Form 16 - Inspection Certificate - 171 Ewarts Road, Cooran

7. Building certifier reference number and building development approval number

Pacific BCQ’s Ref. Number.         20230251                        Development approval number           20230251


8. Building Certifier’s Decision

The Stage of Building Work identified in Section (1) is Approved and work may progress to the next Mandatory Stage of Inspection listed
on the Decision Notice.


9. Building Certifier

Name (in full)                         Don Grehan

Company name (if applicable)           Pacific BCQ

Business phone number                  07 54121 520

Email address                          [email protected]

Postal address                         PO Box 1901 Noosaville BC Q 4566

Licence class                          Level 1 Building Surveyor Class A

Licence No.                            A739669


9. Signature of the Building Certifier

Signature                                                                                         Date    25 October 2023


LOCAL GOVERNMENT USE ONLY

Date received                      Click or tap to enter a date.      Reference number/s




Building Regulation 2021 • Section 53 • Form 16 • Version 2 • March 2023                                                        Page 2 of 4