Republic of the Philippines
Department of the Interior and Local Government
Bureau of Fire Protection
(Region)
(District/Province Office)
(Station)
(Station Address)
(Telephone No./Email Address)
Number: R-
Date
(Name of Owner)
(Name of Establishment)
(Address)
NOTICE OF DISAPPROVAL
FIRE SAFETY EVALUATION CLEARANCE
Dear Sir/Madam;
This is in connection with your application for Fire Safety Evaluation Certificate for
BUILDING PERMIT for the located
(Name of Establishment)
at . Please be informed that said
(Address)
application is disapproved in view of the following deficiencies;
A. _____________________________________________________________________
B. _____________________________________________________________________
C. _____________________________________________________________________
D. _____________________________________________________________________
E. _____________________________________________________________________
In this regard, you are hereby required to make the necessary correction of the
aforementioned deficiencies prior to the re-application to this office.
Your preferential attention hereto will be highly appreciated.
Very truly yours,
____________________________
City/Municipal Fire Marshal
PAALALA: “MAHIGPIT NA IPINAGBABAWAL NG PAMUNUAN NG BUREAU OF FIRE PROTECTION SA MGA KAWANI NITO ANG
MAGBENTA O MAGREKOMENDA NG ANUMANG BRAND NG FIRE EXTINGUISHER”
“FIRE SAFETY IS OUR MAIN CONCERN”
DISTRIBUTION:
Original (Applicant/Owner’s Copy)
Duplicate (BO or BPLO, as the case may be)
Triplicate (BFP Copy)
BFP-QSF-FSED-008 Rev. 01 (07.05.19)