NBC FORM NO.

B - 03

Republic of the Philippines

Department of Public Works & Highways
Pamahalaang Lungsod ng Heneral Santos
TANGGAPAN NG PINUNONG PANGGUSALI
(Office of the Building Official)

FENCING PERMIT
APPLICATION NO. FP NO BUILDING PERMIT NO.

BOX 1 (TO BE ACCOMPLISHED BY THE OWNER/APPLICANT)

OWNER/APPLICANT LAST NAME FIRST NAME M.I. TIN

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP

BY AN ENTERPRISE
ADDRESS: NO., STREET, BARANGAY, CITY/MUNICIPALITY ZIP CODE TELEPHONE NO

LOCATION OF CONSTRUCTION: LOT NO. _______________ BLK NO. ________________ TCT NO. ______________________ TAX DEC. NO.___________________

STREET___________________ BARANGAY ____________________________________________________ CITY/ MUNICIPALITY OF ______________________________

SCOPE OF WORK
NEW CONSTRUCTION REPAIR _________________________________ OTHERS (Specify) ______________________________
ERECTION DEMOLITION ____________________________
ADDITION

BOX 2 BOX 3
DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS FULL-TIME INSPECTOR AND SUPERVISOR OF CONSTRUCTION WORKS

Date___________ Date___________
ARCHITECT OR CIVIL ENGINEER ARCHITECT OR CIVIL ENGINEER
(Signed and Sealed Over Printed Name) (Signed and Sealed Over Printed Name)
Address Address
PRC. No Validity PRC. No Validity
PTR. No Date Issued PTR. No Date Issued
Issued at TIN Issued at TIN

BOX 4 BOX 5
BUILDING OWNER WITH MY CONSENT: LOT OWNER

(Signature Over Printed Name) (Signature Over Printed Name)

Date_______________ Date_______________
Address Address
C.T.C. No. Date Issued Place Issued C.T.C. No. Date Issued Place Issued

BOX 6

APPLICANT
(Signature Over Printed Name)

C.T.C. No. DATE ISSUED PLACE ISSUED

TIN