Plumbing and drainage forms and templates

If the application for the permit for plumbing and drainage work is lodged:

• after 1 July 2019, use the forms for the Plumbing and Drainage Act 2018
• before 1 July 2019, use the forms for the Plumbing and Drainage Act 2002.

Forms and templates for the Plumbing and Drainage Act 2018

Use these forms for permit applications lodged after 1 July 2019.

All are effective as at 1 July 2019.

Forms to be lodged with local government

• 1 - Permit work application for plumbing drainage and on-site sewerage work (PDF, 140KB) or (DOCX, 101KB)
• 2 - Application to amend a permit including an extension of time (PDF, 133KB) or (DOCX, 866KB)
• 3 - Covered work declaration (PDF, 148KB) or (DOCX, 135KB)
• 5 - A testing or commissioning report (PDF, 188KB) or (DOCX, 892KB)
• 6 - Remote area compliance notice (PDF, 142KB) or (DOCX, 891KB)
• 7 - Notification of responsible person (PDF, 275KB) or (DOCX, 868KB)
• 8 - An on-site sewage work declaration (PDF, 160KB) or (DOCX, 892KB)
• 9 - Registration & report on inspection and testing of backflow prevention devices, registered air gaps and registered break tank (PDF, 135KB) or (DOCX, 64KB)
• 11 - Service report treatment plant (PDF, 135KB) or (DOCX, 866KB)
• 12 - Compliance statement for specialised work (PDF, 161KB or (DOCX, 868KB)
• 14 - Compliance declaration (PDF, 119KB) or (DOCX, 59KB)

Forms to be used by local government

• 17 - Permit or amended permit (PDF, 161KB) or (DOCX, 866KB)
• 18A - Inspection certificate (PDF, 111KB) or (DOCX, 857KB)
• 18B - Inspection certificate - fit for use (PDF, 116KB) or (DOCX, 857KB)
• 19 - Final Inspection certificate (PDF, 88KB) or (DOCX, 858KB)

Form to be lodged with the department

• 10 - Application for a treatment plant approval (PDF, 160KB) or (DOCX, 148KB)

Forms to be lodged with the Queensland Building and Construction Commission

Visit the Queensland Building and Construction Commission (QBCC) website for these forms.

Templates for the Plumbing and Drainage Act 2018

• Action notice - notifiable work not under permit (DOC, 51KB)
• Action notice - work under a permit (DOC, 29KB)
• Decision notice (DOC, 29KB)
• Enforcement notice (licensee) (DOC, 40KB)
• Enforcement notice (owner) (DOCX, 37KB)
• Information notice - permit issued with conditions (DOC, 33KB)
• Information notice - refusal of permit (DOC, 28KB)
• Show cause notice (licensee) (DOC, 29KB)

Forms for the Plumbing and Drainage Act 2002

Use these forms for permit applications lodged before 1 July 2019.

Forms to be lodged with local government

• 1 - Application for compliance assessment (PDF, 158KB) or (DOC, 165KB) - effective November 2014
• 3 - Verification of covered work (PDF, 88KB) or (DOC, 130KB) - effective November 2014
• 6 - Notice of compliance - remote area (PDF, 148KB) or (DOC, 135KB) - effective November 2014
• 7 - Notification of responsible person (PDF, 153KB) or (DOC 140KB) - effective November 2014
• 8 - Notice of compliance on-site sewage work (PDF, 90KB) or (DOC, 137KB) - effective November 2014
• 9 - Report on inspection and testing of backflow prevention devices, registered air gaps and registered break tanks (PDF, 127KB) or (DOC, 152KB) – effective March 2013

Form to be lodged with the department

• 10 - Application for chief executive approval (PDF, 160KB) or (DOC, 148KB) - effective November 2014

Forms to be lodged with the Queensland Building and Construction Commission

For forms relating to notifiable work and licensing matters, refer to the QBCC website.

Templates for the Plumbing and Drainage Act 2002

• Notice of inspection (from local government to occupiers/owners) (DOC, 51KB)
• Compliance certificate (DOC, 29KB)
• Compliance permit (DOC, 29KB)
• Enforcement notice (licensee) (DOC, 40KB)
• Enforcement notice (owner) (DOC, 62KB)
• Information notice (compliance permit on conditions) (DOC, 33KB)
• Show cause notice (licensee) (DOC, 28KB)
• Show cause notice (owner) (DOC, 29KB)
• Site induction form - plumbers and drainers (DOC, 47KB)
• Site induction form - fire protection (DOC, 46KB)