APPLICATION FOR CERTIFICATE OF
OCCUPANCY AND USE
Building Act 2004, S151
WARNING TO OWNERS
It is recommended that owners seek appropriate advice to determine whether the building work and other contract requirements have
been completed satisfactorily before signing this form. This form should not be signed before the completion of building work.
PART A
PROJECT DETAILS
.
Block/s
Section
Suburb
Unit No
Street Address
Describe each item of building work to which this application relates
: If more than 6 items please attach further details
1.
2.
3.
4.
Name of Certifier:
PART B
OWNER/LESSEE DETAILS
FULL NAME OF ALL OWNERS – All
owners must be listed or application will not be processed
Please Print ‐ Owner 1 will be considered the contact person in relation to this application
Company Details
Owner 1
Owner 2
Owner 3
Owner 4
Postal Address
Suburb
State
Postcode
Phone Number Business Hours
Mobile
EMAIL ADDRESS
Approved form AF2016‐77 approved by David Middlemiss, Construction Occupations Deputy Registrar on 02 August 2016
under section 151 of the Building Act 2004 and revokes AF2014‐82
Authorised by the ACT Parliamentary Counsel—also accessible at