Republic of the Philippines

OFFICE OF THE BUILDING OFFICIAL

Lucena City

CERTIFICATE OF COMPLETION
SANITARY / PLUMBING WORKS

This is to certify that the Sanitary/Plumbing installation by Sanitary Plumbing No.____

issued on _____________. In the premises of Mr. & Mrs. ______________________________
accordance with the approved plans and specifications and has been Installed/constructed the
sanitary facilities by the NATIONAL BUILDING CODE OF THE PHILIPPINES and other
pertinent laws concerned. Now, the said installation is ready for final inspection.

FIXTURES INSTALLED

Kinds of Fixtures No. of Units Kind of Fixtures No. of Units

Water Closet ___________ Air Conditioning Unit ___________

Urinal ___________ Water Tank/Reservoir ___________
Kitchen Sink ___________ Bidet ___________
Lavatory ___________ Electric Heater ___________
Floor Drain ___________ Water Boiler ___________
Faucet ___________ Drinking Fountain ___________
Bidet ___________ Swimming Pool ___________
Bath Tub ___________ Dental Cuspidor ___________
Grease Trap ___________ Water Meter ___________

Other Specify: ___________________________________________________________

___________________________________________________________
___________________________________________________________

Nature of Work: ___________________________________________________________

Use of Water: ___________________________________________________________
Size of Service Pipe: ___________________________________________________________

SOURCE OF WATER SUPPLY:

Shallow Well __________ City/Municipality Water System ___________

Deep Well & Pump Set __________ Barangay Water System ___________
Spring __________ Others (specify) _________________

SANITARY SEWER SERVICE:

Septic Tank ______________________ Sewage Treatment Plant _________________

Hoff Tank ______________________ Sedimentation Ponds _________________
Cesspool ______________________ Filtration Bed _________________
Pit Privy ______________________ Treatment Lagoons _________________

_________________________________ _________________________________
Sanitary Engineer / Master Plumber Sanitary Engineer / Master Plumber
In-Charge of Installation Prepared Plans & Specs

Conforme:

______________________________
Owner / Applicant