Form 33 - Certificate Of Plumbing Compliance printable pdf download

Form 33 - Certificate Of Plumbing Compliance

Section 113

CERTIFICATE OF PLUMBING COMPLIANCE

To:

Permit Authority/

Administrator

Form

Address

Suburb/postcode

Note: This certificate is also approved by the Administrator of Occupational Licensing as being in the approved form for

certifying plumbing work carried out under a rectification order issued under Section 57 of the Occupational Licensing Act

2005.

Details of plumbing contractor:

Business name:

Nominated Manager

Contractor

name:

Licence No.:

Business address:

Phone No.:

Suburb/postcode:

Mobile No.:

Email address:

Fax No.:

Details of plumber certifying the work:

Plumber – Certifier’s

Certifier

Name:

Licence No.:

Business address:

Phone No.:

Suburb/postcode:

Mobile No.:

Email address:

Fax No.:

(State ‘as above’ if same for contractor details)

Details of completed plumbing work or stage:

Address:

Permit No.:

Suburb/postcode:

Order No.:

Description of the work that is being certified:

Scope or limitation:

NOTES: Insert detailed description of the plumbing work, carried out under a plumbing permit or special plumbing permit or

Rectification Order, which is being certified. Attach additional sheets if insufficient space. If the work or stage of work is incomplete

this certificate may be used to record when a contract has been ended and no further work will be carried out by the contractor.

Director of Building Control – approved 24 May 2013

Building Act 2000 - Approved Form No 33

Form 33 - Certificate Of Plumbing Compliance

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