Plumbing and drainage forms and templates

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 and report on inspection and testing of testable backflow prevention devices (PDF, 245KB) or (DOCX, 81KB)
• 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 (DOCX, 37KB)
• Action notice – work under a permit (DOCX, 40KB)
• Decision notice (DOCX, 36KB)
• Enforcement notice (licensee) (DOCX, 38KB)
• Enforcement notice (owner) (DOCX, 37KB)
• Information notice – permit issued with conditions (DOCX, 33KB)
• Information notice – refusal of permit (DOCX, 35KB)
• Show cause notice (licensee) (DOCX, 59KB)