FORM 15Building Act 1993

BUILDING INTERIM REGULATIONS 2018Regulation 186(1)

APPLICATION FOR OCCUPANCY PERMIT

ToRelevant Building Surveyor - Alan Cocks – Wyndham Building Permits

45 Princes Highway Werribee VIC 3030 BS-U1063

Building Permit Details:

Permit No

FromThis application is made by the owner/agent of the owner of the property.

Applicant ................................................................................................Ph...........................

ACN/ABN ...............................................................................................................................

Email ...................................................................................................................................

Contact person (if applicant not a natural person) ...............................................................

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

Property Details

Property Address:

Legal Description:

Municipal District:

Nature of Application

☐New Building ☐Amendment to existing occupancy permit☐ Alteration to an existing building ☐Place of public entertainment ☐Change of use of an existing building ☐Other

Building practitioners and architects who were engaged in the building work 1

Name ____________________________ Category/Class ________________ Reg No. _________

Name ____________________________ Category/Class ________________ Reg No. _________

Use applied for

Part of Building ______________ Proposed Use _______________ BCA Class of Building_____

Part of Building ______________ Proposed Use _______________ BCA Class of Building _____

……………………………………………….. …………………………Signature of owner or agent Date

………………………………………………..Print Name

Compliance Certificates Required

☐Plumbing (All) ☐ Electrical ☐ Glazing ☐ Window U Value & SHGC

☐ Insulation & Energy Efficiency Design ☐ Solar Hot Water (letter) ☐ Termites

☐ Septic Tank