Appendix D - 52 Hastings Street, Noosa Heads - Change Application 17.1.19 · 51994.1435.01

             Final inspection certificate single detached class 1a
               buildings; and Class 10 buildings or structures.                                                                         21
NOTE:                               Please use Form 17 for final certification of swimming pools and swimming pool fences.
1. Owner details                    Owner Name (in full)
If the owner is a company, a
contact person must be shown.        Belmondos PTY LT T/A CAFÉ LE Monde
All correspondence will be          Company name (if applicable)                                 Contact person
mailed to this address.
                                     As Above                                                      Ryan Taymor
                                    Phone no (business hours)                    Mobile no                          Fax no
                                     (07) 5591 5730
                                    Email address


                                    Postal address
                                     46 Marqarer Street
                                     SOUTHPORT                                                         State: QLD            Postcode 4215

2. Property description             Street address (Include no., street, suburb/locality & postcode)
The description must identify all
land the subject of the              52 Hastings Street
application.
The lot & plan details (eg. SP /
                                     NOOSA HEADS                                                       State: QLD            Postcode 4567
RP) are shown on title              Lot & plan details (Attach list if necessary)
documents or a rates notice.
If the plan is not registered by     L6 BUP4745
title, provide previous lot and
                                    In which local government area is the land situated?
plan details.
                                     Noosa/Terwanton

3. Building description             Building description                                                       Class of building / structure
                                     Shade Sails                                                                  Class 10




4. Building certifier               Building certifier reference number                         Development approval number
reference number /
approval number                      21406

5. Performance Standards            Performance requirements
If the building work uses a
performance based solution,          Note: Termite Management System not to be breached or the warranty will become void.
list the performance
requirements used.
                                     Shade Sail Only




                                                                     OFFICE USE ONLY
 Date                                                                Reference                                                        Approved Form 21
 Received:                                                           Number/s:                                                          Version 2, 02/08