7f Notificationofresponsibleperson
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1 March 2006, Version 2
Plumbing and Drainage Act 2002
(s. 19 & 19B SPDR)
7
Notification of Responsible Plumbing and Drainage Act 2002 Person 1. Description of land
Street address (Include no., street, suburb/locality & postcode)
The description must identify all land the subject of the application. 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 work
The description must be sufficient to identify the work. For example: • construction of new dwelling • new spa installation
3. Responsible Person
The responsible person for regulated work is a person who is licensed to perform the work and either performs or directs the performance of the work. The responsible person for on-site sewerage work is a person who either performs or directs the performance of the work. If the responsible person for the work is not known you must tell the local government who is the responsible person when requesting an inspection.
Postcode Lot & plan details (Attach list if necessary) Shop / Tenancy No. (If applicable)
Storey / Level (If applicable)
Compliance permit number
Local Government Area
Development application number
Copy of application for compliance certificate attached Brief description of the work provided below
Name (In full) Plumbers Licence No.
Drainers Licence No.
QBSA Licence No. (if applicable)
Other Licence/Registration No.
Phone No.
Mobile No.
Fax No.
Postal Address Postcode Signature
4. Change in Responsible Person
If the responsible person changes during the course of a project you must tell the local government who is the responsible person when requesting the next inspection.
Date
Name (In full) Plumbers Licence No.
Drainers Licence No.
QBSA Licence No. (if applicable)
Other Licence/Registration No.
Phone No.
Mobile No.
Fax No.
Postal Address Postcode
OFFICE USE ONLY DATE RECEIVED
RECEIVING OFFICER’S NAME/S
REFERENCE NUMBER/S
5.
Other Details-New Responsible Person
The new responsible person must clearly identify at what stage of the project they became the responsible person.
Date I commenced being the responsible person for the work Stage of the work at which I became the responsible person for the work
Signature
Date
Plumbing and Drainage Act 2002
(s. 19 & 19B SPDR)
7
Notification of Responsible Plumbing and Drainage Act 2002 Person 1. Description of land
Street address (Include no., street, suburb/locality & postcode)
The description must identify all land the subject of the application. 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 work
The description must be sufficient to identify the work. For example: • construction of new dwelling • new spa installation
3. Responsible Person
The responsible person for regulated work is a person who is licensed to perform the work and either performs or directs the performance of the work. The responsible person for on-site sewerage work is a person who either performs or directs the performance of the work. If the responsible person for the work is not known you must tell the local government who is the responsible person when requesting an inspection.
Postcode Lot & plan details (Attach list if necessary) Shop / Tenancy No. (If applicable)
Storey / Level (If applicable)
Compliance permit number
Local Government Area
Development application number
Copy of application for compliance certificate attached Brief description of the work provided below
Name (In full) Plumbers Licence No.
Drainers Licence No.
QBSA Licence No. (if applicable)
Other Licence/Registration No.
Phone No.
Mobile No.
Fax No.
Postal Address Postcode Signature
4. Change in Responsible Person
If the responsible person changes during the course of a project you must tell the local government who is the responsible person when requesting the next inspection.
Date
Name (In full) Plumbers Licence No.
Drainers Licence No.
QBSA Licence No. (if applicable)
Other Licence/Registration No.
Phone No.
Mobile No.
Fax No.
Postal Address Postcode
OFFICE USE ONLY DATE RECEIVED
RECEIVING OFFICER’S NAME/S
REFERENCE NUMBER/S
5.
Other Details-New Responsible Person
The new responsible person must clearly identify at what stage of the project they became the responsible person.
Date I commenced being the responsible person for the work Stage of the work at which I became the responsible person for the work
Signature
Date
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