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Fire Safety Evaluation Clearance Form

Feliciano Adorable has submitted a Fire Safety Evaluation Clearance Application to the Bureau of Fire Protection for a proposed 6-storey multi-family dwelling building located at 109 Matahimik Street in Quezon City. The building will have a total floor area of 3098.9 square meters. Paul Mark Q. Antonio, representing the owner, must submit completed sets of architectural, civil/structural, electrical, mechanical, plumbing, electronics, sanitary and fire protection documents as well as licenses of involved professionals. Once verified by BFP personnel, a Customer Relation Officer will certify the application and issue a claim stub to the authorized representative of the owner.

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Paul Mark Antonio
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266 views1 page

Fire Safety Evaluation Clearance Form

Feliciano Adorable has submitted a Fire Safety Evaluation Clearance Application to the Bureau of Fire Protection for a proposed 6-storey multi-family dwelling building located at 109 Matahimik Street in Quezon City. The building will have a total floor area of 3098.9 square meters. Paul Mark Q. Antonio, representing the owner, must submit completed sets of architectural, civil/structural, electrical, mechanical, plumbing, electronics, sanitary and fire protection documents as well as licenses of involved professionals. Once verified by BFP personnel, a Customer Relation Officer will certify the application and issue a claim stub to the authorized representative of the owner.

Uploaded by

Paul Mark Antonio
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
  • Fire Safety Evaluation Clearance Application Form

BUREAU OF FIRE PROTECTION

FSEC
National Capital Region
District V
Quezon City fire District
City Hall Compound, Diliman, Quezon City
APPLICATION NUMBER

FIRE SAFETY EVALUATON CLEARANCE APPLICATION FORM

PROJECT OWNER ADORABLE, FELICIANO

PROJECT TITLE PROPOSED MULTI-STOREY DWELING (6-STOREY W/ ROOF DECK) BUILDING


PROJECT LOCATION House No.109,MATAHIMIK STREET, St., TEACHERS VILLAGE WEST, 4,
OWNER ADDRESS
QUEZON CITY
109 MATAHIMIK ST., BRGY. TEACHER'S VILLAGE WEST, QUEZON CITY
NAME OF CONTRACTOR /
GENERAL CONTRACTOR
AUTHORIZED REPRESENTATIVE ANTONIO, PAUL MARK Q.
(if applicant is not the owner)
CONTACT NUMBER: EMAIL ADDRESS TOTAL FLOOR AREA (sq.m.) NO. OF STOREY

+63 917-520-0322 3098.9 6

ATTACHED DOCUMENTARY REQUIREMENTS


[ ] APPLICATION FORM FOR BUILDING PERMIT FROM THE OFFICE OF THE BUILDING OFFICIAL THREE (3)
COMPLETE SETS OF THE FOLLOWING DOCUMENTS:
[ ] ARCHITECTURAL DOCUMENTS [ ] PLUMBING DOCUMENTS
[ ] CIVIL/STRUCTURAL DOCUMENTS [ ] ELECTRONICS DOCUMENTS
[ ] ELECTRICAL DOCUMENTS [ ] SANITARY DOCUMENTS
[ ] MECHANICAL DOCUMENTS [ ] FIRE PROTECTION PLAN
[ ] PHOTOCOPIES OF VALID LICENCES OF
INVOLVED PROFESSIONAL
[ ] 1 SET OF ESTIMATED COST OF THE BUILDING TO BE CONSTRUCTED/RENOVATED/MODIFIED AS REFLECTED IN
THE BILL OF MATERIALS INCLUDING LABOR COST SIGNED AND SEALED BY THE DESIGNER/CONTRACTOR AND
DULY NOTARIZED

NOTE: Incomplete documentary requirements will be returned to the applicant.

I hereby certify the correctness of the information provided and the completeness of the attached documents

ADORABLE, FELICIANO
OWNER/AUTHORIZED REPRESENTATIVE'S SIGNATURE OVER PRINTED PRINTED NAME DATE

VERIFIED BY BFP-CRO:

DATE/TIME

FSEC MONITORING (To be filled-up by BFP Personnel only)


CRO FCA FCCA C,FSES BPE C,FSES CMF/MFM CRO
DATE: DATE: DATE: DATE: DATE: DATE: DATE: DATE:
IN OUT IN OUT IN OUT IN OUT IN OUT IN OUT IN OUT IN OUT

PAALALA: "MAHIGPIT NA IPINAGBABAWAL NG PAMUNUAN NG BUREAU OF PROTECTION SA MGA KAWANI NITO ANG MAGBENTA O
MAGREKOMENDA NG ANUMANG BRAND NG FIRE EXTINGUISHER"
"FIRE SAFETY IS OUR MAIN CONCERN"
BFP-QSF-FSED-001 REV.01 (07.05.19)

FSEC
BUREAU OF FIRE PROTECTION
National Capital Region
District V
Quezon City fire District
City Hall Compound, Diliman, Quezon City APPLICATION NUMBER

CLAIM STUB
CERTIFIED BY:

CUSTOMER RELATION OFFICER DATE

NOTE: Authorized Representative must present as Authorization Letter and Copy of Owner's Identification Card
PAALALA: "MAHIGPIT NA IPINAGBABAWAL NG PAMUNUAN NG BUREAU OF PROTECTION SA MGA KAWANI NITO ANG MAGBENTA O
MAGREKOMENDA NG ANUMANG BRAND NG FIRE EXTINGUISHER"
"FIRE SAFETY IS OUR MAIN CONCERN"

BFP-QSF-FSED-001 REV.01 (07.05.19)

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