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Pan FOR NO. 86-001-£
APPLICATION NO.
REPUBLIC OF THE PHILIPPINES
DEPARTMENT OF PUBLIC WORKS AND Hi
OFFICE OF THE LOCAL BUILDING OFFICIAL
Makati City
DISTRICT/CITY/MUNICIPALITY
AREA CODE
Date of Proposed Start of Installation
BOX 1 (TO BE ACCOMPLISHED BY A DULY QUALI
APPLICATION FOR ELECTRICAL PERMIT
‘Aecomplsh in print and in duplicate)
IFIED ELECTRIOAL PRACTITIONER)
GHWAYS
DATE APPLICATION FILED
Expected Date of Completion
CONEW InsTALLATION.
(Cannuat sPEcTiON
NAME OF OWNER/APPLICANT: TAST NAME, FIRST NAME, TDDLE WANE Ww ]
‘ADDRESS WO. STREET, BARANGHY, ‘CHTVIMUNIGIPALTTY | TELFAKWO
LOCATION OF INSTALLATION: NO. STREET, BARANGHY, ‘CHVIMONICTPALITY
‘SCOPE OF WORK: (hanpmion oF EXISTING INSTALLATION Gloriens (sPeciry)
(COREPAIR OF EXISTING INSTALLATION.
(COREMOVAL OF EXISTING INSTALLATION
TYPE OF OGGUPANGY OR USE:
(Ci A RESIDENTIAL DWELLING
(Gi B RESIDENTIAL, HOTEL APARTMENT
C C.EDUCATION & RECREATION
2 o.msrmunionaL
© E-BUSINESS & MERCANTILE
FimpustaIAL
CG STORAGE & HAZARDOUS
HASSEMBLY OTHER THAN GROUP +
i LLASSEMaLY OCCUPANT LOAD 1000 08 MORE
s.accessonr
—————————————
OMBER OF OUTETS MBER OF EOUPRENTaTRING OCES
uci so, cDoKNG unt TosoLe swrren Fa erEcToRS
— convenencenecermcie So, WATER HEATER BELLSBUZZERS OTHERS (See ataened List)
|__ sro, acon SF0, WATER PUM PusH BUTTONS
BK 2 PROFESSIONAL ELECTRICAL ENGINEER HO SIGNED AND SEALED PLANS & SPEOIFCATIONS) =
AME PAC REG. NO way
ADDRESS TECK
FTA 7 ATE SSTED | PLAGE SUED
‘SIGNATURE DATE SIGNED Tin
0X3 (ELECTRICAL CONTRACTOR - 200 AMPERE. MAIN AND ABOVE
NAME: T PCAB LIC. No. (SPECIALTY ELECTRICAL)
| vation
[aopness ] Tet reax wo.
BOK 4 (PERSON IN-CHARGE OF INSTALLATION)
ELECTRICAL PLANS & SPECIFIC
Ono aeomcu nen [Oneromamac nen oR LTaR,
| NAME PAC REG. NO. ~ VALIDITY
“ADDRESS: ~ TEL/FAX NO.
PTR NO. DATE ISSUED. PLACE ISSUED
‘SIGNATURE DATE SIGNED TH -
:ATIONS (5 SETS)
DATE RECEIVED
www.makati.gov.ph ‘wi FORM No. e6-002-£
oF Ma REPUBLIC OF THE PHILIPPINES
Ss >) DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
9 OFFICE OF THE LOCAL BUILDING OFFICIAL
/ A)
“ } Makati City
\ S05.
ee DISTRICT/CITY/MUNICIPALITY
ati AREA CODE
PERMIT NO. [APPLICATION NO.
DATE ISSUED _ DATE FILED
PAID UNDER 0.R. NO.
‘AMOUNT —_
DATE
ELECTRICAL PERMIT
(Fo be Accomplished by the Ofice Concerned)
0x
NAME OF OMNER/APPLICANT LAST WANE FIRST NAME, ‘MIDDLE WANE TW
ODRESS Wo. STREET, BARANGNY, ‘ITWMUNIGIPALITY | TELIFAX WO,
LDGATION OF INSTALLATION: Wo. ‘STREET, BARANGAY CTTYIMUNIGIALTY
boxe aaa
ASSESSED FEES
[AMOUNT DUE O-R, NUMBER a DATE PAID, REVIEWED & ASSESSED BY
Box
PERMIT IS HEREBY GRANTED TO INSTALL THE ELECTRICAL WIRING, DEVICES AND EQUIPMENT ENUMERATED IN THE APPLICATION
SUBJECT TO THE FOLLOWING CONDITIONS:
1. THAT THE PROPOSED INSTALLATION BE IN ACCORDANCE WITH THE APPROVED PLANS FILED WITH THIS OFFICE AND IN
CONFIRMITY WITH THE PROVISIONS OF THE LATEST EDITION OF THE PHILIPPINE ELECTRICAL CODE
2, THAT A DULY LICENSED ELECTRICAL PRACTITIONER BE INCHARGE OF THE INSTALLATION/CONSTRUCTION
3, THAT A CERTIFICATE OF COMPLETION DULY SIGNED BY THE ELECTRICAL PRACTIONER INCHARGE OF THE INSTALLATION BE
SUBMITTED NOT LATER THAN SEVEN (7) DAYS AFTER COMPLETION OF THE INSTALLATION,
4. THAT A CERTIFICATE OF FINAL ELECTRICAL INSPECTION BE SECURED PRIOR TO THE ACTUAL OCCUPANCY OF THE BUILDING.
| 5. THIS PERMIT SHALL BE POSTED AT THE DOOR OR SITE OF WORK.
APPROVED:
~Ghiet, Fleciical Processing Section DATE
Electrical Engineer of the Bldg. Office
‘PRO REG. Wo.
NoTED
ENGR. MARIO. BADILLO
BUILDING OFFICIAL
Note 1: This permit may be cancelled or revoked pursuant to Sections 305 and 306 of the Building Code.
‘Note 2: Alterations on this form are not allowed.
www.makati.gov.ph
