Republic of the Philippines

Department of the Interior and Local Government

BUREAU OF FIRE PROTECTION
Regional Office 4A
Laguna Provincial Office
Biñan City Fire Station
Brgy. Poblacion, Biñan City, Laguna
(049) 511-9111 / binanfirestation@yahoo.com

FSCFWE NO. R ____________ _____________

DATE
FIRE SAFETY CLEARANCE
FIREWORKS EXHIBITION
TO WHOM IT MAY CONCERN:

By virtue of the provisions of RA 9514 otherwise known as the “Fire Code of the
Philippines of 2008” and its Revised Implementing Rules and Regulations (RIRR), this
Clearance is hereby issued to ________________________________________________
(Name of Contractor/Exhibitor/Facility)
located at _________________________________________________________________
(Address)
owned by _________________________________________________________________
(Name of Owner)
for the Fireworks Exhibition to be conducted at ____________________________________
from ____________________________ to be supervised by _________________________.
(Indicate the duration of exhibition, time and date)

This Clearance is hereby granted on condition that all the requirements provided for
under Section 10.4.6.14 and Section 10.4.6.15 of the RIRR of RA 9514 was complied by the
owner and his/her designated and authorized operator and personnel before, during and after
fireworks exhibition. A pre-inspection shall be conducted by the BFP prior to the issuance of this
clearance.

Violation of the provisions of RA 9514 shall cause this Clearance NULL AND VOID after
appropriate proceeding and shall hold the owner and his/her installer/contractor liable to the
penalties provided under RA 9514.
This clearance is valid until _____/______/_____.
Date Month Year

Fire Code Fees: RECOMMEND APPROVAL:

Amount Paid:
O.R. Number:
Date:
CHIEF, FSES

APPROVED:

CITY/MUNICIPAL FIRE MARSHAL

NOTE: “This Clearance is accompanied with PERMIT ISSUED BY THE CONCERNED CITY/MUNICIPALITY MAYOR AND
FIREARMS AND EXPLOSIVE OFFICE, PNP and does not take the place of any license required by law and is not
transferable.”
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 (BFP Copy)

BFP-QSF-FSED-040 REV.02 (08.24.20)