REPUBLIC OF THE PHILIPPINES

OFFICE OF THE CITY MAYOR

QUEZON CITY
(BUILDING OFFICIAL)
DO NOT FILL UP (NSO USE ONLY)

APPLICATION NO. PERMIT NO.

BUILDING PERMIT
DATE OF APPLICATION DATE ISSUED

ORIGINAL RENEWAL

BOX 1 (TO BE ACCOMPLISHED BY DESIGNING ARCHITECT / CIVIL ENGINEER IN PRINT)

OWNER LASTNAME FIRSTNAME M.I. TAX ACCT. NO.

FOR CONSTRUCTION OWNED BY FORM OF OWNERSHIP MAIN ECONOMIC ACTIVITY OF BUSINESS

AN ENTERPRISE
ADDRESS TEL. NO.

LOCATION OF CONSTRUCTION

SCOPE OF WORK: 1. NEW CONSTRUCTION OTHERS (SPECIFY)

2. ADDITION OF _____________________ 6. __________OF______________
3. REPAIR OF ________________________
7. __________OF______________
4. RENOVATION OF __________________
5. DEMOLITION OF ___________________

USE OR TYPE OF OCCUPANCY

RESIDENTIAL INDUSTRIAL
11 SINGLE 31 FACTORY (PLANT)
12 DUPLEX 32 REPAIR SHOP, MACHINE SHOP
13 ROWHOUSE / ACCESSORIA 33 REFINERY
10 OTHERS (SPECIFY)____________________
34 PRINTING PRESS
COMMERCIAL 35 WAREHOUSE
21 BANK 30 OTHERS (SPECIFY)____________________
22 STORE
23 HOTEL / MOTEL, ETC. INSTITUTIONAL
24 OFFICE CONDOMINIUM / BUSINESS OFFICE BUILDING. 41 SCHOOL
25 RESTAURANT, ETC.. 42 CHURCH OR OTHER RELIGIOUS STRUCTURES
26 SHOP (e.g. DRESS SHOP, TAILORING SHOP, BARBER SHOP, ETC. 43 HOSPITAL OR SIMILAR STRUCTURES
27 GASOLINE STATION 44 WELFARE & CHARITABLE STRUCTURES
28 MARKET 45 THEATER, AUDITORIUM. GYMNASIUM, COURT
29 DORMITORY OR OTHER LODGING HOUSE 40 OTHERS (SPECIFY)____________________
30 OTHERS (SPECIFY)____________________
AGRICULTURAL
41 BRAN(S), POULTRY HOUSE(S), ETC.
42 GRAIN MILL
OTHER CONSTRUCTION
60 (SPECIFY)____________________ www.quezoncity.gov.ph 40 OTHERS (SPECIFY)____________________

OFFICE OF THE BUILDING OFFICIAL

STREET FURNITURE, LANDSCAPING & SIGNBOARDS
71 PARK, PLAZA’S, MONUMENT, POOLS, PLANT BOXES, ETC.
72 SIDEWALKS, PREMONADES, TERRACES, LAMPPOSTS, ELECTRIC POLES, TELEPHONE POLES, ETC.
73 OUTDOOR ADS, SIGNBOARDS, ETC.
74 FENCE ENCLOSURE

BOX 2 (TO BE ACCOMPLISHED BY RECEIVING & RECORDING SECTION)

BUILDING DOCUMENTS (FIVE SETS EACH)
SITE DEVELOPMENT & LOCATION PLAN
MECHANICAL PLANS & SPECIFICATIONS
ARCHITECTURAL PLAN & SPECIFICATIONS
LOGBOOK (1COPY)
STRUCTURAL DESIGN & COMPUTATIONS
OTHERS (SPECIFY)
SANITARY/PLUMBING PLANS & SPECIFICATIONS
ELECTRICAL PLANS & SPECIFICATION

BOX 3 (TO BE ACCOMPLISHED BY THE BUILDING OFFICIAL)

ACTION TO BE TAKEN:
PERMIT IS HEREBY GRANTED SUBJECT TO THE FOLLOWING CONDITIONS
1. THAT THE PROPOSED CONSTRUCTION/ADDITION/REPAIR/RENOVATION/
DEMOLITION/INSTALLATION ETC SHALL BE IN CONFORMITY WITH THE NATIONAL
BUILDING CODE (PD 1096) AND ITS CORRESPONDING IMPLEMENTING RULES AND
REGULATIONS
2. THAT A DULY LICENSED ARCHITECT/CIVIL ENGINEER HAS BEEN ENGAGED TO PLANS ENGR. ISAGANI R. VERZOSA JR.
AND SPECIFICATIONS AND TO UNDERTAKE THE SUPERVISION/INSPECTION OF THE
CONSTRUCTION OF THE PROJECT LOCAL BUILDING OFFICIAL
3. THAT A CERTIFICATE OF COMPLETION DULY SIGNED AND SEALED BY THE DESIGNING
ARCHITECT / ENGINEER IN-CHARGE OF CONSTRUCTION SHALL BE SUBMITTED NOT LATER
THAN SEVEN (7) DAYS AFTER COMPLETION OF THE CONSTRUCTION OF THE PROJECT
4. THAT A CERTIFICATE OF OCCUPANCY “SHALL BE SECURED PRIOR TO ACTUAL DATE
OCCUPANCY OF THE BUILDING.

NOTE:
THIS PERMIT MAY BE CANCELLED OR REVOKED PURSUANT TO SECTIONS 305 & 306 OF THE “NATIONAL BUILDING CODE”.
BOX 3A (TO BE ACCOMPLISHED BY THE DESIGNING ARCHITECT/CIVIL ENGINEER IN PRINT
TOTAL ESTIMATED COST COST OF NUMBER OF STOREYS___________ DO NOT FILL (NSO USE ONLY)
EQUIPMENT
BUILDING P_____________ INSTALLED TOTAL FLOOR AREA____________
ELECTRICAL P_____________ P____________ PROPOSED DATE
OF CONSTRUCTION _____________
MECHANICAL P_____________
P____________ EXPECTED DATE
PLUMBING P_____________ OF COMPLETION _______________
P____________
OTHERS P_____________
MATERIAL OF CONST. ____________
TOTAL COST P_____________ (WOOD, CONC, STEEL, MIXED)

BOX 4 (TO BE ACCOMPLISHED BY THE DIVISION CONCERNED

ASSESED FEES

AMOUNT DUE ASSESSED BY O.R. NUMBER DATE PAID

LAND USE / ZONING

LINE and GRADE

BUILDING

PLUMBING

ELECTRICAL

MECHANICAL

OTHERS
REVIEWED:

TOTAL
CHIEF, PROCESSING DIVISION SECTION

BOX 5 (TO BE ACCOMPLISHED BY THE DIVISION CONCERNED

PROGRESS FLOW
NOTED: IN OUT
ACTION / PROCESSED
CHIEF, PROCESSING DIVISION TIME DATE TIME DATE REMARKS BY:

RECEIVING and RECORDING

LAND USE and ZONING

GEODETIC (LINE and GRADE)

ARCHITECTURAL

STRUCTURAL

SANITARY

ELECTRICAL

MECHANICAL
WE HEREBY AFFIX OUR HANDS SIGNIFYING OUR CONFORMITY TO THE INFORMATION HEREIN ABOVE SETFORTH

BOX 6 www.quezoncity.gov.ph
BOX 8

OFFICE OF THE BUILDING OFFICIAL

ARCHITECT / CIVIL ENGINEER PRC REG. NO.
SIGNATURE
SIGNED AND SEALED PLANS & SPECIFICATIONS

PRINT NAME

ADDRESS
COMMUNITY TAX CERT. PTR NO. PLACE ISSUED

PTR NO. PTR NO. PLACE ISSUED

SIGNATURE

WITH MY CONSENT:
BOX 9 (TO BE ACCOMPLISHED BY LOT OWNER)
BOX 7
ARCHITECT / CIVIL ENGINEER PRC REG. NO. TCT / OCT NO.
SIGNED AND SEALED PLANS & SPECIFICATIONS

PRINT NAME PRINT NAME OF LO5T OWNER

ADDRESS ADDRESS

PTR NO. PTR NO. PLACE ISSUED COMMUNITY TAX RECEIPT DATE ISSUED PLACE ISSUED

SIGNATURE SIGNATURE