REPUBLIC OF THE PHILIPPINES DEPARTMENT OF PUBLIC WORKS METROPOLITAN MANILA COMMISSION. (OFFICE OF THE BUILDING OFFICIAL CITY OF MANDALUYONG DISTRICTICITY/MUNICIPALITY DPW FORM NO. 77-001-8 APPLICATION NO. PERMIT AREA CODE 7401-T BUILDING PERMIT DATE OF APPLICATION 1D ORIGINAL RENEWAL BOX 1 (TO BE ACCOMPLISHED BY DESIGNING ARCHITECT / CIVIL ENGINEER IN PRINT) ‘NAME OF OWNER / APPLICANT LAST NAME. FIRST NAME, mi TTAXAGCT. NO. DATE ISSUED FOR CONSTRUCTION OWNED, FORM OF OWNERSHIP. MAIN ECONOMIC ACTIVITY KIND OF BUSINESS, BY AN ENTERPRISE ‘ADDRESS NO, STREET, BARANGAY, CITY/MUNICIPALITY TELEPHONE NO. LOCATION OF CONSTRUCTION NO. STREET, BARANGAY, CITY/MUNICIPALITY ‘SCOPE OF WORK 2 ADDITION OF OTHERS SPECIFY) 3 D REPAIR OF eo. F 1D NEWCONSTRUCTION 4 D RENOVATION OF 70) OF: 5 CI DEMOLITION OF USE OR TYPE OF OCCUPANCY RESIDENTIAL INDUSTRIAL 30 DIOTHERS (SPECIFY) 11 SINGLE 33D FACTORYIPLANT 12. DUPLEX 32 C1 REPAIR SHOP, MACHINE SHOP 13 D ROWHOUSE / ACCESSORIA 33D REFINERY. 10 Gl OTHERS (SPECIFY). 934 0 PRINTING PRESS 35 DI WAREHOUSE COMMERCIAL INSTITUTIONAL 21 BANK 41.0 SCHOOL 22 DSTORE 42 CHURCH AND OTHER RELIGIOUS STRUCTURES 28 CHOTELIMOTEL, ETC. 24 C1 OFFICE CONDOMINIUM/BUSINESS OFFICE BUILDING 25 C RESTAURANT ETC. 26 O SHOP (e.g, DRESS SHOP, TAILORING SHOP, BARBER SHOP ETC.) 27 DIGASOLINE STATION 28 CMARKET 29D DORMITORY or OTHER LODGING HOUSE 30 DOTHERS (SPECIFY) 43 Cl HOSPITAL OR SIMILAR STRUCTURES. 44D WELFARE AND CHARITABLE STRUCTURES 45D) THEATER, AUDITORIUM, GYMNASIUM, COURT 40 © OTHERS (SPECIFY) AGRICULTURAL 51 D BARN(S), POULTRY HOUSE(S), ETC. 520 GRAIN MILL 50 (1 OTHERS (SPECIFY) OTHER CONSTRUCTION 60 C1 (SPECIFY) ‘STREET FURNITURE, LANDSCAPING & SIGNBOARDS: 71 CAPARKS, PLAZAS, MONUMENTS, POOLS, PLANT BOXES ETC. 72 DI SIDEWALKS, PROMENADES, TERRACES, LAMPOSTS, ELECTRIC POLES, TELEPHONE POLES, ETC. 73 DI OUTDOOR ADS, SIGNBOARDS, ETC. 74 CIFENGE ENCLOSURE BOX 2 (TO BE ACCOMPLISHED BY THE RECEIVING & RECORDING SECTION) BUILDING DOCUMENTS (FIVE SETS EACH) Cl MECHANICAL PLANS & SPECIFICATIONS. [LOGBOOK (7'COPY) CLOTHERS (SPECIFY) ISITE DEVELOPMENT AND LOCATION CUARCHITECTURAL PLAN 8 SPECIFICATIONS: CUSTRUCTURAL DESIGNS & COMPUTATIONS. CI SANITARY / PLUMBING PLANS & SPECIFICATIONS. i [ELECTRICAL PLANS & SPECIFICATIONS BOXS (TO BE ACCOMPLISHED BY THE BUILDING OFFICIAL) ‘ACTION TAKEN: PERMIT IS HEREBY GRANTED SUBJECT TO THE FOLLOWING CONDITIONS: 1. THAT THE PROPOSED CONSTRUCTIONADDITION/REPAIRJRENOVATION/ DEMOLITIONINSTALLATION ETC., SHALL BE IN CONFORMITY WITH THE "NATIONAL BUILDING CODE" (PD. 1096) AND ITS CORRESPONDING ISSUED BY: IMPLEMENTING RULES AND REGULATIONS. 2. THAT A DULY LICENSED ARCHITECTICIVIL ENGINEER HAS BEEN ENGAGED TO PREPARE PLANS & SPECIFICATIONS AND TO UNDERTAKE THE SUPERVISIONINSPECTION OF THE CONSTRUCTION OF THE PROJECT. 3. THAT A CERTIFICATE OF COMPLETION DULY SIGNED AND SEALED 8Y THE DESIGNING ARCHITECTICIVIL ENGINEER AND THE ARCHITECT) CIVIL 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 OCCUPANCY OF THE BUILDING. NOTE: ENGR. ROLLY P. DANILA ASSISTANT CITY ENGINEER NOTED: ENGR. CRISANTO W. ROXAS. CITY GOVERNMENT DEPARTMENT HEAD IL DATE | __TMils PRR MAY BE CANCELLED OR REVOKED PURSUANT TO SECTIONS 905 908 OFTHE NATIONAL BUILDING CODE”BOX (TO BE ACCOMPLISHED BY DESIGNING ARCHITECT / CIVIL ENGINEER IN PRINT) cost oF TOTAL ESTIMATED COST EQUIPMENT INSTALLED NUMBER OF STOREYS: BUILDING (obttalad TOTAL FLOOR AREA: tC PROPOSED DATE ee a MECHANICAL. (OF CONSTRUCTION: PLUMBING. a EXPECTED DATE OTHERS PRLS gree SRS ares (OF COMPLETION: ee MATERIAL OR CONSTRUCTION: construction (WOODEN, CONCRETE, STEEL, MIXED) cost P. OX 4 (TO BE ACCOMPLISHED BY THE DIVISION/SECTION CONCERNED) ASSESSED FEES N ‘AMOUNT DUE ASSESSED BY (OR. NUMBER, DATE PAID, LAND USE/ZONING LINE and GRADE: BUILDING. 1 PLUMBING. 1 ELECTRICAL (Dl MECHANICAL OTHERS: REVIEWED: TOTAL CHIEF, PROCESSING DIVISION'SECTION. BOX 5 (TO BE ACCOMPLISHED BY THE DIVISIONISEGTION CONCERNED) PROGRESS FLOW cs iw our ACTION | PROCESSED CHIEF PROCESSING DIVISIONSECTION. TE DATE TNE Dare] Rewarks |'" av RECEIVING AND RECORDING LAND USE and ZONING (GEODETIC (LINE and GRADE) ARCHITECTURAL STRUCTURAL SANITARY, ELECTAICAL MECHANICAL \WE HEREBY AFFIX OUR HANDS SIGNIFYING OUR CONFORMITY TO THE INFORMATION HEREIN ABOVE SETFORTH 20x6 2x8 ARCHITECTICIVILENGINEER | PRCREG. NO. SIGNATURE {NED AND SEALED PLANS & SPECIFICATIONS PRINT NAME APPLICANT ri EDDEEES: RES. CERT. NO. DATE ISSUED PLACE ISSUED PIANO. DATE ISSUED PLACE ISSUED SIGNATURE TaN BOXT WITH MY CONSEN. ARCHITECTICIVIL ENGINEER PRC REG. NO. Fae ae one IN CHARGE OF CONSTRUCTION. es JEP ERLE econ orn PRINT NAME PRINT NAME OF LOT OWNER "ADDRESS ‘ADDRESS PALO. DATEISSUED PLAGE ISSUED RES CERT.NO, | DATE ISSUED PLACE ISSUED (Sane TaN SIGNATURE TAN J