This form may take you 15 minutes to complete.

Form BCA-BE-Permit
JOINT APPLICATION FOR PERMIT TO CARRY OUT STRUCTURAL WORKS
[Section 6 of The Bui!in" Cont#o Act$
Commissioner of Building Control
Building and Construction Authority
5 a!"ell #oad $%&-%%
To"er Block' () Comple!
*ingapore %+,11%
Please tick the appropriate -o! if the re-application of permit is made for the change of
any of the follo"ing pro.ect party/
)e0eloper
1P for super0ision of structural "orks
Builder
1P for architectural "orks
2e here-y apply for a permit to commence the follo"ing "orks and undertake to comply "ith The Building Control Act and its Building #egulations
)emolition 2orks
3i4 Building Type 3for mi!ed de0elopments' more than 1 -o! may-e ticked4/
#esidential 35anded4 #esidential 3(on-landed4 Commercial 6ndustrial 6nstitutional and others
3ii4 )escription of )emolition 2ork/ 7777777777777777777777777777777777777777777777777777777777777777777777777777777777777777777
3e.g. 1 unit of 2-storey semi-detached dwelling house4
3iii4 )etails of )emolition 2ork/
(o. of -locks8-uildings/ 7777777777
(o. of *toreys per -lk/ 77777777777
Total Floor Area to -e demolished 3m&4/ 777777
)emolition 2aste 1uantity 3in tonnes4/
1uantity of concrete "aste/ 7777777777777777777
1uantity of -rick "aste/ 777777777777777777777
1uantity of other "aste (eg. metals, timber, glass, steel re-bars, etc)/ 7777777777777777
Total )emolition 2aste Collected/ 777 777777777777777
3i04 2hen "as the -uilding first -uilt 3-ased on T9P date4 -efore 1,,% after 1,,%
304 6s as-estos-containing material present in the -uilding :es (o
Under the Factories (Asbestos) Regulations, you shall notify the inistry of an!ower !rior to commencement of wor" in#ol#ing asbestos.
$f you are uncertain whether asbestos is !resent, you may ta"e a sam!le of the sus!ected material for analysis or assume that it contains asbestos
*tructural 2orks 3include *ite Formation' Piling' Earth #etaining *tructural 2orks and ;eotechnical Building 2orks4
A% PROJECT &ETAILS
Pro.ect #ef. (o./ E%&&<-%%%&+-&%1=
Pro.ect Title/ Proposed Additions > Alteration To E!isting =-*torey Factory Building At 1 2oodlands A0enue ? '*ingapore <=?,<&
T* 8 @/ #oad
(ame/
5ot 8 Plot/
Aouse (o./ %1 #oad/ 2oodlands A0enue ?
Total Pro.ect Cost/ 1%%%%.%% E!pected )ate of Commencement/
=181&8&%1= )uration of "orks/ = months
Type of )e0elopment/ )esign > Build pro.ect )e0eloper cum Builder pro.ect 3"here de0eloper has
financial interest in -uilderBs company4
9thers
B% &ECLARATION BY &E'ELOPER
6 confirm that 6 ha0e appointed the follo"ing/
3i4 Er. CAA( :E2 56A(; of PE #egistration (o. %&&< as the 1ualified Person for super0ision of structural "orks under *ection ?3143-4 of the
Building Control Act.
3ii4 Er. 777777777777777777777777777777777777777777777 of PE #egistration (o./ 7777777777777777777 as the 1ualified Person for super0ision of
geotechnical "orks under *ection ?3143d43ii4 of the Building Control Act.
3iii4 777777777777777777777777777777777777777777777 of CE( 77777777777 as the Builder under *ection ?3143c4 of the Building Control Act.
*ignature of Authorised *ignatory
(ame > Address (ame > )esignation 3 if applicant is a company4
CE(/ 7777777777 Tel (o./77777777777 Fa! (o./77777777777 (#6C (o./777777777777777777 )ate777777777777777777
BED B17)ec &%1& Page 1 of E
C% &ECLARATION BY T(E )UALIFIE& PERSON FOR SUPER'ISION OF STRUCTURAL WORKS
6 confirm that
3i4 6 ha0e -een appointed as the 1ualified Person for super0ision of structural "orks under *ection ?3143-4 or 113143d43ii4 of the Building Control Act in respect of
the "orks descri-ed a-o0e -y ;ui0audan Pte 5td
3ii4 6 am not a partner' officer or employee of the -uilder or any associate of the -uilder (only a!!licable to !ro%ect that re&uires an Accredited 'hec"er).
3iii4 6 ha0e appointed 77777777777 3state total no.4 of #esident Engineer3s4 and 77777777777 3state total no.4 of #esident Technical 9fficer3s4 to undertake/
6mmediate super0ision of critical structural "orks as reFuired in *ection <3143c4 of the Building Control Act
Full-time super0ision of structural "orks as reFuired in *ection <3143-4 of the Building Control Act
3i04 the particulars of the site super0isors are as sho"n in section 3E4.
Address of 1ualified Person *tamp > *ignature of 1ualified Person
CE(/ 7777777777777 Tel no./ 777777777777777 Fa! no./ 777777777777777
A8P no. / 777777777777
)ate/ 777777777777
&% &ECLARATION BY T(E )UALIFIE& PERSON FOR SUPER'ISION *+EOTEC(NICAL,
6 confirm that
3i4 6 ha0e -een appointed as the 1ualified Person for *uper0ision of geotechnical aspect of geotechnical -uilding "orks under section ?3143d43ii4 or 113143d43iii4
3B4 of the Building Control Act in respect of the "orks descri-ed a-o0e -y 7777777777777777777777777777777
3ii4 6 am not a partner' officer or employee of the -uilder or any associate of the -uilder (only a!!licable to !ro%ect that re&uires an Accredited 'hec"er)
3iii4 6 ha0e appointed 77777777777 3state total no.4 of #esident Engineer3s4 and 77777777777 3state total no.4 of #esident Technical 9fficer3s4 to undertake
Full-time super0ision of structural "orks as reFuired in *ection <3&43-4 of the Building Control Act
3i04 the particulars of the site super0isors are as sho"n in section 3E4.
Address of 1ualified Person *tamp > *ignature of 1ualified Person
CE(/ 7777777777777 Tel no./ 777777777777777 Fa! no./ 777777777777777
A8P no. / 777777777777
)ate/ 777777777777
BED B17)ec &%1& Page & of E
E% &ECLARATION BY SITE SUPER'ISORS*S, OF STRUCTURAL WORKS
G6 8 2e confirm that G6 am 8 "e are
3i4 the appointed site super0isor under *ection 1% of the Building Control Act -y the G1ualified Person of super0ision of structural "orks 8 1ualified Person of
super0ision of geotechnical "orks.
3ii4 not a partner' officer or employee of the -uilder8de0eloper or any associate of the -uilder8de0eloper (only a!!licable to !ro%ect that re&uires an
Accredited 'hec"er).
3iii4 not super0ising any other pro.ects on a full-time -asis.
3i04 currently super0ising 77777 Hsite super0isor 314I' 77777Hsite super0isor 3&4I'77777 Hsite super0isor 3=4I' 77777Hsite super0isor 3E4I' 77777Hsite super0isor 354I'
77777Hsite super0isor 3+4I ' 77777Hsite super0isor 3<4I pro.ects "hich do not reFuire full-time super0ision.
314 (ame > Address of *ite *uper0isor/
*ignature of *ite *uper0isor
G#esident Technical 9fficer 8 #esident Engineer
A8P no./ 777777777777 (#6C no. 8 Passport no. / 777777777777
3&4 (ame > Address of *ite *uper0isor/
*ignature of *ite *uper0isor
G #esident Technical 9fficer 8 #esident Engineer
A8P no./ 777777777777 (#6C no. 8 Passport no. / 777777777777
3=4 (ame > Address of *ite *uper0isor/
*ignature of *ite *uper0isor
G#esident Technical 9fficer 8 #esident Engineer
A8P no./ 777777777777 (#6C no. 8 Passport no. / 777777777777
3E4 (ame > Address of *ite *uper0isor/
*ignature of *ite *uper0isor
G #esident Technical 9fficer 8 #esident Engineer
A8P no./ 777777777777 (#6C no. 8 Passport no. / 777777777777
354 (ame > Address of *ite *uper0isor/
*ignature of *ite *uper0isor
G#esident Technical 9fficer 8 #esident Engineer
A8P no./ 777777777777 (#6C no. 8 Passport no. / 777777777777
3+4 (ame > Address of *ite *uper0isor/
*ignature of *ite *uper0isor
G#esident Technical 9fficer 8 #esident Engineer
A8P no./ 777777777777 (#6C no. 8 Passport no. / 777777777777
3<4 (ame > Address of *ite *uper0isor/
*ignature of *ite *uper0isor
G#esident Technical 9fficer 8 #esident Engineer
A8P no./ 777777777777 (#6C no. 8 Passport no. / 777777777777
( )elete accordingly
BED B17)ec &%1& Page = of E
F% &ECLARATION BY BUIL&ER
6 confirm that 6 am appointed as the Builder under *ection ?3143c4 of the Building Control Act in respect of the "orks descri-ed a-o0e.
$
6 confirm that 6 ha0e appointed the follo"ing/
3i4 Er. CAA( :E2 56A(; of PE #egistration (o./ -../ as the 1ualified Person for super0ision of structural "orks under *ection ?3143-4 of the Building
Control Act.
3ii4 Er. 777777777777777777777777777777777777777777777 of PE #egistration (o./ 7777777777777777777 as the 1ualified Person for super0ision of
geotechnical "orks under *ection ?3143d43ii4 of the Building Control Act.
Cnder the Building Control 3Builda-ility4 #egulations' su-mission of constructa-ility score is/

1
Applica-le

1
(ot Applica-le
Constructa-ility *core has -een su-mitted.
Constructa-ility *core e-*u-mission (o. / 777777777777777777777777777
Constructa-ility *core/ 777777777 points
2ill -e su-mitted "ithin = months from the date of issuance of permit to
carry out structural "orks.
2ill -e su-mitted "ithin + months from the date of issuance of permit to
carry out structural "orks 3for )esign > Build pro.ects only4.
&
The e!pected start date of the superstructure "orks is on 7777777777777777777
;FA J 5%%%m
&
Planning permission applied -efore 15 Kuly &%11
2ai0er is o-tained
E!empted
*
;FA/ 7777777777777777777 *Fuare metres
*
The planning permission "as first applied on / 777777777777777
7777777777777777777777777777777777777777777777
7777777777777777777777777777777777777777777777
(ame > Address of Company
CE(/ 7777777777777777 Tel (o./ 777777777777777
Fa! (o./ 77777777777777 A8P no./ 777777777777777
77777777777777777777777777777777777777777777777777777
*ignature of Technical Controller
7777777777777777777777777777777777777777777777777777
(ame of Technical Controller
(#6C (o./777777777777777777777 )ate 777777777777777777
+% &ECLARATION OF )UALIFIE& PERSON FOR SUPER'ISION OF ARC(ITECTURAL WORKS
6 confirm that 6 am appointed as the 1ualified Person for architectural "orks under section ?3143-4 or 113143d43ii4 in respect of the "orks descri-ed a-o0e.
Address of 1ualified Person (ame > *ignature of 1ualified Person
CE(/ 7777777777777 Tel no./ 777777777777777 Fa! no./
777777777777777
A8P no. / 777777777777
)ate/ 777777777777
$
For )+, !ro%ects, a!!ointment of -.s can also be made by the ,uilder.
1
.lease tic" either one of the bo/es
2
andatory field if constructability score is 0A!!licable1
*
andatory field
BED B17)ec &%1& Page E of E