Republic of the Philippines
Department of the Interior and Local Government
Bureau of Fire Protection
Regional Office 1
Pangasinan Provincial Office
Calasiao Fire Station
Tesoro St., Poblacion, Calasiao, Pangasinan
075 529 3847 / 0917 185 7611
calasiaof@gmail.com
San Vero alge by October P2022
Wgme of Owngiy Date
enor Hist akg e
TWame oF Establishment)
gay Sun Ine quel Calasiao, Pangasinan
: CITY/MUNICIPAL FIRE MARSHAL
CHIEF, FIRE SAFETY ENFORCEMENT SECTION
REFERENCE: INSPECTION 98 ‘ORDER NO. 2022-CFS- - pateissuen Oe /Y 2022
2022
DATE OF INSPECTION
NATURE OF INSPECT ION CONDUCTED: [ ] Check Appropriate Box
[| Building Under Construction |] Periodic Inspection of Occupancy
{| Application for Occupancy Permit {| Verification inspection of Compliance to NTCV
[ ] Application for Business Permit [1 Verification Inspection of Complaint Received
[ ] Others (Specify)
EDUCATIONAL OCCUPANCY CHECKLIST
|, GENERAL INFORMATION
Name of Bulding Jéoro PY
Business Name
Address Baranga\ Calasiao, Pangasinan
Nature of Business School
Name of OwneriOccupant Cora Tesoro Ci eget Contact No.
Name of Represgntative ‘Contact No.
No ofSterey. 2 “Heghtal Sieg eo Occupied
Area per floor. ‘sqm ‘Total Fir. Area
Building Permit No BaweTssus_____ Occupancy PemmitNo______ Date sued
Latest FSIC Issued Control No Date Issued FC Fee
Certificate of Fire Drill Date Issued. FC Fee.
Latest Notice to Correct Violations Control No. Date Issued
Name of Fire Insurance Co/Co-Insurer, Posy No Date Issued
Latest Mayor's/Bus, Permit Date Issued. Municipal License No. Date Issued
Latest Certificate of Eleaiical spection No Date Issued
Other information
1LBUILDJNG CONSTRUCTION
Boars OE
Exterior Walls 2 Corncor Was Room Partitions 2
Main Stair CO™CTE Windows 9455 al Cate
Main Door_@T# ef Trusses. Ot Ket
Cotumnscarer