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Form 15 Compliance certificate for building design or specification Queensland Government This form is to be used by an appointed competent person for the purposes of 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. 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 (include number, street, suburb/locality and postcode) 81 LAKE FLAT ROAD Lot and plan details (attach list if necessary) LOT 31 SP149578 Local government area the land is situated in NOOSA SHIRE COUNCIL 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. PROPOSED ALTERATIONS / RAISING OF EXITING RESIDENCE 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. AS1170.0 STRUCTURAL DESIGN ACTIONS - GENERAL PRINCIPLES AS1170.1 STRUCTURAL DESIGN ACTIONS - PERMANENT & IMPOSED ACTIONS AS1170.2 STRUCTURAL DESIGN ACTIONS - WIND ACTIONS AS4100. STEEL STRUCTURES AS4055__ WIND LOADS FOR HOUSING DESIGN CRITERIA N3 AS1684.2 RESIDENTIAL TIMBER FRAME CONSTRUCTION HYNE IN DESIGN 7.5 AS2870 RESIDENTIAL SLABS & FOOTINGS AS3660.1 TERMITE MANAGEMENT - NEW BUILDING WORK AS1726 GEOTECHNICAL SITE INVESTIGATIONS NCC — NATIONAL CONSTRUCTION CODE OF AUSTRALIA DESIGN FLOOR LIVE LOADS (AS1170.1): DOMESTIC HABITABLE 1.5kPa/BALCONY 2.0kPa DURABILITY: ALL STEELWORK TO BE OF A TYPE SUITABLE FOR THE ATMOSPHERIC EXPOSURE CONDITIONS TO BE ENCOUNTERED, REFER TABLE 3.4.4.2 OF NCC Vol 2 OR MANUF. DETAILS Building Regulation 2021 ¢ Section 73 and 77 © Form 15 © Version 1* September 2021 Page 1 of 3
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