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REPUBLIC OF THE PHILIPPINES PROVINCE OF CAVITE CITY OF DASMARIAS OFFICE OF THE BUILDING OFFICIAL

CERTIFICATE OF COMPLETION
ELECTRICAL WORKS This is to certify th t the e!ectric ! i"st !! tio"s#$or%s of the &'i!(i") co*ere( &y B'i!(i") Per+it No, iss'e( o" h s &ee" co+-!ete( i" ccor( "ce $ith the --ro*e( -! "s "( s-ecific tio"s o" fi!e $ith the Office of the B'i!(i") Offici ! "( the N tio" ! B'i!(i") Co(e .P,D, /0123, Th t the s i( i"st !! tio"s#$or%s is re (y foe fi" ! i"s-ectio", NAME OF O4NER 5 LAST NAME ADDRESS OF O4NER 5 6IVEN NAME MIDDLE INITIAL

LOCATION OF CONSTRUCTION 5

USE OR TYPE OF OCCUPANCY 5 DATE OF START OF CONSTRUCTION 5 DATE OF COMPLETION 5


TOTAL NUMBER OF OUTLETS AND E7UIPMENT INSTALLED
LI6HTS ELECTRIC RAN6E AIRCONDITIONIN6 SYSTEM S4ITCHES 84 HP CONVENIENCE OUTLETS 4ATER HEATER TELEPHONE 84 MOTORS HP BELL SYSTEM

OTHERS .S-ecify3

I" Ch r)e of Co"str'ctio"

If co"str'ctio" is '"(ert %e" &y co"tr ct

ELECTRICAL ENGINEER/MASTER ELECTRICIAN P,R,C, Re), No, TIN A((ress Res, Cert, D te D te TIN

ELECTRICAL ENGINEER/MASTER ELECTRICIAN P,R,C, Re), No, Res, Cert, A((ress D te D te

Co"for+e5

Owner / Applican
.For St tisc ! P'r-oses O"!y3 NUMBER OF STOREYS ESTIMATED COST ACTUAL COST 3 M teri !s .Tot ! Cost3 P / E!ectric ! 4ires : Li)hti") O't!ets < Co"*e"ie"ce O't!ets = S$itches Others .S-ecify3 &3 Other Costs This i"c!'(es -rofessio" ! fees9 -er+its ; other fees,

M ster E!ectrici "s c " si)" for e!ectric ! i"st !! tio" '- to :0 o't!ets or '- to =%$, - )e / of :

REPUBLIC OF THE PHILIPPINES PROVINCE OF CAVITE CITY OF DASMARIAS OFFICE OF THE BUILDING OFFICIAL

WORKSHEET III! ELECTRICAL SECTION


/ Lo (s to &e co""ecte(5 Co"*e"ie"ce O't!ets S$itches Be!! Syste+ E!ec, R ")e 6e"er tir : < = N t're of 4or%s5 Ty-e of Ser*ice5 Re+ r%s5 Vo!t )e Si>e of 4ire Pho"e Co++'"ic tio" Li)ht Others .S-ecify3

I here&y certify th t the &o*e ( t

"( i"for+ tio" re tr'e "( correct to the &est of +y %"o$!e()e "( &e!ief,

ELECTRICAL FEES

Co+-'te( By5

S'rch r)e Tot !

P P

E!ectric ! E")i"eer # M ster E!ectrici " P,R,C, NO, P,T,R, NO, TIN A((ress Res, Cert, No, Iss'e( t D te Iss'e(

LOAD

N t're of 4or% I"s-ectio" Fee P i( '"(er Offici ! Recei-t No, D te

Co"tr ctor O$"er # Occ'- "t

Reco++e"(i") A--ro* !5

Elec rical En"ineer

ENGR! OLIMAR R! ARBOLANTE


OIC ? B'i!(i") Offici !

NOTE5 Renewal or extension of this permit and or final inspection of the elctrical installation are subject to inspection and payment of corresponding fees in conformity with pertinent provisions of the "National Building Code" (P ! "#$%& and its implementing rules and regulations - )e : of :

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