REPUBLIC OF THE PHILIPPINES
OFFICE OF THE BUILDING OFFICIAL
CITY ENGINEERS OFFICE
APPLICATION NO. Lapu-Lapu City PERMIT NO.
AREA CODE___________
BUILDING PERMIT
DATE OF APPLICATION DATE OF APPLICATION
ORIGINAL RENEWAL
BOX 1 (TO BE ACCOMPLISHED BY DESIGNING ARCHITECT/ CIVIL ENGINEER IN PRINT)
NAME OF OWNER/ APPLICANT LAST NAME,FIRST NAME M.I. TAX IDENTIFICATION NUMBER
FOR CONSTRUCTION OWNED FORM OF OWNERSHIP MAIN ECONOMIC ACTIVITY/KIND OF BUSINESS
BY AN ENTERPRISE
ADDRESS NO., STREET, BARANGAY, CITY/ MUNICIPALITY TELEPHONE NO.
LOCATION OF CONSTRUCTION NO., STREET, BARANGAY, CITY/MUNICIPALITY
SCOPE OF WORK 2. ☐ ADDITION OF _______________ OTHER (SPECIFY)
1. ☐ NEW CONSTRUCTION 3. ☐ REPAIR OF _______________ 6.☐ ________ OF _________
4. ☐ RENOCATION OF _______________ 7.☐ ________ OF _________
5. ☐ DEMOLITION OF _______________
USE OF TYPE OF OCCUPANCY
RESIDENTIAL INUSTRIAL
11. ☐ SINGLE 31. ☐ FACTORY /PLANT 30. ☐ OTHERS (SPECIFY)
12. ☐ DUPLEX 32. ☐ REPAIR SHOP/MACHINE SHOP _____________
13.☐ ROWHOUSE/ACCESORIA 33. ☐ REFINERY _____________
10. ☐ OTHERS (SPECIFY)______________ 34. ☐ PRINTING PRESS
COMMERCIAL 35. ☐ WAREHOUSE
21 ☐ BANK INSTITUTIONAL
22 ☐ STORE 41 ☐ SCHOOL
23 ☐ HOTEL/MOTEL, ETC. 42 ☐ CHURCH AND OTHER RELIGIOUS STRUCTURES
24 ☐ OFFICE CONDOMINIUM/BUSIN ESS OFFICE BUILDING 43 ☐ HOSPITAL OR OTHER SIMILAR STRUCTURE
25 ☐ RESTAURANT, ETC. 44 ☐ WELFARE AND CHARITABLE STRUCTURE
26 ☐ SHOP (e.g. DRESS SHOP, TAILORING SHOP, BARBER SHOP, ETC.) 45 ☐ THEATER, AUDITORIUM, GYMNASIUM, COURT
27 ☐ GASOLINE STATION 40 ☐ OTHERS (SPECIFY)______________________
28 ☐ MARKET AGRICULTURA L
29 ☐ DORMITORY or OTHER LODGING HOUSE 51 ☐ BARN(S), POULTRY HOUSE(S), ETC.
20 ☐ OTHERS (SPECIFY)__________________ 52 ☐ GRAIN MILL
OTHER CONSTRUCTION 50 ☐ OTHERS (SPECIFY)______________
60 (SPECIFY)___________________________
STREET FURNITURE, LANDSCAPING & SIGNBOARDS
71 ☐ PARK, PLAZA, MONUMENTS, POOLS, PLANT BOXES, ETC.
72 ☐ SIDEWALKS, PROMENADES, TERRACES, LAMPPOSTS, ELECTRONIC POLES, TELEPHONE POLLES, ETC.
73 ☐ OUTDOORS ADS, SIGNBOARDS, ETC.
74 ☐ FENCE ENCLOSURE
BOX 2 (TOP BE ACCOMPLISHED BY THE RECEIVING & RECORDING SECTION)
BUILDING DOCUMENTS (FIVE SETS EACH)
☐SITE DEVELOPMENT AND LOCATION PLAN ☐MECHANICAL PLANS & SPECIFCATION
☐ARCHITECTURAL PLAN & SPECIFICATION ☐LOGBOOK (1-COPY)
☐STRUCTURAL DESIGNS & COMPUTATIONS ☐OTHERS (SPECIFY)_______________________
☐SANITARY/ PLUMBING PLANS & SPECIFICATIONS ______________________________________
☐ELECTRICAL PLANS & SPECIFICATION ______________________________________
BOX 3 (TO BE ACCOMPLISHED BY THE BUILDING OFFICIAL)
ACTION 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” (P.D. 1098) AND ITS CORRESPONDING
IMPLEMENTATING RULES AND REGULATIONS.
2. THAT A DULY LICENSED ARCHITECT / CIVIL ENGINEER HAS BEEN
ENGAGED TO PREPARE PLANS & SPECIFICATION AND TO UNDERTAKE
THE SUPERVISON/ INSPECTION OF THE CONSTRUCTION OF THE _________________________________________________________
PROJECT. BUILDING OFFICIAL
3. THAT A CERTIFICATE OF COMPLETION DULY SIGNED BY THE
ARCHITECT/ CIVIL ENGINEER IN-CHARGE OF CONSTRUCTION AND
THE CONTRACTOR IN CASE THE CONSTRUCTION IS UNDERTAKEN __________________________________________________________
BY CONTRACT TO BE CONFIRMED BY THE OWNER SHALL BE DATE
SUBMITTED NOT LATER THAN SEVEN ((7) DAYS AFTER COMPLETION
OF THE CONTRUCT OF THE PROJECT.
4. THAT A “CERTIFICATE OF OCCUPANCY” SHALL BE SECURED PRIOR
TO ACTUAL OCCUPANCY OF THE BUILDING.
NOTE:
THIS PERMIT MAY BE CANCELLED OR REMOVED PURSUANT TO SECTION 305 &306 OF THE “NATIONAL BUILDING CODES”
BOX 3A (TO BE ACCOMPLISHED BY DESIGNING ARCHITECTURE /CIVIL ENGINEER IN PRINT)
TOTAL ESTIMATED COST COST OF NUMBER OF STOREYS______________________________
BUILDING P_____________ EQUIPMENT TOTAL FLOOR AREA ________________________________
ELECTRICAL P_____________ INSTALLED PROPOSED DATE
OF CONSTRUCTION________________________________
MECHANICAL P____________________________
EXPECTED DATE
PLUMBING P ____________________________
OF COMPLETION _________________________________
OTHERS P ____________________________
MATERIAL OF CONSTRUCTION: ______________________
(WOOD, CONCRETE, STEEL, MIXED)
TOTAL
CONSTRUCTION
COST P___________________________________
BOX 4 (TO BE ACCOMPLISHED BY THE DIVISION / SECTION CONCERNED)
ASSESSED FEES
AMOUNT DUE ASSESSED BY O.R. NUMBER DATE PAID
☐LAND USE / ZONING
☐LINE a nd GRADE
☐BUILDING
☐PLUMBING
☐ELECTRICAL
☐MECHANICAL
OTHERS :
TOTAL REVIEWED :
CHIEF, PROCESSING DIVISION / SECTION
BOX 5 ( TO BE ACCOMPLISHED BY THE DIVISION CONCERNED )
PROGRESS FLOW
NOTED: IN OUT ACTION/REMARKS PROCESSED BY
CHIEF, PROCESSING DIVISION / SECTION TIME DATE TIME DATE
RECEIVING and RECORDING
LAND USE and ZONING
GEODETIC (LINE and GRADE)
ARCHITECTURAL
STRUCTURAL
SANITARY
ELECTRICAL
MECHANICAL
WE HEREBY AFFIX OUR HANDS SIGNIFYING OUR COMFORMITY TO THE INFORMATION HEREIN ABOVE SETFORTH
BOX 6 BOX 8
ARCHITECT / CIVIL ENGINEER PRC. REG. NO.
SINGATURE
SIGN AND SEALED PLANS & SPECIFICATION
PRINT NAME A P P L I C A N T
RES. CERT. NO. DATE ISSUED PLACE ISSUED
ADDRESS
PTR NO. DATE ISSUED PLACED ISSUED
SIGNATURE TIN:
BOX 7 WITH MY CONSENT
ARCHITECT / ENGINEER PRC. REG. NO. BOX 9 (TO BE ACCOMPLISHED BY LOT OWNER)
IN-CHARGE OF CONSTRUCTION TCT / OCT NO. TAX DECLARATION NO.
PRINT NAME
PRINT NAME OF LOT OWNER
ADDRESS
ADDRESS
PTR NO. DATE ISSUED PLACED ISSUED
RES, CERT. NO. DATE ISSUED PLACE ISSUED
SIGNATURE TIN:
SIGNATURE TAN
