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statement of compliance - schedule 19a part a – builder's statement

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PART B - OWNER’S STATEMENTThis <strong>part</strong> <strong>of</strong> the <strong>statement</strong> must be signed by the owner <strong>of</strong> the relevant land, or by someone acting on his or herbehalf.I certify the following:1. The documents (including all contract documents, attachments, instructions, annotations,variations and clarifying correspondence) issued for the purpose <strong>of</strong> the building work describedabove (disregarding any variation <strong>of</strong> a minor nature that has no adverse effect on the structuralsoundness or safety <strong>of</strong> the building, or on the health <strong>of</strong> the occupants <strong>of</strong> the building, or anyvariation undertaken with the written consent <strong>of</strong> the relevant authority) are consistent with therelevant development approval issued on(enter date).2. Any conditions <strong>of</strong> approval relating to the building work have been satisfied.Signed:Date:Name:Address:USE BLOCKLETTERSContact Phone:

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