Republic of the Philippines

DAMAGE ASSESSMENT REPORT

CITY: LAPU-LAPU CITY
MAGNITUDE OF DAMAGE TO HOUSES AS OF
DECRIPTION OF CALAMITY: FIRE
PROVINCE: CEBU
DATE OF OCCURENCE: NOVEMBER 01, 2021
LOCATION I EXTENT TO DAMAGE HOUSE
PROVINCE CITY BARANGAY PARTIALLY TOTALLY TOTAL OF FAMILIES
CEBU 1 LAPU-LAPU CITY I MARIBAGO
1 I 41 5

Certified True Corre

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Prepared by:

LEON IE 0 POTOT
DC iI

Approved/Endorsed
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NHA VALIDATED MASTERLIST OF FAMILIES ELIGIBLE FOR HOUSING ASSISTANCE

CITY : CEBU CITY
Ctrl Name of Family Head
No.

1 MIRA , ISIDRO C.
2 LAYESE , ELSIE L.
3 DAAO, SILJOE R.
4 ERBITO, CORAZON P.
5 DANO, WILLIAM I.

Validated by:
d-----.1
JA . LINGATONG
Sr. Draftsman
Cebu District Office
Certified Correct by:

DANTE STROBO
Officer-In harge
Cebu Dis ict Office

Approved/Endorsed
. CABAHUG
VII
REPUBLIC OF THE PHILIPPINES
CITY SOCIAL WELFARE AND DEVELOPMENT OFFICE
LAPU-LAPU CITY
Prepared by:
Annex A
MASTERLIST OF DISASTER VICTIMS
PUROK/SITIO: BAYBAYON
CITY : LAPU-LAPU CITY TYPE OF CALAMITY: FIRE
NO. NAME OF STRUCTURE OWNER

FAMILY NAME
MIRA
2 LAYASE
3 DANO
4 ERBITO
5 DANO
* NOTHING FOLLOWS ***

LEONIE POTOT
DC
Appr•orsed by:
JUN L 'AHONG" Q. CHAN
City Mayo
S Republic of the Philippines
Department of the Interior and Local
FIRE INCIDENT CERTIFICATION
TO WHOM IT MAY CONCERN:
THIS IS TO CERTIFY that the hereunder names are HOMEOWNERS,
SHARERS and RENTERS of the residential houses which gutted by fire that
transpired on 01 November 2021 at about 11:26 in the evening in Sitio Baybayon-
Buyong, Barangay Maribago, Lapu-Lapu City. The said residential houses were
declared totally I partially damaged and left nothing for the owners and renters to
save their personal belongings and documents. To wit:
HOMEOWNERS:
1.Isidro C Mira 2.Elsie L Layese - Totally Damaged - Totally Damaged - Totally

RENTER:
1.Manuelito I Dance - Totally Damaged
This certification is issued upon the request of these above-mentioned persons for
their CSWDO Shelter Assistance.
For any verification or inquiry, the investigation of this fire incident is being
undertaken by the Lapu-Lapu City Fire District with office address at Purok Gabi,
Gun-obi Lapu-Lapu City and Telephone Number 3400252.
Fire Code Fee:
O.R. Number : N/A
Amount : N/A
Date

F/SUPT M SES
D rid Fire
OR HOUSING ASSISTANCE
PROVINCE : CEBU
Persons/ M F Address
Dependent
No./Street Purok/Baran ea
4 x BAYBAYON MARIBAGO
4 x BAYBAYON MARIBAGO
5 x BAYBAYON MARIBAGO
3 x BAYBAYON MARIBAGO
5 x BAYBAYON MARIBAGO
 BARANGAY: MARIBAGO
PROVINCE : Cebu
NER FAMIL CATEGORY
Y
FIRST NAME MIDDL SIZE HOT HOP
ISIDRO C /
ELSIE L I
SILJOE R /
CORAZON
WILLIAM
Extent of Damage to House
Partially Totally
• to 20% 21% - 40% 41% - 60% 61% - 80% 81% - 100%
X
X
X
X
X
01, 2021

Remarks