NBC FORM NO.

A - 02

Republic of the Philippines

CIVIL/STRUCTURAL PERMIT
APPLICATION NO. EGPP NO. BUILDING PERMIT NO.

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

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP USE OR CHARACTER OF OCCUPANCY

ADDRESS: NO. ________ STREET ______________________________________________________________ TELEPHONE NO.

BARANGAY ______________________ CITY/MUNICIPALITY __________________________ ZIP CODE _________

STREET ___________________________ BARANGAY ____________________________ CITY/MUNICIPALITY __________________________

SCOPE OF WORK:
NEW CONSTRUCTION RENOVATION RAISING
ERECTION CONVERSION 0DEMOLITION
ADDITION REPAIR 0ACCESSORY BUILDING/STRUCTYURE
ALTERATION 0MOVING 0OTHERS (Specify)
0 0 0
BOX 2 (TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL
USE OR CHARACTER OF OCCUPANCY:
STAKING ERECTION/LIFTING PRESTRESS WORKS
EXCAVATION 0CONCRETE FRAMING 0MATERIAL TESTING
SOIL STABILIZATION STRUCTURAL STEEL FRAMING STEEL TOWERS
PILING WORKS SLABS TANKS
FOUNDATION WALLS OTHERS (Specify)
PREPARED BY

BOX 3 BOX 4

DESIGN PROFESSIONAL, PLANS AND SPECIFICATION SUPERVISOR/IN-CHARGE OF CIVIL/STRUCTURAL WORKS

___________________________________________ ______________________________________________________________
CIVIL/STRUCTURAL ENGINEER CIVIL/STRUCTURAL ENGINEER
(Signed and Sealed Over Printed Name) (Signed and Sealed Over Printed Name)
Date ____________________________ Date _______________________
Address Address
PRC. No Validity PRC. No Validity
PTR. No Date Issued PTR. No Date Issued
Issued at TIN Issued at TIN

BOX 5 BOX 7

BUILDING OWNER WITH MY CONSENT: LOT OWNER

__________________________________________
(Signature Over Printed Name) (Signed Over Printed Name)
Date ____________________ Date _________________

Address Address

C.T.C No. Date Issued Place Issued C.T.C NO. Date Issued Place Issued
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BOX 7 (TO BE ACCOMPLISHED BY THE PROCESSING AND EVALUATION DIVISION)

RECEIVED BY: DATE:

FIVE (5) SETS OF CIVIL/STRUCTURAL DOCUMENTS

CIVIL/STRUCTURAL DESIGNS COMPUTATIONS, PLANS AND SPECIFICATIONS COST ESTIMATES

BILL OF MATERIALS OTHERS (Specify)

BOX 8

PROGRESS FLOW

IN OUT
PROCESSED BY
DATE TIME DATE TIME

CIVIL/STRUCTURAL

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 engineer (or architect) who drew up the plans and 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 defect 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. That the proposed civil/structural works shall be in accordance with the civil/structural plans filed with this office and in conformity with the latest
National Structural 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 and
submit a certificate of completion stating that the civil/structural works conform to the provisions of the National Structural Code of the
Philippines, the National 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 ___________________________