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Form 15 compliance certificate
Department of Housing and Public Works
Form 15—Compliance certificate
for building design or
specification
Version 4 – July 2017
NOTE
This is to be used for the purposes of section 10 of the Building Act 1975 and/or section 46 of the Building Regulation 2006.
RESTRICTION: A building certifier (class B) can only give a compliance certificate about whether building work complies with the BCA or
a provision of the Queensland Development Code (QDC). A building certifier (Class B) can not give a certificate regarding QDC boundary
clearance and site cover provisions.
1. Property description Street address (include no., street, suburb / locality & postcode)
This section need only be completed if
details of street address and property
Noosa District Netball Club
description are applicable. McKinnon Drive, Tewantin Qld Postcode 4565
EG. In the case of (standard/generic)
pool design/shell manufacture and/or
Lot & plan details (attach list if necessary)
patio and carport systems this section
may not be applicable.
In which local government area is the land situated?
The description must identify all land the Noosa Shire Council
subject of the application.
The lot & plan details (eg. SP / RP) are shown
on title documents or a rates notice.
If the plan is not registered by title, provide
previous lot and plan details.
2. Description of component/s certified
Clearly describe the extent of work covered by Netball training lighting
this certificate, e.g. all structural aspects of the
steel roof beams. Obtrusive Light
3. Basis of certification
Detail the basis for giving the certificate and the Australian Standard AS2560.2.4-1986
extent to which tests, specifications, rules,
standards, codes of practice and other
Australian Standard AS4282-2019
publications, were relied upon.
LOCAL GOVERNMENT USE ONLY
Date received Reference Number/s
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4. Reference documentation
Clearly identify any relevant documentation, e.g. Legacy Lighting Noosa District Netball Club 12/11/2020 page 1 of 2
numbered structural engineering plans.
Legacy Lighting Noosa District Netball Club 12/11/2020 page 2 of 2
5. Building certifier reference number Building certifier reference number
6. Competent person details Name (in full)
A competent person for building work, means a
person who is assessed by the building certifier Craig Smith
for the work as competent to practise in an
Company name (if applicable) Contact person
aspect of the building and specification design,
of the building work because of the individual’s Electrical Design Group Cameron Miller
skill, experience and qualifications in the aspect.
The competent person must also be registered (Brisbane) Pty Ltd (Project Manager)
or licensed under a law applying in the State to
practice the aspect. Phone no. business hours Mobile no. Fax no.
If no relevant law requires the individual to be (07) 3278 4375 0418 893 338
licensed or registered to be able to give the help, Email address
the certifier must assess the individual as having
appropriate experience, qualifications or skills to [email protected]
be able to give the help.
Postal address
If the chief executive issues any guidelines for
assessing a competent person, the building PO Box 15
certifier must use the guidelines when assessing
the person.
Sherwood QLD Postcode 4075
Licence or registration number (if applicable)
RPEQ 16022
7. Signature of competent person Signature Date
This certificate must be signed by the individual
assessed by the building certifier as competent.
19 November 2020
The Building Act 1975 is administered by the Department of Housing and Public Works