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REPUBLIC OF THE PHILIPPINES OFFICE OF THE CITY MAYOR QUEZON CITY (BUILDING OFFICIAL) DO NOT

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
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
AN ENTERPRISE
FORM OF OWNERSHIP
MAIN ECONOMIC ACTIVITY OF BUSINESS
ADDRESS
TEL. NO.
LOCATION OF CONSTRUCTION
SCOPE OF WORK:
1. NEW CONSTRUCTION
OTHERS (SPECIFY)
2. ADDITION OF
6.
OF
3. REPAIR OF
7.
OF
4. RENOVATION OF
5. DEMOLITION OF
USE OR TYPE OF OCCUPANCY
RESIDENTIAL
INDUSTRIAL
31
FACTORY (PLANT)
11
SINGLE
32
REPAIR SHOP, MACHINE SHOP
12
DUPLEX
33
REFINERY
13
ROWHOUSE / ACCESSORIA
10
OTHERS (SPECIFY)
34 PRINTING PRESS
COMMERCIAL
35 WAREHOUSE
21 BANK
30
OTHERS (SPECIFY)
22 STORE
INSTITUTIONAL
23 HOTEL / MOTEL, ETC.
24 OFFICE CONDOMINIUM / BUSINESS OFFICE BUILDING.
41
SCHOOL
25 RESTAURANT, ETC
42
CHURCH OR OTHER RELIGIOUS STRUCTURES
43
HOSPITAL OR SIMILAR STRUCTURES
26 SHOP (e.g. DRESS SHOP, TAILORING SHOP, BARBER SHOP, ETC.
44
WELFARE & CHARITABLE STRUCTURES
27 GASOLINE STATION
45
THEATER, AUDITORIUM. GYMNASIUM, COURT
28 MARKET
40
OTHERS (SPECIFY)
29 DORMITORY OR OTHER LODGING HOUSE
30 OTHERS (SPECIFY)
AGRICULTURAL
41
BRAN(S), POULTRY HOUSE(S), ETC.
42
GRAIN MILL
OTHER CONSTRUCTION
40
OTHERS (SPECIFY)
www.quezoncity.gov.ph
60
(SPECIFY)
STREET FURNITURE, LANDSCAPING & SIGNBOARDS
OFFICE OF THE BUILDING OFFICIAL
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
LOGBOOK (1COPY)
STRUCTURAL DESIGN & COMPUTATIONS
OTHERS (SPECIFY)
SANITARY/PLUMBING PLANS & SPECIFICATIONS
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
ENGR. ISAGANI R. VERZOSA JR.
AND SPECIFICATIONS AND TO UNDERTAKE THE SUPERVISION/INSPECTION OF THE
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

COST OF DO NOT FILL (NSO USE ONLY) TOTAL ESTIMATED COST NUMBER OF STOREYS EQUIPMENT
COST OF
DO NOT FILL (NSO USE ONLY)
TOTAL ESTIMATED COST
NUMBER OF STOREYS
EQUIPMENT
INSTALLED
BUILDING P
TOTAL FLOOR AREA
ELECTRICAL P
P
PROPOSED DATE
OF CONSTRUCTION
MECHANICAL P
P
EXPECTED DATE
PLUMBING P
OF COMPLETION
P
OTHERS P
TOTAL COST
P
MATERIAL OF
(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
BOX 8
www.quezoncity.gov.ph
ARCHITECT / CIVIL ENGINEER
PRC REG. NO.
SIGNATURE
SIGNED AND SEALED PLANS & SPECIFICATIONS
OFFICE OF THE BUILDING OFFICIAL
PRINT NAME
ADDRESS
COMMUNITY TAX CERT.
PTR NO.
PLACE ISSUED
PTR NO.
PTR NO.
PLACE ISSUED
SIGNATURE
WITH MY CONSENT:
BOX 9 (TO BE ACCOMPLISHED BY LOT OWNER)
BOX 7
ARCHITECT / CIVIL ENGINEER
SIGNED AND SEALED PLANS & SPECIFICATIONS
PRC REG. NO.
TCT / OCT NO.
PRINT NAME
PRINT NAME OF LO5T OWNER
ADDRESS
ADDRESS
PTR NO.
PTR NO.
PLACE ISSUED
COMMUNITY TAX RECEIPT
DATE ISSUED
PLACE ISSUED
SIGNATURE
SIGNATURE