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

(Form 16 continued…)                                                                                                                         page 2 of 2
6. Certification                    I certify that on an inspection carried out in accordance with best industry practice, the building work for
This form must be used by           the above building or structure was inspected and complies with the building approval or certificates of
building certifiers to certify
compliance of single detached       inspection were accepted from competent persons at the following stages of the construction.
class 1a buildings and class 10
buildings or structures              Inspection type                                   Date of inspection            Date of certificate
(excluding swimming pools and
swimming pool fences) in             Final                                             12-Dec-12                     13-Dec-12
accordance with section 32(3)
of the Building Regulation
2006.
The building certifier must give
both to the owner and
assessment manager a copy of
the final inspection certificate.
Under section 21 of the
Building Regulation 2006 only a
building certifier must sign a
certificate of inspection for the
Foundation and Excavation
stage and the Final Inspection
certificate.
                                    Dated this       Thursday 13                       Day of:     December                       Year:    2012

7. Building Certifier               Name of building certifier (In full)                                            Licence no
                                     Paul McHenry                                                                    A707778
                                    Signature                                                                       Date

                                                                                                                     13/12/2012

                                    Postal address
                                     PO Box 1019
                                     NERANG                                                           State: QLD            Postcode: 4211
                                    Phone no                               Mobile no                               Fax no
                                     (07) 5596 1308                         0402 534 290                            (07) 5596 1302