Sans10400 A - Form 3

NATIONAL BUILDING REGULATIONS AND
BUILDING STANDARDS ACT, 1977 (Act No. 103 of 1977), AS AMENDED
DECLARATION BY A COMPETENT PERSON APPOINTED TO DESIGN

FORM 3
A COMPONENT OR AN ELEMENT OF A SYSTEM
(This form is to be completed:
 by those persons who are not appointed in terms of Form 2; and
 before the commencement of any construction or installation activities.
This form must be submitted to the approved competent person, i.e. the person who assumes overall
responsibility for the system)
TO: APPROVED COMPETENT PERSON: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name of competent person approved in terms of Form 2)
*Erf/Holding/Portion No.: . . . . . . . .
*Township/Agricultural Holding/Farm name:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Street address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . .
........................................................
Nature of project: . Other

. . . . .(Please
. . . . . Describe)
.............................................
(Insert proposed new building(s), or building alteration, building addition, re-erection of building, refurbishment or
building or structural repair to existing building, as relevant.)
SECTION 1: DECLARATION BY APPOINTED COMPETENT PERSON
I, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name)
Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tel. No.: . . . . . . . . . . . . . . . . . . . . . . . . . . . Fax. No.: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Email: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(If representing a partnership, association, company or incorporated body, the name thereof)
undertake and accept full responsibility for:-
i) *the rational design/rational assessment in respect of:

.....................................................................................
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. (Describe scope of work)
in accordance with the *rational design/rational assessment requirements of the National Building
Regulations, and for the inspection, where relevant.
ii) providing the Approved Competent Person with such drawings, details and particulars as are and
may be required for such person to discharge his obligations in terms of the National Building
Regulations;
iii) notifying the Approved Competent Person in writing should:-
a) it appear that any work is being carried out in a manner which may endanger the strength,
stability or serviceability of the building or any adjoining building, structure or property; and
b) my appointment be terminated before the work for which I was appointed is complete ;
iv) informing the Approved Competent Person when the work is due to start on site and when the work
is completed; and
v) completing and submitting Section 3 to the Approved Competent Person, where the work relates to
the structural fire protection or fire installation system and when requested to do so on completion
of the relevant work for which I am responsible, where relevant.
and declare that:-
i) I am competent to undertake the *rational design/rational assessment and any associated

inspection work in relation to the applicable work(s) contemplated in this Form and in support of my
declaration of competence submit that (tick appropriate option):
□ I satisfy the relevant definition for competent person contained SANS 10400 in all respects in
relation to the works contemplated; or
□ I have the necessary qualifications, experience and contextual knowledge to undertake such
work as set out in the attached declaration**;
ii) I shall satisfy Regulation AZ4 by (tick appropriate option):
□ complying with all the relevant requirements of SANS 10400; or
□ reliably demonstrating, or predicting with certainty, to the satisfaction of the appropriate local
authority, that an adopted building solution has an equivalent or superior performance to a
solution that complies with the relevant requirements of SANS 10400;
iii) I am/am not* an employee of the owner and have/do not have* professional indemnity cover; and
iv) my professional registration is current and is not suspended or terminated and is appropriate in
relation to the services required; and
v) all the information given is, to the best of my knowledge and belief, true and correct.
Signature of Competent Person . . . . . . . . . . . . . . . .. . . . . . . . . Date . . . . . . . . . . . . . . . . . . . . . .
Professional registration number: . . . . . . . . . . . . . . . Registration council: . Other

. . . . .(Please
. . . . . specify)
. .........
(Insert number and Engineering Council of South Africa (ECSA)/ South African Council for the Architectural
Professions (SACAP) / South African Council for Natural Scientific Professions (SACNSP))
(* Delete that which does not apply.)

(** Attach declaration setting out qualifications, experience and contextual knowledge relating to the work
contemplated.)
SECTION 2: CRITICAL DESIGN INFORMATION
(Competent person to complete section or attach information to this form)
Design assumptions and criteria: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

....................................................................
Specifications for materials: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
....................................................................
Drawings prepared to communicate design to constructor or installer : . . . . . . . . . . . . . . . . . . . . . . . . . .
..................................................................................
Nature and extent of inspections during construction: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
..................................................................................
Features requiring special attention: .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.................................................................................
SECTION 3: CERTIFICATE OF COMPLETION OF THE STRUCTURAL OR FIRE

PROTECTION OR FIRE INSTALLATION SYSTEM
I, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Name of approved competent person)
hereby certify that for the above project, the portion of *the structural system / the fire protection
system / the fire installation system for which I have taken responsibility has to the best of my
knowledge been designed and *constructed / erected / installed in accordance with the application in
respect of which approval was granted in terms of Section 7 of the Act and that it satisfies the
requirements of the National Building Regulations.
Signature of Competent Person . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date ............
Other (Please specify)

Professional registration number: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Registration council: ECSA
(Insert number)
(* Delete that which does not apply)

Sans10400 A - Form 3

Uploaded by

Copyright:

Available Formats

Sans10400 A - Form 3

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Sans10400 A - Form 3

Uploaded by

Copyright:

Available Formats

NATIONAL BUILDING REGULATIONS AND

BUILDING STANDARDS ACT, 1977 (Act No. 103 of 1977), AS AMENDED

DECLARATION BY A COMPETENT PERSON APPOINTED TO DESIGN

TO: APPROVED COMPETENT PERSON: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Nature of project: . Other

SECTION 1: DECLARATION BY APPOINTED COMPETENT PERSON

Tel. No.: . . . . . . . . . . . . . . . . . . . . . . . . . . . Fax. No.: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

undertake and accept full responsibility for:-

i) *the rational design/rational assessment in respect of:

and declare that:-

i) I am competent to undertake the *rational design/rational assessment and any associated

ii) I shall satisfy Regulation AZ4 by (tick appropriate option):

□ complying with all the relevant requirements of SANS 10400; or

Signature of Competent Person . . . . . . . . . . . . . . . .. . . . . . . . . Date . . . . . . . . . . . . . . . . . . . . . .

Professional registration number: . . . . . . . . . . . . . . . Registration council: . Other

(* Delete that which does not apply.)

Design assumptions and criteria: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 3: CERTIFICATE OF COMPLETION OF THE STRUCTURAL OR FIRE

Signature of Competent Person . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date ............

Other (Please specify)

(* Delete that which does not apply)

You might also like