Form 16 - Inspection Certificate / Aspect Certificate / Qbcc Licensee Aspect Certificate - Queensland Department Of Housing And Public Works Page 2

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4. Description of component/s certified
Clearly describe the extent of work covered by
this certificate, e.g. all structural aspects of the
steel roof beams.
5. Basis of certification
Detail the basis for giving the certificate and the
extent to which tests, specifications, rules,
standards, codes of practice and other
publications, were relied upon.
6. Reference documentation
Clearly identify any relevant documentation,
e.g. numbered structural engineering plans.
7. Building certifier reference number
Building certifier reference number
Development approval number
and development approval number
8. Building Certifier, competent person
Name (in full)
or QBCC licensee details
A competent person must be assessed as
Company name if applicable
Contact person
competent before carrying out the inspection.
The builder for the work cannot give a stage
certificate of inspection.
Phone no. business hours
Mobile no.
Fax no.
A competent person is assessed by the
building certifier for the work as competent to
practice in an aspect of the building and
Email address
specification design, because of the individual’s
skill, experience and qualifications. The
competent person must be registered or
licensed under a law applying in the State to
Postal address
practice the aspect.
If no relevant law requires the individual to be
Postcode
licensed or registered, the certifier must assess
the individual as having appropriate
Licence class
Licence number
experience, qualifications or skills to be able to
give the help.
If the chief executive issues any guidelines for
Date approval to inspect received from building certifier
assessing a competent person, the building
certifier must use the guidelines when
assessing the person.
9. Signature of building certifier,
competent person or QBCC licensee
Signature
Date
Note: A building certifier must sign this form for
temporary swimming pool fencing under
section 4 of Schedule 1 of QDC MP 3.4.

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