Republic of the Philippines

Department of the Interior and Local Government

Bureau of Fire Protection
(Region)
(District/Province Office)
(Station)
(Station Address)
(Telephone No./Email Address)

Number: R-
Date

(Name of Owner)

(Name of Establishment)

(Address)

NOTICE OF DISAPPROVAL
FIRE SAFETY INSPECTION CERTIFICATE FOR OCCUPANCY

Dear Sir/Madam;

This is in connection with your application for Fire Safety Inspection Certificate for
Occupancy for the ______________________________________________________________
(Name of Establishment)
located at ____________________________________________________________________.
(Address)
Please be informed that said application is disapproved in view of the following deficiencies;

A. _____________________________________________________________________
B. _____________________________________________________________________
C. _____________________________________________________________________
D. _____________________________________________________________________
E. _____________________________________________________________________

In this regard, you are hereby required to make the necessary correction of the
aforementioned deficiencies prior to the re-application to this office.

Your preferential attention hereto will be highly appreciated.

Very truly yours,

____________________________
City/Municipal Fire Marshal

PAALALA: “MAHIGPIT NA IPINAGBABAWAL NG PAMUNUAN NG BUREAU OF FIRE PROTECTION SA MGA KAWANI NITO ANG
MAGBENTA O MAGREKOMENDA NG ANUMANG BRAND NG FIRE EXTINGUISHER”

“FIRE SAFETY IS OUR MAIN CONCERN”

DISTRIBUTION:
Original (Applicant/Owner’s Copy)
Duplicate (BO or BPLO, as the case may be)
Triplicate (BFP Copy)

BFP-QSF-FSED-007 Rev. 01 (07.05.19)