Form 15

Building Act 1993

BUILDING REGULATIONS 2018

Regulation 186(1)

Application for Occupancy Permit

To: Socrates Capouleas (BS-U1557), Andrew Lehmann (BS-U15013) Francesco Isgro (BS-U24089), Glenn Clemente (BS-U24818) Codus Pty Ltd Level 5, 136 Exhibition Street MELBOURNE VIC 3000 From: Owner or Agent: *ACN/*ARBN Postal Address: Post Code Contact Person Telephone In accordance with *Section 42/*Section 54 of the Building Act 1993, I hereby apply for an occupancy permit for the *building/*place of entertainment situated at:-
Property Details:	Address:
Lot:	LP/PS:
Volume:	Folio:
Municipal District Of:

Nature of Building Work (Tick if applicable or give other description)

New building	Place of public entertainment	Change of use of an existing building
Other	Alterations to an existing building	Amendment to existing occupancy permit

Building Permit No.:

Building Practitioners¹ and/or Architect

Details of Building Practitioners & Architects who were engaged in the building work1

Category/Class	Registered Practitioner	Registration No.
Architect/Draftsperson
Engineer (Civil/Structural)
Engineer (Mechanical)
Engineer (Electrical)
Engineer (Fire Safety)
Quantity Surveyor
Builder/Demolisher

Use Applied For:	Part of Bldg	Use Applied For	BCA Class
To conduct public entertainment: Yes / No Certificates of Compliance Copies of Compliance Certificates for plumbing work and electrical work are attached in accordance with Regulation 186(2)(b) Signature of *Owner/*Agent Date