aaa res) a PROVECT OMNER PROUECT TLE Wit ATTIC PROJECT LOCATION 2 SUITE ANO SPY SEA AVENUE. BRGY. CANGIT PANTOR. MANLA CTY OWNER ADRESS LOCK 3 LOT 4 ORIGINAL STREET, EXTRA HOT HOMES, MARIKINA CITY TAME OF CONTRACTOR? Seve CONTRACTOR Lucky M. NOODLES AUTHORED REPRESENTATIVE [CALLAN MANSY TOTAL FLOORAREAE): 1314 ‘CONTACT NUMBER 154079651 JM THREE (2) COMPLETE SETS OF THE FOLLOWING (PROPOSED PLAN). eee Se aaa | eerie ELECTRONICS DOCUMENTS ‘SANITARY DOCUMENTS 1 MECHANSCAL DOCUMENTS FIRE PROTECTION DOCUMENTS. 11) Gre) SET OF PRE SAFETY COMPLANCE REFORT (FDEI (NECESSARY? 1 ONE (1) SET OF COST ESTIMATES OF THE BUILDING INCLUDING LABOR COST SIGNED AND SEALED BY THE CRO FCA FCCA [ oare cen | oaresesnsss| im for] mw or] ~ | om x | our Tsp 2 aoped 7 esrta 7 siPtaly saw sou TOPPA S seals WEEMS TIAA ovata s Onatali2e SPIRE SAFETY tS OUR MAIN CONCERN™ Sr aa aero) &) pon ee, re ee [BFP G8r FRED O01 REV-2 (682420), Annex A: Fire ufety Evaluation Clearance Application Form ere a a Nas eanENS aa aaa ny Seer ton) [NAME OF OWNER TANGGOL C_ DIMAGUIBA ‘BULDINGIFAGIL IT Y/STRUCTURESSUSINESST ESTABLISHMENT NAME, KABAVUHAN NI ADONIS EXACT ADDRESS THNOAHAN NG BAYAN. BRGY. LUMANG FAG-ASA QUEZON CITY "AUTHORIZED REPRESENTATIVE DAVID C_DIMAGUIBA TYPE OF OCCUPANCY! BUSINESS NATURE [ASSEMBLY TOTAL FLOOR AREA(M) 4030 (NO OF STOREY. ‘CONTACT NUMBER (03514201969 EMAIL ADORESS._voownuangoun oe PNET eee, eee {) Cernnicate oF COMPLETION [1 Cenriica TRUE COPY OF ASSESSMENT FEE FOR SECURING CERTINCATE OF OCCUPANCY FROM C80 1 Semucr mum ie necesonny) [A_ONe (1) SET OF FIRE GAFETY COMPLIANCE AND COMMISSIONING REPORT (FSCOR) (HF NECESSARY) 'FSIC FOR BUSINESS PERMIT FOR NEW BUSINESS TJrOn RENEWAL OF BUSINESS IRSaESSMENT oF Bons PERMIT FEE'TAX ‘ASSESSMENT BLL PROM BLO M4 NQSesoent BL. racM PCO ll COPY OF FIRE INSURANCE (F NECESSARY) |) APROAVT OF UNGENTAKING THAT THERE WAS NO Ske ifeerorrne saver unwcrowce Reson Saeeeenon SSHMENT a Fine Abery CLEARANCE FOR WELDING, CUTTING. : ‘AND OTHER HOT WORK OPERATIONS (3 REQUIRED) | COPYOPFIRE NEURANCE (F NECESSARY) Theeby cary fe cameras Sha Be Compass T Be wiached aS oles S DAVID C- DIMAGUIBA May 18, 2023 BUREAU OF FIRE PROTECTION Samat ee es ees toed CLAIM STUB a oS tire Caan 05/18/2023 Seanccaores Annex B: Fire Safety Inspection Certificate Application Form (For New Business) OTe VEEUS aa aa oan) one [ore ene aay on) eee eieeeediilieiaeed “ATE Al NAME OF OWNER JEONGYEON M. YOO BURLDINGFAGLITVISTRUCTORESUSINESST ESTABLISHMENT NAME JANNYEONG GOODS. EXACT ADORESS ARG HANTO STREET, QSGARTSANE GIROITINDN GAWEATA TRIE TAOI ‘AUTHORIZED REPRESENTATIVE JEONGYEON M. YOO. TYPE OF OCCUPANCY! BUSINESS NATURE [ASSEMBLY TOTAL FLOOR AREA (NM) S42 WO OF STOREY. 7 EMAIL ADDRESS: 17_PECE@YANOO COM CONTACT NUMBER _-05215485154 CNEL Oa aS CoN aaa arr) Cee ieee) Fs co Se [a ee CLAIM STUB cernmepey 5) Foo EMD Bu Ta RT OO (NOTE: AUTHORIZED REPRESENTATIVE MUST PRESENT AN AUTHORIZATION LETTER AND COPY OF OWNERS IDENTIFICATION CARD cee eee ation Form (For Renewal of Business) Annex C: Fire Safety Inspection Certificate App reidRepublic of the Philippines Department of the Interior and Local Government Bureau of Fire Protection (Region) (Oistnct/Province Office) (Station) (Station Address) (Telephone No /Email Address) August 04, 2023 DATE ‘SFO4 Michael JAckson__ SFO4 William Bradley S. Pitt ‘SFO1 Min Seun B. Custodio _SFO1 Kelby Allen P. Cajigas _| Christian R. Femalino #13 Sct. Chustoco Street, Barangay Roxas, Quezon Cty To conga Pre Sat repecton DUUaTB Be Reved OSTEND Russ Bd Repuatns (UR the Repucte Act $514 (RA 8514) Two (2) Hours. Be in full uniform, coordinate with the owner/occupant, and accomplish the prescribed inspection report soon CINSP JOHN EDUARD J CULLEN CSUPT SAN-MATEO T RIZAL Thief, Fire Satety Enforcement Section CITY / MUNICIPAL FIRE MARSHAL ACKNOWLEDGEMENT ‘This & to acknowledge that permission was granted to the above-named Fire Safety Inspectoris accompanied by authonzed representative to conduct Fire Safety inspection within the premises in accordance with law. A fey KING ARTHUR T. PENDRAGON February 15, 2023 | 10:36 AM ‘Signature over Printed Name/Authorized Representative DateTime PAALALA: “MAMIGPTT NA PLAGBABAWAL NG PAMUNUAH NG BUREAU OF FIRE PROTECTION 84 MGA KAW AMI NETO ‘ANG MAGBENTA O MAGREKOMENDS NG ANUMANG BRAND NG FIRE EXTINCUIGMER™ “FIRE SAFETY IS OUR MAIN CONCERN” = BFP-GSF-FSED 005 Rev 01 (07 05-13) nex D: Inspection OrderFIRE SAFETY INSPECTION CHECKLIST Inspection Onder No. (10) 61620230038 Date issued 08/08/2023 Date inspected 2023 Ml NATURE OF INSPECTION CONDUCTED (Check appropriate box) [ ]inspection during constuction [1 FSIC for Certificate of Annual inspecton (PEZA) [U1 FSIC tor Certificate for Occupancy [1 FSIC tor Business Permit (NewRenewal) { ] Venteaton inspecton tor Compliance: CINTCS [ [NTCV/[ | Abatement [| Closure 6. Otners (Speaity) pawns Mm REQUIREMENTS 1. [V1 FSIC for Occupancy: 1+ Fire Safety Compliance and Commissioning Report (FSCCR) vest 1/ Not] (if appicable) 2. [J FSIC for New! Renewal / Annus! Inspection / Otvers: (+ Fire Safety Maimenance Report (FSMR) (f applicable) vest} / NOt] IV. GENERAL INFORMATION Name of Buling: RABY RABU HOTEL aaa Shibuva Street Barangay Antokvo, Quezon City —, RABU RABU HOTEL Nature of Business Hotel Name of ownerRepresentative -_Tekeru N. Satoh ‘Contact No 105093339514 [VAFSIC fer Occupancy: + FSEC No. 1 Date issued 4 Boing Remit ate tases 1 FSIC for New / Renewal / Annual inspecton / Others: + FSIC No. (Latest) Date issued + Certfoate of Fire Dei 1 Date issued + Business Pert No | Date issued «+ Fire insurance Poy No. 1 Date tase (ay) [BFP-CSF-FSED-061 Rev. 90 (06.17.22) Page 1 of 10Republic of the Philippines Department of the Interior and Local Government BUREAU OF FIRE PROTECTION (FIRE STATION LETTER HEAD) (CONSTRUCTION TYPE [v1 Type |: Concrete & Stee! (Fire Resistive) [1 Type ll: Concrete & Exposed Stee! (Noncombustible) [1 Type tt: Concrete & Wood (Oxinary) [1 Tye lV: Heavy Timber (Lame mass wood) [1 Type Vv: Wood frame (Lightweight wood) WALLS / CEILING INTERIOR FINISH [v1 Cass A: Flame spread index, 0-25,smoke developed index, 450 [ 10ass 8: Flame spread index. 20-75; smoke developed index, 0-450 [ 1Ciass C: Flame spread index, 76-200, smoke developed index. 0460 (ore ame Spread maex can Ge seen in he technica! speccaton of the proauc’ FLOOR INTERIOR FINISH [1 Cass |: Crtical radiant fux, not less than 0.45 Wice2. [1 Gass i: Critical radiant Sux, not more than 0.22 Wien2, but less than 045Wicm2 (ote: Fame Spread index can be seen in me tecnnical spectcaton of the proauct} SECTIONAL OCCUPANCY (INDICATE SPECIFIC USAGE OF EACH FLOOR, PART OR PORTION OF THE BUILDING) Basement : 1a a (Ground floor,_Counter, information Desk Offices ‘Second fioor_Function Rooms “Third floor ;_ Typical 15 Living Rooms with Toilet Fouts Fioar._Tvpica! 15 Livine Rooms with Toilet a Typical 25 Living Rooms with Toilet Use separate sheet necessary (GENERAL OCCUPANCY CLASSIFICATION [ 1 Assembly /{ ] Educatonal /{ | Day Care /{ ]Heaith Care [1 Detention and Correctional / [Vv] Residential /[ ] Residential Board and Care [ 1 Mercansie/{ ] Business /{ ] Industrial /[ ] Storage /[ ] Special Structure. OTHER INFORMATION ‘Maximum Occupant Load: _50_P Floor Number of Stones: S Storey Buileng Height 15m Highrise: [/] Yes/ { 1No (BFP-QSF-FSED-061 Rev. 90 (06.17.22) Page 2 of 10 iNet(FIRE STATION LETTER HEAD) xm Access [/1 Doors [1 Comdors //] Hallways /[ ]Passageways /{ ]Anterooms/{ | Ramps Horzontal components Actual. «= Passed = Failed Remarks / Correctve Action mensions Doors a 0 Comidors | Hatenys En Loa] t2 Passageways NA m (1 ra] Lobby / Anteraom NA m 01 tt Ramps NIA _ 90, cl ta Common pathofravel 8 om vd tl Dead ena zm 61 uu Travel distance 2m Ww rs Rctaat sual | passed | Failed “Tiny door leat in a means of egress shail leave not less than one-half ‘of the required width of an aisle, a comdor. a passageway. or | 0.8m Ll 1 Sancing unabsmusted. —— ‘Ary 6oor leat in a means of egress shail Rot project more than TED rm into the required width of an aisle. a comidor. 2 passageway. or a wi] gy (Snoing. unless the door leat is equipped with an approved sel dosing device. ‘Réleast two (2) means OF egress for each room wih Gscupantioad= | ia | ‘50 or with hazara content. 2 ‘Each guest door used as means of egress shall atleast 20 minutes a fre resistant 20min — ‘Doors that open Greatly GAS @mt SOGEEE GOMGOTS Shall Be Sei GounG and si ia” | Es latching. | "There snail no openings in comder parsbons Gther than Goer Openinee Was Free From any obstucton. a [m No fammable matenal sored ™ [ou 5 exrs Le]Normai Stairs/ [|] Curved Stairs / [| Spiral Stairs / [1 Winding Stairs [ |Horzontal Exits/ [/] Ouiside Stars / Ext Passageways / Fire Escape Stars [Fire Escape Ladder (for 1 & 2 family welling only) [1 Slide Escape (for Industral Occupancy Only) BFP-QSF-FSED-061 Rev. 00 (06.17.22) Page 3 of 10 errWanaing Stars NWAim tt) 01 ‘Horzontal Exits: NA om tl ti Cutaide Sti Be ag ——— emtPassageways NWA m oy 1 Fre cscape Stas lim ly Fire Escape Ladders N/A m 1 1 ‘Side Escape NA m 1 ey Retaat memset | passed | Failed ‘Aileast two (2) means of egress for each floor _ mit ‘Doors assembly. 60 minutes fre resistant for vee GD communcating level anc below soning | a | td ‘Doors aasembly. 60 minutes fre reson for four 4) commanieaine level and above NA tr [oor ‘Exits Doors provided wih Re-enuy meavaniam a every four (2) me | ae sorey tre-entry 1 ‘Siawr treadl Minimum depth = 280 mn we | a ‘Stairriser Minimum’ Maximum height = 100 mm 160 mm som) | 02 ‘Mieimum stair head room: 200mm 5 mo Se St renee ee ore 2Senm tm] Maximum handrails projections: 114 mm = | ‘Star landing shal not be less than the required wath of ent door ie: ia | ‘Ents doors open and dose paoety “a | ‘Doors swing in rection of egress mp ‘Ent Doors prowded wih pane aware, won pane! and se¥-omng mechanism. mo “There shall be ro endoaed uaabe apace Under the SIGH an eit enIOnUTe nor “shall the open space under such stars be used for any purpose mM] intecor Recah Clase to (BFP-QSF-FSED-061 Rev. 00 [06.17 22) Page 4.0f 10 rrrRepublic of the Philippines BUREAU OF FIRE PROTECTION (FIRE STATION LETTER HEAD) Remoteness of exit Gecharge not less than 1/9 of length of the ‘overall mension of the building Or area to be served s the BIO. ta] ota | protected throughout by ASASS. 40m, ‘Extenor grounds are hept clear of GbjeGs that might impede evacuaven OF frefightng equement vt Es “Termanate Grectly at 2 PUBIC Way OF at an exterior et Gacharge mm | Vi_ SIGNS, LIGHTING, AND EXITS SIGNAGE A MARKING OF MEANS OF EGRESS (EXIT) Minimum letter height, 150 mm: Wichh of Stroke. 19mm 170mm, wy] oa EXIT signs are posted along Exit access, Exits and Exit discharge "a tl EXIT signs are property iluminated ~ ta 1B. MARKING OF MEANS OF EGRESS (EMERGENCY EVACUATION PLAN) Posted on strategic and consp-cuous location inside the building m ti ‘Drawn with o photo luminescent background t be readable in case Of power wi TT tastore Containing the following basic information below 1. "You Are Here! room number! building” Marking 2 Fire Eats 3. Primary Route to Exit (Nearest to the viewer) | Secondary Route to Exit (Second nearest to the viewer) ‘5. Fire alarm pull statons and annuncistors 6. Fire extngushers/ hose cabnets 7. Emergency Light 8. First Aid kits locations (if applicable) 8 Emergency Call statons (if applicable 10 Areas of safe refuge (for high-nise Building) 11 Assembly areas instructons 12 “in Case of Emergency” instructons BFP-QSF-FSED-061 Rev @@ (06.17.22) Page 5 of 10 fkRepublic of the Philippines. Department of the interior and Local Government BUREAU OF FIRE PROTECTION (FIRE STATION LETTER HEAD) nema T eases | Fatea Say Coan [ ] Size 330.2 mm wide * 215.9 mm height (Floor area < 50 m#) NIA oo foo + Room er spaces ‘Sexe 600.8 mm wide * 457.2 me! area = 60-150 Q “ eight (Floor NIA Me 1 Building lobbies upon entry. Elevator lobbies at every floor Hattways and comcors. ‘On every bend/corner Or every 15m interval in the case of ong hallway. ‘Size 606.8 mm. +9144 mm: area 2 1511 ts © mm height * 014.4 mm wade (Foor 11) losmman| 1} wv * Upon entry of the building © Area of assembly or every 25m interval in the case ‘auditonum & gymnasium. ‘Symbolsitconsiagas to be used for the marking shall be in accordance with NFPA 170, Standard for Signs and Symbols, . LLUMINATION OF MEANS OF EGRESS: {All Data Below Shall be Referred from Manufacturers Specifications) ‘Actual , vane | Passed | Failed Floors and other walking surfaces: shall be atleast | A-candie (10.8 ax), measured at the floor. 9 ux mofo Th asserbly occupancies: walking sutfaces of ext access shall De atleast 0.2 R-candie (22 tux) ham ta for Stare shall be atleast 10 Rcandie (105 hay. measured ate walking surfaces, 120 nme m | ta Emergency Lghtng [| Mumination not less than an average of 1 R-candie (10.8 ux) | Siu i" 1 ‘and, at any pont, not less than 0.1 Recande (1.1 hix), measured | ———— ‘slong the path of egress at floor level [1 Emergency Sighting system shall be arranged to provige the required iuminaton automateally in te event of any| ists | [v] 1 interruption of normal ightng (e.g Faskure of a pubte usity. ect’) fora penod atleast 15-hour [1 Peniogse Testing of Emergency Lighting Equipment (Writen record) [BFP-OSF-FSED-061 Rev. 00 (06.17.22) Page 6 of 10 eee] QS Bern(FIRE STATION LETTER HEAD) Hazard Contents LPG ‘Quantity (Vol. Weight) 8 - SOK UN 1075 Within MAQ. LAYes! [ 1No Feces retention: ay 68476-85-7 Hazard Classitcaton: \dentficaton No [ JLow/[ | Ordinary /[1 High class 2 Rash Point "0" Low hazard contents shall be classified as those of such low combustbilty hat no sef propagating fre therein can Oraimary hazard contents shall be clacsiied as those that are likely to bum with moderate rapidity or fo gue off 2 Gonsierabie ratume 3 smoke ‘High hazard contents shall be classified as those that are likely to bum with extreme rapidity or from which explosions are ikely. A. OTHER FLAMMABLE LIQUIDS (LE. ALCOHOL, ETHER, ETC...) [ an | ae ‘Gtored in sealed metal containers Mm Pa Properly dispensed aa per SOP A Fa Provided with NO SMOKING Sign a i“ B- MISCELLANEOUS HAZARDS (MECHANICAL EQUIPMENT ROOM, STORAGE, SUPPLY ROOM) Passed Failed Til no smoking areas has adequale Signs. mM fa ‘Gasoline! Diesel is stored in the proper place and in a metal safety can. 2) 1 C. HOUSEKEEPING, MAINTENANCE, STORAGE & WASTE DISPOSAL ‘Brooms. mops. rags and other cleaning supplies stored in metal 1 0 rags in meta! containers u ou Ory leaves. shrubbery trimmrungs and other combustibles kept away i ta BFP-OSF-FSED-061 Rev. 00 (06.17.22) Page 7 of 10Republic of the Philippines Department of the Interior and Local Government BUREAU OF FIRE PROTECTION (FIRE STATION LETTER HEAD) vm FIRE PROTECTION A ‘Automatic Fire Suppression System (Sprinkler) Tem to spect Procedure How to inspect Passed | Fama Spanier Puree ‘Check aalomabe Stan and pressure ml Sealine ites Valves are locked in the open position. no tu leaks. corrosion. or other defects noted. tat Spier water 8 | Coen saat vaive and ensure manual alarm | v1 : bell tuncsons and sponkier pumps start 8. | Wet StandpipelFire Hose Cabinet ‘Check that doors unobstructed and opens ¥ Cabinet Door Operative m ra) ‘cee. Check tet hone is not roe, wet moldy, i gi ‘Check that nozie sin place and operates: M1 Nozzle correctly t oD. Gheck that hose is hung propery so that a ri | Hose nung property | can easily be un-rolled i needed. ‘Check that vaive handles are in place and te that valves operate properly and are in he 1 —— pen powton co. [Fie Fame Pump System Inspect accuracy of pressure gauges and ii Fipne ‘Check pipings if there is leak ra i Motor “Check unusual noige or vibrations m1 Oo Electrical System ‘Check ff there is corrosion in PCBs, cracked ‘eabie/wire insulation, jeak in plumbing 4 1 (parts, sign of water in electrical part | bv. | Fire Detection System Fire Detection System | Random Teat of call pons and smaxe 7 ar detectors © [Fire Ainmm Facames Location Signs (Check ail signs are in place and legible mM a “Rian Panels ‘Check that ail alarm panels are Funcboning orecty and are unobstructed “1 1 [ns (elevator ry ‘Tile “home” © ground fasr during re a i test, coors open and WR stops. Fans Ait fans operate comectly mn 1 Fireman's if Fireman's IR can be Keyed 1 operate ‘dung fire alarm test "1 ti ©. FRStAGd Fire Protection (Fire Extngumhersy BFP-OSF-FSED-061 Rev. 00 (06.17.22) Page 8 of 10 NasRepublic of the Philippines Department of the Interior and Local Government BUREAU OF FIRE PROTECTION (FIRE STATION LETTER HEAD) ‘Minimal sizes of fre extinguishers for he sted grades of hazards shall be proviged z Fire Exinguisner Size on the basis of table 7 & 8 of RIRR of RA Wil ul era) “The ranimnum number of eainguahers ‘Minimum number of ‘shall be sufficent to meet the requrements, 1 ti emanate: Sriatie 78 Sof IRR of RASS" ican ‘Ai exingushers are in their prope = i | Canguisher seals and taps are Rael and Seats & Tags atinguisher wes serviced inthe inst 12 m 1 noobs ‘Proper marking on extinguisher to indicate Markings the ype ot bre the extinguisher can be m 0 Used on _ Tio leaks conuaon or other detects a Tt ‘Pressure Pressure gauge reads in the “green” area. 1 ti = Emergency Lighting Systems Sanery Lah (LIne ee i = |__| sums on when mains power is removed & ‘Kitchen a Tisods, wert, fans and Guts wr god a Ti Hood Fitters, Date of Last Cleaning Ww ti Passed Failed Ualies ‘Cooking equipment protected by AKHFSS (Restaurant and smiiar ww ul _estabishment wath Qooupant Load > £0p) ‘Benign i netaator in accordance weft FEC “4 ul 3. | Smake Control SystemsiSmake Management shall be provided in the following | [VTAI nigh-nse buicings (starwelts, atleast 1 elevator shaft. zoned 1 ‘smoke contol and vestbule) [ ] Pressunzation of smoke refuge area. 1 [1 Every Anum of covered mall of over 2- levels / Other type of ‘Gocupancy over 3 — levels [| ] Underground structure and windowless factives. [ 1A movie nouses. All other cx structures wih at least (not apply to detached single or twc-farrily Gwesong) [U1 Cranes & Incinerators shail be enciosed. tw ra [1 Design and Maintained in accordance wath the latest editon of PMEC. 1S |BFP-QSF-FSED.061 Rev. 9 (06.17.22) Page $ of 10 ckneas CD peer‘Provided wat Fire Wall (ranmmum 2 haus fre resisianon) Pivevi Ne | FW emerson above fe too satace ral not be less fan Team Dive The | See Mae Ne 024-264 ate 28 tne 221 fr Ate Wat type [| 125mm Soid Concrete {| 180mm Sold Masonry/| | 2o0ews alow Unt Mason DEFECTSIDEFICIENCIES (Attach photo, sketch and other) mem wv vena v. Weave oT careas shal be to arenes Wal ere are oe Gand- 0d bOONaTs hallaaye, SOTnGDTE BONES Ware o cour whove death exceed Se neien Won het Segbon TESS mo ve cd Sars os core nl oro oe Vit aoase nosis wr Br ope a RO ger Oy Be ang SE Oey e—eoeoeeeeeeeeeeeeeeeaeweewrroseww_os,| rem a (% RECOMMENDATIONS, [1 Comely the following DEFFECTSIDEFICIENCIES stated above and pay the commesponding Fire Code Fees “nciudg the Storage Ciearance Fee . Conveyance Crearance Fee before he issuance of Fre Safely. Inspecton Certfeate (FSIC) [ 1 Forissuance of [1 Note to Comely [| ] Notoe 12 Comect Vilaton [ ]Ctosure Order {| ] Abatement Onder win Administrative Fine 1 Closure Order for the non-payment of Administratve Fine [1 Notice of Disaperaval (NOD) ‘AcraowneDoe0 By : Uae Dr srontiey ieeatt P (oe auiy tapes Tastee RECOMMEND APPROVAL [BFP.QSF-FSED.O61 Rev. 9 (06.17.22) Page 10 of 10, inex I: Fire Safety Inspection Checklist