20150199 - IDAS Forms 1 & 5

 

 

 

APPLICANT(S) LODGEMENT DECLARATION

 

 

BUILDING CERTIFICATION QUEENSLAND

 

Please Note: Pacific BCQ can assist in completing your application forms however; the Applicant remains the person
responsible for making this application and responsible for ensuring the information provided is correct. Any
development permit that may be issued as a consequence of this application will be issued to the applicant.

 

 

Applicant's Details

Property Details

 

Name(s):

Street Address:

 

BLUE PRINT OSTEOPATHY

20 JUNIPER CRT, PEREGIAN BEACH

 

Postal Address:

Lot /Plan No.: LOT 468 MCH 4837

 

20 JUNIPER CRT PEREGIAN BEACH 4573

Local Authority: NOOSA COUNCIL

 

Email: [email protected]

Is the property subject to any Easements?
Ol yes [No

 

Owner’s Details (Ail owner's details) required)

Proposed Work

 

Name(s):

 

BARRETT FAMILY TRUST

What building work do you propose to carry out?
DA for MCU: HOME BASED BUSINESS TYPE “e
EVIDENT & PARKING BAY

 

Postal Address: 20 JUNIPER CRT

Estimated value of works (inc. GST): $

 

20 JUNIPER CRTPEREGIAN BEACH QLD 4573

No. of Storeys (inc. underground floors): 1

 

Phone:5329 8029 Mobile: 040% &} &|{ 6/

Floor area of new building work (m?): 50SM

 

Email: [email protected]

Proposed Payment Details

 

Builder’s Details

 

(I Owner Builder: or

 

Builders Name:

 

N/A

 

Postal Address:

 

Phone: Mobile:

 

Builders Email:

 

Builders QBCC Registration No.:

 

 

( CHEQUE Mi DIRECT DEPOSIT [] C.0.A

Direct Deposit Details:
Account Name: Pacific BCQ

BSB: 014 556
Account Number: 249 378 586
OR
Cheques: make payable to Pacific BCQ

Please Note: Unless by prior agreement, 100% full
payment of fees is required for processing of the
application to proceed.