BUILDING WORK

Use this form for:

  • Notice of Work
  • Application for a Certificate of Likely Compliance
  • Application for a Building Permit

Section 97

Section 130

Section 139
To: - Permit Authority/Building Surveyor
Address: Address
  Contact Details
  Phone Number

Form

2
Application for: Permit CLC Notice of Work (X ones applicable)
Certificate of Completion: (X to grant approval for certificate to be issued following the final inspection}

NOTE: Standard of Work Certificate and applicable fees must be submitted prior to Certificate of Completion being issued, in accordance with section 153 or section 104 of the Building Act 2016

Permit Authority/Building Surveyor details:

  
Building Surveyor:   Permit Number:
Business:      
Address:   Phone No:
    Fax No:

Owner details:

  
Note: Copy Must be forwarded to Owner  
Owner:
Business:   Phone No:
Address:   Fax No:
    Email Address:

Type of work: ✘ Permit work: Notifiable work: (X one applicable.)  
Address: Lot No:
  , , Certificate of title:
  PID: ( Volume: Folio: ) PID:
The work: Roof Plumbing for ( Approximately m2 ) Permit Number or Likely Compliance Number:

Reticulated water Sewerage Stormwater Is the work gratuitious work
On-site Roof plumbing ✘ Other (please specify)
wastewater management system (X if applicable)

Details of plumber/certifier and contractor:

  
Plumber: Anthony R. Wallis   Project reference No. Bison Job #
Business: Bison Constructions   Licence No: 1550938
Address: 34835 Tasman Hwy, Scottsdale Tas 7260   Phone No: 03 6352 4449
Category: Roof, Stormwater   Email Address: tony@bisonent.com.au
         

Notice details:

  

The plumbing work detailed above is to start work on: Date
Applicant (Plumber) Anthony R. Wallis
Recipient (for phone application) Name [print] Signed Date

Authorisation to start plumbing work: (Permit Authority use only)

  

Your authorisation is issued in accordance with the Building Act 2016 and Building Regulations 2016.
Name:     Date    
Signed:   Authorisation No  

Notes: A copy of this Form is to be sent to the applicant.

- [Form 20] - Document Printed on: at