BOX 6 (SUBMITTALS TO BE CHECKED, RECEIVED AND RECORD)
(FIVE (5) SETS EACH OF BUILDING DOCUMENTS SIGNED AND SEALED BY DULY LICENSED PROFESSIONAL OR RESPECTIVE DISCIPLINES)
LOT PLAN WITH VICINITY MAP SANITARY PLANS AND SPECIFICATIONS
ARCHITECTURAL PLANS AND SPECIFICATIONS PLUMBING PLANS AND SPECIFICATIONS
CIVIL/STRUCTURAL PLANS (DESIGN AND COMPUTATION ELECTRONICS PLANS AND SPECIFICATIONS
ELECTRICAL PLANS AND SPECIFICATIONS OTHERS (Specify)
MECHANICAL PLANS AND SPECIFICATIONS
BOX 7 (TO BE ACCOMPLISHED BY THE TECHNICAL STAFF OF THE DIFFERENT SECTION OF THE OFFICE OF THE BUILDING OFFICIALS)
RECEIVING AND RECORDING IN OUT PROGRESS FLOW
DATE TIME DATE TIME ACTION/REMARKS PROCESSED BY
LOCATIONAL/ZONING OF LAND USE
LINE AND GRADE (Geodetic)
ARCHITECTURAL
CIVIL/STRUCTURAL
ELECTRICAL
MECHANICAL
SANITARY
PLUMBING
ELECTRONICS
INTERIOR
OTHERS(Specify)
Noted
BOX 8 (TO BE ACCOMPLISHED BY THE TECHNICAL STAFF OF THE DIFFERENT SECTION OF THE OFFICE OF THE BUILDING OFFICIALS)
ASSESSED FEES ASSESSES BY AMOUNT DUE DATE PAID O.R. NUMBER
LOCATIONAL/ZONING OF LAND USE
LINE AND GRADE (Geodetic)
FENCING
ARCHITECTURAL
CIVIL/STRUCTURAL
ELECTRICAL
MECHANICAL
SANITARY
PLUMBING
ELECTRONICS
INTERIOR
TOTAL
REVIEWED
BOX 9
BP No. DATE ISSUED
Permit is issued to______________________ for the purposed ______________under ____________of
(OWNER/APPLICANT (Type of Project) (Used or Char of Occupancy)
group ___ located at lot no. _______Barangay _____________ City/Municipality of ________ subject to the following:
1. That the designer is aware that under Article 1723 of the Civil Code of the Philippines, he/she is responsible for damages if within fifteen (15) years from the
completion of the building/structure, it should collapse due to defect or sp.
2. That the proposed construction/erection/additional/alternation/renovation/conversion/repair/moving/demolition/etc. shall be conformity with the
provision of the National Building Code, and its IRR.
2.1 That prior to commencement of the proposed projects and construction an actual relocation survey shall be conducted by a duly licensed
Geodetic Engineer.
2.2 That before commencing the excavation the person making or casing the excavation is to be made shall notify in writing the owner of the
adjoining property no less than ten (10) days before such excavation is to be made and show how the adjoining properly should be protected.
2.3 That the supervising Architect/Civil Engineer shall keep at the jobsite at all the times a logbook of daily construction activities wherein the actual
daily progress of construction including tests, conducted weather condition and other pertinent data are to be recorded.
2.4 That upon completion of the construction, the said licensed supervising Architect or Civil Engineer shall submit the logbook duly signed and
sealed to the Building Official including as-built plans and other documents and shall also prepare and submit a Certificate of Completion of the projects stating
that the construction of the building/structure conform to the provision of the Code. It’s IRR as well as the plans and specifications.
3. That no building/structure be used until the Building Official has issued a Certificate of Occupancy, therefore as provided in the Code. However, a partial
Certificate of Occupancy may be issued for the Used/Occupancy of portions of a building/structure prior to the competition of the entire building/ structure.
4. That this permit shall not serve as an exemption from securing written clearance from various government authorities exercising regulatory function
affecting building/structures.
5. When the construction is undertaken by contract, the work shall be done by a duly licensed and registered contractor.
RECOMMENDING ISSUANCE FOR BUILDING PERMIT:
Engr. RUTCHI L. PEREZ _________________
CHIEF, ENFORCEMENT DIVISION DATE
(Signature over Printed Name)
ENGR. ELRIAN D. BACTOL, MPRM _________________
MUNICIPAL ENGINEER DATE
Republic of the Philippines
Pamahalaang Lungsod ng San Isidro
Lalawigan ng Leyte
Department of Public Works & Highways
TANGGAPAN NG PINUNONG PANGGUSALI
(Office of the Building Official)
APPLICATION FOR BUILDING PERMIT
APPLICATION NO. AREA NO.
BOX 1(TO BE ACCOMPLISHED IN PRINT BY THE APPLICANT)
OWNER/APPLICANT LAST NAME FIRST NAME MI TIN
FOR CONSTRUCTION OWNED FORM OF OWNERSHIP
BY ENTERPRISE
ADDRESS: NO., STREET, BARANGAY, CITY/MUNICIPAL/[Link].
LOCATION OF CONSTRUCTION: LOT NO._________ BLK NO._________ TCT NO._________ TAX [Link]._______
STREET______________ BARANGAY___________________CITY/MUNICIPALITY_____________
SCOPE OF WORK
NEW RENOVATION___________ DEMOLITION_____________
ERECTION CONVERSION__________ ACCESSORY BLDG. STRUCTURE_________
ADDITION
M REPAIR_______________ OTHERS_____________
ALTERATION MOVING_____________ ___________________
USER OR CHARACTER OF OCCUPANCY
GROUP A: RESIDENTIAL, DWELLINGS GROUP F: INDUSTRIAL OTHERS (Specify) ________
GROUP B: RESIDENTIAL, HOTEL, APARTMENT GROUP G: INDUSTRIAL, STORAGE, HAZARDOUS
GROUP C: EDUCATIONAL, RECREATINAL GROUP H: RECREATIONAL, ASSEMBLY OCCUPANT LOAD LESS THAN 1,000
GROUP D: INSTITUTIONAL GROUP I: RECREATIONAL, ASSEMBLY OCCUPANT LOAD 1,000 OR MORE
GROUP J: AGRICULTURAL, ACCESSORY
GROUP E: BUSINESS AND MERCHANTILE
NUMBER OF STOREY(s)________________________ PROPOSED DATE OF CONSTRUCTION__________________
TOTAL FLOOR AREA____________________ SQUARE METERS EXPECTED DATE OF COMPLETION_____________________
TOTAL ESTIMATED COST P________________ (for Statistical Purposes Only)________________________
BOX 2
FULL-TIME INSPECTOR AND SUPERVISOR OF CONSTRUCTION WORKS (REPRESENTING THE OWNER)
ADDRESS
PRC No. Validity
____________________________
ARCHITECT OR CIVIL ENGINEER PTR No. Date Issued
(SIGNATURE AND SEALED OVER PRINTED NAME) Issued AT TIN
BOX 3
APPLICANT: WITH MY CONSENT: LOT OWNER
____________________________ ____________________________
(Signature over Printed Name) (Signature over Printed Name)
Address Address
CTC No. Date Issued Place Issued CTC No. Date Issued Place Issued
BOX 5
REPUBLIC OF THE PHILIPPINES
CIT/MUNICIPALITY OF_____________) S.S
BEFORE ME, at the City/Municipality of _______________________. On _______________________ personally appeared the following:
____________________________ ___________ ___________ ___________
APPLICANT C.T.C. No. Date Issued Place Issued
_______________________________ ___________ ___________ ___________
LICENSED ARCHITECT/CIVIL ENGR. T.C.T. No. Date Issued Place Issued
(Full-Time Inspector and Supervisor at Construction Workers)
Whose signature appear herein above, known to me to be the same persons who executed this standard prescribed form and acknowledge to me that the same
in there 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 of_____________