Republic of the Philippines

Province of South Cotabato

City Government of Koronadal
UNIFIED APPLICATION FORM FOR BUILDING PERMIT
SIMPLE COMPLEX HIGHLY TECHNICAL
NEW RENEWAL AMENDATORY

THIS APPLIES ALSO FOR : LOCATIONAL CLEARANCE FIRE SAFETY EVALUATION CLEARANCE
APPLICATION NO. AREA NO.

BOX 1 (TO BE ACCOMPLISHED IN PRINT BY THE APPLICANT)

OWNER / APPLICANT LAST NAME FIRST NAME M.I. TIN
FILINVEST LAND, INC. DO NOT FILL-UP (PSA USE ONLY)

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP

BY AN ENTERPRISE CORPORATION
ADDRESS: NO., STREET, BARANGAY, CITY / MUNICIPALITY ZIP CODE CONTACT NO.
79 EDSA BRGY HIGHWAY HILLS MANDALUYONG CITY 1550
LOCATION OF CONSTRUCTION: LOT NO. _______ BLK NO. ________ TCT NO. ______________ TAX DEC. NO. ____________________
STREET FUTURA HOMES KORONADAL, GENSAN DRIVE BARANGAY CONCEPCION CITY OF KORONADAL
SCOPE OF WORK
NEW CONSTRUCTION RENOVATION RAISING
ERECTION CONVERSION ACCESSORY BUILDING/STRUCTURE
ADDITION REPAIR OTHERS (Specify)
ALTERATION MOVING
USE OR CHARACTER OF OCCUPANCY
GROUP H : ASSEMBLY (OCCUPANT
GROUP A : RESIDENTIAL (DWELLINGS) GROUP E : COMMERCIAL LOAD LESS THAN 1,000)
SINGLE DUPLEX RESIDENTIAL R-1, R-2 BANK STORE SHOPPING THEATER, AUDITORIUM, CONVENTION HALL,
OTHERS ______________________________________ DRINKING / DINING CENTER / MALL GRANDSTAND/ BLEACHER
GROUP B : RESIDENTIAL ESTABLISHMENT OTHERS ______________________________
HOTEL MOTEL TOWNHOUSE SHOP (i.e. DRESS SHOP, TAILORING,
DORMITORY BOARDINGHOUSE, BARBERSHOP, etc.) GROUP I : ASSEMBLY (OCCUPANT
RESIDENTIAL R-3, R-4, R-5 LODGING HOUSE OTHERS ______________________________ LOAD 1,000 OR MORE)
COLISEUM, SPORTS COMPLEX,
OTHERS _______________________________________ GROUP F : LIGHT INDUSTRIAL CONVENTION CENTER AND SIMILAR
GROUP C : EDUCATIONAL & RECREATIONAL FACTORY / PLANT (USING INCOMBUSTIBLE/ STRUCTURE
SCHOOL BUILDING SCHOOL AUDITORIUM, NON-EXPLOSIVE MATERIALS OTHERS _______________________
CIVIC CENTER GYMNASIUM OTHERS ______________________________
CLUBHOUSE CHURCH, MOSQUE, GROUP J : (J-1) AGRICULTURAL
TEMPLE, CHAPEL GROUP G : MEDIUM INDUSTRIAL BARN, GRANARY, POULTRY HOUSE,
OTHERS _______________ PIGGERY, GRAIN MILL, GRAIN SILO
STORAGE / WAREHOUSE (FOR HAZARDOUS/
GROUP D : INSTITUTIONAL HIGHLY FLAMMABLE MATERIALS OTHERS _______________________
HOSPITAL OR SIMILAR STRUCTURE FACTORY (FOR HAZARDOUS/ HIGHLY GROUP J : (J-2) ACCESSORIES
HOME FOR THE AGED FLAMMABLE MATERIALS PRIVATE CARPORT / GARAGE, TOWER,
GOVERNMENT OFFICE OTHERS _______________________________ SWIMMING POOL, FENCE OVER 1.80m,
STEEL / CONCRETE TANK
OTHERS _______________________________________ OTHERS _______________________
OCCUPANCY CLASSIFIED_____________________________ TOTAL ESTIMATED COST: P ______________________________________
NUMBER OF UNITS__________________________________ BUILDING ____________________________ COST OF EQUIPMENT INSTALLED:
NUMBER OF STOREY________________________________ ELECTRICAL ____________________________ P ______________________________
TOTAL FLOOR AREA ___________________________ SQ. M. MECHANICAL____________________________ P ______________________________
LOT AREA ____________________________________ SQ. M ELECTRONICS___________________________ P ______________________________
PLUMBING ___________________________ P ______________________________
PROPOSED DATE OF CONSTRUCTION: _______________________________ EXPECTED DATE OF COMPLETION: _______________________________
BOX 2
FULL-TIME INSPECTOR AND SUPERVISOR OF CONSTRUCTION WORKS (REPRESENTING THE OWNER)
Address

PRC No. Validity

ARCHITECT OR CIVIL ENGINEER
PTR No. Date Issued
(Signed and Sealed Over Printed Name)
Date_____________________________ Issued at TIN
BOX 3 BOX 4
APPLICANT: WITH MY CONSENT: LOT OWNER / AUTHORIZED REPRESENTATIVE

Date ______________ Date______________

(Signature Over Printed Name) (Signature Over Printed Name)

Address Address
Gov’t Issued ID No. Date Issued Place Issued Gov’t Issued ID No. Date Issued Place Issued
BOX 5
REPUBLIC OF THE PHILIPPINES ) S.S
CITY/MUNICIPALITY OF _________________________________________)
BEFORE ME, at the City/Municipality of _____________________________________________________ , on _________________________ personally appeared the
following:
______________________________________________________ _____________________ _______________ ___________________________________
APPLICANT Gov’t Issued ID No. Date Issued Place Issued

______________________________________________________ _____________________ _______________ ___________________________________

LICENSED ARCHITECT OR CIVIL ENGINEER Gov’t Issued ID No. Date Issued Place Issued
(Full-Time Inspector and Supervisor of Construction Works)

whose signatures appear hereinabove, known to me to be the same persons who executed this standard prescribed form and acknowledged to me that the same is their free and
voluntary act and deed.
WITNESS MY HAND AND SEAL on the date and place above written.
Doc. No. ____________
Page No.____________ ________________________________________________________
Book No.____________ NOTARY PUBLIC (Until December _____________ )
Series of ____________

Copy 1: Owner Copy 2: OBO Copy 3: BFP Copy 4: Philippine Statistics Authority
*May require additional requirements
 BOX 6 (TO BE ACCOMPPLISHED BY THE PROCESSING AND EVALUATION DIVISION)

ASSESSED FEES ACCOUNT BASIS OF ASSESSMENT AMOUNT DUE ASSESSED BY

FOR ZONING (ZONING ADMINISTRATOR) :

 LOCATION/ ZONING OF LAND

FOR BUILDING/ STRUCTURE (OBO):
 FILING FEE
 PROCESSING FEE
 LINE AND GRADE (Geodetic)
 FENCING
 ARCHITECTURAL
 CIVIL / STRUCTURAL
 ELECTRICAL
 MECHANICAL
 SANITARY
 PLUMBING
 ELECTRONICS
 INTERIOR
 SURCHARGES
 PENALTIES
 ONE HALF (1/2) OF FIRE SERIVCE FUND (FSF)

FOR FIRE SAFETY (BFP):

 FIRE CODE CONSTRUCTION TAX
 HOTWORKS
 FILING FEE
 ADMIN FINES
TOTAL

TERMS AND CONDITIONS

1. The Owner/Permittee shall accomplish the prescribe Unified Application Form, with the assistance of the concerned design professional/s and/or the
Architect/Civil Engineer, hired/commissioned by the Owner/Permittee as full-time inspector/supervisor of the construction works, by filling up the necessary
data / information required thereat.

2. The fully accomplished prescribed Unified Application Form, duly notarized, shall be submitted to the concerned Office of the Building Official accompanied
by the various applicable ancillary and accessory permits, plans and specifications signed and sealed by the corresponding design professionals who shall
be responsible for the comprehensive and correctness of the plans in compliance to the National Building Code (PD 1096), its IRR and to all applicable
referral codes and professional regulatory laws, together with the other documentary requirements pursuant to Section 302 of PD 1096 and its IRR.

I have read this form, understood its contents and consent to the processing of my personal data, I understand that my consent does not preclude the existence of
other criteria for lawful processing of my personal data, and does not waive any of my rights under the Data Privacy Act of 2012 and other applicable laws.

____________________________________________________
SIGNATURE OVER PRINTED NAME OF OWNER/ APPLICANT