WI1 28/6/2023, 11:18 PM

Please fill the following form.

委任合資格⼈⼠及窗⼾訂明檢驗／修葺的完⼯證明書(適⽤於由同⼀合資格 表格 Form

WI1
⼈⼠進⾏檢驗及監督修葺)
Notification of Appointment of Qualified Person (QP) and Certificate of
Prescribed Inspection / Repair of Windows (Applicable where the same QP is
appointed for prescribed inspection and supervision of prescribed repair , if necessary)
《建築物（檢驗及修葺）規例》第11條及第14(1) /14(2)條及《建築物（⼩型⼯程）規例》第36條
Building (Inspection and Repair) Regulation Section 11 & Section14(1)/14(2)and Building (Minor Works) Regulation Section 36

• 請以正楷填寫，並在適當⽅格內加上『√』號。填寫前，請細閱《注意事項》。 • Read the “Matters to Note”, complete in BLOCK LETTERS and tick the appropriate boxes.
• 在訂明檢驗或修葺 ( 如適⽤ ) 完成⽇期後 14 天內呈交 。 • Submit this Form within 14 days after the completion of prescribed inspection or repair as appropriate.

致建築事務監督 To the Building Authority (* 不可使⽤可擦式原⼦筆書寫及簽名 Must not use the erasable pen for fill in and sign Forms
甲部 合資格⼈⼠的委任通知
Part A Notification of Appointment of QP
由他⼈代為進⾏訂明檢驗/監督/修葺的⼈填寫(例如業主、業主代表)
To be completed by the person for whom the prescribed inspection / supervision / repair is / are to be carried out (e.g. owner, owner's
representative)

1 已完成窗⼾訂明檢驗/監督/修葺樓宇的詳情
Details of the Building where Prescribed Inspection / Supervision / Repair has/have been completed
樓宇地址 (參照法定通知所顯⽰，如適⽤) 並無接獲法定通知。
Address (as shown in the statutory notice, if applicable) Statutory Notice not received.

區域 香港 九龍 新界 本署檔號+ Our Reference No.+

Area Hong Kong Kowloon New Territories

地區
District + 如編號以“HD-”為⾸，請參閱《注意事項》丙部第 4 項。
+ If the prefix is “HD-”, see “Matters to Note” item C4.
街道/ 鄉 街道號碼
Street/Village Street No. 如空位不敷應⽤，請把地址另寫在附加紙張上
If space is insufficient, please write full address on attached
⼤廈/屋苑 座
sheet.
Building/Estate Block/Tower

2 由他⼈代為進⾏訂明檢驗／監督/修葺的⼈的詳情
Details of the Person for whom the Prescribed Inspection / Supervision / Repair is / are to be carried out

中⽂名稱 Name in Chinese 姓⽒先⾏ Surname first ⾝份証明( 任擇其⼀) Identification (Choose One)
法團編號：
Owners’ Corporation No.:
香港⾝份證號碼：
英⽂名稱 Name in English 姓⽒先⾏ Surname first HKID No.: ***( )

商業登記號碼：
Business Registration No.:
其他(請註明)：
Other (Please specify):
聯絡電話 Contact Tel. No. 傳真號碼 Fax No.
通訊地址 Correspondence Address

電郵地址(作聯絡之⽤) E-mail Address (for contact purpose)

按照《建築物條例》第 30E(1)(a)條及第 30E(1)(b)條，本⼈／我們已委任⼄

部所述的合資格⼈⼠為丁部所述樓宇／處所的窗⼾進⾏訂明檢驗及監督訂明修葺(如適⽤)，按照《建築物(⼩型
⼯程)規例》第 28 條，本⼈／我們 已 委任丙部 所述的訂明註冊承建商為丁部所述樓宇／處所的窗⼾ 進⾏修葺。
In accordance with section 30E(1)(a) and section 30E(1)(b) of the Buildings Ordinance, I/We have appointed
the QP detailed in Part B to carry out prescribed inspection and supervision of prescribed repair, if necessary,
of windows in the building/premises detailed in Part D and if applicable, in accordance with section 28 of the
Building (Minor Works) Regulation, I/We have appointed the prescribed registered contractor detailed in Part
C to carry out the repair of windows in the building/premises detailed in Part D.
本⼈/我們已閱讀並同意於《注意事項》內所列之條款。
I/we have read and hereby agree the terms and conditions as stated in the “Matters to Note” section.

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I/we have read and hereby agree the terms and conditions as stated in the “Matters to Note” section.
由他⼈代為進⾏訂明檢驗／監督/修葺的⼈的簽署及蓋上公司印章（如適⽤）(例如業主、業主代表)
Signature of the person for whom the prescribed inspection / supervision / repair is to be carried out and
affixed with company seal (if applicable) (e.g.owner, owner's representative)
任何失實核證或聲明可引致法律⾏動。
Any false certification or declaration
may be subject to legal action.

⽇期 Date

⽇ dd ⽉ mm 年 yyyy
WI 1 (12/2020) - P.1/4

⼄部 合資格⼈⼠的委任確認及完成窗⼾檢驗/監督修葺
Part B Confirmation of Appointment by the QP & Certificate of Completion of Window Inspection / Supervision of Repair

由已獲委任的合資格⼈⼠填寫
To be completed by the appointed QP

姓名或公司名稱(中⽂)* Name or Company Name (Chinese)* 合資格⼈⼠類別 Type of QP

認可⼈⼠ 註冊⼀般建築承建商
AP RGBC
姓名或公司名稱(英⽂)* Name or Company Name (English)* 註冊結構⼯程師 註冊⼩型⼯程承建商
RSE RMWC

註冊檢驗⼈員
RI

聯絡電話 Contact Tel. No. 傳真號碼 Fax No. 註冊證明書編號* Certificate of Registration Number *
/

電郵地址 (作聯絡之⽤ ) E- mail Address (for contact purpose) 註冊屆滿⽇期* Date of Expiry of Registration*

⽇ dd ⽉ mm 年 yyyy

如合資格⼈⼠為公司
If QP is a company

獲授權簽署⼈姓名(中⽂)* Name of Authorized Signatory(AS) (Chinese)*

獲授權簽署⼈姓名(英⽂)* Name of Authorized Signatory (AS) (English)*

1. 按照《建築物（檢驗及修葺）規例》第11, 14(1)及(2)條，本⼈／我們確認已獲委任為合資格⼈⼠並根據《建築物條例》的規定為丁部所述樓宇/處所窗
⼾進⾏訂明檢驗及/或監督修葺，及證明
In accordance with section 11, 14(1) and 14(2) of the Building (Inspection and Repair) Regulation, I/we confirm that I/we have been appointed as
the QP and certify that I/Our representative have carried out prescribed inspection and/or supervised the prescribed repair to the windows of the
building/premises detailed in Part D in accordance with the Buildings Ordinance, and certify that

(a) (i) 本⼈／我們認為該些窗⼾屬安全，無需進⾏訂明修葺。

in my/our opinion, the window(s) is/are safe and no prescribed repair is required.
(ii) 本⼈／我們認為該些窗⼾已變得危險，或可變得危險，有需要進⾏訂明修葺，以令該窗⼾變得安全；
該項修葺已按照《建築物條例》進⾏ ; 及
本⼈／我們認為在該項修葺完成後，該些窗⼾已變得安全。
in my/our opinion, the window(s) has/have been rendered dangerous, or is/are liable to become dangerous; and a prescribed
repair is required to be carried out to render the window(s) safe;
the prescribed repair has been carried out in accordance with the Buildings Ordinance; and
in my/our opinion, the window(s) has/have been rendered safe after completion of the prescribed repair.

本⼈/我們已閱讀並同意於《注意事項》內所列之條款。
I/we have read and hereby agree the terms and conditions as stated in the “Matters to Note” section.

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I/we have read and hereby agree the terms and conditions as stated in the “Matters to Note” section.

合資格⼈⼠簽署 (或註冊承建商的獲授權簽署⼈簽署及蓋上公司印章(如適⽤))*
Signature of QP (or Authorized Signatory of Registered Contractor
and affixed with companyseal if applicable)*
任何失實核證或聲明可引致法律⾏動。
##

Any false certification or declaration

may be subject to legal action. ##

⽇期 Date

⽇ dd ⽉ mm 年 yyyy

*根據註冊記錄
*In accordance with the registration record

WI 1 (12/2020) - P.2/4

丙部 訂明註冊承建商的委 任確認書及第 III 級別⼩型⼯程(項⽬ 3.6)完⼯通知證明書

Part C Confirmation of Appointment and Certificate of Completion of Class III Minor Works (Item 3.6) by
the Prescribed Registered Contractor (PRC)
所有處所均不需訂明修葺 請填寫丁部
Prescribed Repair not required for all premises Please fill in Part D

如訂明註冊承建商(個⼈)或註冊承建商(公司)的獲授權簽署⼈與⼄部合資格⼈⼠均為同⼀⼈ 只須在下⾯丙 2 部上簽署

If PRC(individual) or AS of the PRC(company) is the same as the QP in Part B Please only sign on the Part C2 below

由已獲委任的訂明註冊承建商填寫
To be completed by the prescribed registered contractor appointed

C1 訂明註冊承建商名稱 Name of Prescribed Registered Contractor 註冊證明書編號* Certificate of Registration Number *

姓名或公司名稱(中⽂)* Name or Company Name (Chinese)*
/
註冊屆滿⽇期* Date of Expiry of Registration*
姓名或公司名稱(英⽂)* Name or Company Name (English)*

⽇ dd ⽉ mm 年 yyyy
如訂明註冊承建商為公司
If PRC is a company
聯絡電話 Contact Te l. No. 傳真號碼 Fax No.
獲授權簽署⼈姓名(中⽂)* Name of Authorized Signatory(AS) (Chinese)*

電郵地址(作聯絡之⽤) E-mail Address (for contact purpose)

獲授權簽署⼈姓名(英⽂)* Name of Authorized Signatory (AS) (English)*

本⼈/我們，根據《建築物（⼩型⼯程）規例》第 36 條的規定，
I/We, in accordance with the provisions of section 36 of the Building (Minor Works) Regulation,
1. 確認本⼈/我們已獲委任為丁部所述⼯程的訂明註冊承建商；
2. 本⼈/我們確認丁部所述⼯程已於丁部所述⽇期展開及完成；
3. 核證所有丁部所述的⼯程已按照《建築物條例》及丁部所述的⼯程描述進⾏；
4. 當本⼈屬於根據《建築物（⼩型⼯程）規例》第 11條註冊的⼩型⼯程承建商【亦即註冊⼩型⼯程承建商（個⼈）】時，核證丁部 所述⼯程已由本⼈親
⾃進⾏。
1. confirm that I/we have been appointed as the prescribed registered contractor of the works detailed in Part D;
2. confirm that the works detailed in Part D had been commenced and completed on the date specified in Part D;

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3. certify that all the works detailed in Part D have been carried out in accordance with the Buildings Ordinance and description of works as specified in
Part D;
4. where I am a contractor registered under section 11 of the Building (Minor Works) Regulation [also known as Registered Minor Works Contractor
(Individual)], certify that I have personally carried out the works detailed in Part D.

本⼈/我們已閱讀並同意於《注意事項》內所列之條款。
I/we have read and hereby agree the terms and conditions
as stated in the “Matters to Note” section.

C2 訂明註冊承建商簽署(或獲授權簽署⼈及蓋上公司印章(如適⽤))*
Signature of the PRC (or Authorized Signatory and
affixed with companyseal if applicable)*

##
任何失實核證或聲明可引致法律⾏動。
Any false certification or declaration
may be subject to legal action.##

⽇期 Date

⽇ dd ⽉ mm 年 yyyy

*根據註冊記錄
*In accordance with the registration record WI 1 (12/2020) - P.3/4

丁部 法定通知編號、位置、訂明檢驗、監督 訂明修葺及完成⼩型⼯程詳情(如適⽤)
Part D Statutory Notice No., Location, Prescribed Inspection, Supervision of Prescribed Repair and Details of Minor Works
Completed (if applicable)

以下列表可涵蓋同⼀樓宇的多份法定通知 (每份表格最多填寫15個單位)
The following table may cover a number of statutory notices for the same building (The maximum amount of MWIS notice in this form is 15
法定通知編號+ 位置(如單位樓層及編號) 訂明檢驗的完成⽇期 ⼩型⼯程/監督修葺的展 呈交⼩型⼯程項⽬的描述
Statutory Notice No.+ Location (e. g. Floor and Flat No.) Date of Completion 開及完成⽇期(如適⽤) (如適⽤)
+ 如編號以“HD-”為⾸ of Prescribed Date of Description of Minor
，請參閱《注意事項》 [如需要以中⽂表達唐樓，請於樓層數字前 Inspection Commencement & Works Submission
丙部 第4 項。 加上”唐”字。] Completion of Minor (if applicable)
+ If the prefix is “HD-” see Works/ Supervision of
“Matters to Note” item C4. Repair
(if applicable)
⽇dd⽉mm年yyyy ⽇dd⽉mm年yyyy
展開⽇期 項⽬3.6 其他
樓層 單位/室
Item No. 3.6 Others
Floor Flat/Room Date of commencement
⼯程描述Description of works
或詳細位置
or detailed 不需要訂明修葺
location
Prescribed Repair 完成⼩型⼯程/監督修葺⽇期
is not required Date of completion of
例如: 停⾞場、天台、店舖、公⽤部分等
e.g. car park, roof, shop, common parts, etc. MW/Supervision of Repair ⼩型⼯程呈交編號(項⽬3.6除外
Minor Works Submission No. (For
items other than 3.6)^

MW
樓層 展開⽇期 項⽬3.6 其他
單位/室
Item No. 3.6 Others
Floor Flat/Room Date of commencement
⼯程描述Description of works
或詳細位置
or detailed 不需要訂明修葺
location Prescribed Repair 完成⼩型⼯程/監督修葺⽇期
is not required Date of completion of
例如: 停⾞場、天台、店舖、公⽤部分等
e.g. car park, roof, shop, common parts, etc. MW/Supervision of Repair ⼩型⼯程呈交編號(項⽬3.6除外
Minor Works Submission No. (For

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Minor Works Submission No. (For

items other than 3.6)^

MW
展開⽇期 項⽬3.6 其他
樓層 單位/室
Date of commencement Item No. 3.6 Others
Floor Flat/Room
⼯程描述Description of works
或詳細位置
or detailed 不需要訂明修葺
location Prescribed Repair 完成⼩型⼯程/監督修葺⽇期
is not required Date of completion of
例如: 停⾞場、天台、店舖、公⽤部分等
e.g. car park, roof, shop, common parts, etc. MW/Supervision of Repair ⼩型⼯程呈交編號(項⽬3.6除外
Minor Works Submission No. (For
items other than 3.6)^

MW
^如⼯程涉及第I 或II 級別⼩型⼯程，請根據⼩型⼯程監管制度向屋宇署提交指明表格/⽂件。
另加附加⾴ 張
^If the works related to Class I or II minor works, please follow Minor Works Control System
and submit specified forms/documents to Buildings Department. Additional Pages

合資格⼈⼠簽署(或註冊承建商的獲授權簽署⼈簽署
及蓋上公司印章(如適⽤)) *
Signature of QP (or Authorized Signatory of 訂明註冊承建商簽署(或獲授權簽署⼈及蓋上公司印章(如適⽤))*
Registered Contractor and affixed with company seal Signature of the PRC (or Authorized Signatory of PRC and
if applicable)* affixed with company seal if applicable)*

任何失實核證或聲明可引致法律⾏動。
Any false certification or declaration may
be subject to legal action.##

⽇期Date ⽇期Date

⽇ dd ⽉ mm 年 yyyy ⽇ dd ⽉ mm 年 yyyy

*根據註冊記錄
*In accordance with the registration record

WI 1 (12/2020) - P.4

注意事項 Matters to Note

##
1. 任何⼈如作出虛假聲明或就重要事項作出失實陳述即屬觸犯刑事罪⾏ 1. ##Any person making a false declaration or misrepresenting a material
可能會被檢控。 fact shall be guilty of a criminal offence and subject to prosecution.

2. 請注意，合資格⼈⼠及訂明註冊承建商須根據"強制驗樓計劃及強制 2. QP and PRC should carry out the prescribed inspection, supervision of
prescribed repair and repair to windows of the premises/building in
驗窗計劃作業守則"內所規定的技術標準為處所／樓宇窗⼾進⾏訂明 accordance with the technical standards as stipulated in the “Code of
檢驗、監督修葺及修葺。 Practice for Mandatory Building Inspection Scheme and Mandatory
Matters to NoteScheme”.
Window Inspection (MW 3)

甲. 個⼈資料 A. Personal Data

收集的⽬的 Purposes of Collection

1. 屋宇署會使⽤透過本表格所獲得的個⼈資料作下列⽤途： 1. The personal data provided by means of this form will be used
(a) 處理你在本表格中所呈交的⽂件的相關事務； by the Buildings Department for the following purposes:
(b) 處理有關上述法定通知的相關事務；及 (a) activities relating to the processing of your submission in this form;
(c) ⽅便屋宇署與你聯絡。 (b) activities relating to the above statutory notice ; and
(c) facilitating communication between the Buildings Department and
2. 你必須提供本表格所要求的個⼈資料。假如你未能提供所需資料，可
yourself.
能導致處理你所呈交的⽂件時出現延誤，或甚⾄導致無法處理你的申 2. It is obligatory for you to provide the information as required in the
請。 form. If you fail to provide the required data, delay may be caused in
processing of your submission or even result in rejection of the
獲轉交資料的部⾨/ ⼈⼠
application.
3. 本署可能會向其他政府部⾨、決策局、機構或任何⼈⼠披露你透過本表

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3. 本署可能會向其他政府部⾨、決策局、機構或任何⼈⼠披露你透過本表
格所提供的個⼈資料，以作上述第 1 段所列的⽤途。 Classes of Transferees
4. 為保障個⼈資料，請確保所呈交的⽂件並不包含任何與《建築物條例》 3. The personal data you provided by means of this form may be disclosed to
所述的事宜無關的個⼈資料。就私穩事宜的細則，你可參考《個⼈資料 other government departments, bureaux organiations or any persons for the
(私穩)條例》的條⽂。 purposes mentioned in paragraph 1 above.
4. For the reason of personal data protection, please ensure that your submitted
索閱個⼈資料 documents do not contain any personal data not required under the Buildings
， Ordinance. For details of privacy issues, you can make reference to the
5 根據《個⼈資料（私隱）條例》你有權 查閱及改正你所提交 的個⼈資料。
provisions of the Personal Data (Privacy) Ordinance.
屋宇署有權有關資料索閱的要求收取合理費⽤。如要求查閱及改正你的
個⼈資料，請與屋宇署強制驗樓部聯絡。 Access to Personal Data
6. 你須確保政府在使⽤或管有你所呈交的⽂件時不會侵犯任何⼈的知識 5. You have a right of access and correction with respect to personal data as
產權；如有關⽂件包含屬於第三者的知識產權資料，你須確保已獲得所 provided under the Personal Data (Privacy) Ordinance. The Buildings
有必須的許可證。如侵犯任何第三者的知識產權，你須承擔政府可能蒙 Department has the right to charge a reasonable fee for the processing of any
受的任何損失或損害。就版權事宜的細則，你可參考《版權條例》的條 data access request. Request for personal data access and correction should
be addressed to the Mandatory Building Inspection Division of the Buildings
⽂。
Department.
6. You are required to ensure that the Government's use or possession of your
submitted documents will not infringe the intellectual property rights of any
person and that where the documents contain materials of which the
intellectual property rights belong to a third party, all the necessary licences
have been obtained. You are also liable for any loss or damage that the
Government may suffer in case of any infringement of the intellectual
property rights of any third party. For details of copyright issues, you can make
reference to the provisions of the Copyright Ordinance.

⼄. 填寫表格 B. Completion of Form

1. 請填妥表格載列所有有關的部分，並在表格上簽署。 1. Please ensure that all relevant parts of the form are duly completed, and
2. 如需進⾏修葺⼯程，請確保有關⼯程需按照「⼩型⼯程監管制度」的簡 the form is signed.
化⼿續⽽進⾏，並填妥有關表格及連同相關交⽂件，呈交到屋宇署；或 2. When repair works are required, please ensure that the works should be
有關⼯程需先取得建築事務監督的批准及同意才可進⾏ (如適⽤)。 carried out in accordance with the simplified procedures under the
3. 如對本表格有任何疑問，請與屋宇署強制驗樓部聯絡。 Minor Works Control System and the specified forms are duly completed
4. 根據《建築物(檢驗及修葺)條例》第 30(3)(5) 條，合資格⼈⼠需向由他⼈ together with the relevant documents and submitted to the Buildings
Department; or the works should not be carried out until the approval
代為進⾏檢驗的⼈(例如：業主、業主代表)提交⼀份本表格及相關⽂件
and consent have been obtained from the Building Authority, if
的副本。 applicable.
3. Enquiries regarding this form should be addressed to Mandatory Building
Inspection Division of the Buildings Department .
4. QP is required under section 30(3)(5) of the Building (Inspection & Repair)
Regulation to deliver a copy of this form and associated report(s) to the
person for whom the prescribed inspection is carried out (e.g. Owner ,
Owner ’s representative ).

WI 1 (12/2020)

丙. 呈交⽅法 C. Submission Methods

1. 郵寄/ 親⾝呈交 – 本表格連同有關⽂件應郵寄或親⾝呈交⾄: 1. By Post / In Person – This form together with the relevant documents shall be
be posted to or submitted in person to:
九龍油⿇地海庭道11號⻄九龍政府合署北座屋宇署總部地下⼀般查詢 General Enquiry and Receipt Counter, G/F, Buildings Department Headquarters,
及收件處。 North Tower, West Kowloon Government Offices, 11 Hoi Ting Road, Yau Ma
Tei, Kowloon.
2. 電⼦郵件傳送 – 透過電⼦郵件傳送本表格及有關⽂件(全部必須獲香港
郵政署長發出的數碼證書認證，或根據《電⼦交易條例》認可的其他核 2. Through Email – Email this form together with the relevant documents, all
證機關所發出的數碼證書認證)到屋宇署電⼦收件處，電郵地址為 with identity authenticated by a digital certificate issued by the Postmaster
[email protected] 。 General or other certification authorities recognized under the Electronic

https://eform1.bd.gov.hk/lc/content/xfaforms/profiles/default.ht…2F%2F%2FApplications%2FEFSS_PRD%2F1.0&template=WI1.xdp&dataRef= Page 6 of 7
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。
3. 電⼦呈交 – 按本表格上的「提交」傳送本表格及有關⽂件 ( 全部必須附 Transactions Ordinance to the e-Counter of the Buildings Department at
上數碼證書認證 )。 請使⽤ Acrobat Reader 中的「附加檔案」功能，附 [email protected]
上已數碼認證的⽂件。 3. Through e-Submission – Click the Submit button to electronically submit this
4. 如樓宇或處所位於居者有其屋計劃屋苑、租者置其屋計劃屋邨或公共屋 form together with attachment of the relevant documents, all with identity
authenticated by your digital certificates. You may attach all authenticated
邨範圍內，請將已填妥的指明表格連同有關⽂件以郵寄或親⾝遞交運輸
documents using Acrobat Reader’s “Attachments ” function.
及房屋局常任秘書長 ( 房屋 )辦公室的的獨立審查組辦理。
4. Where buildings / premises fall within the boundary of Home Ownership
Scheme (HOS) courts. Tenants Purchase Scheme (TPS) estates or Public Rental
如欲查詢哪些屋苑/ 屋邨是受建築物條例監管，可瀏覽下網址以參閱建築
Housing estates, please submit the specified forms together with the relevant
物條例適⽤之屋邨/ 屋苑/ 設施名單。
document(s) to The Independent Checking Unit of Office of the Permanent
Secretary for Transport and Housing (Housing) by post or in person for
http://www.housingauthority.gov.hk/ tc/business- processing.
partnerships/resources/index.html
Please visit the following web -address to check which Estate / Court in the List
of Housing Estates / Courts / Facilities are subject to the control of the
Buildings Ordinance.

http://www.housingauthority.gov.hk/en/business -
partnerships/resources/index.html

丁. 聯絡資料 D. Contact Details

屋宇署強制驗樓部 Mandatory Building Inspection Division, Buildings Department

地址：九龍油⿇地海庭道11 號⻄九龍政府合署北座屋宇署總部 Address: Buildings Department Headquarters, North Tower, West Kowloon
電話：2626 1616 (由”1823 ” 接聽) Government Offices, 11 Hoi Ting Road, Yau Ma Tei, Kowloon
傳真：3582 4227 Tel No.: 2626 1616 (handled by “ 1823” )
Fax No.: 3582 4227
電郵：[email protected]
Email: [email protected]

WI 1 (12/2020)

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