Fencing Permit

Republic of the PhilippinesLucena City

Quezon Province

OFFICE OF THE BUILDING OFFICIAL

FENCING PERMIT

APPLICATON NO. FP NO. BUILDING PERMIT NO.

BOX 1 ( TO BE ACCOMPLISHED BY THE OWNER / APPLICANT )

OWNER/APPLICANT LAST NAME FIRST NAME M.I. TIN

FOR CONSTRUCTION OWNED FORM OF OWNERSHIPBY ENTERPRISEADDRESS NO. STREET BARANGAY CITY/MUNICIPALITY ZIP CODE TEL. NO.

LOCATION OF CONSTRUCTION LOT NO._____ BLK. NO._____ TCT NO. __________ TAX DEC NO. _____________

STREET ______________ BARANGAY _______________ CITY/MUNICIPALITY OF ________________

SCOPE OF WORK :( ) NEW CONSTRUCTION ( ) REPAIR ( ) OTHERS (specify) ________________( ) ERECTION ( ) DEMOLITION ______________________________________( ) ADDITION

BOX 2 BOX 3DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS FULL-TIME INSPECTOR & SUPERVISOR OF CONSTRUCTION WORKS

__________________________ Date __________ ____________________________ Date ____________ARCHITECT/CIVIL ENGINEER ARCHITECT/CIVIL ENGINEER(Signed & Seal Ove Printed Name) (Signed & Seal Ove Printed Name)

Address AddressPRC No. Validity PRC No. ValidityPTR No. Date Issued PTR No. Date IssuedIssued at TIN Issued at TIN

BOX 4 ( TO BE ACCOMPLISHED Y THE APPLICANT )APPLICANT : WITH MY CONSENT : LOT OWNER

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

Date _______________ Date _______________Address AddressCTC NO. Date Issued Place Issued CTC NO. Date Issued Place Issued

BOX 5REPUBLIC OF THE PHILIPPINES ) S.S.CITY / MUNICIPALITY OF ______________)

BEFORE ME, at the City / Municipality of ___________________________ on _____________________appeared the following :

__________________________ _____________ ____________________ ____________________APPLICANT CTC NO. Date Issued Place Issued

__________________________ _____________ ____________________ ____________________LICENSED ARCHITECT OR CIVIL ENGINEER CTC NO. Date Issued Place Issued

whose signatures appear herein above, known to me to be the same persons who executed this standard prescribed form andacknowledged to me that 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. __________ NOTARY PUBLIC (UNTIL December ______Book No. __________

Series No. __________


Quezon Province


CERTIFICATE OF COMPLETION

___________________DATE

This is to certify that the building/structure covered by Building Permit No. ______________ issued on __________has been constructed and completed under our supervision, conforms with the plans and specifications submitted and onfile with the Office of the Building Official, and complies with the provisions of the National Building Code and AccessibilityLaw (BP Blg. 344)NAME OF OWNER ______________________________________________________________________________________________________________________

(Last Name) First Name M.I.ADDRESS OF THE OWNER _______________________________________________ ZIP CODE ______ TEL. NO._____________

LOCATION OF THE CONSTRUCTION: LOT NO. _____ BLK. NO. _____ BARANGAY ________________ CITY/MUNICIPALITY _______________________

USE OR CHARACTER OF OCCUPANCY ______________________________________________ GROUP _____________________________

PLANNED ACTUAL

DATE OF START OF CONSTRUCTION

DATE OF COMPLETION

TOTAL FLOOR AREA (SQM)

NO. OF STOREY (S)

NO. OF UNITS

SUMMARY OF ACTUAL COSTS

1. TOTAL COST OF MATERIALS: P __________________

1.1 CEMENT (bags) __________________________

1.2 LUMBER (bd.ft.) __________________________

1.3 REINFORCEMENT BARS (kg.) _______________

1.4 G.I. SHEETS (shts. ________________________

1.5 PREFAB STRUCTURAL STEEL (kg ___________

1.6 OTHERS materials ________________________

2. TOTAL COST OF DIRECT LABOR P __________________

This includes compensation whether by salary or contract for project architect or engineer down to laborers.

3. TOTAL COST OF EQUIPMENT UTILIZATION: P __________________

4. OTHER COST: P __________________

This includes professional services fees, permits and othe fees

TOTAL COST OF BUILDING / STRUCTURE P _________________

FULL TIME SUPERVISOR OR INSPECTOR OF CONSTRUCTION IF CONSTRUCTION WAS UNDERTAKEN BY CONTRACTContrctor PCAB Lic. No. _____________

____________________________________ Validity ___________________ARCHITECT OR CIVIL ENGINEER TIN ______________________

(Signed and Sealed Over Printed Name) Address Tel. No.Date _______________

PRC No. ValidityPTR No. Date Issued __________________________ Date ______________Issued at TIN AUTHORIZED MANAGING OFFICERCTC No. Date Issued Issued at (Signature Over Printed Name)

CTC No. Date Issued Place IssuedCONFORME:

_________________________________ Date _______________ CTC No.OWNER / APPLICANT Date Issued

(Signature Over Printed Name) Place IssuedREPUBLIC OF THE PHILIPPINES ) S.S.CITY / MUNICIPALITY OF ______________)

BEFORE ME, at the City / Municipality of ___________________________ on _____________________ personally appeared the personwhose signatures appear herein above, known to me to be the same persons who executed this standard prescribed form andacknowledged to me that 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. __________ NOTARY PUBLIC (UNTIL December ______Book No. __________Series No. __________


Quezon Province


CERTIFICATE OF COMPLETION

___________________

This is to certify that the building/structure covered by Building Permit No. ______________ issued on __________

NAME OF OWNER ______________________________________________________________________________________________________________________

CITY/MUNICIPALITY _______________________

PCAB Lic. No. _____________Validity ___________________TIN ______________________

Date ______________

personally appeared the person


Quezon Province


APPLICATION FOR BUILDING PERMIT

NEW RENEWAL AMENDATORY

APPLICATON NO. AREA NO.


OWNER/APPLICANT LAST NAME FIRST NAME M.I. TIN DO NOT FILL-UP

(NSO USE ONLY)

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP

BY ENTERPRISE

ADDRESS NO. STREET BARANGAY CITY/MUNICIPALITY ZIP CODE TEL. NO.

LOCATION OF CONSTRUCTION FERNANDO S. SU BLK. NO._____ TCT NO. __________ TAX DEC NO. ____________

Engineer I

STREET ______________ BARANGAY _______________ CITY/MUNICIPALITY OF ________________

SCOPE OF WORK :[ NEW CONSTRUCTION [ REPAIR____________ [ RAISING ______________________________

[ ERECTION [ MOVING ___________ [ DEMOLITION __________________________

[ ADDITION [ CONVERSION_______ [ ACCESORY BUILDING STRUCTURE ______

[ ALTERATION [ RENOVATION ______ [ OTHERS (specify _______________________

USE OR CHARACTER OF OCCUPANCY

[ ] GR. A: RESIDENTIAL,DWELLINGS [ ] GR. F: INDUSTRIAL [ ] OTHERS (Specify) ____________

[ ] GR. B: RES., HOTEL, APARTMENT [ ] GR. G: INDUSTRIAL STORAGE & HAZARDOUS

[ ] GR. C: EDUCATIONAL, RECREATIONAL [ ] GR. H: RECREATIONAL,ASSEMBLY OCCUPANT LOAD LESS THAN 1000

[ ] GR. D: INSTITUTIONAL [ ] GR. I: RECREATIONAL,ASSEMBLY OCCUPANT LOAD 1000 OR MORE

[ ] GR. E: BUSINESS & MERCANTILE [ ] GR. J: AGRICULTURAL, ACCESORY

OCCUPANCY CLASSIFIED _________________ TOTAL ESTIMATED COST P __________________________________________

NUMBER OF UNITS _______________________ PROPOSED DATE OF CONSTRUCTION ________________________________

TOTAL FLOOR AREA__________________ SQM. EXPECTED DATE OF COMPLETION ___________________________________

BOX 2FULL-TIME INSPECTOR AND SUPERVISE OF CONSTRUCTION WORKS (REPRESENTING THE OWNER)

Address

PRC No. ValidityPTR No. Date IssuedIssued at TIN

TO BE ACCOMPLISHED BY THE PROCESSING AND EVALUATION DIVISION

BOX 7

RECEIVED BY: DATE :

FIVE (5) SETS OF MECHANICAL DOCUMENTS

( ) MECHANICAL PLANS AND SPECIFICATIONS ( ) COST ESTIMATE( ) BILL OF MATERIALS ( ) OTHERS (Specify) _______________________

BOX 8

PROGRESS FLOW

IN OUTPROCESSED BYDATE TIME DATE TIME

MECHANICALOTHERS (Specify) FERNANDO S. SURQUIAAMOUNT DUE OR NO. Engineer I

BOX 9

ACTION TAKEN:

PERMIT IS HEREBY ISSUED SUBJECT TO THE FOLLOWING:

1. That under Article 1723 of the Civil code of the Philippines, the engineer (or architect) who drew up the plans and specifications for the building/structure is responsible for damages if within fifteen (15) years of completion of the building/structure, the same should collapse due to defect in the plans or specifications or defect sin the ground. The engineer or architect who supervises the construction shall be solidarily liable with the contractor should the edifice collapse due to defect in the construction or the use of interior materials.2. That the proposed civil/structural works shall be in accordance with the civil/structural plans filed with this office and in conformity with the latest National Structural Code of the Philippines, the National Building Code and its IRR.

Building Code.4. That upon completion of the construction, the licensed full-time inspector and supervisor/in-charge of construction works shall submit the entry to the logbook duly signed and sealed to the Building Official including as-built plans and other documents and shall also accomplish and submit a certificate of completion stating that the civil/structural works conform to the provision of the National Structural Code of the Philippines, the National Building Code and its IRR.5. That this permit is null and void unless accompanied by the building permit.

PERMIT ISSUED BY:

AMAURY M. POLINTAN, JR.BUILDING OFFICIAL

(Signature Over Printed Name)Date ______________

3. That prior to any construction activity, a duly accomplished prescribed "Notice of Construction" shall be submitted to the Office of the

collapse due to defect in the plans or specifications or defect sin the ground. The engineer or architect who supervises the construction

2. That the proposed civil/structural works shall be in accordance with the civil/structural plans filed with this office and in conformity with the

4. That upon completion of the construction, the licensed full-time inspector and supervisor/in-charge of construction works shall submit the

accomplish and submit a certificate of completion stating that the civil/structural works conform to the provision of the National Structural


Quezon Province


CIVIL / STRUCTURAL PERMIT

APPLICATON NO. C/SP NO. BUILDING PERMIT NO.




LOCATION OF CONSTRUCTION FERNANDO S. SURQUIA BLK. NO._____ TCT NO. __________ TAX DEC NO. _____________Engineer I

STREET ______________ BARANGAY _______________ CITY/MUNICIPALITY OF ________________SCOPE OF WORK :

( ) NEW CONSTRUCTION ( ) REPAIR_____________ ( ) RAISING ____________________________________( ) ERECTION ( ) MOVING ____________ ( ) DEMOLITION ________________________________( ) ADDITION ( ) CONVERSION________ ( ) ACCESORY BUILDING STRUCTURE _________( ) ALTERATION ( ) RENOVATION _______ ( ) OTHERS (specify) ____________________________

BOX 2 (TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL)

1. That under Article 1723 of the Civil code of the Philippines, the engineer (or architect) who drew up the plans and specifications for the building/structure is responsible for damages if within fifteen (15) years of completion of the building/structure, the same should ( ) STAKING ( ) ERECTION/LIFTING ( ) PRESTRESS WORKS ( ) EXCAVATION ( ) CONCRETE FRAMING ( ) MATERIAL TESTING2. Th( ) SOIL STABILIZATION ( ) STRUCTURAL STEEL FRAMING ( ) STEEL TOWERS ( ) PILING WORKS ( ) SLABS ( ) TANKS

( ) FOUNDATION ( ) WALLS ( ) OTHERS (Specify) ___________________ Building Code.4. That upPREPARED BY ____________________________________________________________________________________ entry to the logbook duly signed and sealed to the Building Official including as-built plans and other documents and shall also accomplish and submit a certificate of completion stating that the civil/structural works conform to the provision of the National Structural Code of the Philippines, the National Building Code and its IRR.5. That this permit is null and void unless accompanied by the building permit.DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS SUPERVISOR/IN-CHARGE OF MECHANICAL WORKS

PER____________________________________ _______________________________________CIVI/STRUCTURAL ENGINEER CIVI/STRUCTURAL ENGINEER

(Signed and /or Sealed Over Printed Name) (Signed and /or Sealed Over Printed Name)

Date _____________________Address BUILDING OFFICIAL AddressPRC No. (Signature Over Printed Name) PRC No. ValidityPTR No. Date _______ Date Issued PTR No. Date IssuedIssued at TIN Issued at TIN

BOX 5 BOX 4

BUILDING OWNER




WITH MY CONSENT : LOT OWNER

TCT NO. __________ TAX DEC NO. _____________

CITY/MUNICIPALITY OF ________________

RAISING ____________________________________DEMOLITION ________________________________ACCESORY BUILDING STRUCTURE _________OTHERS (specify) ____________________________

1. That under Article 1723 of the Civil code of the Philippines, the engineer (or architect) who drew up the plans and specifications for the

_______________________________________

Republic of the PhilippinesDEPARTMENT OF PUBLIC WORKS AND HIGHWAYS


CITY OF LUCENAAREA CODE ___________

APPLICATION NO. DATE APPLICATION FILED

DATE __________________________ DATE FILED __________________PAID UNDER O.R. NO. __________AMOUNT ______________DATE _________________

ELECTRICAL PERMIT

BOX 1OWNER/APPLICANT LAST NAME FIRST NAME M.I. TIN

ADDRESS NO. STREET FERNANDO S. SU BARANGAY CITY/MUNICIPALITY ZIP CODE TEL. NO.Engineer I

LOCATION OF INSTALLATION NO. STREET BARANGAY CITY

BOX 2ASSESSED FEES

AMOUNT DUE ASSESSED BY O.R. NUMBER DATE PAID

1. That under Article 1723 of the Civil code of the Philippines, the engineer (or architect) who drew up the plans andREVIEWED BY: building/structure is responsible for damages if within fifteen (15) years of completion of the building/structure, the same should collapse due to defect in the plans or specifications or defect sin the ground. The engineer or architect who su ESTELITO M. RAMOS, JR. shall be solidarily liable with the contractor should the edifice collapse due to defect in the construction or the use of Electrical Engineer2. That the proposed civil/structural works shall be in accordance with the civil/structural plans filed with this office and in conformity with the latest National Structural Code of the Philippines, the National Building Code and its IRR.

Building Code.

4. T 1. THAT THE PROPOSED INSTALLATIONS BE IN ACCORDANCE WITH THE APPROVED PLANS FILED WITH THIS OFFICE AND IN COMFORMITY

WITH THE PROVISIONS OF THE LATEST EDITION OF THE PHILIPPINE ELECTRICAL CODE

2. THAT A DULY LICENSED ELECTRICAL PRACTITIONER BE IN-CHARGE OF THE INSTALLATION/CONSTRUCTION

3. THAT A CERTIFICATE OF COMPLETION DULY SIGNED BY THE ELECTRICAL PRACTITIONER IN-CHARGE OF THE INSTALLATION BE

5. T SUBMITTED NOT LATER THAN SEVEN (7) DAYS AFTER COMPLETION OF THE INSTALLATION

4. THAT A CERTIFICATE OF FINAL INSPECTION BE SECURED PRIOR TO THE ACTUAL OCCUPANCY OF THE BUILDING

5. THIS PERMIT SHALL BE POSTED AT THE DOOR OR SITE OF WORK.

PERMIT ISSUED BY:RECOMMENDED:

AMAURY M. POLINTAN, JR.BUILDING OFFICIAL __________________________

(Signature Over Printed Name) DATEDat Engineer IV

Electrical Engineer

PERMIT GRANTED:

__________________________ __________________________AMAURY M. POLINTAN, JR. DATE

City Building Official

NOTE 1. This permit may be cancelled or revoked pursuant to Section 305 and 306 of the National Building Code.

NOTE 2. Alterations on this form are not allowed.





DATE FILED __________________

ELECTRICAL PERMIT

TEL. NO.

ASSESSED FEES

ESTELITO M. RAMOS, JR.




APPLICATION NO. DATE APPLICATION FILED

_______________________ _____________________________Date of proposed Start of installation Expected Date of Completion

APPLICATION FOR ELECTRICAL PERMIT

BOX 1 (TO BE ACCOMPLISHED BY A DULY QUALIFIED ELECTRICAL PRACTITIONER)OWNER/APPLICANT LAST NAME FIRST NAME M.I. TIN

ADDRESS NO. STREET BARANGAY CITY/MUNICIPALITY ZIP CODE TEL. NO.FERNANDO S. SURQUIA

LOCATION OF INSTALLATION NO. EnginSTREET BARANGAY CITY

SCOPE OF WORK: ( ) ADDITION OF _______________ ( ) OTHERS (SPECIFY)( ) NEW INSTALLATION ( ) REPAIR OF _________________ _______________________( ) ANNUAL INSPECTION ( ) REMOVAL OF ______________ _______________________TYPE OF OCCUPANCY OR USE:( ) RESIDENTIAL DWELLING ( ) BUSINESS & MERCANTILE ( ) ASSEMBLY OCCUPANT LOAD( ) RESIDENTIAL, HOTEL, APARTMENT ( ) INDUSTRIAL 1,000 OR MORE( ) EDUCATION & RECREATION ( ) STORAGE & HAZARDOUS ( ) ACCESORY( ) INSTITUTIONAL ( )ASSEMBLY OTHER THAN GROUP I ( ) OTHERS (SPECIFY) _________________1. That under Article 1723 of the Civil code of the Philippines, the engineer (or architect) who drew up the plans and specifications for the building/structure is responsible for damages if within fifteen (15) years of completio NUMBER OF EQUIPMENT: WIRING DEVICES: collapse due to defect in the plans or specifications or defect sin the ground. The engineer or architect who supervises the construction LIGHTS SPO, COOKING UNIT TOGGLE SWITCH FA DETECTORS

2. Th CONVENIENCE/RECEPTACLE SPO, WATER HEATER BELLS/BUZZERS OTHERS (see attach list)

SPO, AIRCON SPO, WATER PUMP PUSH BOTTONS ___________________

Building Code.4. That upon completion of the construction, the licensed full-time inspector and supervisor/in-charg PRC REG. NO. VALIDITY entry to the logbook duly signed and sealed to the Building Official including as-built plans and other documents and shall also accomplish and submit a certificate of completion stating that the civil/structural works conform t TEL. NO./FAX NO. Code of the Philippines, the National Building Code and its IRR.5. That this permit is null and void unl DATE ISSUED PLACE ISSUEDSIGNATURE DATE ISSUED TIN

BOX 3 (ELECTRICAL CONTRACTOR - 200 AMPERE MAIN AND ABOVE)

PERMIT ISSUED BY: PCAB LIC. NO. SPECIALTY ELECTRICALVALIDITY

ADDRESS TEL. NO./FAX NO.


BOX 4 (PE(Signature Over Printed Name)( ) PROFESSIONA Date ______________ ( ) REGISTERED ELECT. ENGINEER ( ) REG. MASTER ELECTRICIAN

(not exceeding 600 volts & 500 KVA)NAME PRC REG. NO. VALIDITY

ADDRESS TEL. NO./FAX NO.

PTR NO. DATE ISSUED PLACE ISSUEDSIGNATURE DATE ISSUED TIN

BOX 5 (OWNER / AUTHORIZED REPRESENTATIVE)NAME SIGNATURE TIN CTC NO.______________________

DATE ISSUED ________________PLACE ISSUED _______________

BOX 6RECEIVED BY _________________________________

DESIGN PLANS & SPECIFICATIONS (5sets) Signature Over Printed NameDATE RECEIVED ______________________________





_____________________________

APPLICATION FOR ELECTRICAL PERMIT

TEL. NO.

( ) OTHERS (SPECIFY) _________________

OTHERS (see attach list)

___________________

CTC NO.______________________DATE ISSUED ________________PLACE ISSUED _______________

RECEIVED BY _________________________________

DATE RECEIVED ______________________________


Quezon Province


ARCHITECTURAL PERMIT





LOCATION OF CONSTRUCTION FERNANDO S. SURQUIA BLK. NO._____ TCT NO. __________ TAX DEC NO. _____________Engineer I



BOX 2 (TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL)

1. That under Article 1723 of the Civil code of the Philippines, the engineer (or architect) who drew up the plans and specifications for the building/structure is responsible for damages if within fifteen (15) years of completion of the building/structure, the same should collapse due to defect in the plans or specifications or defect sin the ground. The engineer or architect who supervises the construction ( ) STARS ( ) WASH ROOMS & TOILETS ( ) SWITCHES CONTROLS BUZZERS ( ) DRINKING FOUNTAINS2. Th( ) WALKWAYS ( ) LIFTS ELEVATORS ( ) HANDRILLS ( ) PUBLIC TELEPHONES ( ) CORRIDORS ( ) PUMPS ( ) THRESHOLDS ( ) SEATING ACCOMODATIONS

( ) STARS ( ) PARKING AREAS ( ) FLOOR FINISH ( ) OTHERS (specify) ___________ Building Code.4. That upon completion of the construction, the licensed full-time inspector and supervisor/in-charge of construction works shall submit the entry to the logbook duly signed and sealed to the Building Offici 3. CONFORNANCE TO PRE CODE OF THE PHILIPPINES (PD 1155 accomplish and submit a certificate of completion stating that the civil/structural works conform to the provision of the National Structural Code of the Philippines, the National Building Code and its IRR. ( ) NUMBER & WIDTH OF EXIT DOOR ( ) FIRE WALLS

5. That this permit is null and void unless accompanied by the building permit. ( ) WIDTH OF CORRIDORS ( ) FIRE FIGHTING & SAFETY FACILITIES

PERCENTAGE OF UNPAVED SURFACE AREA __________% ( ) DISTANCE TO FIRE EXIT ( ) SMOKE DETECTORS

OTHERS (Specify) ___________________________________ ( ) ACCESS TO PUBLIC STREET ( ) EMERGENCY EXIT( ) OTHERS (specify) _______________

PERMIT ISSUED BY:BOX 3

DESIGN PROFAMAURY M. POLINTAN, JR. SUPERVISOR/IN-CHARGE OF MECHANICAL WORKSBUILDING OFFICIAL ( ) PROFESSIONAL MECHANICAL ENGINEER

(Signature Over Printed Name) ( ) MECHANICAL ENGINEER__________Date ______________

PROFESSIONAL MECHANICAL ENGINEER _______________________________________ (Signed and /or Sealed Over Printed Name) (Signed and /or Sealed Over Printed Name)

Date _____________________ Date _____________________Address AddressPRC No. Validity PRC No. ValidityPTR No. Date Issued PTR No. Date IssuedIssued at TIN Issued at TIN

BOX 5 BOX 4

BUILDING OWNER WITH MY CONSENT : LOT OWNER




DESIGN PROFESSIONALS, PLANS AND SPECIFICATIONS

ARCHITECTURAL CIVIL / STRUCTURAL

______________________________ DATE _________ ______________________________ DATE _________(Signature Over Printed Name) (Signature Over Printed Name)

Address AddressPRC No. Validity PRC No. ValidityPTR No. Date Issued PTR No. Date IssuedIssue at TIN Issue at TIN

ELECTRICAL MECHANICAL


Address AddressPRC No. Validity PRC No. ValidityPTR No. Date Issued PTR No. Date IssuedIssue at TIN Issue at FERNANDO S. SURQUIA

Engineer I

SANITARY PLUMBING


Address AddressPRC No. Validity PRC No. ValidityPTR No. Date Issued PTR No. Date IssuedIssue at TIN Issue at TIN1. That under Article 1723 of the Civil code of the Philippines, the engineer (or architect) who drew up the plans and specifications for the building/structure is responsible for damages if within fifteen (15) years of completion of the building/structure, the same should collapse due to defect in the plans or specifications or defect sin t INTERIOR DESIGN shall be solidarily liable with the contractor should the edifice collapse due to defect in the construction or the use of interior materials.2. That the proposed civil/structural works shall be in accordance with the ______________________________ DATE _________

latest National Structural Code of the Philippines, the National Building Code and its IRR. (Signature Over Printed Name)Address

Building Code. Validity PRC No. Validity4. That upon completion of Date Issued PTR No. Date Issued entry to the logbook du TIN Issue at TIN accomplish and submit a certificate of completion stating that the civil/structural works conform to the provision of the National Structural Code of the Philippines, the National Building Code and its IRR.

5. That this permit is null and void unless accompanied by the building permit.

ELECTRICAL WORKS MECHANICAL WORKS

PERMIT ISSUED BY: ______________________________ DATE _________(Signature Over Printed Name) (Signature Over Printed Name)

_____________________________________________ _____________________________________________

Address AMAURY M. POLINTAN, JR.PRC No. Validity BUILDING OFPRC No. ValidityPTR No. Date Issue (Signature Over Printed Name) Date IssuedIssue at TIN Date _______Issue at TIN

SANITARY WORKS PLUMBING WORKS


_____________________________________________ _____________________________________________Address AddressPRC No. Validity PRC No. ValidityPTR No. Date Issued PTR No. Date IssuedIssue at TIN Issue at TIN

ELECTRONICS WORKS INTERIOR DESIGN WORKS


_____________________________________________ _____________________________________________Address AddressPRC No. Validity PRC No. ValidityPTR No. Date Issued PTR No. Date Issued

3. That prior to any construction activity, a duly accomplished prescribed

Issue at TIN Issue at TIN

BOX 3 (TO BE ACCOMPLISHED BY DIVISION / SECTION CONCERNED)_____________________________________________________________________________________________________________

ASSESSED FEES_____________________________________________________________________________________________________________Amount Due Assessed By: O.R. No. Date

PEDRITO F. ABADILLA_____________________________________________________________________________________________________________

BOX 4 (TO BE ACCOMPLISHED BY DIVISION / SECTION CONCERNED)

Progress Flow_____________________________________________________________________________________________________________

In Out Action RemarksProcessed By_____________________________________________________________________________________________________________Noted Time Date Time Date_____________________________________________________________________________________________________________Chief Processing________________________________________________________________________FERNANDO S. SURQUIADivison / Section Engineer I_____________________________________________________________________________________________________________Receiving & Releasing_____________________________________________________________________________________________________________Geodetic Line & Grade_____________________________________________________________________________________________________________Sanitary_____________________________________________________________________________________________________________WE AFFIX OUR HANDS SIGNIFYING OUR CONFORMITY TO THE INFORMATION HEREIN ABOVE SETFORTH

1. That under Article 1723 of the Civil code of the Philippines, the engineer (or architect) who drew up the plans and specifications for the building/structure is responsible for damages if within fifteen (15) years of completion of the building/structure, the same should collapse due to defect in the plans or specificatio P.R.C. REG. NO. SANITARY ENGINEER/MASTER PLUMBER shall be solidarily liable with the contractor should the edifice collapse due to defect in the construction or the use of interior materials.2. That the proposed civil/structural works shall be in accordance with the civil/structural plans filed with this office and in conformity with the latest National Structural Code of the Philippines, the National Building Code and its IRR.

PRINT NAME Building Code.4. That upon completion of the construction, the licensed full-time inspector and s ADDRESS entry to the logbook duly signed and sealed to the Building Official including as-built plans and other documents and shall also accomplish and submit a certificate of completion stating that the civil/structur PRC NO. Code of the Philippines, the National Building Code and its IRR.5. That this permit is null and void unle TAN SIGNATURE TAN_____________________________________________________________________________________________________________

BOX 6

PERMIT ISSUED BY:SIGNATURE ___________________________

Applicant

___________________________ AMAURY M. POLINTAN, JR.Res. Cert.No. Date Issue BUILDING Place Issued

(Signature Over Printed Name)____________________________________Date _______________________________________________________________________________________

BOX 7 (TO BE ACCOMPLISHED BY BUILDING OFFICIAL)

ACTION TAKENPERMIT IS HEREBY GRANTED TO INSTALL THE SANITARY, PLUMBING FIXTURE

Enumerated herein subject to the following conditions:

1. That the proposed installation shall be in

accordance with approved plans filed with

this office and in conformity with the National

Building Code.

2.That the duly licensed to undertake the

installation

3 That a certificate of completion duly signed AMAURY M. POLINTAN, JR. by aSanitary Engineer, Master Plumber in- City Building Official charge of installation shall be submitted not

later than (7) days completion of the

installation.

3. That prior to any construction activity, a duly accomplished prescribed "Notice of Construction"

4 That a certificate of final inspection and a

certificate of Occupancy by insured prior to

the actual occupancy of the building

NOTE :This permit may be cancelled or revoked pursuant to Section 305 & 306 of the National Building Code.

_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

FERNANDO S. SURQUIA

_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

1. That under Article 1723 of the Civil code of the Philippines, the engineer (or architect) who drew up the plans and specifications for the

P.R.C. REG. NO.


_____________________________________________________________________________________________________________

AMAURY M. POLINTAN, JR.

This permit may be cancelled or revoked pursuant to Section 305 & 306 of the National Building Code.

TO BE ACCOMPLISHED BY THE PROCESSING AND EVALUATION DIVISION

BOX 7

RECEIVED BY: DATE :

FIVE (5) SETS OF MECHANICAL DOCUMENTS

( ) MECHANICAL PLANS AND SPECIFICATIONS ( ) COST ESTIMATE( ) BILL OF MATERIALS ( ) OTHERS (Specify) _______________________

BOX 8

PROGRESS FLOW

IN OUTPROCESSED BYDATE TIME DATE TIME

MECHANICAL

OTHERS (Specify) FERNANDO S. SURQUIAAMOUNT DUE OR NO. Engineer I

BOX 9

ACTION TAKEN:

PERMIT IS HEREBY ISSUED SUBJECT TO THE FOLLOWING:

1. That under Article 1723 of the Civil code of the Philippines, the engineer (or architect) who drew up the plans and specifications for the building/structure is responsible for damages if within fifteen (15) years of completion of the building/structure, the same should collapse due to defect in the plans or specifications or defect sin the ground. The engineer or architect who supervises the construction shall be solidarily liable with the contractor should the edifice collapse due to defect in the construction or the use of interior materials.2. That the proposed civil/structural works shall be in accordance with the civil/structural plans filed with this office and in conformity with the latest National Structural Code of the Philippines, the National Building Code and its IRR.

Building Code.4. That upon completion of the construction, the licensed full-time inspector and supervisor/in-charge of construction works shall submit the entry to the logbook duly signed and sealed to the Building Official including as-built plans and other documents and shall also accomplish and submit a certificate of completion stating that the civil/structural works conform to the provision of the National Structural Code of the Philippines, the National Building Code and its IRR.5. That this permit is null and void unless accompanied by the building permit.5. That a Certificate of Operation shall be issued for the continuous use of mechanical installations.

PERMIT ISSUED BY:PERMIT ISSUED BY:


(Signature Over Printed Name)BUILDING OFFICIAL

(Signature Over Printed Name)Date _________________


collapse due to defect in the plans or specifications or defect sin the ground. The engineer or architect who supervises the construction


4. That upon completion of the construction, the licensed full-time inspector and supervisor/in-charge of construction works shall submit the

accomplish and submit a certificate of completion stating that the civil/structural works conform to the provision of the National Structural


Quezon Province


MECHANICAL PERMIT





LOCATION OF CONSTRUCTION LOT NO._____ BLK. NO._____ TCT NO. __________ TAX DEC NO. _____________



BOX 2 ( TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL )

INSTALLATION AND OPERATION OF:

( ) BOILER ( ) CENTRAL AIRCONDITIONING ( ) DUMBWAITER

( ) PRESSURE VESSEL ( ) MECHANICAL VENTILLATION ( ) PUMPS

( ) INTERNAL CONBUSTION ENGINE ( ) ESCALATOR ( ) COMPRESSED AIR, VCUUM, INSTI-

( ) REFRIGERATION AND ICE MAKING ( ) MOVING SIDEWALK TUTIONAL and/or INDUSTRIAL GAS

( ) WINDOW TYPE AIRCONDITIONING ( ) FREIGHT ELEVATOR ( ) PNEUMATIC TUBES, CONVEYORS

( ) PACKAGE SPLIT TYPE AIRCONDITIONING ( ) PASSENGER ELEVATOR and/or MONORAILS

( ) OTHER (specify) ( ) CABLE CAR ( ) FUNICULAR

PREPARED BY : _________________________________________________________________________

BOX 3

DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS SUPERVISOR/IN-CHARGE OF MECHANICAL WORKS( ) PROFESSIONAL MECHANICAL ENGINEER( ) MECHANICAL ENGINEER

____________________________________PROFESSIONAL MECHANICAL ENGINEER _______________________________________

(Signed and /or Sealed Over Printed Name) (Signed and /or Sealed Over Printed Name)Date _____________________ Date _____________________

Address AddressPRC No. Validity PRC No. ValidityPTR No. Date Issued PTR No. Date IssuedIssued at TIN Issued at TIN

BOX 5

BUILDING OWNER WITH MY CONSENT : LOT OWNER




Quezon Province


MECHANICAL PERMIT

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