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Electrical Permit (FRONT)

This document is an application for an electrical permit from the City of Dasmariñas, Province of Cavite. It contains boxes to be filled out providing details of the owner/applicant, location of construction, scope of work, electrical loads and capacities, design professional, supervisor of electrical works, and signatures of the building owner and lot owner consenting to the work. Upon approval, it will be issued an electrical permit number.

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Mark Anthony Follero
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1K views1 page

Electrical Permit (FRONT)

This document is an application for an electrical permit from the City of Dasmariñas, Province of Cavite. It contains boxes to be filled out providing details of the owner/applicant, location of construction, scope of work, electrical loads and capacities, design professional, supervisor of electrical works, and signatures of the building owner and lot owner consenting to the work. Upon approval, it will be issued an electrical permit number.

Uploaded by

Mark Anthony Follero
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

NBC FORM NO.

A - 03

Republic of the Philippines


City of Dasmariñas
Province of Cavite

OFFICE OF THE BUILDING OFFICIAL

ELECTRICAL PERMIT
APPLICATION NO. EP NO BUILDING PERMIT NO.

BOX 1 (TO BE ACCOMPLISHED IN PRINT 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 ZIP CODE TELEPHONE NO

LOCATION OF CONSTRUCTION: LOT NO. _______________ BLK NO. ________________ TCT NO. ______________________ TAX DEC. NO.
____________________STREET___________________ BARANGAY _____________________________ CITY OF DASMARIÑAS

SCOPE OF WORK
NEW INSTALLATION RECONNECTION OF SERVICE TRANCE RELOCATION OF SERVICE ENTRANCE
ANNUAL INSPECTION SEPARATION OF SERVICE ENTRANCE OTHERS (Specify)___________________________________
TEMPORARY UPGRADING OF SERVICE ENTRANCE __________________________________________

SUMMARY OF ELECTRICAL LOADS/CAPACITIES APPLIED FOR

TOTAL CONNECTED LOAD TOTAL TRANSFORMER CAPACITY TOTAL GENERATOR/UPS CAPACITY

___________________ kVA _____________________ kVA ____________________ kVA

BOX 2 (TO BE ACCOMPLISHED IN PRINT BY THE DESIGN PROFESSIONAL)


DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS

Address
PRC. No Validity
Date____________
PROFESSIONAL ELECTRICAL ENGINEER PTR. No Date Issued
(Signed and Sealed Over Printed Name)
Issued at TIN

BOX 3
SUPERVISOR / IN-CHARGE OF ELECTRICAL WORKS

PROFESSIONAL ELECTRICAL ENGINEER REGISTERED ELECTRICAL ENGINEER REGISTERED MASTER ELECTRICIAN

Date______________
(Signed and Sealed Over Printed Name)

PRC. No Validity
PTR. No Date Issued
Issued at TIN
Address

BOX 4 BOX 5
BUILDING OWNER WITH MY CONSENT: LOT OWNER

Date_____________ Date____________
(Signature Over Printed Name) (Signature Over Printed Name)

Address Address
C.T.C. No. Date Issued Place Issued C.T.C. No. Date Issued Place Issued

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