35484 Approved Plans Ba · MCU21/0222.01

Form 15                Compliance certificate for building design or specification

This form is the approved form that must be used in accordance with section 10 of the Building Act 1975 and sections 73 and 77 of
the Building Regulation 2021 (Design-specification certificate) stating that an aspect of building work or specification will, if installed
or carried out as stated in this form, comply with the building assessment provisions.
Additional explanatory information is included in the Appendix at the end of this form.


1. Property description
This section need only be completed if details of street address and property description are applicable.
E.g. in the case of (standard/generic) pool design/shell manufacture and/or patio and carport systems this section may not be
applicable.
Where applicable, the description must identify all land the subject of the application.
The lot and plan details (e.g. SP/RP) are shown on title documents or a rates notice.
If the plan is not registered by title, provide previous lot and plan details.

 Street address     7/56 David Low Way

                                                                     Suburb/locality    Sunrise Beach

 State              QLD                                              Postcode           4567

 Lot and plan details (attach list if necessary)

 Lot 7 on SP133491

 Local government area the land is situated in

 Sunshine Coast Council, Gubbi Gubbi Country


2. Description of aspect/s certified
Clearly describe the extent of work covered by this certificate, e.g. all structural aspects of the steel roof beams.




 ENERGY EFFICIENCY




3. 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.


                                                                                              APPROVED WITH CONDITIONS
                                                                                         This is an Approved Building Works Document. Refer
 BERS PRO V4.4.1.5 (3.21)                                                                  to the Decision Notice for conditions of approval
                                                                                               PERMIT No. 35484
 ABCB NCC 2019 VOL. 2 PART 3.12                                                                DATE 09/11/2023
                                                                                           ISSUED BY COASTAL BUILDING
                                                                                           CERTIFICATIONS PTY LTD




Building Regulation 2021 • Section 73 and 77 • Form 15 • Version 2 • March 2023                                                    Page 1 of 4