OFFICE OF THE PUNONG BARANGAY

PERMIT FOR CONSTRUCTION AND/OR OTHER CIVIL WORKS

This is to certify that the Office of the Punong Barangay interposes no objection to the
grant of permit for construction and/or other civil works to the applicant whose name and other
personal circumstances appearing below:

Name of Applicant : ____________________________

Address : ____________________________

Purpose of Application:

Excavation (___) Electrical Works (___)

Pipe Laying/Water System (___) Drainage/Sewerage (___)
Others (Please specify) _________________

Applicant agrees to observe and fully comply with the following conditions:

 Structure to be constructed shall not encroach on sidewalks, streets, avenues, waterways

or any government property.
 Provisions of the National Building Code shall be executed.
 Full restoration of excavated street, sidewalks, drainage system, etc.
 Installation of proper safety and precautionary signs.
 Non-storage of harmful chemicals or substances that may cause health hazard or result to
environmental dangers.
 Vehicle parking shall be provided but shall not exceed property limits.
 Others: _______________________

Non-compliance of any or all of the foregoing conditions shall result to the revocation of this
Barangay Clearance without prejudice to the filing of legal action of the applicant.