NBC FORM NO.

B - 01
Republic of the Philippines
City of Dasmariñas
Province of Cavite

UNIFIED APPLICATION FORM FOR BUILDING PERMIT

SIMPLE COMPLEX
NEW RENEWAL AMENDATORY
LOCATIONAL CLEARANCE FIRE SAFETY EVALUATION CLEARANCE
APPLICATION NO. AREA NO

BOX 1 (TO BE ACCOMPLISHED IN PRINT BY THE APPLICANT)

DO NOT FILL-UP (NSO USE ONLY)
OWNER/APPLICANT LAST NAME FIRST NAME M.I. TIN

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP

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 DASMARINAS, CAVITE
SCOPE OF WORK
NEW CONSTRUCTION ________________ RENOVATION ____________________________ RAISING ____________________________________________________
ERECTION _________________________ CONVERSION ___________________________ ACCESSORY BUILDING/STRUCTURE____________________________
ADDITION __________________________ REPAIR ________________________________ LEGALIZATION OF EXISTING BUILDING __________________________
ALTERATION _______________________ MOVING _______________________________ OTHERS (Specify) _____________________________________________
USE OR CHARACTER OF OCCUPANCY
GROUP A : RESIDENTIAL, DWELLINGS GROUP E : COMMERCIAL GROUP H : ASSEMBLY OCCUPANT LOAD LESS THAN 1000
SINGLE DUPLEX RESIDENTIAL, R-1, R-2 BANK STORE SHOPPING CENTER/MALL THEATER, AUDITORIUM, CONVENTION HALL
OTHERS _________________________________ DRINKING / DINING ESTABLISHMENT GRANDSTAND / BLEACHER
GROUP B : RESIDENTIAL
HOTEL SHOP (i.e. DRESS SHOP, TAILORING, OTHERS __________________________________
DORMITORY BARBER SHOP, etc. GROUP I : ASSEMBLY OCCUPANT LOAD 1000 OR MORE
RESIDENTIAL R-3, R-4, R-5 OTHERS _______________________ COLISEUM, SPORTS & COMPLEX, CONVENTION
OTHERS _________________________________ GROUP F : LIGHT INDUSTRIAL CENTER AND SIMILAR STRUCTURE
GROUP C : EDUCATIONAL, RECREATIONAL FACTORY / PLANT (USING INCOMBUSTIBL OTHERS __________________________________
SCHOOL BUILDING NON – EXPLOSIVE MATERILAS) GROUP J : (J-1) AGRICULTURAL,
CIVIC CENTER OTHERS _______________________ BARN, GRANARY, POULTRY HOUSE, PIGGERY,
CLUBHOUSE GROUP G : MEDIUM INDUSTRIAL GRAIN MILL, GRAIN SILO
OTHERS __________________________________ STORAGE / WAREHOUSE (FOR HAZARDOUS/ OTHERS __________________________________
GROUP D : INSTITUTIONAL HIGHLY FLAMMABLE MATERIALS) GROUP J : (J-2) ACCESSORIES
HOSPITAL OR SIMILAR STRUCTURE FACTORY (FOR HAZARDOUS HIGHLY PRIVATE CARPORT, GARAGE, TOWER, SWIMMING
HOME FOR THE AGED FLAMMABLE MATERIALS) POOL, FENCE OVER 1.80M. STEEL /CONCRETE TANK
GOVERNMENT OFFICE
OTHERS __________________________________ OTHERS ________________________ OTHERS _________________________________

OCCUPANCY CLASSIFIED _________________________________________ TOTAL ESTIMATED COST P __________________________________

NUMBER OF UNITS_______________________________________________
NUMBER OF STOREY ____________________________________________
TOTAL FLOOR AREA ______________________________ SQUARE METERS
LOT AREA _______________________________________ SQUARE METERS
PROPOSED DATE OF CONSTRUCTION ______________________________
BOX 2
FULL-TIME INSPECTOR AND SUPERVISOR OF CONSTRUCTION WORKS (REPRESENTING THE OWNER)
Address
BUILDING ___________________________ COST EQUIPMENT INSTALLED
ELECTRICAL ________________________ P _______________________
MECHANICAL _______________________ P _______________________
ELECTRONICS ______________________ P _______________________
PLUMBING _________________________ P _______________________
EXPECTED DATE OF COMPLETION________________________________

PRC No. Validity

ARCHITECT OR CIVIL ENGINEER PTR No. Date Issued
(Signed and Sealed Over Printed Name)
Date_____________________________ Issued at TIN
BOX 3 BOX 4
APPLICANT: WITH MY CONSENT: LOT OWNER

Date______________ Date______________
(Signature Over Printed Name) (Signature Over Printed Name)
Address Address

CTC No Date Issued Place Issued CTC No Date Issued Place Issued
BOX 5
REPUBLIC OF THE PHILIPPINES )
S.S
CITY/MUNICIPALITY OF ___________________________________________)
BEFORE ME, at the City/Municipality of _____________________________________________________ , on _________________________ personally appeared
the following:
______________________________________________________ _______________ ______________ ___________________________________________
APPLICANT C.T.C. No. Date Issued Place Issued

______________________________________________________ _______________ ______________ ___________________________________________

LICENSED ARCHITECT OR CIVIL ENGINEER C.T.C. No. Date Issued Place Issued
(Full-Time Inspector and Supervisor of Construction Works)
whose signatures appear hereinabove, known to me to be the same persons who executed this standard prescribed form and acknowledged to me that the same is their free and
voluntary act and deed.
WITNESS MY HAND AND SEAL on the date and place above written.
Doc. No. ________
Page No. ________ ________________________________________________________
Book No. ________ NOTARY PUBLIC (Until December _____________ )
Series of _________________