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Form 16 Boundry Approval 21.9.20
Queensland » Government Department of Housing and Public Works Form 16—Inspection Certificate/Aspect Certificate/QBCC Licensee Aspect Certificate Version 5 — July 2017 ‘NOTE: This form is to be used for the purposes of section 10(c) and 239 of the Building Act 1975 and/or sections '32, 35B, 43, 44 and 47 of the Building Regulation 2006. 1. Indicate the type of certificate The stages of assessable building ‘work are listed in section 24 of the Building Regulation 2006 or as conditioned by the building certifier. An aspect of building work is part of a stage (e.g. waterproofing). O Inspection Certificate for | Stage of building work (for single detached class 1a or class 10 building or structure) (indicate the stage) fa Aspect of building work SETOUT (indicate the aspect) | QBCC Licensee Aspect Certificate Scope of the work Scope of the work covered by the licence class under the Queensland Building and Construction Commission Regulation 2003 for the aspect being certified, e.g. scope of work for a waterproofing licence is “installing waterproofing materials or systems for preventing moisture penetration”. An aspect being certified may include “wet area sealing to showers”. Setout of building with respect to boundaries 2. Property description ‘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 no., street, suburb/locality and postcode) 53 Mary Street Noosaville QLD Lot and plan details (attach list if necessary) Lot 2 RP802207 | In which local government area is the land situated? | NOOSA SHIRE COUNCIL | Postcode 4566 3. Building/structure description Building/structure description Class of building/structure COMMERCIAL BUILDING LOCAL GOVERNMENT USE ONLY DATE RECEIVED REFERENCE NUMBER/S
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4. Description of components certified Clearly describe the extent of work covered by this certificate, e.g. all structural aspects of the steel roof beams. Building grid setout with respect to cadastral boundaries and in accordance with plans supplied 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. FIELD SURVEY 01/04/2019 6. Reference documentation Clearly identify any relevant documentation, e.g. numbered structural engineering plans. IDC Design Arch Dwgs and computer file 53 Mary Street Noosaville FLOOR PLANS.dwg Attached setout plan 7. Building certifier reference Building certifier reference number Development approval number number and development MCU18/0074.01 approval number | | 8. Building certifier, competent Name (in full) parser oh Sgn renee [ DAVID HARVEY LAU, cadastral surveyor A competent person must be Company name if applicable Contact person assessed as competent before | Noosa Cooloola Land Surveys Pty Ltd | | David Lau | carrying out the inspection. The builder for the work cannot give a Phone no. (business hours) Mobile no. Fax no. stage certificate of inspection. | | [ 0419 782 360 A competent person is assessed by the building certifier for the work as competent to practice in an aspect of the building and specification design, because of the individual's skill, experience and qualifications. The competent person must be registered or licensed under a law applying in the State to practice the aspect. If no relevant law requires the individual to be licensed or registered, the certifier must assess the individual as having appropriate experience, qualifications or skills to be able to give’ the help. If the chief executive issues any guidelines for assessing a competent person, the building certifier must use the guidelines when assessing the person. Email address | [email protected] Postal address PO Box 1684 NOOSA HEADS QLD Postcode 4567 Licence class Licence number Surveyor — cadastral SBQ 2559 endorsement Date approval to inspect received from building certifier 9. Signature of building certifier, competent person or QBCC licensee Note: A building certifier must sign this form for temporary swimming pool fencing under section 4 of Schedule 1 of QDC MP 3.4. Signature Date 72 A; 19/11/2019 The Building Act 1975 is administered by the Department of Housing and Public Works
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Noosa Council documents
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Version: 1, Version Date: 07/02/2019 Print Mate: ft Fehrians 9910 0-44 AA