tiew REPUBLIC OF THE PHILIPPINES. QUEZON CITY CIRENEWAL GuSINESS PERMITS & LICENSING DEPARTMENT, BRS APPLICATION FOR BUSINESS PERMIT & LICENSE . i FOR SINGLE PROPRIETORSHIP eeu 2 THE CHIEF, Li BUSINESS PERMITS & LICENSE OFFICE TATE OFFICE OF THE MAYOR amore QUEZON CITY Pursuant to the provisions of Sec. 67 of the 1983 Quezon City Revenue Code and Sec, 108 of MMC Ord, No, 82-03, a8 amended, | have te honor 10 apply fora Business Permit to operate my business and hereby submis the lelioning. eas are ream ie [owen [ew eae can win a cep. pecty sat man Roarromtar —[SYECIN | Sata aay DATE boou Yes Ne ‘Shoe he PLO dacovertins ary fees] ander mopresetatn(s) hapten, Ie are a eae cancetoon othe buses part & fomoe ns asec faite sae ie oa nr cena te ayaa oe pine sce eta et awe he Scene pert nd shal ate Osean Cy ese ewan hse Puna i ara ardor arantatre Eby an emo Sr te he seieston me SECS gate Se ie ey fe nats oa cormerts We ae tse WALT Metyln [8 pe yr po ae {HIS AEPLICATON ANOOR. BPLO FERMITLICENSE DOES NOT EXEMPT APPLICAITPERMITTEE FROM COMPLYING WITHTHE REGURTEMEKTS AND OF [SEOUING. THE PeAMISK CenGES GY OTHER ACENCIESIAUTHONTIES REGURED EY EXISTING LANGORONMNGESHULES AND REGULATIONS AND TERED ONGuRRTARE TO COMPLY THEREGE 11 We hereby certiy thatthe statemenvinformation glven above are true ans correct to my/our knowledgo, IN WITNESS WHEREOF, IWE set my/ourhand this day of. at SIGNATURE OVER PRINTED NAME OF APPLIGANTIS) SUBSCRIBED AND SWORN tobbefore methis___day of at ‘CHIEF OF OFFICE VERIFIED BY BUSINESS PERMIT & LICENSE OFFICE NOTED: ‘ONLINE FORMSUBMITTED BY: VERIFED BY: ERMIT REQUI ‘GRIGINAL GORY OF UARANGAY CLEARANGE (CURRENT) ‘BARANGAY GLEARANGE [|_| Baotocory oF or gecisTRaTion ron SINGLE PROPRIETOR OR ORG PHoroccey OF SEC REGISTRATION "FOR PARTNERSHIF Lo CORPORATION SANITARYREACTH CERT, TOTO COPY OF TILE TOPROPERTY TAX DECLARATION [GF OWNED} OR CONTRAST OF LEASE OF RENTING) PLING PERT ‘PHOTOCOPY OF LESGOR'S DUSNESS PERMIT (F RENTED) Se (earnTaISUNaSS OWNER & FLER) MECHANICAL PERM “OTHER COCUNENTS ARE REQUIRED PER NATURE OF BUSINESS ELECTRICAL INSPECTION POLICE CLEARANCE, NOTE: ORIGINAL COPY TO aE PRESENTED (a ea Be TO aPpLcT-PueAae abu We PHOTOSIAT COPY OF THE FOLLOWING: “P eantuenans ox conrotaron ae creas Sart wd Change Cormson (SEC) Ty Chere ass" Conc 2 ene torinntnt a ee ree eB as Scere a ea ea Ei wracapr oe Geeiatenre mavens Fi Eewemeemmnccore. RSS a Ret cone moran 1 She seat for Busine Perm osan anal on second hae 2. Tie SEpiSatn must ans bye ment rac oy ashanzes etosotsn-e BUT POSES Reta leer se aernteonortmor te inns sh bese ane Cy Tesi’ Oton dy resntas win me eaneonarg Oma Bec 4, FSet eeu ann RNG iy emclayae of he asin Cy Goverment rehbts DO NOT Push Hen ovis segue Pej tne ly ovement en rgmmche aint sree (torent way of ag oar, ‘ONLINE FORMRepublic of the Philippines susnessrenmrsapucnsnccerammmet BRS Quezon cy Metta Mans ee BUSINESS PERMITS CHECKLIST & ROUTING FORM (NEW/AMENDMENT AND RENEWAL) Control No.: (sta TS PORTION LEG TO AVOID ENON PERSONA FERENCE ‘BUSINESS NAME/CORPORATE NAME: BUSINESS PERMIT NO.: NAME OF SOLE PROPRIETOR/ PARTNERSHIP/PRESIDENT: Business Address: — ws DISTRICT: c ‘Authorized Representative : Celiphone N 7 Address: —_ : _ DOCUMENTARY REQUIREMENTS ATTACHED (Please Check ;Appropiiste box): 5 PORE Aaa = i I ral Brangay Geran (Tor Bsns Purposes) Til so of previous Busines Pert, Fok pga Certifies x ‘OpY Regain Ve Sie Popiiocti) TY sin Copy of Barangay Clearance neva auo%e (for Corpor Title o property of Tax Declaration (ifowned) ‘Contract of lease and Lessor’s Business Permit (irerted) _ Authorization otter &1 (representate] rt ~ [owner's 1D, _ ‘Sanitary Permit (SP) TEMARKS: ~ ~ [ETO Certificate [certificate of Electrical inspection [GEIL a Note: Tessor's ausiness Permit i ent) “oniinai Copy presented FeABLicense 4% The Chedkt should be reviewed regulary CES PID RIS {recheck ne sues covered and 19 ensure compliance of requirements. . ss Prepared/Filed by: — Received by: - Form Signature over printed name Dae $ Date oo. VALID CONTACT NO, -_ DOCUMENT TRACKING WORKSTATION | Received [Inia] Recordout | Initial Remarks “time EVALUATE RECORDING ENCODING SORTING FORINITIAL FOR APPROVAL RELEASING "AGKNOWLEDGEMENT/CLAIM SLIP BUSINESS PERMAIT NO. Control No. BUSINESS /OWNERS NAME: RECEIVED DATE: __ REMARKS: Evaluator: For follow up: Pls. Contact 988-0282 lc. 6172, 8173,8285(80SS) Mobile No. 0828-9633072 +Business Permits willbe released upon presentation of this claim slip ot Counter 110 3. ‘ONLINE FORM QCG-BPLD FO1 V.5