NBC FORM NO. A-03 Republic of the Philippines “Municipality of General Luna Province of Surigao del Norte OFFICE OF THE BUILDING OFFICIAL ELECTRICAL PERMIT APBLICATION NO. Ep BUILDING PERMIT No, BOX 1 (10 BE ACCOMPLISHED IN PRINT BY THE OWNERIAPPLICANT) [OWNER APPLICANT: ors FST HE TONE 7 [FSR SORE TRISTION OWED BY AT ENTER TOF ORS [DRE OR ARASTER OF SOSRET [aDDRRESS: To. “STREET SRR CTYMOREPATTY FOE TEERRENG: |COCATION GF CONSTRUCTION: STREET ARAN GENERAL LUNA, SURIGAO DEL NORTE [SCOPE OF WoRK [NEW INSTALLATION RECONNECTION OF SERVICE ENTRANCE [RELOCATION OF SERVICE ENTRANCE [1 ANNUAL INSPECTION. [7 SEPARATION OF SERVICE ENTRANCE OTHERS (Speoty) == [TEMPORARY [1 UPGRADING OF SERVICE ENTRANCE ‘BOX 2 (TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL) [NUMBER OF OUTLETS AND EQUIPMENT TO BE INSTALLED (users cl swircues conv. ourters, nu [Se svsTeM ] ELECTRICRANGE __ KW. [WATER HEATER [J AIRRCONDMONING SYSTEM TELEPHONE Morors OTHERS (Spee [SUMMARY OF ELECTRICAL LOADSICAPACITIES APPLIED FOR. TOTAL CONNECTED LOAD TOTAL TRANSFORMER CAPACITY TOTAL GENERATORUPS CAPACITY KvA KVA KVA 0x3, BOx4 [DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS [SUPERVISOR /IN-CHARGE OF ELECTRICAL WORKS PROFESSIONAL ELECTRICAL ENGINEER ‘PROFESSIONAL ELECTRICAL ENGINEER / ELECTRICAL (Stored ans Seed over ots Nore) ENGINEER / MASTER ELECTRICIAN ue (Sore ant Sets oer Prag Nae) exc no. [ross ferc wo [vos Box 0x6 [BUILDING OWNER |wiTH iy CONSENT: LOT OWNER Baar ne PINT Sigua PrmTaT‘TO BE ACCOMPLISHE BY THE PROCESSING AND EVALUATION DIVISION 0x7 RECENED BY: DATE: FOUR (4) SETS OF ELECTRICAL DOCUMENTS ELECTRICAL PLANS AND SPECIFICATIONS || SPECIAL FIXTURES AND EQUIPMENTS. U EXPECTED DATE OF COMPLETIONINSTALLATIONICONSTRUCTION. 1 OTHERS (Speci 1 PROPOSED STARTING DATE OF INSTALLATIONICONSTRUCTION Boxe PROGRESS FLOW ur mE PROCESSED BY: leLecTRcAL [seecrIcATIONS [OTHERS (5 PERMIT IS HEREBY ISSUED SUBJECT TO THE FOLLOWING: 1 That the proposed electrical works shall be in accordance with the electrical plans filed with this Office and in ‘conformity with the provisions of the latest Philippine Electrical Code, the National Building Code and its Implementing Rules and Regulations. 2 That prior to any construction activity, a duly accomplished prescribed "NOTICE OF CONSTRUCTION" shall bo submitted to the Ofce of the Building Oficial 3 That for installed electrical capacity of 200 amperes and above at 230 Volts nominal and above, a specialty electrical Contractor duly licensed by the Philippine Contractors Accreditation Board (PCAB) shall be required. 4 That a duly licensed electrical practioner shall be in-charge of the installation, and that upon completion of the electrical works, helshe shall submit the entry to the logbook duly signed and sealed to the Office ofthe Building Official including As-Buit plans and other documents. He/She shall also accomplish the Certificate of Completion stating that the electrical works conform to the provisions of the Philippine Electrical Code, the National Building Code and its IRR. 5. That this permit is null and void unless accompanied by the Building Permit except for projects involving purely electrical works in which case only the building permit number of the existing building/structure shall be required, 6 That a Certificate of Final Electrical Inspection (CFE!) and Certificate of Occupancy shall be secured first prior to the actual occupancy of the building 7 That this permit shall be posted at the door of site of work. PERMIT ISSUED BY: ENGR. JERSON E, GALVEZ BUILDING OFFICIAL (Signature over Printed Narre) NOTE: THIS PERMIT MAY BE CANCELLED OR REVOKED PURSUANT TO SECTIONS 206 AND 206 OF THE ‘NATIONAL BUILDING CODE”.