Table 15.9 & 15.10) ☐ ☐ ☐ Click to enter Membrane roof framing (joists) size, span, Click here to enter text. Page/Doc No: ☐ c/s, fixings, fall (ref E2/AS1 Section 8.5) ☐ ☐ ☐

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Click to enter Ceiling battens Size, span, c/s, fixings, ceiling Click here to enter text. Page/Doc No: ☐ lining (ref NZS 3604 para 13.2) ☐ ☐ ☐

B2 Durability

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Click to enter Concrete strength (Mpa) (ref NZS 3604 Para Click here to enter text. Page/Doc No: ☐ 2.6 & 4.5.2) ☐ ☐ ☐ Timber treatment: (ref B2/AS1 3.2.2 and Click to enter Tables 1A and Table 2A in conjunction with Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ NZS 3602 108 to 111) Click to enter Flashings: Type, compatability Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Click to enter Fixings: sheltered/ exposed, galv/ stainless Click here to enter text. Page/Doc No: ☐ (ref NZS 3604 Section 4.4) ☐ ☐ ☐

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C1- C6 Fire Protection

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Scope

Click to enter Means of compliance with Clauses C1 – C6 Click here to enter text. Page/Doc No: ☐ C/AS1 (ref C/AS1 Para 1.1.1) ☐ ☐ ☐

Click to enter Multi Unit- no more than one unit above Click here to enter text. Page/Doc No: ☐ another (C/AS1 Para 1.1.b) ☐ ☐ ☐

Click to enter Boarding House/Homestay- no more than 5 Click here to enter text. Page/Doc No: ☐ guests ((C/AS1 Para 1.1.c) ☐ ☐ ☐ Part 1: General Click to enter Risk group & scope (Table 1.1 & Para. 1.1.1) Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐

Click to enter Alterations & Change of use (Para 1.3) Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Part 2: Firecells, Fire Safety Systems & FRR Click to enter Number of firecell identified (Para 2.1) Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Click to enter Fire safety system specified Click here to enter text. Page/Doc No: ☐ (Para. 2.2 & Table 2.1) ☐ ☐ ☐

☐ Life 30min min? Click to enter FRR values stated (Para 2.3) ☐ Property 30min min? Page/Doc No: ☐ ☐ ☐ ☐ Click here to enter text.

Part 3: Means of Escape Click to enter DEOP & TOP (Para 3.4 & Table 3.2) Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Part 4: Control of Internal Fire & Smoke spread Click to enter Fire separations between household units Click here to enter text. Page/Doc No: ☐ (Para. 4.1, min 30/30/30) ☐ ☐ ☐ Click to enter FRR Construction details provided Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Click to enter Structural stability, pre & post fire established Click here to enter text. Page/Doc No: ☐ for any upper level separate dwelling ☐ ☐ ☐ Click to enter Surface finishes: foam plastics or combustible Click here to enter text. Page/Doc No: ☐ materials Group # <3 (Para 4.2 & 4.3) ☐ ☐ ☐ Part 5: External Fire Spread Click to enter External walls 30/30/30 min (Para 5.1) Click here to enter text. Page/Doc No: ☐ required? ☐ ☐ ☐

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☐ External wall <1.0 to boundary?

Relevant or notional boundary distance ☐ Eaves <650mm to boundary? Click to enter (distance measured from cladding not Page/Doc No: ☐ foundation) ☐ ☐ ☐ ☐ 2.0m between any two dwellings on site?

☐ Multi-unit dwelling one above other <5m Click here to enter text.

☐ Wall only FRR? Click to enter Roof Projections: (Para 5.2) Page/Doc No: ☐ ☐ ☐ ☐ ☐ Wall & eaves FRR? Click here to enter text.

Click to enter Protection from lower roof (Para 5.3) ☐ ☐ ☐ ☐ ☐ 5m/9m rule applicable? Page/Doc No: Click here to enter text.

☐ Non-combustible? Exterior surface finish, buildings <1.0m from Click to enter boundary, any height (Para. 5.4 & Table 5.1) ☐ Combustible compliant with Table 5.1 Page/Doc No: ☐ ☐ ☐ ☐ column B? Click here to enter text. Exterior surface finish, buildings >1.0m from ☐ Sprinklered to NZS 4515 no requirement? Click to enter boundary AND building height >10m Page/Doc No: ☐ (Para. 5.4 & Table 5.1) ☐ ☐ ☐ ☐ Unsprinklered compliant with Table 5.1 Click here to enter text.

Click to enter Carport construction (Para 5.5) Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐

Part 6: Firefighting. Fire Service Vehicle Access

Click to enter Multi-unit dwellings only >2 units Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Part 7: Prevention of Fire Occurring Click to enter Solid fuel appliances (C/VM1, AS/NZS 2918) Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Click to enter Gas burner (AS/NZS 5601-1 & Para. 7.2) Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Click to enter Oil fire (AS1691 & Para. 7.3) Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Click to enter Down lights (AS/NZS 60598-2-2, Para. 7.4) Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Click to enter Open fire (AS/NZS 2918, Para. 7.5) Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐

D1 Access (Internal and External)

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Building entrances: stairs , slip resistance, Click to enter internal/ external, type, tread, pitch, riser, Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ surface (ref D1/AS1 Section 2.0 & 4.0)

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Landings top and bottom of stairs and ramps Click to enter Handrails provided to stairs > 3 risers ( ref Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Para 4.3 & 6.0) Click to enter Stairwell width, height (ref Para 1.4.1, Fig 3 & Click here to enter text. Page/Doc No: ☐ section 4.2) ☐ ☐ ☐ Click to enter Ladders (Para 5.0) access to infrequently Click here to enter text. Page/Doc No: ☐ used spaces ☐ ☐ ☐

D2 Lifts or Cable Cars

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A

☐ D2/AS1 ☐ EN/81 ☐ PS1 ☐ PS2 Click to enter Design calculations and specifications Page/Doc No: ☐ ☐ ☐ ☐ ☐ CS7.2 completed Click here to enter text.

E1 Surface Water

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Sediment and erosion control plans provided Click to enter where appropriate (i.e. site works proposed Click here to enter text. Page/Doc No: ☐ where run off to neighbouring property, road, ☐ ☐ ☐ river or lake requires management) Overflow path / runoff to other land (Flooding Click to enter report may be required, Verification Method Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ E1/VM1 requires PS1) Downpipes, external & internal gutter No, size, Click to enter distribution, spreaders (to lower roof)Ref Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ E1/AS1 Table 5, Fig 15 & Fig 16 Click to enter Stormwater run-off (paved areas >10 m²) Click here to enter text. Page/Doc No: ☐ Soakpit size, cut-off drain garage / basement ☐ ☐ ☐ Stormwater drainage: Public, Soak pit, detention tank, rainwater tank, dual purpose Click to enter tank inlet leaf strainer/ first flush/ drain Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ (Identify requirement: PIM/PIC & means of compliance) Click to enter Public drains affected / approval, easement Click here to enter text. Page/Doc No: ☐ created or required. ☐ ☐ ☐

E2 External Moisture

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Click to enter E2 risk matrix provided and score correct (ref Click here to enter text. Page/Doc No: ☐ E2/AS1 Section 3) (matrix on elevation sheet) ☐ ☐ ☐ Wall cladding type: E2/AS1 or alternative Click to enter solution (SBCG 34.1), maintenance and ☐ E2/AS1 ☐ Alternative solution Page/Doc No: ☐ ☐ ☐ ☐ installation details (ref E2/AS1 Section 9.0) Click here to enter text. CS19.3 Page 14 of 30 Last Updated: 13/09/2017 Revision: 6 CS19.3 Residential Building Consent Application and Processing Checksheet

Click to enter Wall cladding clearances ground, deck, roof Click here to enter text. Page/Doc No: ☐ (ref E2/AS1, Section 7.0 & 8.0 & 9.0) ☐ ☐ ☐ Click to enter Building wrap: type, compatibility, strapping Click here to enter text. Page/Doc No: ☐ (ref E2/AS1 Para 9.1.7) ☐ ☐ ☐ Air barrier provided where required Interior Click to enter linings, rigid underlay, non-rigid (ref E2/AS1 Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Section 9.1.4 & Table 23) Click to enter Cavity battens: size, type, fixing, vermin proof Click here to enter text. Page/Doc No: ☐ (ref E2/AS1 Para 9.1.8.4) ☐ ☐ ☐

Click to enter Window details: E2/AS1 or alternative ☐ E2/AS1 ☐ Alternative solution Page/Doc No: ☐ solution (SBCG 34.1) ☐ ☐ ☐ Click here to enter text.

Click to enter Wall junction details: E2/AS1, SED, ☐ ☐ ☐ ☐ ☐ ☐ ☐ E2/AS1 Alternative solution SED Page/Doc No: Alternative solution (SBCG 34.1) Click here to enter text. Barge, fascia, spouting to wall junction details Click to enter E2/AS1, SED or alternative solution (SBCG ☐ E2/AS1 ☐ Alternative solution ☐ SED Page/Doc No: ☐ ☐ ☐ ☐ 34.1) Click here to enter text. Internal gutters and roof penetrations slope, Click to enter size, scupper, overflow, flashing details for Click here to enter text. Page/Doc No: ☐ roof penetrations (generally ref E2/AS1 Para ☐ ☐ ☐ 8.4 & Section 8.5) Click to enter Control joints / junctions (ref E2/AS1 Section Click here to enter text. Page/Doc No: ☐ 9.0 & manufacturer’s details) ☐ ☐ ☐ Flashing details: E2/AS1, alternative solution Click to enter (SBCG 34.1), roof, wall, pergola, chimney, ☐ ☐ ☐ ☐ ☐ ☐ E2/AS1 Alternative solution Page/Doc No: apron, pipes, joinery, meter box (ref E2/AS1 Click here to enter text. Sections 8 & 9) Parapets / enclosed barriers: Framing, cap, Click to enter drainage, junctions, slope (ref E2/AS1 Section Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ 6.0) Internal decks (over internal space below): joists, slope, junctions, drainage, FFL, air- Click to enter gap, fixings, saddle, 2nd floor limitations (ref Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ E2/AS1 Para 8.5.6). NB - no direct fixed tiles permitted Roof cladding / underlay (type): E2/AS1, Click to enter alternative solution (SBCG 34.1), ☐ ☐ ☐ ☐ ☐ ☐ E2/AS1 Alternative solution Page/Doc No: maintenance and installation details (ref Click here to enter text. E2/AS1 Para 8.1.5) Membrane substrate (type): E2/AS1, Click to enter alternative solution (SBCG34.1), thickness, ☐ ☐ ☐ ☐ ☐ ☐ E2/AS1 Alternative solution Page/Doc No: fixing, venting, control joints (ref E2/AS1 Click here to enter text. Section 8.5) Click to enter Split level floor: Drainage material, drain coil, Click here to enter text. Page/Doc No: ☐ tanking, strapped, lined ☐ ☐ ☐ Click to enter Earth Building to E2/AS2 Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ Click to enter Concrete & Masonry Building to CCANZ CP Click here to enter text. Page/Doc No: ☐ 01 (ref E2/AS3) ☐ ☐ ☐

E3 Internal Moisture

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY

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Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Click to enter Ventilation / condensation control (ref E3/AS1 Click here to enter text. Page/Doc No: ☐ Para 1.2 & 1.3) ☐ ☐ ☐ Click to enter Showers, urinals, baths – impervious surfaces Click here to enter text. Page/Doc No: ☐ walls, floors and waterproofing ☐ ☐ ☐ Click to enter Wall junction to fixtures: Bath, basin, sink , Click here to enter text. Page/Doc No: ☐ tub, urinal, kitchens (ref E3/AS1 Para 3.0) ☐ ☐ ☐ Click to enter Thermal resistance walls / ceiling; thermal Click here to enter text. Page/Doc No: ☐ break for steel framing (ref E3/AS1 Para 1.1) ☐ ☐ ☐ Click to enter Overflow provision (other property) (ref Click here to enter text. Page/Doc No: ☐ E3/AS1 Para 2.0) ☐ ☐ ☐ Skillion roof details demonstrate ventilation Click to enter path, min: 25mm gap. (ref E3/AS1 Para 1.1, Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ BRANZ Ventilation Seminar Notes Pg. 40)

F1 Hazardous Agents on Site

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Contamination checked on PIM/PIC (No Click to enter F1/AS1 avail., Ref F1/VM1, HSNO ref Click here to enter text. Page/Doc No: ☐ ☐ ☐ ☐ www.epa.govt.nz)

F2 Hazardous Building Materials

N/A ☐ APPLICANT TO COMPLETE N/A ☐ COUNCIL USE ONLY Document Ref N/ N/A Description Yes RFI Reasons for Decisions / Comments or Page No. A Click to enter Glazing specification provided (ref F2/AS1 Page/Doc No: ☐ Para 1.0 & NZS4223.3) ☐ ☐ ☐ Click here to enter text. Safety glass shower, skylights, barriers, ☐ windows shown ☐ ☐ ☐ Click here to enter text. Click to enter Asbestos products especially in adds / alts Click here to enter text. Page/Doc No: ☐ pre 1990 on PIM/PIC (ref F2/AS1 Para 2.0) ☐ ☐ ☐

F3 Hazardous Not applicable for Substances Residential N/A  and Building usage. Processes

F4 Safety from Falling APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE Reasons for Document Ref or N/A Description Yes N/A RFI Decisions / Page No. Comments

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Potential fall height >1.0m: Window Lower edge 760mm Click to enter above FL Click here to Page/Doc No: ☐ Restrictors if ☐ ☐ ☐ enter text. opening width <1.0m Barrier if opening width >1.0m Barrier construction Click to enter details (stairs) Click here to Page/Doc No: ☐ Height, SED, ☐ ☐ ☐ enter text. balusters, palings, openings

F5 Construction & Demolition Hazards APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE Reasons for Document Ref or N/A Description Yes N/A RFI Decisions / Page No. Comments Work-site Click to enter Click here to barriers. Para 1.0 Page/Doc No: ☐ ☐ ☐ ☐ & Table 1 enter text.

Requirements F6.2 do not apply to Detached F6 Visibility Dwellings, in Escape household units N/A  Routes within Multi-unit Dwellings, Outbuildings, or Ancillary buildings

F7 Warning Systems APPLICANT N/A ☐ TO N/A  COUNCIL USE ONLY COMPLETE Reasons for Document Ref or N/A Description Yes N/A RFI Decisions / Page No. Comments Smoke alarms Click to enter Click here to shown on plan Page/Doc No: ☐ ☐ ☐ ☐ type, location. enter text.

F8 Signs APPLICANT N/A ☐ TO N/A  COUNCIL USE ONLY COMPLETE Reasons for Document Ref or N/A Description Yes N/A RFI Decisions / Page No. Comments

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Only required for multi-unit Click to enter residential Click here to Page/Doc No: ☐ buildings with ☐ ☐ ☐ enter text. shared means of escape.

F9 Restricting Access to Residential Pools APPLICANT N/A ☐ TO N/A  COUNCIL USE ONLY COMPLETE Reasons for Document Ref or N/A Description Yes N/A RFI Decisions / Page No. Comments Click to enter Pool barrier construction Page/Doc No: Click here to ☐ details provided ☐ ☐ ☐ (ref. F9/AS1 Para enter text. 2.1 & Fig 1) Pool barrier height details provided: Click here to ☐ 1200mm ☐ ☐ ☐ enter text. (ref F9/AS1 Para 2.1.6 & Fig 2) Pool barrier gate details provided Click here to ☐ (ref F9/AS1 Para ☐ ☐ ☐ enter text. 3.0 & Fig 3) Building Wall forming the pool Click to enter Click here to barrier details Page/Doc No: ☐ ☐ ☐ ☐ provided (ref enter text. F9/AS1 Para 4.0) Small heated pools: cover, Click to enter Click here to signage, barrier Page/Doc No: ☐ ☐ ☐ ☐ details: 760mm enter text. (ref F9/AS2)

G1 Personal Hygiene APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE Reasons for Document Ref or N/A Description Yes N/A RFI Decisions / Page No. Comments Basins provided within the WC Click to enter space or in an Click here to Page/Doc No: ☐ adjacent space ☐ ☐ ☐ enter text. (ref G1/AS1 3.3.1) Minimum room Click to enter Click here to size (WC) (ref Page/Doc No: ☐ ☐ ☐ ☐ G1/AS1 Figure 4) enter text.

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G2 Laundering APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE Reasons for Document Ref or N/A Description Yes N/A RFI Decisions / Page No. Comments Click to enter Laundering Page/Doc No: facilities provided Click here to ☐ where ☐ ☐ ☐ required(ref enter text. G2/AS1 Table 1) Working space Click here to ☐ (ref G2/AS1 ☐ ☐ ☐ Figure 1) enter text. Impervious Click to enter surfaces (ref Click here to Page/Doc No: ☐ E3/AS1 3.1.1 and ☐ ☐ ☐ enter text. E3/AS1 3.1.2)

G3 Food preparation and Prevention of Contamination APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE Reasons for Document Ref or N/A Description Yes N/A RFI Decisions / Page No. Comments Cooker, oven, fridge, food Click to enter Click here to storage space, Page/Doc No: ☐ ☐ ☐ ☐ work space (ref enter text. G3/AS1) Prep bench and sink provided: Click to enter Click here to size, capacity, Page/Doc No: ☐ ☐ ☐ ☐ surface finishes enter text. (ref G3/AS1 1.1)

G4 Ventilation APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE Reasons for Document Ref or N/A Description Yes N/A RFI Decisions / Page No. Comments Natural ventilation Click to enter Click here to 5% of floor area Page/Doc No: ☐ ☐ ☐ ☐ (ref G4/AS1 1.2) enter text. Laundry, WC, Ensuite, Click to enter Bathroom, Click here to Page/Doc No: ☐ Kitchen – natural ☐ ☐ ☐ enter text. or mechanical ( ref G4.3.3)

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Ventilation for gas appliances Hob, Click to enter Click here to bayonet, HWC ref Page/Doc No: ☐ ☐ ☐ ☐ G4/AS1 Para 2.0 enter text. and 3.0

Mechanical ☐ G4/AS1 1.5 Click to enter ventilation (ref ☐ SED Page/Doc No: ☐ G4/AS1 1.5 or ☐ ☐ ☐ SED) Click here to enter text.

Requirements only apply to buildings in G5 Interior BA2004 section Environment 118 i.e. old N/A  people’s homes and early childhood centres

G6 Airborne and Impact Sound APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE Reasons for Document Ref or N/A Description Yes N/A RFI Decisions / Page No. Comments STC 55 between household units Click to enter Type, system, Click here to Page/Doc No: ☐ construction ☐ ☐ ☐ enter text. details (ref G6.3.1 and G6.3.2)

G7 Natural light APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE Reasons for Document Ref or N/A Description Yes N/A RFI Decisions / Page No. Comments Windows 10% of Click to enter floor area (ref Click here to Page/Doc No: ☐ G7/AS1 Section ☐ ☐ ☐ enter text. 1.0) Restricted light, daylight angle, reflectance Click to enter Click here to finishes (ref Page/Doc No: ☐ ☐ ☐ ☐ G7/AS1 Para enter text. 1.0.2 – 1.0.4 & Table 1 & 2) Click to enter ☐ Awareness of ☐ ☐ ☐ Click here to Page/Doc No: outdoor enter text. environment & 50% of clear glazing in CS19.3 Page 20 of 30 Last Updated: 13/09/2017 Revision: 6 CS19.3 Residential Building Consent Application and Processing Checksheet

habitable areas (ref G7/AS1 Section 2.0)

G8 Artificial light APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE Reasons for Document Ref or N/A Description Yes N/A RFI Decisions / Page No. Comments All access routes excluding Click to enter Click here to Outbuildings & Page/Doc No: ☐ ☐ ☐ ☐ Ancillary buildings enter text. (ref G8.2) Common spaces & exit ways in Click to enter Click here to multi-unit Page/Doc No: ☐ ☐ ☐ ☐ dwellings(ref enter text. G8.2)

G9 Electricity APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE Reasons for Document Ref or N/A Description Yes N/A RFI Decisions / Page No. Comments

☐ G9/AS1 ☐ Electrical Click to enter G9/VM1 installations (ref Page/Doc No: ☐ ☐ ☐ ☐ G9/VM1, G9/AS1) Click here to enter text.

G10 – G11 Piped Services & Gas as an Energy Source APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE Reasons for Document Ref or N/A Description Yes N/A RFI Decisions / Page No. Comments Click to enter Piped services, Click here to Page/Doc No: ☐ gas specifications ☐ ☐ ☐ enter text. Flue terminal Click to enter location Click here to Page/Doc No: ☐ (refASNZS5601.1 ☐ ☐ ☐ enter text. fig 6.2) Location and size of gas cylinders, windows, doors Click to enter Click here to drains and other Page/Doc No: ☐ ☐ ☐ ☐ openings. Ref enter text. ASNZS 5601.1 fig J4 CS19.3 Page 21 of 30 Last Updated: 13/09/2017 Revision: 6 CS19.3 Residential Building Consent Application and Processing Checksheet

G12 Water supplies APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE Reasons for Document Ref or N/A Description Yes N/A RFI Decisions / Page No. Comments Click to enter ☐ AS/NZS Page/Doc No: Water supply 3500.1 ☐ ☐ (potable) cold ☐ ☐ ☐ G12 AS1 water Click here to enter text. Town, rainwater, Click here to ☐ bore, other water ☐ ☐ ☐ supply (potable) enter text. Click to enter ☐ AS/NZS Page/Doc No: Water supply 3500.4 ☐ ☐ (potable) hot ☐ ☐ ☐ G12 AS1 water Click here to enter text. Mains, low, solar (attach CS4.1SH Click here to ☐ checklist), gas ☐ ☐ ☐ HWC type and enter text. size specified Access, support, overflow, HWC / Click to enter header tank in Click here to Page/Doc No: ☐ roof space (ref ☐ ☐ ☐ enter text. G12/AS1 para 5.0) Backflow prevention valves, other operating Click to enter Click here to devices and Page/Doc No: ☐ ☐ ☐ ☐ valves (ref enter text. G12/AS1 para 3.6 & 3.7) Wetback pipework, tempering valve; Click to enter Click here to low pressure - Page/Doc No: ☐ ☐ ☐ ☐ open vented, enter text. schematic provided Hot water cylinder shows relief and Click to enter Click here to drain discharge Page/Doc No: ☐ ☐ ☐ ☐ (ref G12/AS1 Figs enter text. 7-10 & 12) Click to enter ☐ Seismic restraint ☐ ☐ ☐ Click here to Page/Doc No: for hot water enter text. heater detailed (ref G12/AS1 Fig CS19.3 Page 22 of 30 Last Updated: 13/09/2017 Revision: 6 CS19.3 Residential Building Consent Application and Processing Checksheet

14)

G13 Sanitary Plumbing and Drainage APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE Reasons for Document Ref or N/A Description Yes N/A RFI Decisions / Page No. Comments Part 1: Plumbing

☐ G13/AS3 ☐ Plumbing system G13/AS1 ☐ ☐ identified ☐ ☐ ☐ Other: Click here to enter text. ☐ Fully vented ☐ Fully vented modified ☐ Single stack Plumbing Click to enter Type of stack ☐ Single stack Page/Doc No: ☐ system identified ☐ ☐ ☐ modified ☐ Suspended drainage principles ☐ Other: Click here to enter text. Schematic/Diagra mmatic drawing Click here to ☐ for any stack ☐ ☐ ☐ enter text. system Stacks sized Click here to ☐ correctly ☐ ☐ ☐ enter text. Click to enter Maximum length Click here to Page/Doc No: ☐ of branch to stack ☐ ☐ ☐ not exceeded enter text. Waste pipe minimum Click here to ☐ gradients ☐ ☐ ☐ enter text. nominated Stack vents & branches: size, gradients & Click here to ☐ lengths provided ☐ ☐ ☐ enter text. (Ref Section 8.5, AS/NZS 3500.2) ☐ Waste pipe ☐ ☐ ☐ Click here to diameter, length, enter text. material and gradients (Ref CS19.3 Page 23 of 30 Last Updated: 13/09/2017 Revision: 6 CS19.3 Residential Building Consent Application and Processing Checksheet

Table 6.5.1 & Appendix C, AS/NZS 3500.2) Waste length to floor waste gully (trapped 2.5m, Click here to ☐ untrapped 1.2m) ☐ ☐ ☐ (Ref Table enter text. 4.6.7.2, AS/NZS 3500.2) Exclusion zones at base of stacks Click here to ☐ (Ref 6.7 & Fig ☐ ☐ ☐ 6.5,7.1, AS/NZS enter text. 35002.2) Mid floor Click to enter Joist/Beam layout Click here to Page/Doc No: ☐ allow passage of ☐ ☐ ☐ enter text. stack/branches Part 2: Suspend and Subsoil Drainage

☐ G13/AS3 Click to enter Drainage system ☐ G13/AS2 Page/Doc No: ☐ identified ☐ ☐ ☐ Click here to enter text. Schematic/Diagra mmatic provided Click to enter Click here to for above ground Page/Doc No: ☐ ☐ ☐ ☐ suspended enter text. drainage Check PIM/PIC for services requirements & available drainage ☐ connection, ☐ ☐ ☐ including invert levels where min Click to enter gradients Page/Doc No: proposed. Click here to Is Utility services enter text. application required? ☐ ☐ ☐ ☐ (application Click here to included/forwarde d to QLDC) enter text. Connection to public sewer shown on plans Click here to ☐ and aligns with ☐ ☐ ☐ enter text. QLDC mapping & As-built plans Drainage schematic Click here to ☐ provided clearly ☐ ☐ ☐ enter text. shows gradients Click to enter ☐ Min gradient of ☐ ☐ ☐ Click here to Page/Doc No: 1:60 can be enter text. achieved with min CS19.3 Page 24 of 30 Last Updated: 13/09/2017 Revision: 6 CS19.3 Residential Building Consent Application and Processing Checksheet

depth cover? (Table 3.4 AS/ANZS 3500.2) If gradient <1:80, has min 80dia vent been Click here to ☐ specified ☐ ☐ ☐ enter text. (G13/AS2 Principles apply) Terminal vent located and correctly sized Click here to ☐ (Ref 3.9.3.1 & ☐ ☐ ☐ enter text. Table 3.7.3.1, AS/NZS 3500.2) Unvented branch drains max length 10m and sized Click here to ☐ (Ref Clause 3.10 ☐ ☐ ☐ – 3.12 & Table enter text. 3.10.2, AS/NZS 3500.2) Location of ORG, charged by fixture, hose tap, Click here to ☐ or priming device ☐ ☐ ☐ (Ref Section 4.6 enter text. to Para 4.6.6.8, AS/NZS 3500.2) Floor waste gully is charged by fixture in same Click here to ☐ room or tundish ☐ ☐ ☐ enter text. (Ref 4.6.7.2, AS/NZS 3500.2) Inspection openings (Ref Click here to ☐ Section 4.7, ☐ ☐ ☐ enter text. AS/NZS 3500.2) Drainage Click here to ☐ connections Invert ☐ ☐ ☐ level enter text. Angle of influence Depth and Click here to ☐ proximity of drain ☐ ☐ ☐ enter text. to building Council Sewer under or within 2.0m of building. Has QLDC Click to enter Click here to Drainage Page/Doc No: ☐ ☐ ☐ ☐ Engineering enter text. approval been received / provided. Click to enter ☐ Drains entering ☐ ☐ ☐ Click here to Page/Doc No: other properties. enter text. Section 75 / easements details provided where CS19.3 Page 25 of 30 Last Updated: 13/09/2017 Revision: 6 CS19.3 Residential Building Consent Application and Processing Checksheet

applicable.

Onsite effluent system. Onsite Wastewater Disposal Click to enter Application Form Click here to Page/Doc No: ☐ (avail QLDC ☐ ☐ ☐ enter text. website) attached in addition to design/calcs/repor t.

G14 Industrial waste not applicable for Industrial residential N/A  Liquid Waste buildings

G15 Solid waste APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE Reasons for Document Ref or Description: N/A Yes N/A RFI Decisions / Page No. Comments Detached Click to enter Dwellings: Click here to Page/Doc No: ☐  Storage ☐ ☐ ☐ enter text. outside Click to enter Multi-unit and Page/Doc No: group dwellings (ref G15/AS1 para 1.0 and 2.0)  Space and Click here to ☐ access ☐ ☐ ☐ enter text. at ground level for refuse; screenin g in place  80Ltr capacity per dwelling Click here to ☐ / max ☐ ☐ ☐ enter text. carry distance 30m ☐  Floors ☐ ☐ ☐ Click here to graded enter text. 1:50; waste and tap

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☐  Chutes – access; size; surfaces ; Click here to sprinkler ☐ ☐ ☐ enter text. (complia nce schedul e); ventilati on

H1 Energy Efficiency APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE Reasons for Document Ref or Description: N/A Yes N/A RFI Decisions / Page No. Comments Click to enter ☐ H1/AS1 ☐ Page/Doc No: Means of compliance (i.e. NZS4218 ☐ ☐ H1/AS1, ☐ ☐ ☐ NZS4214 NZS4218, NZS4214) Click here to enter text. Method Schedule, Click here to calculation, enter text. ☐ modelling clearly ☐ ☐ ☐ identified. Insulation type and R values Click to enter Click here to detailed on plans Page/Doc No: ☐ ☐ ☐ ☐ Sub floor, walls, enter text. ceiling Click to enter Glazing Click here to Page/Doc No: ☐ requirements ☐ ☐ ☐ enter text. Thermal break to Click to enter Click here to metal framing (ref Page/Doc No: ☐ ☐ ☐ ☐ E3/AS1, 1.1.4) enter text. Hot water system Click to enter insulated (ref Click here to Page/Doc No: ☐ H1/AS1 NZS4305 ☐ ☐ ☐ enter text. s.5) Garages included/excluded Click to enter Click here to Included min. R- Page/Doc No: ☐ ☐ ☐ ☐ value 1.5 (ref enter text. E3/AS1, 1.1.1)

Producer Statements and/or other Certificates

APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE CS19.3 Page 27 of 30 Last Updated: 13/09/2017 Revision: 6 CS19.3 Residential Building Consent Application and Processing Checksheet

Reasons for Document Ref or Description: N/A Yes N/A RFI Decisions / Page No. Comments Click to enter CS7.2 form ☐ ☐ ☐ ☐ ☐ CS7.1 Page/Doc No: completed completed All relevant ☐ Producer CS7.2 Statements &/or completed certificates Click here to provided together enter text. with statement of those to be ☐ provided prior to ☐ ☐ ☐ CCC issue. Construction monitoring info provided about inspections to be performed by engineer

Building Act Matters

APPLICANT N/A ☐ TO N/A ☐ COUNCIL USE ONLY COMPLETE Reasons for Document Ref or Description: N/A Yes N/A RFI Decisions / Page No. Comments S.14G Manufacturer or supplier product will comply with Click to enter the building code Click here to Page/Doc No: ☐ if installed in ☐ ☐ ☐ enter text. accordance with the technical date, plans and specifications

☐ Sec 67 of CS19.1 S.67 Waivers and completed Click to enter modifications Page/Doc No: ☐ (Form SBCG ☐ ☐ ☐ ☐ SBCG23.1 23.1) completed Click here to enter text.

☐ BC Advice Note 5, 6 or 7 S.72 Building on Click to enter land subject to identified on Page/Doc No: ☐ ☐ ☐ ☐ natural hazards. Form CS19.1 Click here to enter text. S75 Construction Click to enter ☐ ☐ AF 13.1 of building on 2 or ☐ ☐ ☐ Page/Doc No: Completed (BC more allotments (Form AF13.1) Advice Note 42) CS19.3 Page 28 of 30 Last Updated: 13/09/2017 Revision: 6 CS19.3 Residential Building Consent Application and Processing Checksheet

Click here to enter text. S.84 Restricted building work identified & all Click to enter Click here to Certificates of Page/Doc No: ☐ ☐ ☐ ☐ Design Work enter text. (CODWs) provided S.112 Alterations to existing. Building complies ☐ Sec 112 of with means of CS19.1 Click to enter escape from fire completed Page/Doc No: ☐ requirements and ☐ ☐ ☐ other code Click here to clauses to at least enter text. the same extent as before.

S.115 Change of ☐ Sec 115 of Use to existing CS19.1 Click to enter Building completed. Page/Doc No: ☐ considered and ☐ ☐ ☐ an addressed as Click here to appropriate enter text.

Applicant Declaration

Declaration: I am satisfied that the Building Consent Application Documents submitted together with this Checklist meet the ‘suitable quality’ requirements defined in this checklist, and are complete and accurate as required by Section 45 of the Building Act 2004 and Queenstown Lakes District Council.

Name (Print) Click here to enter name.

Date Click here to enter text.

 Owner,  Agent

COUNCIL USE ONLY- FINAL SIGN OFF (signature) Yes N/A No

I am satisfied ‘on reasonable grounds’ that the Building Consent Documentation to be stamped ‘Approved’ demonstrates compliance with the Building Code, and the Building Consent/Amendment is approved and ready for granting, as per ☐ ☐ Section 49 of the Building Act 2004 Processing Officer- Building: Click here to enter name. Date:Click here to enter text. ☐ ☐ ☐

Processing Officer-Plumbing & Drainage: Click here to enter name. Date:Click here to enter text. ☐ ☐ ☐

Other: Click here to enter text and name. Date:Click here to enter text. ☐ ☐ ☐

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I am NOT satisfied that the Building Consent Application Documentation received demonstrates compliance with the Building Code, and the Building Consent/Amendment is therefore recommended for Refusal under Section 50 of the Building Act 2004 Note: only complete if any decision in the ‘Final sign off’ section above is ‘No’ Processing Officer- Building: Click here to enter name. Date: Click here to enter text.

Supervision (signature and comments) N/A

Supervisor Name: Click here to enter text. Date:Click here to enter text. ☐ Click here to enter text. Click here to enter text. Click here to enter text.

CS19.3 Page 30 of 30 Last Updated: 13/09/2017 Revision: 6