Dennis - Design Certificates · OPW13/0583

Inspection Certificate / Aspect Certificate / QBSA Licensee Aspect

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NOTE

This form is to be used for the purposes of sactlon 10(c) and 239 of the Building Act 1975 andlor sections 32, 35B, 43, 44
and 47 of the Buliding Regulation 2006.

 

4, Indicata the type of certificate

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O QBSA Licensee Aspect Certificate
Scope of the work

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inspection Cartiiicate for
Stage of building work (for single detached class 1a or class 10 building or structure)

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2. Property description

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Street address _ frchide no. street, suburb / locality & postcode)

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In which local goverment area is the land situated?

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3, Buildingistructure description Bullding/structure description Class of building / structure
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4. Description of onenus certified S -
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§. Reference documentation

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7. Building certifier reference number and

 

 

Building certifier reference number
development approval number = ae “A. TH... i
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Phone no. business hours
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Email address:
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Licence class

Date approval to i received from. sertiier a
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9, Signature of building certifier,

competent person or OBSA licensee
Note: A building certifier must sign this form for
temporary swimming pool fencing under section
4 of Schedule 1 of QDC MP 3.4.

 

Signature