WORK PERMIT

CONTROL NUMBER:________________________
DATE FILED: 05/04/22
CONTACT DETAILS: 09958568151

TO: SM ADMINISTRATION OFFICE

FROM: PRESTIGE INTERACTIVE Ent. OPC

INSTRUCTION: Please check the box that applies and fill out all the details. Please attach all required documents for thisWork Permit to be processed.

TYPE OF WORK:

 Construction  Renovation  Operations

SCOPE:

 Maintenance  Repair  Installation  Waterproofing  Welding/Hot Works

 Carpentry  Exhaust/Fresh Air  Electrical  Plumbing  Spray Painting
 Masonry  Aircon  Gas Line  Draining and Refilling  Sanding
 Ingress  Egress  Delivery  Pullout

55” Cyberzone Digital Signage rectification and cleaning

Remarks:
-requesting: Service elevator, Lights, Power
Indicate reason if the request
is emergency or urgent

NOTES: • For welding or hot works, please answer the Hot Work Permit Checklist.
• Attach another sheet for the list of items/tools/equipment.

VALIDITY From To NAME OF CONTRACTOR: PIE-OPC/ RMM

Date 05/04/22 05/07/22 NAMES OF PERSONNEL: (attach another sheet for additional names)
Time 09:00 PM 09:00 AM 1. LUIS MARCO DELA TORRE 5.
2. ADELIO ENRIQUEZ, JR. 6. Additional personnel
LOCATION SMMK: Mall Area /Cyberzone 3. JUNRYL VILLORIA 7. 2nd page
4. SHERWIN BALUT 8.

REQUESTED BY: TENANT’S OR CONTRACTOR’S AUTHORIZED SIGNATORY

DYAN FAE PADILLA - CSR / TECH. ADMIN

Signature over printed name and designation

CONCURRED BY: APPROVED BY:

CRS EDD MALL OPERATIONS

FOR THE APPROVERS: Indicate the Personnel Posting needed.

 Guard:  Janitor:  EMB:

From: From: From:

To: To: To:

RMM Trading
MANPOWER

Ronald Marticio
Ronald Eclarinal
Kobe Bermas
Jovin Espinolo
Ryan M. Apin
Jimmy Anyasco
Cj Lana

TOOLS
Allen key 1 set
Open wrench 1 set
Vise grip 1 pc
Drill box 1 set
Screw box 1 set
Screwdriver positive 2 pcs
Screwdriver negative 2pcs
Hand drill 1 pc
Grinder 1 pc
Vacuum 1pc
Tap handle 1 pcs
Tapping box 1 pcs
Residue tape remover 1