Form 21 - Final Inspection Certificate - 171 Ewarts Road, Cooran

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