Republic of the Philippines
Department of the Interior and Local Government
BUREAU OF FIRE PROTECTION
National Headquarters
Agham Road, [Link] Pag-asa, Diliman, Quezon City
FSIC NO. R R-8-80224-83298 Date Jan 06, 2025
FIRE SAFETY INSPECTION CERTIFICATE
(FOR BUSINESS PERMIT)
TO WHOM IT MAY CONCERN:
By virtue of the provisions of RA 9514 otherwise known as the Fire Code of the Philippines of 2008 the
application for FIRE SAFETY INSPECTION CERTIFICATE of
BRIGILDO SARI SARI STORE
(Name of Establishment)
owned and managed by
JINKY BRIGILDO
(Name of Owner/Representative)
with postal address at
Cangmuya PALOMPON
(Address)
is hereby GRANTED after said building structure or facility has been duly inspected with the finding that it has
fully complied with the fire safety and protection requirements of the Fire Code of the Philippines of 2008 and
its Revised Implementing Rules and Regulations.
This certification is valid for Issuance of business permit for BRIGILDO SARI SARI STORE valid until 2026-01-
06
Violation of Fire Code provisions shall cause this certificate null and void after appropriate proceeding and
shall hold the owner liable to the penalties provided for the said Fire Code.
Fire Code Fees: 500.00
Amount Paid PHP 520.00 RECOMMEND APPROVAL
O.R Number: OR-45325 Gilbert Requitillo
Date: Jan 06,2025 Fire Officer I
CHIEF, FSES
APPROVED
JOSEPH RAYMUND ARENDAYEN
Inspector
CITY/MUNICIPAL FIRE MARSHAL
NOTE: “This Clearance is accompanied by Fire Safety Checklist and does not take the place of any license
required by law and is not transferable. Any change or alteration in the design and specification during
construction shall require a new clearance”
PAALALA: “MAHIGPIT NA IPINAGBABAWAL NG PAMUNUAN NG BUREAU OF FIRE PROTECTION SA MGA
KAWANI NITO ANG MAGBENTA O MAGREKOMENDA NG ANUMANG BRAND NG FIRE EXTINGUISHER”
“FIRE SAFETY IS OUR MAIN CONCERN”
Original (Applicant/Owner's Copy)
Duplicate (BO/BPLO copy as the case
maybe) Triplicate (BFP copy)
BFP-QSF-FSED-005
This is a system generated document,
signature is not required.