Short stay application - 19 Wyuna Dr, Noosaville · SSL22/2210

                                                                                                                                             Electrical
                                                     H TESTING AND COMPLIANCE (                                                           installations
                                                                                                                                                          )
                                                            Issued in accordance with s227 of the Electrical Safety Regulation 2013
 CERTIFICATE OF:
                                                                                                                                           Electrical
 (Please mark relevant check-box)                    □ TESTING AND SAFETY                                                             (   equipment
                                                                                                                                                          )
                                                            Issued in accordance with s26 of the Electrical Safety Regulation 2013

 * Work performed for:

     * Name        Mr                    Rod                                                Utting
                   Title              Given name/s                                         Surname

  * Address        19 Wyuna Drive
                   Street

                   Noosa Heads                                                                                   4567
                   Suburb/town                                                                                   Postcode


 * Electrical installation / equipment tested (Please include site address for electrical installation work ifdifferent from above):

 Electrical Installation and Smoke Detectors

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 ‘Date of test             10 /       09 /     2019                 * Electrical contractor licence number                           68688

   Name on contractor licence                        Jason Brookfield

   Electrical contractor phone number                             0408639076

   For electrical installations, this certifies that the electrical installation, to the extent it is
   affected by the electrical work, has been tested to ensure that it is electrically safe and is in
   accordance with the requirements of the wiring rules and any other standard applying under
   the Electrical Safety Regulation 2013 to the electrical installation.
   For electrical equipment, this certifies that the electrical equipment, to the extent it is affected
   by the electrical work, is electrically safe.

        Name           Jason Brookfield                     / /       I
                           Person                                         msible for, the electrical work


   Signature                                                                                                    □at       12 /        09 /      2019

* Indicates a mandatory Ifield                       l                                                                                          V4.12-201 S

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