Our Ref:

Form 5

Building Act 1993 BUILDING REGULATIONS 2006

Regulation 1002

Application for Occupancy Permit

To: PLP Building Surveyors & Consultants Pty Ltd (Private Building Surveyor) Level 4, 63 Exhibition Street MELBOURNE Vic 3000 FROM: Owner or agent: Postal Address: Post Code Contact Person Telephone

In accordance with Section 42 of the Building Act 1993, I hereby apply for an occupancy permit for the building at:-

Property Details: Address:

Property

Lot LP/PS

Volume Folio

Municipal District Of:

Details of Building Practioners1 & Architects who were engaged in the building work1 Architect/Draftsperson:

Quantity Surveyor:

Engineer (Civil/Structural):

Engineer (Mechanical):

Engineer (Electrical):

Builder (Construction):

Use Applied For: Part of Bldg Use Applied For BCA Class

Signature: ...................................................................……………………………………………….......

Owner/Agent Date

Note 1: Include practitioners who were involved in the building work and who were not known or listed at the time of

completion of application for building permit. GS.FORM 7 OP APPLICATION FORM.DOT REVISION: FEBRUARY 2007