Fencing Permit

Republic of the Philippines Lucena 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

FOR CONSTRUCTION OWNED BY ENTERPRISE ADDRESS NO. STREET

FIRST NAME

M.I.

TIN

FORM OF OWNERSHIP BARANGAY

CITY/MUNICIPALITY

ZIP CODE

TEL. NO.

LOCATION OF CONSTRUCTION LOT NO._____ BLK. NO._____ TCT NO. __________ TAX DEC NO. _____________ STREET ______________ SCOPE OF ( ) ( ) ( )

BARANGAY _______________

WORK : NEW CONSTRUCTION ERECTION ADDITION

( (

) )

REPAIR DEMOLITION

CITY/MUNICIPALITY OF ________________

( ) OTHERS (specify) ________________ ______________________________________

BOX 2 BOX 3 DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS FULL-TIME INSPECTOR & SUPERVISOR OF CONSTRUCTION WORKS __________________________ Date __________ ARCHITECT/CIVIL ENGINEER (Signed & Seal Ove Printed Name) Address PRC No. Validity PTR No. Date Issued Issued at TIN

____________________________ Date ____________ ARCHITECT/CIVIL ENGINEER (Signed & Seal Ove Printed Name) Address PRC No. Validity PTR No. Date Issued Issued at TIN

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

____________________________________ ( Signature Over Printed Name ) Date _______________ Address CTC NO. Date Issued Place Issued

____________________________________ ( Signature Over Printed Name ) Date _______________ Address CTC NO. Date Issued Place Issued

BOX 5 REPUBLIC 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 prescr acknowledged 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. __________ Book No. __________

____________________________________ NOTARY PUBLIC (UNTIL December ______

Series No. __________

TCT NO. __________ TAX DEC NO. _____________

OTHERS (specify) ________________

IME INSPECTOR & SUPERVISOR OF CONSTRUCTION WORKS

__________________________ Date ____________

be the same persons who executed this standard prescribed form and

Republic of the Philippines Lucena City Quezon Province

OFFICE OF THE BUILDING OFFICIAL

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 on file with the Office of the Building Official, and complies with the provisions of the National Building Code and Accessibility Law (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 CONTRACT Contrctor PCAB Lic. No. _____________ ____________________________________ Validity ___________________ ARCHITECT OR CIVIL ENGINEER TIN ______________________ (Signed and Sealed Over Printed Name) Address Tel. No. Date _______________ PRC No. Validity PTR No. Date Issued __________________________ Date ______________

Issued at CTC No.

TIN Date Issued

Issued at

AUTHORIZED MANAGING OFFICER (Signature Over Printed Name) CTC No. Date Issued Place Issued

CONFORME: Date _______________ CTC No. _________________________________ OWNER / APPLICANT Date Issued (Signature Over Printed Name) Place Issued REPUBLIC OF THE PHILIPPINES ) S.S. CITY / MUNICIPALITY OF ______________) BEFORE ME, at the City / Municipality of ___________________________ on _____________________ personally appeared the perso whose signatures appear herein above, known to me to be the same persons who executed this standard prescribed acknowledged 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. Book No. Series No.

__________ __________ __________ __________

____________________________________ NOTARY PUBLIC (UNTIL December ______

____________________________________________________________________

CITY/MUNICIPALITY _______________________

_______________________ GROUP _____________________________

TIN ______________________

personally appeared the person he same persons who executed this standard prescribed form and

Republic of the Philippines Lucena City Quezon Province

OFFICE OF THE BUILDING OFFICIAL

APPLICATION FOR BUILDING PERMIT NEW

RENEWAL

APPLICATON NO.

AMENDATORY

AREA NO.

BOX 1 ( TO BE ACCOMPLISHED BY THE OWNER / APPLICANT ) 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 CONSTRUCTIONFERNANDO S. SURQUIA BLK. NO._____ TCT NO. __________ TAX DEC NO. ____________ Engineer I STREET ______________

SCOPE OF WORK : [ ] NEW CONSTRUCTION [ ] ERECTION [ ] ADDITION [ ] ALTERATION

BARANGAY _______________

[ [ [ [

] ] ] ]

REPAIR____________ MOVING ___________ CONVERSION_______ RENOVATION ______

[ [ [ [

] ] ] ]

CITY/MUNICIPALITY OF ________________

RAISING ______________________________ DEMOLITION __________________________ ACCESORY BUILDING STRUCTURE ______ 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 2 FULL-TIME INSPECTOR AND SUPERVISE OF CONSTRUCTION WORKS (REPRESENTING THE OWNER)

Address

PRC No. PTR No. Issued at

Validity Date Issued 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 ( ) BILL OF MATERIALS

( ) COST ESTIMATE ( ) OTHERS (Specify) _______________________

BOX 8 PROGRESS FLOW IN DATE MECHANICAL OTHERS (Specify) AMOUNT DUE

OUT TIME

DATE

OR NO.

TIME

PROCESSED BY FERNANDO S. SURQUIA 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 building/structure is responsible for damages if within fifteen (15) years of completion of the building/structu collapse due to defect in the plans or specifications or defect sin the ground. The engineer or architect who s shall be solidarily liable with the contractor should the edifice collapse due to defect in the construction or th 2. That the proposed civil/structural works shall be in accordance with the civil/structural plans filed with this of latest National Structural Code of the Philippines, the National Building Code and its IRR. 3. That prior to any construction activity, a duly accomplished prescribed "Notice of Construction" Building Code. 4. That upon completion of the construction, the licensed full-time inspector and supervisor/in-charge of constru entry to the logbook duly signed and sealed to the Building Official including as-built plans and other docum accomplish and submit a certificate of completion stating that the civil/structural works conform to the provi 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 ______________

FERNANDO S. SURQUIA

e engineer (or architect) who drew up the plans and specifications for the (15) years of completion of the building/structure, the same should sin the ground. The engineer or architect who supervises the construction e collapse due to defect in the construction or the use of interior materials. e with the civil/structural plans filed with this office and in conformity with the

rescribed "Notice of Construction" shall be submitted to the Office of the

me inspector and supervisor/in-charge of construction works shall submit the Official including as-built plans and other documents and shall also t the civil/structural works conform to the provision of the National Structural

Republic of the Philippines Lucena City Quezon Province

OFFICE OF THE BUILDING OFFICIAL

CIVIL / STRUCTURAL PERMIT APPLICATON NO.

C/SP NO.

BUILDING PERMIT NO.

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

LAST NAME

FOR CONSTRUCTION OWNED BY ENTERPRISE ADDRESS NO. STREET

FIRST NAME

M.I.

TIN

FORM OF OWNERSHIP BARANGAY

CITY/MUNICIPALITY

ZIP CODE

TEL. 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 u building/structure is responsible for damages if within fifteen (15) years of completion of the building/structure collapse due to defect in the or specifications or defect sin the ground. The engineer ( ) STAKING ( ) plans ERECTION/LIFTING ( ) PRESTRESS WORKS or architect who sup shall be solidarily liable with contractor should the edifice collapse to defect in the construction or the ( ) EXCAVATION ( )the CONCRETE FRAMING ( due ) MATERIAL TESTING 2. That the proposed civil/structural works shall be in accordance with the ( ) SOIL STABILIZATION ( ) STRUCTURAL STEEL FRAMING ( civil/structural ) STEEL TOWERSplans filed with this office latest National Structural Code of the Philippines, the National Building and its IRR. ( ) PILING WORKS ( ) SLABS ( Code ) TANKS 3. That prior to any construction activity, a duly accomplished prescribed( ) OTHERS (Specify) ___________________ ( ) FOUNDATION ( ) WALLS Building Code. 4. That PREPARED upon completion of the construction, the licensed full-time inspector and supervisor/in-charge of construct BY ____________________________________________________________________________________ entry to the logbook duly signed and sealed to the Building Official including as-built plans and other documen accomplish and submit a certificate of completion stating that the civil/structural works conform to the provisio 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

PERMIT ISSUED BY: ____________________________________

_______________________________________

CIVI/STRUCTURAL ENGINEER

(Signed and /or Sealed Over Printed Name)

CIVI/STRUCTURAL ENGINEER

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

Address PRC No. PTR No. Issued at

BUILDING OFFICIAL (Signature Over Printed Name) Date ______________ Date Issued TIN

Address PRC No. PTR No. Issued at

Validity Date Issued TIN

BOX 5

BOX 4

BUILDING OWNER

WITH MY CONSENT : LOT OWNER

____________________________________ ( Signature Over Printed Name ) Date _______________ Address CTC NO. Date Issued Place Issued

____________________________________ ( Signature Over Printed Name ) Date _______________ Address CTC NO. Date Issued Place Issued

TEL. NO.

__________ TAX DEC NO. _____________

NICIPALITY OF ________________

AISING ____________________________________ EMOLITION ________________________________ CCESORY BUILDING STRUCTURE _________ THERS (specify) ____________________________

engineer (or architect) who drew up the plans and specifications for the s of completion of the building/structure, the same should

) OTHERS (Specify) ___________________

uding as-built plans and other documents and shall also structural works conform to the provision of the National Structural

CHARGE OF MECHANICAL WORKS

Republic of the Philippines DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS

OFFICE OF THE BUILDING OFFICIAL CITY OF LUCENA AREA CODE ___________ APPLICATION NO.

DATE APPLICATION FILED

DATE __________________________ PAID UNDER O.R. NO. __________

DATE FILED __________________

AMOUNT ______________ DATE _________________

ELECTRICAL PERMIT BOX 1 OWNER/APPLICANT ADDRESS

NO.

LAST NAME

FIRST NAME

STREETFERNANDO S. BARANGAY SURQUIA Engineer I

LOCATION OF INSTALLATIONNO.

STREET

M.I.

CITY/MUNICIPALITY BARANGAY

TIN ZIP CODE

TEL. NO.

CITY

BOX 2 AMOUNT DUE

ASSESSED BY

ASSESSED FEES O.R. NUMBER

DATE PAID

1. That under Article 1723 of the Civil code of the Philippines, the engineer (or architect) who drew REVIEWED BY: up the plans a building/structure is responsible for damages if within fifteen (15) years of completion of the building/structure collapse due to defect in the plans or specifications or defect sin the ground. TheESTELITO engineerM. or RAMOS, architectJR. who sup shall be solidarily liable with the contractor should the edifice collapse due to defectElectrical in the construction or the Engineer 2. That the proposed civil/structural works shall be in accordance with the civil/structural plans filed with this offic latest National Structural Code of the Philippines, the National Building Code and its IRR. 3. That prior to any construction activity, a duly accomplished prescribed "Notice of Construction" shall be sub Building Code.

4. That upon of the construction, the licensed full-time inspector and supervisor/in-charge construct 1. THAT THEcompletion PROPOSED INSTALLATIONS BE IN ACCORDANCE WITH THE APPROVED PLANS FILED WITH THIS OFFICE AND INof COMFORMITY entry thePROVISIONS logbook duly signed sealed to the Building Official CODE including as-built plans and other documen WITHtoTHE OF THE LATESTand EDITION OF THE PHILIPPINE ELECTRICAL accomplish and submitELECTRICAL a certificate of completion statingOFthat civil/structural works conform to the provisio 2. THAT A DULY LICENSED PRACTITIONER BE IN-CHARGE THE the INSTALLATION/CONSTRUCTION Code ofAthe Philippines, the National Code and its IRR. 3. THAT CERTIFICATE OF COMPLETION DULYBuilding SIGNED BY THE ELECTRICAL PRACTITIONER IN-CHARGE OF THE INSTALLATION BE 5. That this permit nullTHAN and SEVEN void unless accompanied by the building permit. SUBMITTED NOT is LATER (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) Date ______________ Engineer IV Electrical Engineer

__________________________ DATE

PERMIT GRANTED:

__________________________ AMAURY M. POLINTAN, JR. City Building Official

__________________________ DATE

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.

s D HIGHWAYS

OFFICIAL

_

MIT

TEL. NO.

15) years of completion of the building/structure, the same should ESTELITO M. RAMOS, JR.

with the civil/structural plans filed with this office and in conformity with the

escribed "Notice of Construction" shall be submitted to the Office of the

OVED PLANS FILED WITH THIS OFFICE AND IN COMFORMITY

RACTITIONER IN-CHARGE OF THE INSTALLATION BE

Republic of the Philippines DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS

OFFICE OF THE BUILDING OFFICIAL CITY OF LUCENA AREA CODE ___________ 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. ADDRESS

NO.

STREET BARANGAY FERNANDO S. SURQUIA

LOCATION OF INSTALLATIONNO. Engineer STREET I

CITY/MUNICIPALITY

TIN ZIP CODE

BARANGAY

TEL. NO.

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 a building/structure is responsible for damages if within fifteen NUMBER (15) years OFofEQUIPMENT: completion of WIRING the building/structure, DEVICES: the same s collapse due to defect in the plans or specifications or defect sin the ground. The engineer or architect who sup shall LIGHTS be solidarily liable with the contractor SPO, COOKING should UNIT the edifice collapse TOGGLE dueSWITCH to defect in the construction FA DETECTORS or the use of interio 2. That CONVENIENCE/RECEPTACLE the proposed civil/structural SPO, worksWATER shall be HEATER in accordance with BELLS/BUZZERS the civil/structural plans filed OTHERS with this (seeoffice attach and list) in conf latest SPO, AIRCON National Structural Code ofSPO, the Philippines, WATER PUMP the National Building PUSH BOTTONS Code and its IRR. ___________________ 3. That prior to any construction activity, a duly accomplished prescribed "Notice of Construction" shall be sub Building Code. 4. That upon completion of the construction, the licensed full-time inspector PRC and REG.supervisor/in-charge NO. VALIDITYof construct entry to the logbook duly signed and sealed to the Building Official including as-built plans and other documen accomplish and submit a certificate of completion stating that the civil/structural TEL. NO./FAXworks NO. conform to the provisio Code of the Philippines, the National Building Code and its IRR. 5. That this permit is null andDATE void unless ISSUEDaccompanied by the building permit. PLACE ISSUED SIGNATURE DATE ISSUED TIN BOX 3 (ELECTRICAL CONTRACTOR - 200 AMPERE MAIN AND ABOVE)

PERMIT ISSUED BY:

PCAB LIC. NO. VALIDITY

ADDRESS

SPECIALTY ELECTRICAL TEL. NO./FAX NO.

AMAURY M. POLINTAN, JR. BUILDING OFFICIAL BOX(Signature 4 (PERSON Over IN-CHARGE Printed Name) OF INSTALLATION) ( ) PROFESSIONAL DateELECTRICAL ______________ ENGINEER ( ) REGISTERED ELECT. ENGINEER ( ) REG. MASTER ELECTRICIAN (not exceeding 600 volts & 500 KVA)

NAME

PRC REG. NO.

ADDRESS

TEL. NO./FAX NO.

PTR NO. SIGNATURE

DATE ISSUED DATE ISSUED

BOX 5 (OWNER / AUTHORIZED REPRESENTATIVE) NAME SIGNATURE

VALIDITY

PLACE ISSUED TIN

TIN

CTC NO.______________________ DATE ISSUED ________________ PLACE ISSUED _______________

BOX 6 DESIGN PLANS & SPECIFICATIONS (5sets)

RECEIVED BY _________________________________ Signature Over Printed Name DATE RECEIVED ______________________________

s D HIGHWAYS

OFFICIAL

_

_____________________________ Expected Date of Completion

AL PERMIT

TEL. NO.

( ) ASSEMBLY OCCUPANT LOAD

( ) OTHERS (SPECIFY) _________________

engineer (or architect) who drew up the plans and specifications for the

in the ground. The engineer or architect who supervises the construction

OTHERS (see attach list) ___________________ escribed "Notice of Construction" shall be submitted to the Office of the

ficial including as-built plans and other documents and shall also

(not exceeding 600 volts & 500 KVA)

CTC NO.______________________ DATE ISSUED ________________ PLACE ISSUED _______________

ED BY _________________________________

ECEIVED ______________________________

Republic of the Philippines Lucena City Quezon Province

OFFICE OF THE BUILDING OFFICIAL

ARCHITECTURAL PERMIT APPLICATON NO.

FP NO.

BUILDING PERMIT NO.

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

LAST NAME

FOR CONSTRUCTION OWNED BY ENTERPRISE ADDRESS NO. STREET

FIRST NAME

M.I.

TIN

FORM OF OWNERSHIP BARANGAY

CITY/MUNICIPALITY

ZIP CODE

TEL. 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

collapse due to defect in the plans or specifications or defect sin the ground. The engineer or architect who supervises the shall be solidarily the&contractor edificeCONTROLS collapse due to defect in the construction ( ) STARS ( )liable WASHwith ROOMS TOILETS should ( ) the SWITCHES BUZZERS( ) DRINKING FOUNTAINS or the use of interi 2. That the proposed works shall be(in)accordance plansTELEPHONES filed with this office and in con ( ) WALKWAYS ( ) civil/structural LIFTS ELEVATORS HANDRILLS with the civil/structural ( ) PUBLIC latest National Structural National Building Code and( its IRR. ( ) CORRIDORS( ) PUMPS Code of the Philippines, ( )the THRESHOLDS ) SEATING ACCOMODATIONS 3. That prior to any activity, a duly accomplished prescribed ( ) STARS ( construction ) 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 sh entry to the logbook duly signed and sealed to the Building Official including as-built plans and other documents and shall 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 Nat ( ) NUMBER & WIDTH OF EXIT DOOR( ) FIRE WALLS Code of the Philippines, the National Building Code and its IRR. ( ) WIDTH OF CORRIDORS 5. That this permit is null and void unless accompanied by the building permit. PERCENTAGE OF UNPAVED SURFACE AREA __________% OTHERS (Specify) ___________________________________

( ) DISTANCE TO FIRE EXIT ( ) ACCESS TO PUBLIC STREET

( ) FIRE FIGHTING & SAFETY FACILITIES

( ) SMOKE DETECTORS ( ) EMERGENCY EXIT ( ) OTHERS (specify) _______________

PERMIT ISSUED BY: BOX 3

AMAURY M. POLINTAN, JR. SPECIFICATIONS DESIGN PROFESSIONAL, PLANS AND BUILDING OFFICIAL (Signature Over Printed Name) ____________________________________ Date ______________

SUPERVISOR/IN-CHARGE OF MECHANICAL WORKS ( ) PROFESSIONAL MECHANICAL ENGINEER ( ) MECHANICAL ENGINEER

(Signed and /or Sealed Over Printed Name) Date _____________________ Address PRC No. Validity PTR No. Date Issued Issued at TIN

_______________________________________ (Signed and /or Sealed Over Printed Name) Date _____________________ Address PRC No. Validity PTR No. Date Issued Issued at TIN

BOX 5

BOX 4

BUILDING OWNER

WITH MY CONSENT : LOT OWNER

____________________________________ ( Signature Over Printed Name ) Date _______________ Address CTC NO. Date Issued Place Issued

____________________________________ ( Signature Over Printed Name ) Date _______________ Address CTC NO. Date Issued Place Issued

PROFESSIONAL MECHANICAL ENGINEER

eer (or architect) who drew up the plans and specifications for the

sin the ground. The engineer or architect who supervises the construction

me inspector and supervisor/in-charge of construction works shall submit the

t the civil/structural works conform to the provision of the National Structural

DESIGN PROFESSIONALS, PLANS AND SPECIFICATIONS ARCHITECTURAL

CIVIL / STRUCTURAL

______________________________ DATE _________ (Signature Over Printed Name) Address PRC No. Validity PTR No. Date Issued Issue at TIN

______________________________ DATE _________ (Signature Over Printed Name) Address PRC No. Validity PTR No. Date Issued Issue at TIN

ELECTRICAL

MECHANICAL

______________________________ DATE _________ (Signature Over Printed Name) Address PRC No. Validity PTR No. Date Issued Issue at TIN

______________________________ DATE _________ (Signature Over Printed Name) Address PRC No. Validity PTR No. Date Issued Issue at FERNANDO S. SURQUIA Engineer I

SANITARY

PLUMBING

______________________________ DATE _________ ______________________________ DATE _________ (Signature Over Printed Name) (Signature Over Printed Name) Address Address PRC No. Validity PRC No. Validity PTR No. Date Issued PTR No. Date Issued Issue at TIN Issue at TIN 1. That under Article 1723 of the Civil code of the Philippines, the engineer (or architect) who drew up the plans a building/structure is responsible for damages if within fifteen (15) years of completion of the building/structur collapse due to defect in the plans or specifications or defect sin the ground. The engineer or architect who su INTERIOR DESIGN shall be solidarily liable with the contractor should the edifice collapse due to defect in the construction or the 2. That the proposed civil/structural works shall be in______________________________ accordance with the civil/structural plans filed with this offic DATE _________ uctural Code of the Philippines, the National Building Code and (Signature its IRR. Over Printed Name) 3. That prior to any construction activity, a duly accomplished Address prescribed Building Code. Validity PRC No. Validity 4. That upon completion of the construction, the licensed full-time inspector supervisor/in-charge of construc Date Issued PTR No. Dateand Issued entry to the logbook Building Official including as-built plans and other documen TIN duly signed and sealed to the Issue at TIN accomplish and submit a certificate of completion stating that the civil/structural works conform to the provisi 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 PRC No. PTR No. Issue at

AMAURY M. POLINTAN, JR. Validity BUILDING OFFICIAL PRC No. Date Issued (Signature Over Printed Name) TIN Date ______________ Issue at

Validity Date Issued TIN

SANITARY WORKS

PLUMBING WORKS

______________________________ DATE _________ (Signature Over Printed Name) _____________________________________________ Address PRC No. Validity PTR No. Date Issued Issue at TIN

______________________________ DATE _________ (Signature Over Printed Name) _____________________________________________ Address PRC No. Validity PTR No. Date Issued Issue at TIN

ELECTRONICS WORKS

INTERIOR DESIGN WORKS

______________________________ DATE _________ (Signature Over Printed Name) _____________________________________________ Address PRC No. Validity PTR No. Date Issued

______________________________ DATE _________ (Signature Over Printed Name) _____________________________________________ Address PRC No. Validity PTR No. Date Issued

Issue at

TIN

Issue at

TIN

the engineer (or architect) who drew up the plans and specifications for the en (15) years of completion of the building/structure, the same should

ice collapse due to defect in the construction or the use of interior materials.

hat the civil/structural works conform to the provision of the National Structural

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 Remarks Processed By ____________________________________________________________________________________________________ Noted Time Date Time Date ____________________________________________________________________________________________________ Chief Processing ____________________________________________________________________________________________________ FERNANDO S. SURQUIA Divison / 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 building/structure is responsible for damages if within fifteen (15) years of completion of the building/structu collapse due to defect in the plans orP.R.C. specifications REG. NO.or defect SANITARY sin the ENGINEER/MASTER ground. The engineer PLUMBER or architect who s shall be solidarily liable with the contractor should the edifice collapse due to defect in the construction or th 2. That the proposed civil/structural works shall be in accordance with the civil/structural plans filed with this of latest National Structural Code of the Philippines, the National Building Code and its IRR. 3. That prior to any construction activity, a duly accomplished prescribed PRINT NAME Building Code. 4. That upon completion of the construction, the licensed full-time inspector and supervisor/in-charge of constru ADDRESS entry to the logbook duly signed and sealed to the Building Official including as-built plans and other docum accomplish and submit a certificate of completion statingPRC thatNO. the civil/structural works conform to the provi Code of the Philippines, the National Building Code and its IRR. 5. That this permit is null and TAN void unless accompanied by the building permit. SIGNATURE TAN ____________________________________________________________________________________________________ BOX 6

PERMIT ISSUED BY: SIGNATURE

___________________________ Applicant

AMAURY M. POLINTAN, JR. _________________________________________________________________________ Res. Cert.No. Date IssuedBUILDING Place OFFICIAL Issued (Signature Over Printed Name) _________________________________________________________________________ Date ______________ _________________________________________________________________________ BOX 7 (TO BE ACCOMPLISHED BY BUILDING OFFICIAL) ACTION TAKEN PERMIT 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 by aSanitary Engineer, Master Plumber incharge of installation shall be submitted not later than (7) days completion of the installation.

AMAURY M. POLINTAN, JR. City Building Official

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

_______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________ MATION HEREIN ABOVE SETFORTH

, the engineer (or architect) who drew up the plans and specifications for the years of completion of the building/structure, the same should P.R.C. REG. NO. apse due to defect in the construction or the use of interior materials. h the civil/structural plans filed with this office and in conformity with the

l including as-built plans and other documents and shall also

_______________________________________________

AMAURY M. POLINTAN, JR.

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 ( ) BILL OF MATERIALS

( ) COST ESTIMATE ( ) OTHERS (Specify) _______________________

BOX 8 PROGRESS FLOW IN DATE MECHANICAL OTHERS (Specify) AMOUNT DUE

OUT TIME

DATE

TIME

PROCESSED BY FERNANDO S. SURQUIA

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 building/structure is responsible for damages if within fifteen (15) years of completion of the building/structu collapse due to defect in the plans or specifications or defect sin the ground. The engineer or architect who s shall be solidarily liable with the contractor should the edifice collapse due to defect in the construction or th 2. That the proposed civil/structural works shall be in accordance with the civil/structural plans filed with this of latest National Structural Code of the Philippines, the National Building Code and its IRR. 3. That prior to any construction activity, a duly accomplished prescribed "Notice of Construction" Building Code. 4. That upon completion of the construction, the licensed full-time inspector and supervisor/in-charge of constru entry to the logbook duly signed and sealed to the Building Official including as-built plans and other docum accomplish and submit a certificate of completion stating that the civil/structural works conform to the provi 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:

AMAURY M. POLINTAN, JR. BUILDING OFFICIAL

(Signature Over Printed Name) BUILDING OFFICIAL (Signature Over Printed Name) Date _________________

FERNANDO S. SURQUIA

e engineer (or architect) who drew up the plans and specifications for the (15) years of completion of the building/structure, the same should sin the ground. The engineer or architect who supervises the construction e collapse due to defect in the construction or the use of interior materials. e with the civil/structural plans filed with this office and in conformity with the

rescribed "Notice of Construction" shall be submitted to the Office of the

me inspector and supervisor/in-charge of construction works shall submit the Official including as-built plans and other documents and shall also t the civil/structural works conform to the provision of the National Structural

Republic of the Philippines Lucena City Quezon Province

OFFICE OF THE BUILDING OFFICIAL

MECHANICAL PERMIT APPLICATON NO.

FP NO.

BUILDING PERMIT NO.

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

LAST NAME

FOR CONSTRUCTION OWNED BY ENTERPRISE ADDRESS NO. STREET

FIRST NAME

M.I.

TIN

FORM OF OWNERSHIP 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_____________( ) RAISING ____________________________________ ( ) ERECTION ( ) MOVING ____________( ) DEMOLITION ________________________________ ( ) ADDITION ( ) CONVERSION________ ( ) ACCESORY BUILDING STRUCTURE _________ ( ) ALTERATION ( ) RENOVATION _______ ( ) OTHERS (specify) ____________________________ BOX 2 ( TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL ) INSTALLATION AND OPERATION OF: ( ( ( ( ( ( (

) ) ) ) ) ) )

( ( PRESSURE VESSEL ( INTERNAL CONBUSTION ENGINE ( REFRIGERATION AND ICE MAKING ( WINDOW TYPE AIRCONDITIONING PACKAGE SPLIT TYPE AIRCONDITIONING ( ( OTHER (specify) BOILER

) ) ) ) ) ) )

CENTRAL AIRCONDITIONING (

)

DUMBWAITER

MECHANICAL VENTILLATION (

)

PUMPS

ESCALATOR

(

)

COMPRESSED AIR, VCUUM, INSTI-

(

)

MOVING SIDEWALK FREIGHT ELEVATOR

TUTIONAL and/or INDUSTRIAL GAS

PASSENGER ELEVATOR CABLE CAR

PNEUMATIC TUBES, CONVEYORS and/or MONORAILS

(

)

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 Address PRC No. Validity PRC No. Validity PTR No. Date Issued PTR No. Date Issued Issued at TIN Issued at TIN BOX 5 BUILDING OWNER

WITH MY CONSENT : LOT OWNER

____________________________________ ( Signature Over Printed Name ) Date _______________ Address CTC NO. Date Issued Place Issued

____________________________________ ( Signature Over Printed Name ) Date _______________ Address CTC NO. Date Issued Place Issued

public of the Philippines Lucena City Quezon Province

THE BUILDING OFFICIAL

HANICAL PERMIT

TCT NO. __________ TAX DEC NO. _____________

RAISING ____________________________________ DEMOLITION ________________________________ OTHERS (specify) ____________________________

COMPRESSED AIR, VCUUM, INSTITUTIONAL and/or INDUSTRIAL GAS PNEUMATIC TUBES, CONVEYORS