site access , Driveway Earthworks,Retaining , · OPW24/0017

Form 15                Compliance certificate for building design or specification


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     38 Plover St

                                                                     Suburb/locality   Peregian Beach

 State              QLD                                              Postcode          4573

 Lot and plan details (attach list if necessary)




 Local government area the land is situated in




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.




 Driveway slab on ground and retaining walls.




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.




Building Regulation 2021 • Section 73 and 77 • Form 15 • Version 1 • September 2021                                         Page 1 of 4