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Form 15 - Compliance Certificate For Building Design Or Specification - Queensland Department Of Housing And Public Works Page 3

5. Building certifier reference

Building certifier reference number

number

6. Competent person details

Name

(in full)

A competent person for building work,

James Ellis

means a person who is assessed by

the building certifier for the work as

competent to practice in an aspect of

Company name

Contact person

(if applicable)

the building and specification design,

James Ellis & Associates Pty Ltd

James Ellis

of the building work because of the

individual’s skill, experience and

qualifications in the aspect. The

competent person must also be

Phone no. (business hours) Mobile no.

Fax no.

registered or licensed under a law

(02) 8764 1035

0405 149 834

applying in the State to practice the

aspect.

If no relevant law requires the

Email address

individual to be licensed or registered

.au

to be able to give the help, the certifier

must assess the individual as having

appropriate experience, qualifications

Postal address

or skills to be able to give the help.

PO Box 56 Hurlstone Park NSW

If the chief executive issues any

guidelines for assessing a competent

Postcode 2193

person, the building certifier must use

the guidelines when assessing the

person.

Licence or registration number

(if applicable)

RPEQ No. : 11921

Signature

Date

7. Signature of competent

person

July 2017

This certificate must be signed by the

individual assessed by the building

certifier as competent.

James Ellis BE(Struct)

The Building Act 1975 is administered by the Department of Housing and Public Works

Form 15 - Compliance Certificate For Building Design Or Specification - Queensland Department Of Housing And Public Works Page 3

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