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