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

 

20!» fon Gold Coast Building Approvals
= 9/1 Nerang St, Nerang QLD 4211
PO BOX 1019, Nerang QLD 42114

PH: (07)5596 1308 F: (07) 5596 1302

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

~ Company or Personal Name | Name of Representative
- Cover DnSTALLATIONS Fiyrto are Roaary
3 | -
all Address Contact Details
Sco foRr Quo 45 FOK (p71) SS4aiIS 73>

: Company or Personal Name Name_of Representative
ss Cour Txstatatons Fay er autKoartey .
z 3 Address: 'f different to above Contact Details ig g
cs
<2 & Phone: (07) SS4/S 730 )

S Above Fax (07) SS41¢ 73>
Com Personal ‘ N fR ;
sas Tan ieasueien Tet ik a. ee z.
= Ta Cake te Monde x sade aiid
z | Address: Contact Details
= | Si HASTircs Strat Phone pr SS maureen 746 )
: 7 =
| Project Address: —. paatines ST
” | INOooSA QO 4567
g S | Value of work Real Property Description.
| 3 : 3 50, S50. 5% ola etc)
= Site Area: 6 Bu 148 2
Ete Pan Aer. | ine Const Regional Gourd!
CFEC CEREKE SS
Makin Sekcas (ook 11693>)

? Pau McHenry is authorized under the Integrated Planning Act 1997 (QLD) to undertake the work of a private
z The chent nas requested Paul McHenry to provide Building certification services in respect of the Building work

at the project address.
ae Paul McHenry will provide to the Client the services in respect of the project to receive assess and decide the
on cremate na ont dated as per agreed fee for Professional

 

 

Cartifying services as indicated on the fee proposal.
agreement constitutes the engagement in writing required under the IPA (Section 5.3.9)
oooh Mettemny or delegate is authorized by the owner/applicant to sign forms & documents to facilitate statutory

SIGNED by or on behaif of the Owner a2 a)

ths the owner or authorized representative) candy
2s/i/dor

Saint name of signatory’ Renker

Acwrumberitacompany.___/ 37 S8/ 77

Fee H 1 P® Horny - o4o> S34240

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| OFT BEE Manbraee Doorn s (O-tt3>!
buns St. > hans Str fie " ;

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