REPUBLIC OF THE PHILIPPINES
OFFICE OF THE CITY MAYOR
QUEZON CITY
(BUILDING OFFICIAL)
DO NOT FILL UP (NSO USE ONLY)
APPLICATION NO. PERMIT NO.
BUILDING PERMIT
DATE OF APPLICATION
DATE ISSUED
ORIGINAL RENEWAL
BOX 1 (TO BE ACCOMPLISHED BY DESIGNING ARCHITECT / CIVIL ENGINEER IN PRINT)
OWNER LASTNAME FIRSTNAME M.I. TAX ACCT. NO.
FOR CONSTRUCTION OWNED BY
FORM OF OWNERSHIP MAIN ECONOMIC ACTIVITY OF BUSINESS
AN ENTERPRISE
ADDRESS
TEL. NO.
LOCATION OF CONSTRUCTION
SCOPE OF WORK: 1. NEW CONSTRUCTION
OTHERS (SPECIFY)
2. ADDITION OF
3. REPAIR OF 6. OF
4. RENOVATION OF 7. OF
5. DEMOLITION OF
USE OR TYPE OF OCCUPANCY
RESIDENTIAL
INDUSTRIAL
11 SINGLE
31 FACTORY (PLANT)
12 DUPLEX
32 REPAIR SHOP, MACHINE SHOP
13 ROWHOUSE / ACCESSORIA
33 REFINERY
10 OTHERS (SPECIFY)
COMMERCIAL 34 PRINTING PRESS
21 BANK 35 WAREHOUSE
22 STORE 30 OTHERS (SPECIFY)
23 HOTEL / MOTEL, ETC.
INSTITUTIONAL
24 OFFICE CONDOMINIUM / BUSINESS OFFICE BUILDING.
25 RESTAURANT, ETC.. 41 SCHOOL
42 CHURCH OR OTHER RELIGIOUS STRUCTURES
26 SHOP (e.g. DRESS SHOP, TAILORING SHOP, BARBER SHOP, ETC.
43 HOSPITAL OR SIMILAR STRUCTURES
27 GASOLINE STATION
44 WELFARE & CHARITABLE STRUCTURES
28 MARKET
45 THEATER, AUDITORIUM. GYMNASIUM, COURT
29 DORMITORY OR OTHER LODGING HOUSE
40 OTHERS (SPECIFY)
30 OTHERS (SPECIFY)
AGRICULTURAL
41 BRAN(S), POULTRY HOUSE(S), ETC.
42 GRAIN MILL
[Link] e z o n c it y .[Link]
OTHER CONSTRUCTION
4 0O TH ERS (S PEC IF Y)
60 (SPECIFY)
STREET FURNITURE, LANDSCAPING & O F F I CE OF THE BUILDING OFFICIAL
SIGN BO ARD S
71 PARK, PLAZA’S, MONUMENT, POOLS, PLANT BOXES, ETC.
72 SIDEWALKS, PREMONADES, TERRACES, LAMPPOSTS, ELECTRIC POLES, TELEPHONE POLES, ETC.
73 OUTDOOR ADS, SIGNBOARDS, ETC.
74 FENCE ENCLOSURE
BOX 2 (TO BE ACCOMPLISHED BY RECEIVING & RECORDING
SECTION)
BUILDING DOCUMENTS (FIVE SETS EACH)
SITE DEVELOPMENT & LOCATION PLAN
ARCHITECTURAL PLAN & SPECIFICATIONS MECHANICAL PLANS & SPECIFICATIONS
STRUCTURAL DESIGN & COMPUTATIONS LOGBOOK (1COPY)
SANITARY/PLUMBING PLANS & SPECIFICATIONS OTHERS (SPECIFY)
ELECTRICAL PLANS & SPECIFICATION
BOX 3 (TO BE ACCOMPLISHED BY THE BUILDING OFFICIAL)
ACTION TO BE TAKEN:
PERMIT IS HEREBY GRANTED SUBJECT TO THE FOLLOWING CONDITIONS
1. THAT THE PROPOSED CONSTRUCTION/ADDITION/REPAIR/RENOVATION/
DEMOLITION/INSTALLATION ETC SHALL BE IN CONFORMITY WITH THE NATIONAL
BUILDING CODE (PD 1096) AND ITS CORRESPONDING IMPLEMENTING RULES AND
REGULATIONS
2. THAT A DULY LICENSED ARCHITECT/CIVIL ENGINEER HAS BEEN ENGAGED TO PLANS
AND SPECIFICATIONS AND TO UNDERTAKE THE SUPERVISION/INSPECTION OF THE ENGR. ISAGANI R. VERZOSA JR.
CONSTRUCTION OF THE PROJECT
LOCAL BUILDING OFFICIAL
3. THAT A CERTIFICATE OF COMPLETION DULY SIGNED AND SEALED BY THE DESIGNING
ARCHITECT / ENGINEER IN-CHARGE OF CONSTRUCTION SHALL BE SUBMITTED NOT LATER
THAN SEVEN (7) DAYS AFTER COMPLETION OF THE CONSTRUCTION OF THE PROJECT
4. THAT A CERTIFICATE OF OCCUPANCY “SHALL BE SECURED PRIOR TO ACTUAL DATE
OCCUPANCY OF THE BUILDING.
NOTE:
THIS PERMIT MAY BE CANCELLED OR REVOKED PURSUANT TO SECTIONS 305 & 306 OF THE “NATIONAL BUILDING CODE”.
BOX 3A (TO BE ACCOMPLISHED BY THE DESIGNING ARCHITECT/CIVIL ENGINEER IN PRINT
TOTAL ESTIMATED COST COST OF NUMBER OF STOREYS DO NOT FILL (NSO USE ONLY)
EQUIPMENT
BUILDING P INSTALLED TOTAL FLOOR AREA
ELECTRICAL P P PROPOSED DATE
OF CONSTRUCTION
MECHANICAL P
P EXPECTED DATE
PLUMBING P OF COMPLETION
P
OTHERS P
MATERIAL OF CONST.
TOTAL COST P (WOOD, CONC, STEEL, MIXED)
BOX 4 (TO BE ACCOMPLISHED BY THE DIVISION CONCERNED
ASSESED FEES
AMOUNT DUE ASSESSED BY O.R. NUMBER DATE PAID
LAND USE / ZONING
LINE and GRADE
BUILDING
PLUMBING
ELECTRICAL
MECHANICAL
OTHERS
REVIEWED:
TOTAL
CHIEF, PROCESSING DIVISION SECTION
BOX 5 (TO BE ACCOMPLISHED BY THE DIVISION CONCERNED
PROGRESS FLOW
NOTED: IN OUT
ACTION / PROCESSED
CHIEF, PROCESSING DIVISION TIME DATE TIME DATE REMARKS BY:
RECEIVING and RECORDING
LAND USE and ZONING
GEODETIC (LINE and GRADE)
ARCHITECTURAL
STRUCTURAL
SANITARY
ELECTRICAL
MECHANICAL
WE HEREBY AFFIX OUR HANDS SIGNIFYING OUR CONFORMITY TO THE INFORMATION HEREIN ABOVE SETFORTH
BOX 6 [Link].Xg8
ARCHITECT / CIVIL ENGINEER PRC REG. NO.
[Link] SIGNATURE
SIGNED AND SEALED PLANS & OF THE BUILD ING OFFICIAL
SO F FCATIICONSE
PRINT NAMEIFI
PEC
ADDRESS
COMMUNITY TAX CERT. PTR NO. PLACE ISSUED
PTR NO. PTR NO. PLACE ISSUED
SIGNATURE
WITH MY CONSENT:
BOX 7 BOX 9 (TO BE ACCOMPLISHED BY LOT OWNER)
ARCHITECT / CIVIL ENGINEER PRC REG. NO. TCT / OCT NO.
SIGNED AND SEALED PLANS & SPECIFICATIONS
PRINT NAME PRINT NAME OF LO5T OWNER
ADDRESS ADDRESS
PTR NO. PTR NO. PLACE ISSUED COMMUNITY TAX RECEIPT DATE ISSUED PLACE ISSUED
SIGNATURE SIGNATURE
