NBC FORM NO.

B-10

Republic of the Philippines

City of Bayawan
Province of Negros Oriental

OFFICE OF THE BUILDING OFFICIAL

CERTIFICATE OF COMPLETION
DATE

This is to certify that the building/structure covered by Building Permit No. ________________issued on _____________
has been constructed and completed under our supervision, conforms with the plans and specification submitted and on
file with the office of the Building Official, and complies with the provision of the National Building Code and Accessibility
Law (BP bldg. 344).
NAME OF OWNER
__________________________________________________________________________________________________________
(LAST NAME)

(GIVEN)

(M.I)

ADDRESS OF OWNER _________________________________________________________ZIP CODE________________TEL

NO._________________
LOCATION OF CONSTRUCTION: LOT NO.____BLK NO.____ STREET_______________BARANGAY___________________________
CITY OF BAYAWAN
USE OR CHARACTER OF OCCUPANCY _____________________________________________________________GROUP
________________________
PLANNED
DATE OF START OF CONSTRUCTION
DATE OF COMPLETION
TOTAL FLOOR AREA (Square meter)
NO. OF STOREY(S)
NO. OF UNITS
SUMMARY OF ACTUAL COSTS
1. TOTAL COST OF MATERIALS:
1.1.CEMENT (bags) __________________________
1.2.LUMBER(bd.ft.) __________________________
1.3.REINFORCING BARS (Kg) __________________
1.4.G.I SHEETS (sheets) _______________________
1.5.PREFAB STRUCTURAL STEEL (Kg) ____________
1.6.Other materials _________________________
2.

ACTUAL

PHP ____________________________

TOTAL COST OF DIRECT LABOR:

PHP _____________________________

This includes compensation whether by salary or contract for project architecture/ engineer down to laborers.

3.
4.

TOTAL COST OF EQUIPMENT UTILIZATION;

OTHER COSTS:

PHP _____________________________
PHP _____________________________

This includes professional services fees, permits and other fees

TOTAL COST OF BUILDING / STRUCTURE

PHP _____________________________
FULL-TIME SUPERVISOR OR INSPECTOR OF
IF CONSTRUCTION WAS UNDERTAKEN BY
CONSTRUCTION
CONTRACT
PCAB NO.:
CONTRACTOR
VALIDITY:

________________________________________________
ARCHITECT OR CIVIL ENGINEER

TIN:

(Signed and Sealed Over Printed Name)

Date________________

PRC No.
PTR No.
Issued at
CTC No.

Validity
Date Issued
TIN
Date Issued

Issued at

ADRESS:

TEL. NO.

____________________________________Date____________
AUTHORIZED MANAGING OFFICER
(Signature Over Printed Name)

CTC No.

CONFORME:

Date Issued:

Place Issued:

CTC NO.

___________________________________________Date____________
OWNER / APPLICANT
(Signature Over Printed Name)

DATE ISSUED
PLACE ISSUED

(REPUBLIC OF THE PHILIPPINES

)S.S
(CITY OF BAYAWAN
)
BEFORE ME, at the City of Bayawan, on ______________________personally appeared the persons whose signatures
appear herein at the front and back of this page known to me the same persons who executed this standard prescribed
form and acknowledged to me that the same is their free and voluntary act and deed.

WITNESS MY HAND AND SEAL on the date and place above written.
Doc. No.______________
______________________________________________
Page No. _____________
Until December __________)
Book No. _____________
Series No._____________
Note: COPY TO BE FURNISHED THE NSO
ARCHITECTURAL

NOTARY PUBLIC (

CIVIL / STRUCTURAL

_________________________________Date____________
(Signature Over Printed Name)
Address
PRC No.
Validity
IAPOA No.
O.R. No.
Date
Issued:
PTR No.
Date Issued
Issued at
TIN
ELECTRICAL

_________________________________Date____________
(Signature Over Printed Name)
Address
PRC No.

Validity

PTR No.
Issued at

Date Issued
TIN

MECHANICAL

_________________________________Date____________
(Signature Over Printed Name)
Address
PRC No.
Validity
PTR No.
Date Issued
Issued at
TIN

_________________________________Date____________
(Signature Over Printed Name)
Address
PRC No.
PTR No.
Issued at

SANITARY

PLUMBING

_________________________________Date____________
(Signature Over Printed Name)
Address
PRC No.
Validity
PTR No.
Date Issued
Issued at
TIN

Address
PRC No.
PTR No.
Issued at

ELECTRONICS

INTERIOR DESIGN

_________________________________Date____________
(Signature Over Printed Name)
Address
PRC No.
PTR No.
Issued at

Validity
Date Issued
TIN

Validity
Date Issued
TIN

_________________________________Date____________
(Signature Over Printed Name)
Validity
Date Issued
TIN

_________________________________Date____________
(Signature Over Printed Name)
Address
PRC No.
PTR No.
Issued at

Validity
Date Issued
TIN

SUPERVISOR OF SPECIALTY WORKS

ELECTRICAL WORKS

MECHANICAL WORKS

_________________________________Date____________
(Signature Over Printed Name)
Address
PRC No.
Validity
PTR No.
Date Issued
Issued at
TIN

Address
PRC No.
PTR No.
Issued at

SANITARY WORKS

PLUMBING WORKS

_________________________________Date____________
(Signature Over Printed Name)
Address
PRC No.
Validity
PTR No.
Date Issued
Issued at
TIN

_________________________________Date____________
(Signature Over Printed Name)
Validity
Date Issued
TIN

_________________________________Date____________
(Signature Over Printed Name)
Address
PRC No.
PTR No.
Issued at

Validity
Date Issued
TIN

ELECTRONICS WORKS

_________________________________Date____________
(Signature Over Printed Name)
Address
PRC No.
Validity
PTR No.
Date Issued
Issued at
TIN

INTERIOR DESIGN WORKS

_________________________________Date____________
(Signature Over Printed Name)
Address
PRC No.
PTR No.
Issued at

Validity
Date Issued
TIN