NBC FORM NO.
A-01
Republic of the Philippines
Municipality of Infanta
Province of Pangasinan
OFFICE OF THE BUILDING OFFICIAL
ARCHITECTURAL PERMIT
APPLICATION NO. AP NO. BUILDING PERMIT NO.
BOX 1 (TO BE ACCOMPLISHED IN PRINT BY THE OWNER/APPLICANT)
OWNER/APPLICANT LAST NAME FIRST NAME MI 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___________________ ACCESSORY BUILDING STRUCTURE___________________
ADDITION REPAIR________________________ OTHERS(specify)_________________________________
ALTERATION MOVING_______________________ _______________________________________________
BOX 2 (TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL)
1. ARCHITECTURAL FACILITIES AND OTHER FEATURES PURSUANT TO BATAS PAMBANSA BILANG 344, REQUIRING CETAIN BUILDINGS, INSTITUTIONS, ESTABLISHMENTS
AND PUBLIC UTILITIES TO INSTALL FACILITIES AND OTHER DEVICES.
STAIRS WASH ROOMS AND TOILETS SWITCHES, CONTROLS, BUZZERS DRINKING FOUNTAINS
WALKWAYS LIFTS/ELEVATORS HANDRAILS PUBLIC TELEPHONES
CORRIDORS RAMPS THRESHOLDS SEATING ACCOMODATIONS
DOORS ENTRANCES & THRESHOLDS PARKING AREAS FLOOR FINISHES OTHERS (Specify)_________
2. PERCENTAGE OF SITE OCCUPANCY 3. CONFORMANCE TO FIRE CODE OF THE PHILIPPINES (P.D. 1185)
PERCENTAGE OF BUILDING FOOTPRINT _____________________% NUMBER AND WORTH OF EXIT DOORS FIRE WALLS
PERCENTAGE OF IMPERVIOUS SURFACE AREA _____________________% WIDTH OF CORRIDORS FIRE FIGHTING AND SAFETY FACILITIES
PERCENTAGE OF UNPAVED SURFACE AREA _____________________% DISTANCE TO FIE EXITS SMOKE DETECTORS
OTHERS (SPECIFY) _____________________ ACCESS TO PUBLIC STREET EMERGENCY LIGHTS
BOX 3 BOX 4
DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS
_______________________________________Date______________ _______________________________________Date______________
ARCHITECT ARCHITECT
Signed and Sealed Over Printed Name Signed and Sealed Over Printed Name
Address Address
PRC No. Validity PRC No. Validity
/APOA No. O.R.No. Date Issued /APOA No. O.R.No. Date Issued
PTR No. Place Issued Date Issued PTR No. Place Issued Date Issued
TIN TIN
BOX 5 BOX 6
BUILDING OWNER WITH MY CONSENT: LOT OWNER
____________________________________________________ ____________________________________________________
Signed and Sealed Over Printed Name Signed and Sealed Over Printed Name
Date_____________________ Date_____________________
Address Address
CTC No. Date Issued Place Issued CTC No. Date Issued Place Issued
TO BE ACCOMPLISHED BY THE PROCCESSING AND EVALUATION DIVISION
BOX 7
RECEIVED BY DATE
FIVE (5) SETS OF ARCHITECTURAL DOCUMENTS
1. VICINITY MAP/ LOCATION PLAN WITHIN A TWO 8. DETAILS OF RAMPS, PARKING FOR DISABLED,STAIRS, FIRE ESCAPES, CABINETS AND
KILOMETER RADIUS PARTITION
2. SITE DEVELOPMENT PLAN 9. SCHEDULE OF DOORS AND WINDOWS
3. PERSPECTIVE 10. SCHEDULE OF FINISHES FOR FLOORS, CEILING AND WALLS
4. FLOOR PLANS 11. ARCHITECTURAL INTERIOR
5. ELEVATIONS, ATLEAST FOUR (4) 12. SPECIFICATIONS
6. SECTIONS, ATLEAST TWO (2) 13. COST ESTIMATE
7. CEILING PLANS SHOWING LIGHTING FIXTURES AND 14. OTHERS (Specify )
DIFFUSERS
BOX 8
PROGRESS FLOW
IN OUT PROCESSED BY:
DATE TIME DATE TIME
ARCHITECTURAL DRAWINGS
SPECIFICATIONS
OTHERS SPECIFY
BOX 9
ACTION TAKEN:
PERMIT IS HEREBY ISSUED SUBJECT TO THE FOLLOWING:
1. That under Article 1723 of the Civil Code of the Philippines, the architect ( and engineer ) who drew up the plans and the specifications for the
building/ structure is responsible for damages if within fifteen (15) years from the completion of the building/ structure, the same should collapse
due to deffect in the plans or specifications or defects in the ground. The engineer or architect who supervises the construction shall be solidarily
liable with the contractor should the edifice collapse due to defect in the construction or the use of inferior materials.
2. The proposed architectural works shall be in accordance with the structural plans filed with this Office and in conformity with the latest
Architectural Code of the Philippines, the National Building Code and its IRR.
3. That prior to any construction activity, a duly accomplished prescribed '' Notice of Construction '' shall be submitted to the Office of the Building
Official.
4. That upon completion of the construction, the licensed full- time inspector and supervisor/ in charge of construction works shall submit the entry
to the logbook duly signed and sealed to the building official including as-built plans and other documents, and shall also accomplish the Certificate
of Completion stating that the architectural works conform to the provision of the Architectural Code, the National Building Code and its IRR.
5. That this permit is null and void unless accompanied by the building permit.
PERMIT ISSUED BY:
BUILDING OFFICIAL
(Signature Over Printed Name)
Date
