Record of Site Inspection for CC

• Development Description

• DA No

• CC Application No

• Conducted on

  Date

• Prepared by

• Address of property at which the inspection was carried out
  Address

• TYPE OF INSPECTION:
  This inspection was carried out for the purposes of clause 143B of the Environmental Planning and Assessment Regulation 2000.

Statutory checks

• Does the development affect an existing building?

  Yes

  No

  N/A

• What class(es) is the existing building?

  Select

• Provide details of the current fire safety measures in the existing building the subject of the inspection

• Mark which fire safety measures were noted during the inspection.

• Fire-resisting construction (incl. lightweight)

• Lightwieght construction

• Fire seals protecting openings in fire resisting components of the building

• Access panels, door and hoppers to fire-resisting shafts

• Automatic fail-safe devices

• Magnetic door trips/holders

• Mechanical air-conditioning trips

• Smoke and heat ventilation

• Gas supply automatic cut-offs

• Automatic fire detection and alarm systems

• Automatic fire suppression systems

• Emergency Lifts

• Emergency Lighting

• Emergency warning and intercommunication systems

• Exit Signs

• Exit doors

• lever-action door handles

• 'panic' (push) bar latch mechanism

• Fire alarm monitoring (connected to service)

• Fire control centre/room

• Fire Dampers

• Fire doors

• Fire hose reel systems

• Fire Hydrant Systems

• Fire Shutters

• Fire Windows

• Lightweight construction

• Mechanical air handling systems

• Perimeter vehicle access for emergency vehicles

• Portable fire extinuishers

• Safety curtains in proscenium openings

• Smoke alarms and/or heat alarms

• Smoke dampers

• Smoke doors

• Solid core doors

• Standby power systems

• Wall-wetting sprinkler and drencher systems

• Warning and operaitonal signs

• Other

• Please specify

• Provide details of the current fire safety measures in the existing building the subject of the inspection

• Has any building or subdivision work authorised by the relevant development consent commenced on site?

  Yes

  No

  N/A

• Provide details of the works that have been carried out.

General Site Matters

• Is the development clear of any sewer main? (particularly access/inspection points locations)

  Yes

  No

  N/A

• Is the development clear of overhead or underground powerlines?

  Yes

  No

  N/A

• General Notes

• Photos

  Media

• Name and signature of individual who carried out inspection on behalf of Council:

  Sign