QB1910553 - STG 1 19 Ind Units - Lot 13 (#64) - QB1910553 - MISC - Form 11 Final & Supporting Certificates - 26.11.2021 KW

 

5. Basis of certification

Detail the basis for giving the
certificate and the extent to which
tests, specifications, rules, standards,
codes of practice and other
publications were relied upon by the
inspecting person.

The Supplier/Manufacturer’s Specification, Building Code of Australia 2016 and
relevant Australian Standards. Only tested and approved systems (as
recognised by the BCA) have been used. Installed as per manufacturers
instructions AS4072.1 and AS1530.4.

 

 

6. Reference documentation

Clearly identify any relevant
documentation, e.g. numbered
structural engineering plans or aspect
inspection certificates.

Reference documentation in accordance with the Building Certifiers Decision
Notice and Approved Plans.

 

 

7. Building certifier reference
number and building development
approval number

Building certifier reference number Building development approval number

 

 

 

8. Building certifier or appointed
competent person

Under Part 6 of the Building
Regulation a person must be
assessed, by the relevant building
certifier as competent to give
inspection help for the stage work.

Name (in full)
Company name (if applicable) Contact person
East Coast Joint Sealers (Qld) Pty Ltd Troy Walter
Business phone number Mobile number
Oe ONO masz

Email address
i StOINtSealers COM a a caeumumunmannanansnananen

    

Postal address
poe

 

 

eet am

 

Licence class or registration type (if applicable)
Passive Fire Protection, Fire Collars, Pet

     

Licence or registration number (if applicable)

ee

 

 

9. Signature of building certifier or
appointed competent person

Note: a building certifier must sign
this form for temporary swimming
pool fencing under section 4 of
Schedule 1 of the QDC MP 3.4.

 

Date

va OB(LOf2O2 cr

Signature

G ae

 

LOCAL GOVERNMENT USE ONLY

 

 

Date received

 

Reference number/s

 

 

 

 

Building Regulation 2021 © Section 53 © Form 16 © Version 1 * September 2021

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