Form 15

4. Reference documentation
Clearly identify any relevant documentation, e.g. numbered structural engineering plans.


       •    LINDSAY CONSULTING P/L DRAWINGS 231061 SHEETS PL1 TO PL3 REV A
       •    LINDSAY CONSULTING P/L SITE CLASSIFICATION REPORT 231061 DATED NOVEMBER 2023
       •    LINDSAY CONSULTING P/L GEOTECHNICAL SLOPE STABILITY REPORT 231061 DATED 16/11/23
       •    BUILDERS SKETCHES



5. Building certifier reference number and building development approval number

 Building certifier reference                                                  Building development
 number                                                                        application number (if available)



6. Appointed competent person details
Under Part 6 of the Building Regulation 2021 a person must be assessed as a competent for the type of work (design-
specification) by the relevant building certifier.

 Name (in full)                             JASON LINDSAY

 Company name (if applicable)               LINDSAY CONSULTING P/L

 Contact person                             JASON LINDSAY

 Business phone number                      0754792118                                            Mobile

 Email address                              [email protected]

 Postal address                             2C/82 PARKER STREET

                                                                                      Suburb/locality          MAROOCHYDORE

 State                                      QLD                                       Postcode                 4558

 Licence class or registration
 type (if applicable)

 Licence or registration number
                                            RPEQ 4928
 (if applicable)



7. Signature of appointed competent person
This certificate must be signed by the individual assessed and appointed by the building certifier as competent to give design-
specification help.

 Signature                                                                                                     Date     16/11/2023


LOCAL GOVERNMENT USE ONLY

 Date received                          Click or tap to enter a date.          Reference number/s

                                                        Appendix – explanatory information

IMPORTANT NOTE: It is an offence for a competent person to give a building certifier a document, including this form, that the person knows or
reasonably suspects, is false or misleading.

Who can complete this certificate? (section 10 of the Building Act 1975 (Building Act) and 73 and 77 of the Building Regulation 2021 (BR
2021).

A building certifier can accept from a competent person (design-specification) a certificate stating that the competent person has assessed the
building design or specification for the aspect of building work, and it will, if installed or carried out under the certificate, comply with the building
assessment provisions, including any relevant standards and codes.



Building Regulation 2021 • Section 73 and 77 • Form 15 • Version 2 • March 2023                                                               Page 2 of 3