NBC FORM NO.

E - 01
Republic of the Philippines
City/Municipality of ________________
Province of _________________________

OFFICE OF THE BUILDING OFFICIAL

Meter/Account No._______________________ Reference No.____________________

NOTICE OF UNSAFE ELECTRICAL INSTALLATION

USE OR CHARACTER OF OCCUPANCY___________________________________________ Date of Inspection_________________________
OWNER OF BUILDING_________________________________________________ OCCUPANT________________________________________________

This is to certify that in accordance with the provisions of the “National Building Code of the Philippines” (PD 1096) and the
Philippine Electrical Codes (PEC 1 & 2), an inspection has been made of the electrical installation, with load/capacities specified
herein, installed in your building and/or premises located at:

No. Street Barangay City/Municipality

SUMMARY OF ELECTRICAL LOADS/CAPACITIES

TOTAL CONNECTED LOAD: TOTAL TRANSFORMER CAPACITY: TOTALGENERATOR/UPS CAPACITY:

____________________kVA ____________________kVA ____________________kVA

LIST OF DEFECT(S) (Attach extra sheets if necessary)

You are hereby notified that the electrical installation was found unsafe. The electrical defects must be properly corrected
under the supervision of a duly licensed and qualified electrical practitioner in accordance with the Philippine Electrical Codes and
under an electrical permit issued by this Office within ten (10) days from receipt of this notice. Failure to do so shall cause this
Office to recommend for the disconnection of your service mains and to initiate legal actions against you.
INSPECTED BY:

ELECTRICAL INSPECTOR
(Signature Over Printed Name)
Date_____________________

__________________ ___________________
PRC REG. NO. VALIDITY
NOTED BY:

CHIEF, ELECTRICAL SECTION

(Signature Over Printed Name)
Date_____________________
__________________ ___________________
PRC REG. NO. VALIDITY
RECOMMENDING ISSUANCE OF NUEI:

CHIEF, INSPECTION AND ENFORCEMENT DIVISION

(Signature Over Printed Name)
Date_____________________
ISSUED BY:

RECEIVED BY:
BUILDING OFFICIAL
(Signature over printed name)
Date_____________________
OWNER / REPRESENTATIVE
(Signature Over Printed Name)
Date_____________________

INSPECTION FEE: P ______________________ O.R. NO. _____________________________ DATE: ___________________________