Form 56 Regulation 47 - Annual Maintenance Statement
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156
ANNUAL MAINTENANCE STATEMENT
Form
Regulation 47
Building Details
Name (building description)
Address
Suburb
Postcode
Owner/Occupier details
Name
Address
Suburb
Postcode
Email Address
Phone Number
Fax Number
This statement is in relation to
Relevant Occupancy Permit
Issue Date
( ü one if applicable)
As the owner of this building, I have ensured that all the prescribed features and measures, including those essential for the health and
safety of occupants, have been assessed by an appropriately qualified person and are performing to standard required by the Building
Regulations 2004
As the occupier with contractual responsibility for this building, I have ensured that all the prescribed features and measures, including
those essential for the health and safety of occupants, have been assessed by an appropriately qualified person and are performing to
standard required by the Building Regulations 2004
(Note: The term “Occupier” applies to an occupier with contractual responsibility for maintenance of prescribed features or measures.)
Notes:
This form must be displayed in a prominent place in the main public entrance to the building or main building of a complex of buildings.
Where an occupancy permit has been issued this Statement must be replaced every year no later than 14 days after the anniversary date of the
building's occupancy permit or in other cases by the anniversary date of the display of the first annual statement.
Owner/Occupier Name
Date
Signed
Director of Building Control - approved 28 November 2012:
Building Regulations 2004 - Approved Form No 56
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