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W6107rw F15.pdf - form 15 Retaining wall 71016 · OPW16/0220
Attached to the e-mail Operational works application OPW16/0220.
Version 3 – March 2013
F orm 15—C o m plia n c e C ertific ate for b uildin g D e sig n or S p e cific atio n
NOTE This is to be used for the purposes of section 10 of the Building Act 1975 and/or section 46 of the
Building Regulation 2006.
RESTRICTION: A building certifier (class B) can only give a compliance certificate about whether
building work complies with the BCA or a provision of the QDC. A building certifier (Class B) can
not give a certificate regarding QDC boundary clearance and site cover provisions.
1. Property description Street address (include no., street, suburb / locality & postcode)
This section need only be completed if
details of street address and property No 61 Morinda Circuit, Noosaville.
description are applicable.
EG. In the case of (standard/generic) Postcode
pool design/shell manufacture and/or Lot & plan details (attach list if necessary)
patio and carport systems this section
may not be applicable.
The description must identify all land the
In which local government area is the land situated?
subject of the application. Noosa Shire Council
The lot & plan details (eg. 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.
2. Description of component/s certified
Clearly describe the extent of work covered by Retaining Wall - Timber Walers Design
this certificate, e.g. all structural aspects of the
steel roof beams.
3. Basis of certification
Detail the basis for giving the certificate and the AS 1170 - SAA Loading Code.
extent to which tests, specifications, rules,
standards, codes of practice and other
AS 1720 - Timber Structures
publications, were relied upon.
4. Reference documentation
Clearly identify any relevant documentation, W6107rw
e.g. numbered structural engineering plans.
LOCAL GOVERNMENT USE ONLY
D ate re c eive d R efere n c e N u m b er/s
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5. Building certifier reference number Building certifier reference number
6. Competent person details Name (in full)
A competent person for building work, means a
person who is assessed by the building certifier
for the work as competent to practise in an
Ray Williams.
aspect of the building and specification design, Company name (if applicable) Contact person
of the building work because of the individual’s
skill, experience and qualifications in the Sunrise Design Qld Pty Ltd. Ray
aspect. The competent person must also be
registered or licensed under a law applying in Phone no. business hours Mobile no. Fax no.
the State to practice the aspect. 5442 5930 5442 5934
If no relevant law requires the individual to be Email address
licensed or registered to be able to give the
help, the certifier must assess the individual as
having appropriate experience, qualifications or
skills to be able to give the help. Postal address
If the chief executive issues any guidelines for PO Box 621, Cooroy.
assessing a competent person, the building
certifier must use the guidelines when Postcode Q 4563
assessing the person.
Licence or registration number (if applicable)
RPEQ 2166
7. Signature of competent person Signature Date
This certificate must be signed by the individual October 5, 2016
assessed by the building certifier as competent.
The Building Act 1975 is administered by the
Department of Infrastructure and Planning
Department of Infrastructure and Planning
Used in these records
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