Sans10400 A - Form 2
Sans10400 A - Form 2
Sans10400 A - Form 2
(To be completed and submitted for all appointments in terms of Regulation A19)
To: .Municipality
. . . . . . . . . of
. . Tshwane
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name of Local Authority)
*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.)
Tel. No.: . . . . . . . . . . . . . . . . . .
............................................................................
(Name of Competent Person)
in terms of Regulation A19(1) as the Competent Person for the work, duties and responsibilities set
out herein, and *I / we understand and accept that the onus is on *me / us to:-
i) inform the Competent Person when the work is due to start on site; and
ii) notify the local authority in writing should the appointment be terminated before the work for which
this person was appointed is completed, and to make another appointment in terms of
Regulation A19(2);
iii) extend the above appointment to meet the requirements of Regulations A19(7) and A19(8) where
applicable
Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Email: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(If representing a partnership, association, company or incorporated body, the name thereof)
accept the appointment made in section 1 and undertake and accept full responsibility for
i) *The rational design/rational assessment/geotechnical investigation in respect of the above project
and in accordance with the *rational design/rational assessment/geotechnical investigation
requirements of the National Building Regulations for the applicable work described herein, and,
where relevant, for the inspection, in respect of work contemplated in Section 3 of this Form, and
accept that the provisions of Regulations A19(6), (7) and (8), and, where applicable,
Regulation A14 shall apply to the duties and responsibilities of any appointment;
ii) providing the local authority with such drawings, details and particulars as are and may be required
by the National Building Regulations;
iii) notifying the local authority 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) submitting to the local authority in terms of Section 14(2)(a) of the National Building Regulations
and Standards Act, Form 4 on completion of the relevant work, where required, and
v) maintaining contact with the owner of the project as to when my services may be required,
Signature. . . . . . . . . . . . . . . . . . . . . . . . . Date. . . . . . . . . . . . . .