Republic of the PhiliPPines

Department of the lnterior and Local Government

BUREAU OF FIRE PROTECTION
National Capital Region

FSEC.OSS-RI 6-21 040328 06t1612022

Date

FIRE SAFETY EVALUATION CLEARANCE

TO WHOM IT MAY CONCERN:

By virtue of the provisions of RA 9514 otherwise known as the Fire Code of the Philippines of
2008 the application fors*s CLEARANCE of
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(N ame of B u iId i n g/Stru ctu re/Faci lity)
to b* r6flFiblq{"$a, 5pAfi[€W?firAv f$Etflr*,, is CH,i$Brl#er4rSl,+t9 sreffnrffid Bf,lHUr I ggn$dnet
SILANGAN. CT2. OUEZON CITY
(Address)
I3MAGNA, EMETINDAV is hereby GRANTED after
owned by
(N ame of Own e r/Re p re se ntative)
the building plans and other documents conform to the fire safety and life safety requirements of the
Fire Code of the Philippines of 2008 and its Revised lmplementing Rules and Regulations and that
the recommendations in the Fire Safety Checklist (FSC)will be adopted.

Violation of Fire Code provisions shall cause this certificale null and void after appropriate
proceeding and shall hold the owner liable to the penalties provided for by the said Fire Code.

Fire Gode Fees 4,tsz;z RECOMMEND APP

Amount Paid: ARROYO
O.R. Number
SFO3 James Paralta CHIEF,
Date:
PLAN EVALUATOR

APPRovEPiupr

CITY/IVUN ICI PAL FI RE MARSHAL

NOTE: "This Clearance is accompanied by Fire Safety Checklist on Building Plans and does not take the
place of any /icense required by taw and is not transferable. Any change or alteration in the design and
specification during construction shall require a new clearance"

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.,FIRE SAFETY IS OUR MAIN CONCERN"

ApplicanUOwner's COPY