Republic of the Philippines APPENDIX B

OFFICE OF THE CITY BUILDING OFFICIAL DO NOT FILL UP (NSO USE ONLY)
BAGUIO CITY

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/APPLICANT LAST NAME FIRST NAME M.I. TIN
USE OR TYPE OF OCCUPANCY
RESIDENTIAL INDUSTRIAL
11 SINGLE
FOR CONSTRUCTION OWNED FORM OF OWNERSHIP MAIN31ECONOMIC
FACTORY/PLANT
ACTIVITY/KIND OF BUSINESS
BY 12
ANDUPLEX
ENTERPISE 32 REPAIR SHOP/MACHINE SHOP
13 ROWHOUSE/ACCESORIA 33 REFINERY
ADDRESS:
10 OTHER (SPECIFY ) 34 PRINTING SHOP TELEPHONE NO.
35 WAREHOUSE
LOCATION OF CONSTRUCTION: 30 OTHER ( SPECIFY)
COMMERCIAL INSTITUTIONAL
SCOPE OF WORK
21 BANK 41 SCHOOL
22 STORE 1. NEW CONSTRUCTION OTHER ( SPECIFY)
42 CHURCH AND OTHER RELIGIOUS STRUCTURE
2. ADDITION
23 HOTEL/MOTEL,ETC. 6. _____________________
42 HOSPITAL OR SIMILAR OF __________________
STRUCTURES
3. REPAIR OF
24 OFFICE/CONDOMINIUM OFFICE BUILDING 7. _____________________ OF __________________
44 WELFARE AND CHARITABLE STRUCTURES
4.RENOVATION OF
25 RESTAURANT,ETC 45 THEATER, AUDITORIUM, GYMNASIUM, COURT
5. DEMOLITION
26 SHOP (e.g. DRESS OF
SHOP, TAILORING,BARBER SHOP, etc. NUMBER
40 OTHER OF UNITS ______________________
(SPECIFY)
27 GASOLINE STATION
28 MARKET AGRICULTURAL
29 DORMITORY OR OTHER LODGING HOUSE 51 BARN(S), POULTRY HOUSE(S), ETC.
20 OTHERS (SPECIFY) 52 GRAIN MILL
50 OTHER (SPECIFY)
OTHER TYPE OF OCCUPANCY
60 SPECIFY
STREET FURNITURE, LANDSCAPING & SIGNBOARDS
71 PARKS, PLAZAS, MONUMENT, POOLS, PLANT BOXES,ETC
72 SIDEWALKS, PROMENADES, TERRACES, LAMPOST, ELECTRIC POLES, TELEPHONE POLES,ETC.
73 OUTDOOR ADS, SIGNBOARDS, ETC.
74 FENCE ENCLOSURE
BOX 2 (TO BE ASSESSED BY THE RECEIVING AND RECORDING SECTION)
BUILDING DOCUMENT (FIVE SETS EACH)
SITE DEVELOPMENT AND LOCATION PLAN MECHANICAL PLANS & SPECIFICATION
ARCHITECTURE PLAN AND SPECIFICATIONS LOGBOOK ( 1 COPY)
STRUCTURAL DESIGN & COMPUTATIONS OTHERS (SPECIFY) ______________________________________
SANITARY/PLUMBING & SPECIFICATIONS ____________________________________________________________
ELECTRICAL PLAN & SPECIFICATIONS

BOX (TO BE ACCOMPLSHED BY THE BUILDING OFFICIAL)

ACTION TAKEN
PERMIT IS HEREBY GRANTED SUBJECT OF THE FOLLOWING CONDITIONS:
1 THAT THE PROPOSED CONSTRUCTION/ADDITION/REPAIR/
RENOVATION/DEMOLITION /INSTALLATION, ETC. SHALL BE IN
CONFORMITY WITH THE NATIONAL BUILDING CODE (P.D. 1096)
AND ITS CORRESPONDING IMPLEMENTING RULES AND REGULATIONS
2 THAT A DULY LICENSED ARCHITECTURE/CIVIL ENGINEER HAS BEEN
ENGAGED TO PREPARE PLANS AND SPECIFICATION AND TO
UNDERTAKE THE SUPERVISION/INSPECTION OF THE CONSTRUCTION
OF THE PROJECT.
3 ESTIMATED
TOTAL THAT A CERTIFICATION
COST OFOF
COST COMPLETION
NO.DULY SIGNED4 AND SEALED
OF STOREYS:
EQUIPMENT
BY THE DESIGNING ARCHITECT/ENGINEER TOTAL FLOOR
AND THE ARCHITECT/
BUILDING ENGINEER
P 8,665,083.00 INSTALLED
IN-CHARGEOF CONTRUCTION AREA: 1,945BE
SHALL sqm
SUMBITTED ENGR. NAZITA F. BAÑEZ
ELECTRICAL P 323,340.00
NOT LATER P
THAT SEVEN PROPOSED
(7) DAYS AFTER DATE OF THE
COMPLETION City Building Official
MECHANICAL P P OF CONSTRUCTION
CONSTRUCTION OF THE PROJECT. City Government Department Head II
PLUMBING P 118,610.00 P MATERIALS OF CONST.
4 THAT A “CERTIFICATE OF OCCUPANCY” SHALL BE SECURED Date: ______________
OTHER P (WOOD ,CONC,STEEL,MIXED)
PRIOR TO ACTUAL OCCUPANCY OF THE BUILDING.
NOTE:
TOTALTHIS
COSTPERMIT MAY BE CANCELLED OR REVOKED PURSUANT TO SECTION 305 & 306 OF THE “NATIONAL BUILDING CODE”.
P9,107,033.00
BOX 4 (TO ACCOMPLISHED BY THE DIVISION/SECTION CONCERNED) To be accomplished in five (5) copies, one each
for: applicant (original), Assessor, National
ASSESSED FEES Statistics Office, Building Official, Fire
AMOUNT DUE ASSESSED BY O.R NUMBER DATE PAID Department

LAND USE/ZONING
BOX 3A (TO BE ACCOMPLISHED BY
DESIGNING ARCHITECT/CIVIL
DO NOT FILL (NSO USE ONLY) ENGINEER
LINE & GRADE
IN PRINT

BUILDING
REVIEWED BY:
PLUMBING CHIEF, PROCESSING DIVISION/SECTION

ELECTRICAL

MECHANICAL

TOTAL
 BOX 5 (TO BE ACCOMPLISHED BY THE DIVISION/SECTION CONCERNED)
PROGRESS FLOW
NOTED: IN OUT
CHIEF ,PROCESSING DIVISION TIME DATE TIME DATE ACTION/ REMARKS PROCESSED BY

RECEIVING and RECORDING

LAND USE and ZONING

GEODETIC (LINE &GRADE)

ARCHITECTURAL

STRUCTURAL

SANITARY/PLUMBING

ELECTRICAL

MECHANICAL

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

BOX 6 BOX 8
WITH MY CONSENTENGINEER
ARCHITECT/CIVIL PRC REG. NO.
SIGNED AND SEALED PLANS & 28530
BOX 9 (TO BE ACCOMPLISHED BY LOT OWNER)
SPECIFICATION
PRINT NAME
JUANITO C. APIGO JR.

ADDRESS
18 PUROK 1, PINSAO PILOT PROJECT, BAGUIO CITY

SIGNATURE

SIGNATURE

BOX 7
ARCHITECT/CIVIL ENGINEER PRC REG.NO. TCT/OCT NO.
IN-CHARGE OF CONSTRUCTION 28530 APPLICANT

PRINT NAME COMMUNITY TAX

PRINT NAME OFCERT
LOT DATE ISSUED
OWNER PLACED ISSUED
JUANITO C. APIGO JR

ADDRESS ADDRESS
18 PUROK 1, PINSAO PILOT PROJECT, BAGUIO CITY

PTR NO. DATE ISSUED PALCE ISSUED COMMUNITY TAX CERT.

4529216 JAN. 16, 2020 BAGUIO CITY

SINATURE TIN SIGNATURE

261-428-535-000