NBC FORM NO.

B - 02

Republic of the Philippines

City/Municipality of CABADBARAN
Province of AGUSAN DEL NORTE
OFFICE OF THE BUILDING OFFICIAL

EXCAVATION AND GROUND PREPARATION PERMIT

APPLICATION NO. EGPP 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 USE OR CHARACTER OF OCCUPANCY

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

LOCATION OF CONSTRUCTION: LOT NO. __________ BLK NO. ____________TCT NO. _______________ TAX DEC. NO. _____________
STREET__________________ BARANGAY __________________________________ CITY/ MUNICIPALITY ____________________________

SCOPE OF WORK
NEW CONSTRUCTION RENOVATION OTHERS (Specify)

ERECTION REPAIR
ADDITION
USE OR CHARACTER OF OCCUPANCY
GROUP F : INDUSTRIAL OTHERS (Specify) ___________________
GROUP A : RESIDENTIAL, DWELLINGS
GROUP G : INDUSTRIAL STORAGE AND HAZARDOUS
GROUP B : RESIDENTIAL HOTEL, APARTMENT
GROUP H : RECREATIONAL, ASSEMBLY OCCUPANT LOAD LESS THAN 1000
GROUP C : EDUCATIONAL, RECREATIONAL
GROUP I : RECREATIONAL, ASSEMBLY OCCUPANT LOAD 1000 OR MORE
GROUP D : INSTITUTIONAL
GROUP J : AGRICULTURAL, ACCESSORY
GROUP E : BUSINESS AND MERCANTILE

BOX 2 BOX 3

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

ARCHITECT OR CIVIL ENGINEER ARCHITECT OR CIVIL ENGINEER

(Signed and Sealed Over Printed Name) (Signed and Sealed Over Printed Name)
Date______________________ Date_____________________
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