REPUBLIC OF THE PHILIPPINES

OFFICE OF THE CITY/MUNICIPAL MAYOR

DO NOT FILL-UP (NSO USE ONLY)
CITY/MUNICIPALITY
APPLICATION NO. PERMIT NO

BUILDING PERMIT

DATE OF APPLICATION DATE ISSUED

RENEWAL ORIGINAL
BOX 1 (TO BE ACCOMPLISHED BY DESIGNING ARCHITECT)
OWNER LAST NAME FIRST NAME MI TAX ACCT. NO.

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP MAIN ECONOMIC ACTIVITY/KIND

BY AN ENTERPRISE BUSINESS

ADDRESS

LOCATION OF CONSTRUCTION

SCOPE OF WORK 1. NEW CONSTRUCTION OTHERS (SPECIFY)

2. ADDITION OF ______________ 6. __________ OF _________
3. REPAIR OF ________________ 7. __________ OF _________
4. RENOVATION OF ___________
5. DEMOLITION OF ____________
NUMBER OF UNITS _____________
USE OR TYPE OF OCCUPANCY:
OTHERS (SPECIFY)
RESIDENTIAL 31 FACTORY/PLANT
11 SINGLE 32 REPAIRS SHOP, MACHINE SHOP
12 DUPLEX 33 REFINERY
13 ROWHOUSE (ACCESSORIA) 34 PRINTING PRESS
14 OTHERS (SPECIFY) __________________ 35 WAREHOUSE
30 OTHER (SPECIFY)
COMMERCIAL
21 BANK INSTITUTIONAL
22 STORE 41 SCHOOL
23 HOTEL/MOTEL 42 CHURCH AND OTHER RELIGIOUS STRUCTURES
24 OFFICE CONDOMINIUM/BUSINESS OFFICE BUILDING 43 HOSPITAL OR SIMILAR STRUCTURES
25 RESTAURANT, ETC. 44 WELFARE AND CHARITABLE STRUCTURES
26 SHOP (e.g. DRESS SHOP, TAILORING SHOP, BARBER SHOP, ETC 45 THEATER
27 GASOLINE STATION 41 OTHERS (SPECIFY) __________________
28 MARKET
29 DORMITORY OR OTHER LODGING HOUSE AGRICULTURAL
20 OTHERS (SPECIFY) __________________ 51 BARN(S) POULTRY HOUSE(S), ETC.
52 GRAIN MILL
OTHER CONSTRUCTION 50 OTHERS (SPECIFY) __________________
60 SPECIFY __________________________

STREET FURNITURES, LANDSCAPING &SIGNBOARDS

71 PARKS, PLAZA, MONUMENTS, POOLS, PLANT BOXES, ETC
72 SIDEWALKS, PROMENADES, TERRACES, LANDPOSTS, ELECTRIC POLES, TELEPHONE POLES, ETC.
73 OUTDOOR ADS SIGNBOARDS, ETC.
74 FENCE ENCLOSURE
BOX 2 (TO BE ACCOMPLISHED BY THE RECEIVING & RECORDING SECTION)
BLDG. DOCUMENTS (FIVE SETS EACH)
SITE DEVELOPMENT AND LOCATION PLAN MECHANICAL PLANS &SPECIFICATIONS
ARCHITECTURAL PLAN & SPECIFICATIONS LOGBOOK (1 COPY)
STRUCTURAL DESIGN & COMPUTATIONS OTHERS (SPECIFY)____________________
SANITARY/PLUMBING PLANS & SPECIFICATIONS
ELECTRICAL PLANS & SPECIFICATIONS
BOX 3 (TO BE ACCOMPLISHED BY THE BUILDING OFFICIAL)
ACTION TAKEN:
PERMIT IS HEREBY GRANTED SUBJECT TO THE FOLLOWING CONDITIONS:
1. THAT THE PROPOSED CONSTRUCTION/ADDITION/ REPAIR/RENOVATION/INSTALLATION ETC.
SHALL BE IN CONFORMITY WITH THE NATIONAL BUILDING CODE (P.D. 1096) AND ITS
CORRESPONDING IMPLEMENTING RULES AND REGULATIONS
2. THAT A DULY LICENSED ARCHITECT/CIVIL ENGINEER HAS BEEN ENGAGED TO PREPARE PLANS
AND SPECIFICATIONS AND TO UNDERTAKE THE SUPERVISION/INSPECTION OF THE
CONSTRUCTION OF THE PROJECT BUILDING OFFICIAL
3. THAT A CERTIFICATE OF COMPLETION DULY SIGNED AND SEALED BY THE DESIGNING
ARCHITECT/ENGINEER AND THE ARCHITECT/ENGINEER IN-CHARGED OF THE CONSTRUCTION
SHALL BE SUBMITTED NOT LATER THAN SEVEN (7) DAYS AFTER COMPLETION OF THE
CONSTRUCTION OF THE PROJECT DATE
4. THAT A "CERTIFICATE OF OCCUPANCY" SHALL BE SECURED PRIOR TO ACTUAL OCCUPANCY OF
THE BUILDING
NOTE:
THIS PERMIT MAY BE CANCELLED OR REVOKED PURSUANT TO SECTIONS 305 & 306 OF THE
"NATIONAL BUILDING CODE"
To be accomplished in five copies, one each for applicant (original), Assessor, National Statistics Office, Building Official, Fire Department
BOX 3A (TO BE ACCOMPLISHED BY DESIGNING ARCHITECT/CIVIL ENGINEER IN PRINT)
TOTAL ESTIMATED COST COST OF NUMBER OF STOREYS _____________ DO NOT FILL (NSO USE ONLY)
EQUIPMENT
BUILDING ___________________ INSTALLED TOTAL FLOOR AREA_______________

ELECTRICAL ___________________ P ____________ PROPOSED DATE

OF CONSTRUCTION ________________
MECHANICAL ___________________ P ____________
EXPECTED DATE
PLUMBING ___________________ P ____________ OF COMPLETION __________________

OTHER ___________________ MATERIAL OF CONST ______________

(WOOD, CONCRETE, STEEL, MIXED)
TOTAL COST ___________________
BOX 4 (TO BE ACCOMPLISHED BY THE DIVISION/SECTION CONCERNED)
ASSESSED FEES

AMOUNT DUE ASSESSED BY O.R. NUMBER DATE PAID

LAND USE/ZONING

LINE AND GRADE

BUILDING

PLUMBING

ELECTRICAL

MECHANICAL REVIEWED:

OTHERS

TOTAL CHIEF, PROCESSING SECTION

BOX 5 (TO BE ACCOMPLISHED BY THE DIVISION/SECTION CONCERNED)

PROGRESS FLOW
NOTED BY: IN OUT ACTION PROCESSED
CHIEF, PROCESSING DIVISION/SECTION TIME DATE TIME DATE REMARKS BY

WE HEREBY AFFIX OUR HANDS SIGNIFYING OUR CONFORMITY TO THE INFORMATION HEREIN ABOVE SETFORTH

BOX 6 BOX 8
ARCHITECTURE/CIVIL ENGINEER PRC REG NO SIGNATURE
SIGNED AND SEALED PLANS &SPECIFICATION
PRINT NAME
APPLICANT

ADDRESS COMMUNITY TAX DATE ISSUED PLACE ISSUED

CERTIFICATE
PTR NO.

SIGNATURE

BOX 7 WITH MY CONSENT

BOX 9 (TO BE ACCOMPLISHED BY LOT OWNER)
ARCHITECT/CIVIL ENGINEER IN-CHARGE OF PRC REG NO TCT/OCT NO.
CONSTRUCTION
PRINT NAME PRINT NAME OF LOT OWNER

ADDRESS ADDRESS

PTR NO. DATE ISSUED PLACE ISSUED COMMUNITY TAX CERT.

SIGNATURE TAN SIGNATURE