2017 Form15 - SP - Copy · MCU14/0082.03

Department of Housing and Public Works
Form 15—Compliance certificate for building design or specification

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 Queensland Development Code (QDC). A building certifier (Class B) can not give a certificate regarding QDC boundary clearance and site cover provisions.
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 no., street, suburb/locality and postcode)
31 Rotary Lane  Noosa

	Postcode 4567

Lot and plan details (attach list if necessary)
Lot 17 SP 239726

In which local government area is the land situated?
Noosa Council

Description of component/s certified
Clearly describe the extent of work covered by this certificate, e.g. all structural aspects of the steel roof beams.
All structural aspects of the proposed new Woodwork building extension .

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.
AS/NZS 1170.0:2002 Part 0: Structural design actions

AS/NZS 1170.1:2002 Part1: Permanent, imposed and other actions

AS/NZS 1170.2:2011 Part 2: Structural design actions – Wind actions

AS/NZS 1170.4-2007 Part 4: Earthquake actions in Australia

AS1684.2-2010 – Timber Framed Construction – Non-cyclonic areas

AS1720.1-2010 – Timber Structures: Design Methods

AS2870-2011 – Residential Slabs & Footings

AS3600-2009 – Concrete structures

AS3700-2011 – Masonry structures

AS4100-1998 - Steel Structures

Reference documentation
Clearly identify any relevant documentation, e.g. numbered structural engineering plans.	Tod Consulting drawings 019 MS 1--6

LOCAL GOVERNMENT USE ONLY
Date received
	Reference Number/s

Building certifier reference number 	Building certifier reference number

Competent person details
A competent person for building work, means a person who is assessed by the building certifier for the work as competent to practice in an aspect of the building and specification design, of the building work because of the individual’s skill, experience and qualifications in the aspect. The competent person must also 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 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.
If the chief executive issues any guidelines for assessing a competent person, the building certifier must use the guidelines when assessing the person.	Name (in full)
Stefan Prystupa – B.Eng, R.P.E.Q, M.I.E. Aust

Company name if applicable	Contact person
Tod Consulting Pty Ltd

Phone no. (business hours)	Mobile no.	Fax no.
07 5449 9600

07 5449 9494

Email address
[email protected]

Postal address
PO Box 61

NOOSAVILLE  QLD	Postcode 4566

Licence or registration number (if applicable)
R.P.E.Q. 1137

Signature of competent person
This certificate must be signed by the individual assessed by the building certifier as competent.	Signature	Date

10 October 2019

The Building Act 1975 is administered by the Department of Housing and Public Works

17545-F15-A

Version 4 – July 2017