简化规定下的新增小型工程展开通知书没有委任建筑专业人(5页).doc

1、運輸及房屋局常任秘書長(房屋)辦公室Office of the Permanent Secretaryfor Transport and Housing (Housing)ICU MW12簡化規定下的新增小型工程展開通知書（沒有委任建築專業人士）NOTICE OF COMMENCEMENT OF ADDITIONAL MINOR WORKS UNDER THE SIMPLIFIED REQUIREMENTS (WITHOUT BUILDING PROFESSIONAL APPOINTED)本表格及所有證明文件最遲須在展開新增的小型工程項目前7天呈交This form and all suppo

2、rting document(s) must be submitted not less than 7 days before the commencement of the additional minor works item(s)請以正楷填寫表格，並在適當方格內加上號。填寫前，請仔細閱讀注意事項。Please read the “Matters to Note”, complete the form in BLOCK LETTERS and tick in the appropriate box(es).致獨立審查組To Independent Checking Unit (“ICU”)

3、甲部Part A註冊承建商的委任通知（由安排進行小型工程的人填寫）Notice of appointment of the registered contractor(To be completed by the person who arranged for the minor works to be carried out)MWHD小型工程呈交編號Minor Works Submission Number必須填寫 MUST COMPLETE本人/我們中文名稱 Name in ChineseI/We, 英文名稱（如有，姓氏先行） Name in English (Surname first,

4、 if any)為上述呈交編號呈交文件內安排進行小型工程的人，本人/我們已就本部所述的工程，委任上述呈交編號呈交文件內已獲委任的註冊承建商，作為註冊承建商。am/are the person who arranged for the minor works to be carried out under the submission with the above mentioned submission number, I/we have appointed the registered contractor appointed under the submission with the ab

5、ove mentioned submission number, as registered contractor in respect of the works detailed in this Part.擬在上述呈交編號呈交文件內相同位置或地址進行新增的小型工程的詳情Details of the proposed additional minor works to be carried out at the same location or address under the submission with the above mentioned submission number 另加附

6、加頁Additional 張Page added小型工程項目Minor works Item描述Description各項小型工程項目及其描述（包括性質、位置和數量）必須提供。如空位不敷應用，請另加紙張填寫，附於本通知書內，並在每頁加簽、註明日期及（如適用）蓋上公司印鑑。Every minor works item and its description (including the nature, location and quantity) shall be provided. If space is insufficient, please attach additional sheet

7、(s) which must be signed, dated and affixed with company seal (if applicable). 20安排進行小型工程的人 簽署（如適用）蓋上公司印鑑Signature of the person who arranged for the minor works to be carried out & affixed with company seal (if applicable) 日 月年Day month year乙部Part B註冊承建商的委任確認書（由已獲委任的註冊承建商填寫）Confirmation of appointm

8、ent by the registered contractor (To be completed by the registered contractor appointed)我們中文名稱 Name in ChineseWe,英文名稱（如有，姓氏先行） Name in English (Surname first, if any)為上述呈交編號呈交文件內的已獲委任的註冊承建商， are the registered contractor appointed under the submission with the above mentioned submission number, 1.確

9、認我們已獲委任為甲部所述工程的註冊承建商；confirm that we have been appointed as the registered contractor of the works detailed in Part A; 202.確認甲部所述的小型工程將於展開;confirm that the minor works detailed in Part A are to be commenced on 日 月 年 Day month year;3.現呈交顯示甲部所述工程的圖則及詳圖，和處所實際狀況的照片；submit herewith the plans and details

10、of the works detailed in Part A, and the photographs showing the physical condition of the premises where the works detailed in Part A are to be carried out;4.確認在本部呈交的圖則及詳圖，均由我們製備和簽署； confirm that the plans and details submitted under this Part, have been prepared and signed by us ;5.當甲部所述工程包括對任何建築物

11、進行修葺、改動或加建時，已核證以下事宜：在檢查該建築物後，本人認為該建築物有能力承受因工程而可能有所增加或在任何方面有所改動的荷載及應力；及where the works detailed in Part A comprise repairs, alterations or additions to any building, certified that, after inspecting the building, I am of the opinion that the building is capable of bearing the loads and stresses which

12、 may be increased or altered in any way as a result of the works; and6.當甲部所述工程涉及豎設招牌時，確認由他人代為豎設招牌的人士已在丙部提供獨立審查組所要求的詳情。where the works detailed in Part A involve the erection of a signboard, confirm that the person for whom the signboard is to be erected has provided the particulars of the person as

13、required by the Independent Checking Unit in Part C.獲授權簽署人之中文姓名* Name in Chinese of the authorized signatory*傳真號碼* Fax Number*獲授權簽署人之英文姓名* Name in English of the authorized signatory*聯絡電話 Contact Number /願意接收短訊通知Willing to receive Short Messaging Service (SMS) Notification註冊證明書編號*Certificate of Regi

14、stration Number*註冊屆滿日期Date of expiry of registration 20 20 日 月 年Day month year註冊承建商（獲授權簽署人）簽署*Signature* of the registered contractor (authorized signatory) 日 月年Day month year丙部Part C 由他人代為豎設招牌的人士的詳情 （只在甲部所述工程涉及豎設招牌時適用，並由他人代為豎設招牌的人士填寫）Particulars of the person for whom the signboard is to be erected

15、 (Only applicable to works detailed in Part A involving the erection of a signboard and to be completed by the person for whom the signboard is to be erected)當由他人代為豎設招牌的人士的詳情已在上述呈交編號呈交文件內的ICU MW03表格內提供時Where the particulars of the person for whom the signboard is to be erected had been provided in t

16、he Form ICU MW03 submitted under the submission with the above mentioned submission number本人/我們中文名稱 Name in ChineseI/We,英文名稱（如有，姓氏先行） Name in English (Surname first, if any)為上述呈交編號呈交文件內由他人代為豎設招牌的人士，確認本人/我們亦同時是甲部所述工程的由他人代為豎設招牌的人士，而本人的詳情已在上述呈交編號呈交文件內提供。am/are the person for whom the signboard is to be

17、 erected detailed in the submission with the above mentioned submission number, hereby confirm that I am/we are also the person for whom the signboard is to be erected detailed in Part A, and my particulars had been provided in the submission with the above mentioned submission number.中文名稱 Name in C

18、hinese英文名稱（如有，姓氏先行） Name in English (Surname first, if any)香港身份證號碼HKID Number商業登記號碼Business Registration Number護照號碼 Passport Number其他（請註明）Others (Please specify)護照簽發國家（如適用） Country of issue of passport (If applicable)通訊地址Correspondence Addressz傳真號碼 Fax Number聯絡電話 Contact Number電郵地址 E-mail Address 20

19、由他人代為豎設招牌的人士 簽署（如適用）蓋上公司印鑑Signature of the person for whom the signboard is to be erected & affixed with company seal (if applicable) 日 月年Day month yearICUMW-F12(06/2015) 3/3*根據屋宇署註冊記錄in accordance with the registration record in Buildings DepartmentICU MW12 注意事項ICU MW12 Matters to Note1.若有關小型工程涉及在樓

20、宇公用地方進行建築工程，註冊承建商應留意有關樓宇租約中的相關條文，並於展開工程前通知有關樓宇的物業管理處。1.If the minor works involve building works in the common parts of a building, the registered contractor is advised to pay attention to the relevant conditions in the Tenancy Agreement of the subject building and notify the property management off

21、ice concerned before commencement of the works.2.註冊承建商應採取合適的措施，以確保妥善處置有關的建築廢料。2.Registered contractor shall take appropriate measures to ensure construction wastes are disposed of properly.甲.個人資料A.PERSONAL DATA收集的目的Purposes of Collection1.獨立審查組會使用透過本表格所獲得的個人資料作下列用途：1.The personal data provided by me

22、ans of this form will be used by the Independent Checking Unit for the following purposes:(a)辦理有關處理你在本表格中所呈交的文件的事務；(a)activities relating to the processing of your submission in this form;(b)辦理有關小型工程的事務；及(b)activities relating to minor works matters; and(c)方便獨立審查組與你聯絡。(c)facilitating communication b

23、etween the Independent Checking Unit and yourself.2.你必須提供本表格所要求的個人資料。假如你未能提供所需資料，可能導致處理你所呈交的文件時出現延誤。2.It is obligatory for you to provide the personal data as required by this form. If you fail to provide the required data, delay may be caused in processing of your submission.獲轉交資料的部門/人士Classes of T

24、ransferees3.你透過本表格所提供的個人資料會向下列人士/部門公開：3.The personal data you provide by means of this form may be disclosed to:(a)其他政府部門、決策局及有關機構，以作上述第1段所列的用途；及(a)other Government departments, bureaux & relevant organizations for the purposes mentioned in paragraph 1 above; and(b)任何人士，以作上述第1段(b)項所列的用途。(b)any perso

25、n for the purpose mentioned in paragraph 1(b) above.索閱個人資料Access to Personal Data4.根據個人資料（私隱）條例第18及22條及附表1第6條，你有權索閱及修正你的個人資料。你的索閱權包括獲取本表格所提供的個人資料副本一份。4.You have a right of access and correction with respect to personal data as provided for in sections 18 and 22 and principle 6 of Schedule 1 of the P

26、ersonal Data (Privacy) Ordinance. Your right of access includes the right to obtain a copy of your personal data provided by this form.乙.填寫表格B.COMPLETION OF FORM1.請填妥表格載列所有有關的部分，並在表格上簽署。請附上所有證明文件，包括圖則及詳圖、顯示工程處所在工程前實際狀況的照片及（如有）監工計劃書等。1.Please ensure that all relevant parts of the form are duly comple

27、ted, and the form is signed. Please enclose all supporting documents, including plans and details of the works, photographs showing the physical condition of the premises before the commencement of works and supervision plan (if any), etc.2.所提供的資料如有不全或錯誤，獨立審查組將不能處理呈交的文件。2.If incomplete or erroneous

28、information is provided in the form, the Independent Checking Unit may not be able to process the submission.3.所有根據簡化規定呈交的文件，都會隨機抽取進行審核，以確保該工程已按照建築物條例及其規例和呈交的圖則及詳圖進行。3.All documents submitted under the simplified requirements will be randomly selected for audit check, with a view to ensuring that th

29、e works have been carried out in accordance with the Buildings Ordinance and regulations and the submitted plans and details.4.就有關此通知的任何失實核證或聲明可引致法律行動。4.Any false certification or declaration in connection with this Notice may be subject to legal action.丙.呈交方法C.SUBMISSION METHODS1.郵寄呈交 - 本表格連同有關文件應郵

30、寄至九龍黃大仙龍翔道138號龍翔辦公大樓8樓獨立審查組。1.By Post - This form together with the relevant documents shall be posted to Independent Checking Unit, 8/F, Lung Cheung Office Block, 138 Lung Cheung Road, Wong Tai Sin, Kowloon.2.親身呈交 - 親往九龍黃大仙龍翔道138號龍翔辦公大樓8樓獨立審查組，於收發處櫃位遞交本表格及有關文件。2.In Person - In person at Independent

31、 Checking Unit, 8/F, Lung Cheung Office Block, 138 Lung Cheung Road, Wong Tai Sin, Kowloon. Produce and submit this form together with the relevant documents at the Receipt & Dispatch counter.ICU MW12擬在上述呈交編號內相同位置或地址進行新增的小型工程的詳情的附加頁Additional Page of details of the proposed additional minor works to

32、 be carried out at the same location or address under the above mentioned submission number for ICU MW12附加頁Additional Page No. 小型工程項目Minor works Item描述Description 20安排進行小型工程的人 簽署（如適用）蓋上公司印鑑Signature of the person who arranged for the minor works to be carried out & affixed with company seal (if applicable) 日 月年Day month year