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