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Civil Structural Permit Front

This document is a civil/structural permit application for construction work. It provides details about the owner, location of the construction site, scope of work, and involved design and construction professionals. Engineer Andrea Mae Sanchez is listed as the design professional and supervisor of the civil/structural works. The owner and lot owner must both consent to the permit by signing in boxes 5 and 6.

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Andrea Mae Sanchez
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251 views1 page

Civil Structural Permit Front

This document is a civil/structural permit application for construction work. It provides details about the owner, location of the construction site, scope of work, and involved design and construction professionals. Engineer Andrea Mae Sanchez is listed as the design professional and supervisor of the civil/structural works. The owner and lot owner must both consent to the permit by signing in boxes 5 and 6.

Uploaded by

Andrea Mae Sanchez
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

NBC FORM NO.

A - 02

Republic of the Philippines


City/Municipality of GATTARAN
Province of CAGAYAN
OFFICE OF THE BUILDING OFFICIAL

CIVIL/STRUCTURAL PERMIT
APPLICATION NO. C/SP NO BUILDING PERMIT NO.

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


OWNER/APPLICANT LAST NAME FIRST NAME M.I. TIN

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP USE OR CHARACTER OF OCCUPANCY

BY AN ENTERPRISE
ADDRESS: NO., STREET, BARANGAY, CITY/MUNICIPALITY ZIP CODE TELEPHONE NO

LOCATION OF CONSTRUCTION: LOT NO. _______________ BLK NO. ________________ TCT NO. ______________________ TAX DEC. NO.___________________

STREET___________________ BARANGAY ____________________________________________________ CITY/ MUNICIPALITY OF ______________________________

SCOPE OF WORK
NEW CONSTRUCTION RENOVATION ________________________ RAISING ______________________________________
ERECTION CONVERSION ________________________ DEMOLITION __________________________________
ADDITION REPAIR _____________________________ ACCESSORY BUILDING/STRUCTURE _____________
ALTERATION MOVING _____________________________ OTHERS (Specify) ______________________________

BOX 2 (TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL)

NATURE OF CIVIL/STRUCTURAL WORKS:

STAKING ERECTION/LIFTING PRESTRESS WORKS


EXCAVATION CONCRETE FRAMING MATERIAL TESTING
SOIL STABILIZATION STRUCTURAL STEEL FRAMING STEEL TOWERS
PILING WORKS SLABS TANKS
FOUNDATION WALLS OTHERS (Specify)___________________________

ENGR. ANDREA MAE SANCHEZ


PREPARED BY _______________________________________________________________________________________________________________

BOX 3 BOX 4
DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS SUPERVISOR/IN-CHARGE OF CIVIL/STRUCTURAL WORKS

ENGR. ANDREA MAE SANCHEZ ENGR. ANDREA MAE SANCHEZ


CIVIL/STRUCTURAL ENGINEER CIVIL/STRUCTURAL ENGINEER
(Signed and Sealed Over Printed Name) (Signed and Sealed Over Printed Name)
Date________________________ Date________________________
Address: SCOUT BARRIO, BAGUIO CITY, BENGUET Address: SCOUT BARRIO, BAGUIO CITY, BENGUET
PRC. No.: 0163517 Validity: 05/18/2024 PRC. No: 0163517 Validity: 05/18/2024
PTR. No: 5044132 Date Issued: 02/10/2022 PTR. No: 5044132 Date Issued: 02/10/2022
Issued at: BAGUIO CITY TIN: 333-064-693-000 Issued at: BAGUIO CITY TIN: 333-064-693-000

BOX 5 BOX 6
BUILDING OWNER WITH MY CONSENT: LOT OWNER

(Signature Over Printed Name) (Signature Over Printed Name)


Date___________________ Date___________________

Address Address
C.T.C. No. Date Issued Place Issued C.T.C. No. Date Issued Place Issued

NOTE: THIS PERMIT MAY BE CANCELLED OR REVOKED PURSUANT TO SECTIONS 305 AND 306 OF THE “NATIONAL BUILDING CODE”.

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