Republic of the Philippines

MINISTRY OF PUBLIC WORKS

OFFICE OF THE BUILDING OFFICIALS

APPLICATION NO. PERMIT NO.

DISTRICT/CITY MUNICIPALITY
AREA CODE:08-90
BUILDING PERMIT
1 ORIGINAL 2 RENEWAL
DATE OF APPLICATION DATE ISSUED
BOX 1 (TO BE ACCOMPLISHED BY DESIGNING ARCHITECT/CIVIL ENGINEER IN PRINT)
NAME OF OWNER/APPLICANT LAST NAME, FIRST NAME, M.I. TAX ACCT. NO.

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP MAIN ECONOMIC ACTIVITY/KIND OF BUSINESS

ADDRESS NO., STREET, BARANGAY, CITY/MUNICIPALITY TELEPHONE NO.

LOCATION OF CONSTRUCTION NO., STREET, BARANGAY, CITY/MUNICIPALITY

SCOPE OF WORK 2 ADDITION OF OTHERS (SPECIFY)

3 REPAIR OF 6 ________ OF ________
1 NEW CONSTRUCTION 4 RENOVATION OF 7 ________ OF ________
5 DEMOLITION OF
USE OR TYPE OF OCCUPANCY
RESIDENTIAL INDUSTRIAL
11 SINGLE 31 FACTORY/PLANT
12 DUPLEX 32 REPAIR SHOP, MACHINE SHOP
13 ROWHOUSE/ACCESORIA 33 REFINERY
10 OTHERS (SPECIFY) 34 PRINTING PRESS
35 WAREHOUSE
COMMERCIAL 30 OTHERS (SPECIFY)
21 BANK INSTITUTIONAL
22 STORE
23 HOTEL/MOTEL, ETC. 41 SCHOOL
24 OFFICE CONDOMINIUM/BUSINESS OFFICE BUILDING 42 CHURCH AND OTHER RELIGIOUS STRUCTURES
25 RESTAURANT, ETC. 43 HOSPITAL OR SIMILAR STRUCTURES
26 SHOP (E.G. DRESS SHOP, TAILORING SHOP, BARBER SHOP, ETC.) 44 WELFARE AND CHARITABLE STRUCTURE
27 GASOLINE STATION 45 THEATER, AUDITORIUM, GYMNASUIM, COURT
29 MARKET 40 OTHERS (SPECIFY)
30 DORMITORY OR OTHER LODGING HOUSE
20 OTHERS (SPECIFY) AGRICULTURAL
OTHER CONSTRUCTION 51 BARN(S), POULTRY HOUSE(S), ETC.
60 OTHERS (SPECIFY) 52 GRAIN MILL
STREET FURNITURE, LANDSCAPPING & SIGNBOARDS 50 OTHERS (SPECIFY)
71 PARKS, PLAZAS, MONUMENTS, POOL, PLANT BOXES, ETC.
72 SIDEWALKS, PROMENADES, TERRACE, LAMPOSTS POLES, TELEPHONE POLES, ETC.
73 OUTDOOR ADS, SIGNBOARDS, ETC.
74 FENCE ENCLOSURE
BOX 2 (TO BE ACCOMPLISHED BY RECEIVING AND RECORDING SECTION)
BUILDING DOCUMENTS (FIVE SETS EACH)

SITE DEVELOPMENT PLAN AND LOCATION PLAN MECHANICAL PLANS & SPECIFICATIONS
ARCHITECTURAL PLAN & SPECIFICATION LOGBOOK (1 COPY)
STRUCTURAL PLANS & COMPUTATIONS OTHERS (SPECIFY)
SANITARY/PLUMBING PLANS & SPECIFICATIONS
ELECTRICAL PLANS & SPECIFICATIONS

BOX 3 (TO BE ACCOMPLISHED BY THE BUILDING OFFICIAL)

ACTION TAKEN
PERMIT IS HEREBY GRANTED SUBJECT TO THE FOLLOWING CONDITIONS:
1. THAT THE PROPOSED CONSTRUCTION/ADDITION/REPAIR/RENOVATION/DEMOLITION/
INST, ETC., SHALL BE IN CONFORMITY WITH THE “NATIONAL BUILDING CODE”(P.D. 1098)
AND ITS CORRESPONDING IMPLEMENTING RULES AND REGULATIONS.
2. THAT A DULY LICENSED ARCHITEC/CIVIL ENGINEER HAS BEEN ENGAGED TO PREPARE
PLANS AND SPECIFICATION AND TO UNDERTAKE THE SUPERVISION/INSPECTION OF THE
CONSTRUCTION OF THE PROJECT.
3. THAT A CERTIFICATION OF COMPLETION DULY SIGNED BY ARCHITECT/CIVIL ENGINEER IN- BUILDING OFFICIAL
CHARGE OF CONSTRUCTION AND THE CONTRACTOR IN CASE THE CONSTRUCTION IS UN-
DERTAKEN BY CONTRACT TO BE CONFIRMED BY THE OWNER SHALL BE SUBMITTED NOT
LATER SEVEN (7) DAYS AFTER COMPLETION OF THE CONSTRUCTION OF THE PROJECT. DATE
4. THAT A “CERTIFICATE OF OCCUPANCY” SHALL BE SECURED PRIOR TO ACTUAL OCCUPANCY
OF THE BUILDING

NOTE: THIS PERMIT MAY BE CANCELLED OR REMOVED PURSUANT TO SECTION 305 & 306 OF “NATIONAL BUILDING CODE”
BOX 3A (TO BE ACCOMPLISHED BY DESIGNING ARCHITECT/CIVIL ENGINEER IN PRINT)

TOTAL ESTIMITED COST COST OF EQUIPMENT

NUMBER OF STOREY
INSTALLED
Php TOTAL FLOOR AREA
BUILDING
ELECTRICAL PROPOSED DATE
MECHANICAL OF CONSTRUCTION
PLUMBING
OTHERS EXPECTED DATE
OF COMPLETION
TOTAL MATERIAL OF CONSTRUCTION
CONSTRUCTION (wooden,concrete,steel,mixed)
COST Php

BOX 4 (TO BE ACCOMPLISHED BY THE DIVISION/SECTION CONCERNED)

ASSESSED FEES
AMOUNT DUE ASSESSED BY O.R. NUMBER DATE PAID
LAND USE / ZONING

LINE AND GRADE

BUILDING

PLUMBING

ELECTRICAL

OTHERS
REVIEWED BY:

TOTAL CHIEF, PROCESSING DIVISION/SECTION

BOX 5 (TO BE ACCOMPLISHED BY THE DIVISION/SECTION CONCERNED)
PROCESS FLOW
NOTED: IN OUT ACTION/REMARKS PROCESSED BY
CHIEF, PROCESSING DIVISION/SECTION
RECEIVING AND RECORDING
LAND USE AND ZONING
GEODETIC (LINE AND GRADE)
ARCHITECTURAL
STRUCTURAL
SANITARY
ELECTRICAL
MECHANICAL
WE HEREBY AFFIX OUR HANDS SIGNIFYING OUR CONFORMITY TO THE INFORMATION HEREIN ABOVE SETFORTH

BOX 6 BOX 8
PRC REG NO. SIGNATURE
ARCHITECT/CIVIL ENGINEER
SIGNED AND SEALED PLANS & SPECIFICATION
PRINT NAME

ADDRESS APPLICANT

RES. CERT. NO DATE ISSUED PLACE ISSUED

PTR NO. DATE ISSUED PLACE ISSUED

SIGNATURE TAN

WITH MY CONSENT:
BOX 7 BOX 9 (TO BE ACCOMPLISHED BY LOT OWNER)
PRC REG NO. TCT / OCT NO. TAX DECLARATION NO.
ARCHITECT/CIVIL ENGINEER
IN - CHARGE OF CONSTRUCTION
PRINT NAME PRINT NAME OF LAND OWNER

ADDRESS ADDRESS

PTR NO. DATE ISSUED PLACE ISSUED RES. CERT. NO. DATE ISSUED PLACE ISSUED

SIGNATURE TAN SIGNATURE TAN