SuSD.F.

009
Rev.01, 01 Oct. 2017
Philippine Economic Zone Authority
SUPPORT SERVICES DEPARTMENT
OFFICE OF THE BUILDING OFFICIAL
Telephone : (632) 551 3451 loc. 113 / 114 | (632) 891 6382
Website: www.peza.gov.ph | Email: susd@peza.gov.ph

Company :
(PEZA Reg. Name)
Location: :
Application Type : Electronics Permit (ELP) Electronics Permit-To-Operate (ELPTO)
Project Title :
Contractor :
PCAB License :

ELECTRONICS DATA SHEET (ELDS)

DESCRIPTION / DETAILS
QUANTITY UNITS
No. of Ports
a. Communication Equipment
units Central Office Switching Equipment
units Main Distribution Frames
units Intermidiate Distribution Frame
units Remote Switching Units
units Concentrators
units PABX / PBX's
units Cordless / Wireless Telephone Communication System
units Intercommunication system
units Switch / Hub
units Router
units Patch Panel
units Server (IT / Telecommunication)
units Workstation
units Voice and Data Outlets (Simplex)
units Voice and Data Outlets (Duplex)
units Voice and Data Outlets (Triplex)
units Voice and Data Outlets Quadruplex)
units Telephone Outlets
units Telephone Handset / Slave
units Wifi Access Point
Others: (please specify)

b. Audio / Visual System

units Neon Sign Unit / Signage
units Monitors (LCD, CRT, Plasma, etc.)
units Projector
units Paging System Amplifier
units Paging System Switcher
units Matrix Controller
units Speakers
terminals Conference System
Others: (please specify)

c. Photography and Reproduction Materials

units Printers
units Photo Machines
units Plotters
units Image Scanners
Others:(please specify)

Signed and sealed by a PECE (Designer or In-Charge of Installation):

Signature over Printed Name

1 of 7
 SuSD.F.009
Rev.01, 01 Oct. 2017
PRC License No: ____________

QUANTITY UNITS DESCRIPTION / DETAILS

d. Imaging Equipment
units X-ray Machines
units Ultra Sound
units Magnetic Resonance Imaging
Others: (please specify)

e. Location / Direction Finding System

units GPS
units Land Navigation Equipment
units Aeronautical Navigational Equipment
Others: (please specify)

f. Antenna Towers
units Guyed Towers
units Three-legged Self Supporting Towers
units Four-legged Supporting Towers
units Repeaters
Others: (please specify)

g. Other Auxilliary Equipment and Devices

units Automated Teller Machines
units Ticketing Machines
units Vendo Machines
units Telephone Booths / Pay Phones
units Coin Changers
Others: (please specify)

h. Safety System Equipment and Monitoring Devices

terminals Access Control Main Panel
terminals Access Card Reader Modules
terminals Intrusion System Output Modules
terminals Intrusion System Output Modules
terminals Electronic Barrier System
terminals Card Readers
terminals Motion Sensors
terminals Door Contact
terminals Electro-Magnetic Locks
terminals CCTV Cameras
terminals Building Management System (BMS) Main Control Panel
terminals BMS Humidity Sensors
terminals BMS Temperature Sensor
terminals BMS Actuators
terminals BMS Relays
terminals BMS Contactors
terminals Water Leak Detection Main Control Panel
terminals Water lEak Sensing Cable
terminals Fire Alarm Control Panel
terminals Fire Alarm Speaker / Strobe
terminals Fire Alarm Electric Bell
terminals Smoke and Heat Detectors
terminals Firemans Intercom
terminals Annunciator System
terminals Watchman System
terminals Burglar Alarms
Signed and sealed by a PECE (Designer or In-Charge of Installation):

2 of 7
 SuSD.F.009
Rev.01, 01 Oct. 2017

Signature over Printed Name

PRC License No: ____________

QUANTITY UNITS DESCRIPTION / DETAILS

terminals Lighting Controls
terminals Parking Management System
terminals Barrier Controls
terminals CATV
terminals MATV
Others: (please specify)

i. Structures for Radio / TV Broadcasting, Audio / Video Recording and Simulation

locations Studios
locations Auditoriums
locations Theaters
locations Audio / Video Reproduction
locations Simulation
Others: (please specify)

j. Communications / Electronic Centers

locations Transmitter
locations Receiver
locations Radio Relay
locations Operation and/or Maintenace Centers
locations Call Centers
locations Cell Sites
locations Equipment Silos/Shelters
locations Navigational Ads Service Centers
locations Radar Service Centers
locations Telemetry
locations Tests and Measurements Services Centers
locations Switching Centers
locations Control Centers
Others: (please specify)

k. Poles and Attachments

no. Poles
no. Attachments

Signed and sealed by a PECE (Designer or In-Charge of

Installation): Noted by:

Signature over Printed Name Signature over Printed Name

PRC License No: ____________ Owner or Authorized Representative

REMINDERS :
1. Only those permit applications with complete plans and supporting documents will be processed.

2. All equipment / devices to be installed / operated should be listed in this form, use extra sheets if necessary.
3. Equipment / devices that are not specified in the above sheets but were installed during PEZA inspection shall be imposed with corresponding penalty,
surcharges and/or administrative fine.

3 of 7
 SuSD.1.F.009
Rev.01, 04 Dec. 2018
Philippine Economic Zone Authority
SUPPORT SERVICES DEPARTMENT
OFFICE OF THE BUILDING OFFICIAL
Telephone : (632) 551 3451 loc. 113 / 114 | (632) 891 6382
Website: www.peza.gov.ph | Email: susd@peza.gov.ph

Company : EMAPTA VERSATILE SERVICES INC.

(PEZA Reg. Name)
Location : 5F, St. Francis Square Mall, Julia Vargas Avenue Cor. Bank Drive Ortigas Center, Mandaluyong City
Application Type : √ Electronics Permit √ Electronics Permit-To-Operate (ELPTO)
Project Title : EMAPTA ST. FRANCIS SQUARE OFFICE FIT-OUT PROJECT
Contractor : R.S. Mesa Construction Corp./DVR Builders and Electrical Contractor, Inc.
PCAB License : 22218 Category :

ELECTRONICS DATA SHEET (ELDS)

DESCRIPTION / DETAILS
QTY UNIT
No. of Ports
a. Communication Equipment
units Central Office Switching Equipment
units Main Distribution Frames
units Intermidiate Distribution Frame
units Remote Switching Units
units Concentrators
units PABX / PBX's
units Cordless / Wireless Telephone Communication System
units Intercommunication system
units Switch / Hub
units Router
units Patch Panel
units Server (IT / Telecommunication)
units Workstation
units Voice and Data Outlets (Simplex)
units Voice and Data Outlets (Duplex)
units Voice and Data Outlets (Triplex)
units Voice and Data Outlets Quadruplex)
units Telephone Outlets
units Telephone Handset / Slave
units Wifi Access Point
Others: (please specify)

b. Audio / Visual System

units Neon Sign Unit / Signage
units Monitors (LCD, CRT, Plasma, etc.)
units Projector
units Paging System Amplifier
units Paging System Switcher
units Matrix Controller
units Speakers
terminals Conference System
Others: (please specify)

c. Photography and Reproduction Materials

units Printers
units Photo Machines
units Plotters
units Image Scanners
Others:(please specify)

Signed and sealed by a PECE (Designer or

In-Charge of Installation): Reference Number

Signature over Printed Name (to be filled out by PEZA representative)

PRC License No: ____________
4 of 7
 SuSD.1.F.009
Rev.01, 04 Dec. 2018

QTY UNITS DESCRIPTION / DETAILS

d. Imaging Equipment
units X-ray Machines
units Ultra Sound
units Magnetic Resonance Imaging
Others: (please specify)

e. Location / Direction Finding System

units GPS
units Land Navigation Equipment
units Aeronautical Navigational Equipment
Others: (please specify)

f. Antenna Towers
units Guyed Towers
units Three-legged Self Supporting Towers
units Four-legged Supporting Towers
units Repeaters
Others: (please specify)

g. Other Auxilliary Equipment and Devices

units Automated Teller Machines
units Ticketing Machines
units Vendo Machines
units Telephone Booths / Pay Phones
units Coin Changers
Others: (please specify)

h. Safety System Equipment and Monitoring Devices

terminals Access Control Main Panel
terminals Access Card Reader Modules
terminals Intrusion System Output Modules
terminals Intrusion System Output Modules
terminals Electronic Barrier System
terminals Card Readers
terminals Motion Sensors
terminals Door Contact
terminals Electro-Magnetic Locks
terminals CCTV Cameras
terminals Building Management System (BMS) Main Control Panel
terminals BMS Humidity Sensors
terminals BMS Temperature Sensor
terminals BMS Actuators
terminals BMS Relays
terminals BMS Contactors
terminals Water Leak Detection Main Control Panel
terminals Water lEak Sensing Cable
terminals Fire Alarm Control Panel
terminals Fire Alarm Speaker / Strobe
terminals Fire Alarm Electric Bell
terminals Smoke and Heat Detectors
terminals Firemans Intercom
terminals Annunciator System
terminals Watchman System
terminals Burglar Alarms
Signed and sealed by a PECE (Designer or In-Charge of Installation):

Signature over Printed Name

5 of 7
 SuSD.1.F.009
Rev.01, 04 Dec. 2018
PRC License No: ____________

QTY UNITS DESCRIPTION / DETAILS

terminals Lighting Controls
terminals Parking Management System
terminals Barrier Controls
terminals CATV
terminals MATV
Others: (please specify)

i. Structures for Radio / TV Broadcasting, Audio / Video Recording and Simulation

locations Studios
locations Auditoriums
locations Theaters
locations Audio / Video Reproduction
locations Simulation
Others: (please specify)

j. Communications / Electronic Centers

locations Transmitter
locations Receiver
locations Radio Relay
locations Operation and/or Maintenace Centers
locations Call Centers
locations Cell Sites
locations Equipment Silos/Shelters
locations Navigational Ads Service Centers
locations Radar Service Centers
locations Telemetry
locations Tests and Measurements Services Centers
locations Switching Centers
locations Control Centers
Others: (please specify)

k. Poles and Attachments

no. Poles
no. Attachments

Signed and sealed by a PECE (Designer or In-

Charge of Installation): Noted by:

Signature over Printed Name Signature over Printed Name

PRC License No: ____________ Owner or Authorized Representative

REMINDERS :
1. Only those permit applications with complete plans and supporting documents will be processed.

2. All equipment / devices to be installed / operated should be listed in this form, use extra sheets if necessary.
3. Equipment / devices that are not specified in the above sheets but were installed during PEZA inspection shall be imposed with corresponding
penalty, surcharges and/or administrative fine.

6 of 7
 Philippine Economic Zone Authority SuSD.F.008
SUPPORT SERVICES DEPARTMENT Rev.01, 01 Oct. 2017
OFFICE OF THE BUILDING OFFICIAL
Telephone : (632) 551 3451 loc. 113 / 114 | (632) 891 6382
Website: www.peza.gov.ph | Email: susd@peza.gov.ph

Company :
(PEZA Reg. Name)
Location :
Application Type : Electronics Permit (EP) Electronics Permit-To-Operate (EPTO)
Project Title :
Contractor : PCAB Lic. No. / Category :

ELECTRONICS DATA SHEET (EDS)

QTY RATING DESCRIPTION / DETAILS QTY DESCRIPTION / DETAILS

kWHR. Meter f. Circuit Breaker / Disconnecting Means

a. Automatic Voltage Regulator (kW / kVA) 5,000 Amp.
AVR 4,000 Amp.
AVR 3,200 Amp.
AVR 3,000 Amp.
b. Uninterrupted Power Supply (kW / kVA) 2,500 Amp.
UPS 2,000 Amp.
UPS 1,800 Amp.
UPS 1,600 Amp.
c. Transformers (kW / kVA) 1,500 Amp.
Transformer (Oil Immersed) 1,250 Amp.
Transformer (Oil Immersed) 1,200 Amp.
Transformer (Oil Immersed) 1,000 Amp.
Transformer (Dry Type) 800 Amp.
Transformer (Dry Type) 700 Amp.
Transformer (Dry Type) 630 Amp.
d. Generator Set (kW / kVA) 600 Amp.
Generator Set (Continuos Operation) 500 Amp.
Generator Set (Continuos Operation) 450 Amp.
Generator Set (Stand by) 400 Amp.
Generator Set (Stand by) 350 Amp.
e. Motors and Controlling Apparatus 300 to 275 Amp.
10 HP up to 20 HP 250 to 225 Amp.
5 HP up to 10 HP 200 to 175 Amp.
1 HP up to 5 HP 150 to 125 Amp.
1/4 HP up to 1 HP 100 to 60 Amp.
Other Available Rating 50 to 5 Amp.

Signed and sealed by a PEE (Designer or In-Charge of

Installation): Noted by:

Signature over Printed Name Signature over Printed Name

PRC License No: ____________ Owner or Authorized Representative

Reference Number

(to be filled out by PEZA representative)

REMINDERS
1. Only applications with complete plans and documents will be processed.
2. For electrical equipment/devices to be installed/operated but not listed in this form should also be included in the data sheet, use another sheet with the same
format and information.
3. Electrical equipment / devices not declared but found installed during inspection will be subject to 100% Surcharge and Administrative Fine.