Original source · versioned page text
Form 21 - Final Inspection Certificate - 171 Ewarts Road, Cooran
Form 21 Final Inspection Certificate
Single detached class 1a&10 buildings or structures
1. Owner details
Name
Company Name Rosecliffe Boutique Farm Cottages
Contact Person Nadia Bellerby & Paul Bellerby
Business Ph No. 0419 855 283 - Nadia Mobile 0419 852 283 - Paul
Email Address [email protected]
Postal Address 171 Ewarts Road Cooran Qld 4569 Australia
2. Property description
Street Address 171 Ewarts Road Cooran Qld 4569
Lot & Plan Details 113 MCH 464
LGA Noosa Shire Council
3. Building description and Classification
Class 10a: Detached Covered Area/Carport
4. Details of the building development approval
Approval for Covered Area/Carport (Retrospective Approval).
Pacific BCQ’s Ref. No.: 20230251 Development Approval No.: 20230251
5. Performance solutions
The following systems and procedures from part of the performance solution:
1. Not Applicable
6. Restrictions on the use or occupation of the building or specific determinations applied to it’s approval.
The following restrictions apply to the use or occupation of the building or formed specific determinations of it’s Approval.
1. The building work has been approved as Class 10a Non-habitable structure suitable for private non-commercial
use only.
2. The open structure must not be enclosed by walls, including fitting roller doors or similar, without obtaining a
separate Development Permit for Building Work.
3. This Form 21 relates to the retrospective approval of building work that was constructed without first obtaining a
Development Approval for Building Work. Any person relying on this Certificate releases and holds harmless the
Farside Trading Pty Ltd T/A Pacific BCQ and its directors, officers, employees, agents or subcontractors against all
claims, demands, expenses, loss or damage arising in connection to or with any part of the building or structure
that is unable to be inspected due to it being covered at the time of final inspection.
7. Certification
I certify that on the following inspection were carried out in accordance with best industry practice, the building work for the
above building or structure was inspected and complies with the building approval or certificates of inspection were accepted
from competent persons at the following stages of the construction.
Building Act 1975 • Section 98 and 99 • Form 21 • Version 1• September 2021 Page 1 of 5
See the original
The page text is free to read. Viewing or downloading an original file needs an account.
Log in to see the originalSearchable page text hides email addresses. Original files are unchanged and may show email addresses.
Full text of the other 3 pages
Page 2
Stage Inspection Date Certificate Date Inspected By Final Stage CL10 25/10/2023 25/10/2023 Pacific BCQ Dated this day October 25, 2023 8. Building certifier Name Don Grehan Company name Pacific BCQ Ph. No. 07 5412 1520 Email address [email protected] Postal address PO Box 1901 Noosaville BC Q 4566 Licence class Level 1 Building Surveyor Class A Licence number A739669 9.Signature of building certifier for the work Signature Date 25 October 2023 LOCAL GOVERNMENT USE ONLY Date received Click or tap to enter a date. Reference number/s Building Act 1975 • Section 98 and 99 • Form 21 • Version 1 • September 2021 Page 2 of 4
Page 3
Appendix – explanatory information
Who can complete and sign a Form 21? (section 99(2) of the Building Act 1975)
The relevant building certifier must complete and sign the Form 21 for the purpose of stating the work is certified compliant with
the building development approval.
The building certifier is required to attach to this form, all relevant inspection documentation that has been relied on by the
building certifier to certify the building work complies with the building development approval. Inspection documentation, for
inspection of building work, means the following documents given for the building work:
a compliance certificate
a notice, given to the builder for the work by or for the building certifier about an inspection of the work
a certificate about an inspection under this Act
a final inspection certificate
a certificate of occupancy
a certificate relating to the inspection of the building work relied on by the relevant building certifier
Examples of the above documents are the Form 16 – Inspection certificate, 43 – Aspect certificate (QBCC licensee) and 12
– Aspect inspection certificate (appointed competent person).
Visit the Business Queensland website for all approved and administrative building forms published by the department.
When is a Form 21 issued? (section 99 of the Building Act 1975)
If the building certifier is satisfied the final stage of building work complies with the building development approval and the
inspection was carried out under industry best practice, that the work complies with the building development approval, they
must within the required period give the Form 21 and the inspection documentation to the owner. The required period means
the period that ends five business days after:
accepting all the inspection documentation relied on by the building certifier, or
all of the building work has been inspected.
Giving inspection documents to the relevant local government (section 149 of the Building Act 1975)
A private certifier must give the relevant local government copies of all inspection documentation within five business days after
oneof the following happens:
the giving of the final inspection certificate for the building work or a certificate of occupancy for the relevant building
the discontinuance of the engagement of the private certifier
the lapsing of the building development approval; in these circumstances the certifier must also give the local government a
copy of the relevant reminder notice issued under section 95 of the Building Act.
However, if the inspection documentation includes certificates relied on by the certifier, the five business days do not start until
after the certifier has accepted all the certificates.
Note: under section 150 of the Building Act the building certifier must keep all inspection documentation for at least seven
years.
Competent person (section 10 of the Building Act 1975 and Part 6 of the BR 2021)
A building certifier must assess and decide to appoint an individual as a competent person before they can, as a competent
person, give design-specification help. The building certifier is required to keep detailed records about what was considered
when appointing a competent person.
A competent person cannot give inspection help to a building certifier until they have been appointed by the building certifier.
For further information about assessment of someone as a competent person refer to the Guideline for the assessment of
competent persons.
Under section 36 of the Building Regulation 2021 the building certifier must record the details of their decision making to appoint
a competent person and keep this record for at least 7 years. A maximum 20 penalty units apply for each offence committed
under this provision.
Inspection help (section 34 of the BR 2021)
A building certifier must be satisfied that an individual is competent to give the type of inspection help having regard to the
individual’s experience, qualifications and skills and if required by law to hold a licence or registration, that the individual is
appropriately registered or licensed.
For further information about conducting inspections for class 2 to 9 buildings, refer to the Guideline for inspection of class 2
to 9 buildings.
For further information about conducting inspections for detached class 1a and 10 buildings or structures refer to the Guideline
for inspections of class 1 and 10 buildings and structures.
Building Act 1975 • Section 98 and 99 • Form 21 • Version 1 • September 2021 Page 3 of 4
Page 4
PRIVACY NOTICE The Department of Energy and Public Works is collecting personal information as required under the Building Act 1975. This information may be stored by the Department, and will be used for administration, compliance, statistical research and evaluation of building laws. Your personal information will be disclosed to other government agencies, local government authorities and third parties for purposes relating to administering and monitoring compliance with the Building Act 1975. Personal information will otherwise only be disclosed to third parties with your consent or unless authorised or required by law. Building Act 1975 • Section 98 and 99 • Form 21 • Version 1 • September 2021 Page 4 of 4