REPUBLIC OF THE PHILIPPINES

PROVINCE OF BATANGAS
MUNICIPALITY OF SAN LUIS
OFFICE OF THE BUILDING OFFICIAL
AREA CODE_____________

CERTIFICATE OF COMPLETION
ELECTRICAL WORKS

This is to certify that the electrical installations/works of the building covered by the Building
Permit No. _________________ issued on _________________ has been completed in accordance has
been approved plans and specifications on file with the Office of the Building Official and the National
Building Code ( P.D. 1096). That the said installations/works is ready for final inspection.

NAME OF OWNER: ____________________________________________________________________

LAST NAME GIVEN NAME MIDDLE INITIAL

ADDRESS OF OWNER: _________________________________________________________________

LOCATION OF CONSTRUCTION: ________________________________________________________
USE OR TYPE OF OCCUPANCY: ________________________________________________________
DATE OF START OF CONSTRUCTION: ___________________________________________________
DATE OF COMPLETION: _______________________________________________________________

TOTAL NUMBER OF OUTLETS AND EQUIPMENT INSTALLED

LIGHTS______________ SWIITCHES____________ CONVINIENCE OUTLETS ______________
BELL SYSTEM ______ ELECTRICAL RANGE:______ KW ____ WATER HEATER______ KW_____
AIR CONDITIONING SYSTEM_____ HP______ TELEPHONE: _____ MOTORS_______ HP_______
OTHERS (specify) ______________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

In-charge of construction If construction is undertaken by contract

_______________________________________
ELECTRICAL ENGINEER
P.R.C. Reg. No. ________ Date _____________
TIN ______ Res. Cert. _______ Date: _______
Address: ________________________________
___________________________________
CONTRACTOR
P.R.C. Reg. No. _______ Class__________
TIN ______ Res. Cert. ______ Date:_____
Address: ____________________________

Conforme

_________________________________
OWNER/APPLICANT