Republic of the Philippines

City/Municipality of Bustos
Province of Bulacan

OFFICE OF THE BUILDING OFFICIAL

APPLICATION FOR BUILDING PERMIT
SIMPLE COMPLEX
NEW RENEWAL AMANDATORY
LOCATIONAL CLEARANCE FIRE SAFETY EVALUATION CLEARANCE
APPLICATION NO. BUILDING PERMIT NO.

BOX 1 (TO BE ACCOMPLISHED IN PRINT BY THE OWNER/APPLICANT)

OWNER/APPLICANT LAST NAME FIRST NAME M.I. TIN
DO NOT FILL-UP (PSA USE ONLY
FOR CONSTRUCTION OWNED FORM OF OWNERSHIP
BY AN ENTERPRISE
ADDRESS: NO., STREET, BARANGAY, CITY/MUNICIPALITY ZIP CODE TELEPHONE NO

LOCATION OF CONSTRUCTION: LOT NO. ____ BLK NO. ______ TCT NO. ___________CURRENT TAX DEC. NO._________________

STREET___________________ BARANGAY _________________ _________ CITY/ MUNICIPALITY OF ______________________________

SCOPE OF WORK
NEW CONSTRUCTION RENOVATION RAISING
ERECTION CONVERSION DEMOLITION
ADDITION REPAIR ACCESSORY BUILDING/STRUCTURE
MOVING OTHERS (Specify) _________________ _____
ALTERATION

USE OR CHARACTER OF OCCUPANCY GROUP H:ASSEMBLY OCCUPANT

GROUP A: RESIDENTIAL DWELLINGS GROUP E: COMMERCIAL LOADLESS THEN 1,000
SINGLE DUPLEX RESIDENTIAL R-1, R2 BANK STORE SHOPPING THEATER AUDITORIUM CONVENTION HALL
OTHERS_________________________________ DRINKING/DINING CENTER MALL GRANDSTAND/ BLEACHER
ESTABLISHMENT OTHERS
GROUP B: RESIDENTIAL HOTEL APPARTMENT SHOP ( i.e DRESS SHOP, TAILORING
HOTEL MOTEL TOWNHOUSE GROUP I:ASSEMBLY OCCUPANT
BARBER SHOP) etc LOADLESS THEN 1,000 OR MORE
DORMITORY BOARDINGHOUSE
RESIDENTIAL R-3,R-4,R5 LODGING HOUSE GROUP F: LIGHT INDUSTRIAL COLISEUM SPORT COMPLEX
FACTORY / PLANT USING INCUMBUSTIBLES CONVENTION CENTER AND
GROUP C: EDUCATIONAL RECREATIONAL NON-EXPLOSIVE MATERIALS SIMILAR STRUCTURES
SCHOOL BUILDING SCHOOL AUDITORIUM OTHERS OTHERS
CIVIC CENTER GYMNASIUM GROUP G: MEDIUM INDUSTRIAL GROUP J: (J-1) AGRICULTURAL
CLUBHOUSE CHURCH , MOSQUE STORAGE /WAREHOUSE FOR HAZARDOUS/ BARN, GRAINARY,POULTRY HOUSE
OTHERS_______________ TEMPLE, CHAPEL HIGHLY FLAMMABLE MATERIALS PIGGERY, GRAIN MILL, GRAIN SILO
GROUP D: INSTITUTIONAL FACTORY (FOR HAZARDOUS HIGHLY OTHERS
HOSPITAL OR SIMILAS STRUCTURES FLAMMABEL MATERIALS GROUP J: (J-2) ACCESSORIES
HOME FOR THE AGED OTHERS PRIVATE CARPORT/ GARAGE, TOWER
GOVERNMENT OFFICE SWIMMING POOL, FENCE OVER 1.80m
OTHERS_________________________ STEEL, CONCRETE TANK
OTHERS

OCCUPANCY CLASSIFIED______________________ TOTAL ESTIMATED COST P____________________________________

NUMBER OF UNITS__________________________BUILDING _________________________ COST OF EQUIPMENT INSTALLED
NUMBER OF STOREY________________________ ELECTRICAL ______________________ P___________________________
TOTAL FLOOR AREA ___ ________________sq.mt
MECHANICAL______________________ P___________________________
LOT AREA ____________________ ________sq.mt
ELECTRONICS_____________________ P___________________________
PLUMBING_________________________ P___________________________
PROPOSED DATE OF CONSTRUCTION_____________________EXPECTED DATE OF COMPLETION_______________________________

BOX2
FULL-TIME INSPECTOR AND SUPERVISOR OF CONSTRUCTION WORKS (REPRESENTING THE OWNER)
Address:
____________________________________
ARCHITECT OR CIVIL ENGINEER PRC No. Validity.
(Sign and Sealed Over Printed Name) P T R No. Date Issued
Date:_________________ Issued at TIN
BOX 3 BOX 4
APPLICANT: WITH MY CONSENT: LOT OWNER/AUTHORIZED REPRESENTATIVE

_____________________________________DATE_____________ ___________________________________DATE_________________
(Signature Over Printed Name) (Signature Over Printed Name)

Address:
CTC No. Date Issued: Placed Issued: CTC No. Date Issued Place Issued:
BOX 5
REPUBLIC OF THE PHILLIPINES
CITY/MUNICIPALITY OF__________________
BEFORE ME at the City/Municipality of_________________________________________ on ________________personally appeared
the following:
__________________________________ _______________________ ________________ ____________________
APPLICANT C.T.C. No. DATE ISSUED PLACE ISSUED

_________________________________________ ____________________________ ___________________ _______________________

LICENSED ARCHITECT OR CIVIL ENGINEER C.T.C. No. DATE ISSUED PLACE ISSUED
(Full time Inspector and Supervisor of Construction Works)

Whose signature appear herein above known to me to be the same persons who executed this standard prescribed form and acknowledged to me
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_______
Book No_______ ____________________________
Series No______ NOTARY PUBLIC
BOX 6(TO BE ACCOMPLISHED BY THE PROCESSING AND EVALUATION DIVISION)
ASSESSED FEES ASSESSED BY: AMOUNT DUE DATE PAID O.R NUMBER NSO
O FILLING FEE
O PROCESSING FEE
O LOCATIONAL/ZONING LAND USE
O LINE AND GRADE(GEODETIC)
O FENCING
O ARCHITECTURAL
O CIVIL/STRUCTURAL
O ELECTRICAL
O MECHANICAL
O SANITARY
O PLUMBING
O ELECTRONICS
O INTERIOR
O ONE HALF OF FIRE SERVICE FUND
TOTAL

BOX 8 (TO BE ACCOMPLISED BY THE BUILDING OFFICIAL)

BUILDING PERMIT
BUILDING PERMIT NO. OFFICIAL RECEIPT NO.

DATE ISSUED DATE PAID

Permit is issued to __________________ for the proposed ______________________________________

under ________________ of Group _____________, located at Lot No.____ Block No. OCT/TCT No.________________________

______________Street, Barangay ______________________City/Municipality of _______________subject to the following:

1. That under Article 1723 of the Civil Code of the Philippines, the engineer (or architect) who drew up the plans and specifications for the
building/structure is responsible for damages if within fifteen (15) years from the completion of the building/structure, the same should collapse due to
defect in the plans or specifications or defects in the ground. The engineer or architect who supervises the construction shall be solidarity liable with the
contractor should the edifice collapse due to defect in the construction or the use of interior materials.
2. This permit shall be accompanied by the various applicable ancillary and accessory permits plans and specifications signed and sealed by the
corresponding design professionals who shall be responsible for the comprehensive and correctness of the plans in compliance to the Code and its IRR
and to all applicable referral codes and professional regulatory laws.
3. That the proposed construction/erection/addition/alternation/renovation/convertion/repair/moving/demolition, etc. shall be in conformity with the
provisions of the National Building Code and its IRR.
a) That prior to commencement of the proposed projects and construction an actual relocation survey shall be conducted by a duly licensed
Geodetic Engineer.
b) That before commencing the excavation the person making or causing the excavation to be made shall notify in writing the owner of adjoining
property not less than ten (10) days before such excavation is to made and show how the adjoining property should be protected
c) That no person shall use or occupy a street alley or public sidewalk for the performance of work covered by the building permit.
d) That no person shall perform any work on any building or structure adjacent to a public way in general use for pedestrian travel unless the
pedestrian are protected.
e) That the supervising Architect/Civil Engineer shall keep at the job site at the times a logbook of daily construction activities wherein the actual
daily progress of construction including tests conducted weather condition and other pertinent data are to be recorded same shall be made
available for scrutiny and comments by the OBO representative during the conduct of his/her inspection pursuant to Section 207 of the
National Building Code.
f) That upon completion of the construction and said licensed supervising Architect/Civil Engineer shall submit to the Building Official duly signed
and sealed logbook as-built plans and other documents and shall also prepare and submit a Certificate of Completion of the project stating
that the construction of the building/structure conform to the provision of the Code its IRR as well as the plans and specifications.
g) All such changes modifications and alterations shall likewise be submitted to the Building Official and the subsequent amendatory permit
therefore issued before any work on said changes modifications and alternations shall be started. The as-built plans and specification maybe
just an orderly and comprehensive compilation of all documents which includes the originally submitted plans and specifications of all
amendments thereto as actually built or they may be an entirely new set of plans and specifications accurately describing and/or reflecting
therein the building as actually built.
4. That no building/structure shall be used until the Building Official has issued a Certificate of Occupancy thereof as provided in the Code. However a
partial Certificate of Occupancy may be issued for the Use/Occupancy of a portion or portions of a building/structures prior to the completion of the entire
building/structures.
5. That his permit shall not serve as an exemption from securing written clearances from various government authorities exercising regulatory function
affecting building/structures.
6. When the construction is undertaken by contract the work shall be done by a duly licensed and registered contractor pursuant to the provisions of the
Contractor’s License Law (RA 4566).
7. The Owner/Permittee shall submit a duly accomplished prescribe “Notice of Construction” to the Office of the Building Official prior to any construction
activity.
8. The Owner/Permitee shall put a Building Permit sign which complies with the prescribed dimensions and information, which shall remain posted on
the construction site for the duration of the construction.

PERMIT ISSUED BY:

__________________________________________
BUILDING OFFICIAL
(Signature Over Printed Name)
Date______________________
NBC FORM NO. A - 01

Republic of the Philippines

City/Municipality of Bustos
Province of Bulacan

OFFICE OF THE BUILDING OFFICIAL

ARCHITECTURAL PERMIT
APPLICATION NO. AP NO BUILDING PERMIT NO.

BOX 1 (TO BE ACCOMPLISHED IN PRINT BY THE OWNER/APPLICANT)

OWNER/APPLICANT LAST NAME FIRST NAME M.I. TIN

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP USE OR CHARACTER OF OCCUPANCY

BY AN ENTERPRISE
ADDRESS: NO., STREET, BARANGAY, CITY/MUNICIPALITY ZIP CODE TELEPHONE NO

LOCATION OF CONSTRUCTION: LOT NO. _______________ BLK NO. ________________ TCT NO. ______________________ TAX DEC. NO. _____________________
STREET___________________ BARANGAY ____________________________________________________ CITY/ MUNICIPALITY OF ________________________________

SCOPE OF WORK
NEW CONSTRUCTION RENOVATION ________________________ RAISING _______________________________________
ERECTION CONVERSION ________________________ ACCESSORY BUILDING/STRUCTURE________________
ADDITION REPAIR _____________________________ OTHERS (Specify) ________________________________
ALTERATION MOVING _____________________________ ________________________________________________

BOX 2 (TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL)

1. ARCHITECTURAL FACILITIES AND OTHER FEATURES PURSUANT TO BATAS PAMBANSA BILANG 344, REQUIRING CERTAIN BUILDINGS, INSTITUTIONS,
ESTABLISHMENTS AND PUBLIC UTILITIES TO INSTALL FACILITIES AND OTHER DEVICES.
STAIRS WASH ROOMS AND TOILETS SWITCHES, CONTROLS, BUZZERS DRINKING FOUNTAINS
WALKWAYS LIFTS/ELEVATORS HANDRAILS PUBLIC TELEPHONES
CORRIDORS RAMPS THRESHOLDS SEATING ACCOMMODATIONS
DOORS, ENTRANCES & THRESHOLDS PARKING AREAS FLOOR FINISHES OTHERS (Specify) __________

2. PERCENTAGE OF SITE OCCUPANCY 3. CONFORMANCE TO FIRE CODE OF THE PHILIPPINES (P.D. 1185)

PERCENTAGE OF BUILDING FOOTPRINT ______________% NUMBER AND WIDTH OF EXIT DOORS FIRE WALLS OTHERS (Specify)
___________
PERCENTAGE OF IMPERVIOUS SURFACE AREA _______% WIDTH OF CORRIDORS FIRE FIGHTING AND SAFETY FACILITIES
PERCENTAGE OF UNPAVED SURFACE AREA __________% DISTANCE TO FIRE EXITS SMOKE DETECTORS

BOX 3
DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS
BOX 4
SUPERVISOR / IN-CHARGEOF ARCHITECTURAL WORKS

Date____________ Date____________
ARCHITECT ARCHITECT
(Signed and Sealed Over Printed Name) (Signed and Sealed Over Printed Name )
Address Address
IAPOA No. Validity IAPOA No. Validity
PRC No. Validity PRC No. Validity
PTR. No Date Issued PTR. No Date Issued
Issued at TIN Issued at TIN

BOX 6
BOX 5 OWNER
BUILDING WITH MY CONSENT: LOT OWNER

(Signature Over Printed Name) (Signature Over Printed Name)

Date__________________ Date___________________

Address Address

C.T.C. No. Date Issued Place Issued C.T.C. No. Date Issued Place Issued
TO BE ACCOMPLISHED BY THE PROCESSING AND EVALUATION DIVISION

BOX 7

RECEIVED BY DATE

FIVE (5) SET OF ARCHITECTURAL DOCUMENTS

1. VICINITY MAP/LOCATION PLAN WITHIN A TWO - 8. DETAILS OF RAMPS, PARKING FOR THE DISABLED,
KILOMETER RADIUS STAIRS, FIRE ESCAPES, CABINETS AND PARTITIONS
2. SITE DEVELOPMENT PLAN 9. SCHEDULE OF DOORS AND WINDOWS
3. PERSPECTIVE 10. SCHEDULE OF FINISHES FOR FLOORS, CEILINGS AND
WALLS
4. FLOOR PLANS 11. ARCHITECTURAL INBTERIOR
5. ELEVATIONS, AT LEAST FOUR (4) 12. SPECIFICATIONS
6. SECTIONS, AT LEAST TWO (2) 13. COST ESTIMATE
7. CEILING PLANS SHOWING LIGHTING FIXTURES AND 14. OTHERS (Specify)
DIFFUSERS ______________________________________________
________________________________

BOX 8

PROGRESS FLOW

IN OUT PROCESSED BY:

DATE TIME DATE TIME

ARCHITECTURAL DRAWINGS

SPECIFICATIONS

OTHERS (Specify)

BOX 9

ACTION TAKEN:

PERMIT IS HEREBY ISSUED SUBJECT TO THE FOLLOWING:

1. That under Article 1723 of the Civil Code of the Philippines, the architect (and engineer) who drew up the plans and specifications
for the building/structure is responsible for damages if within fifteen (15) years from the completion of the building/structure, the same
should collapse due to defect in the plans or specifications or defect sin the ground. The engineer or architect who supervises the
construction shall be solidarily liable with the contractor should the edifice collapse due to defect in the construction or the use of interior
materials.

2. That the proposed architectural works shall be in accordance with the architectural plans filed with this office and in conformity with
the latest Architectural Code of the Philippines, the National Building Code and its IRR.

3. That prior to any construction activity, a duly accomplished prescribed “Notice of Construction” shall be submitted to the Office of
the Building Official.

4. That upon completion of the construction, the licensed full-time inspector and supervisor/in-charge of construction works shall submit
the entry to the logbook duly signed and sealed to the Building Official including as-built plans and other documents and shall also
accomplish the Certificate of Completion stating that the architectural works conform to the provisions of the Architectural Code of the
Philippines, the National Building Code and its IRR.

5. That this permit is null and void unless accompanied by the building permit.

PERMIT ISSUED BY:

_________________________________________
BUILDING OFFICIAL
(Signature Over Printed Name)
Date______________________
NBC FORM NO. A -06
Republic of the Philippines
City/Municipality of Bustos
Province of Bulacan

OFFICE OF THE BUILDING OFFICIAL

PLUMBING PERMIT
APPLICATION NO. PP NO BUILDING PERMIT NO.

BOX 1 (TO BE ACCOMPLISHED IN PRINT BY THE OWNER/APPLICANT)

OWNER/APPLICANT LAST NAME FIRST NAME M.I. TIN

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP USE OR CHARACTER OF OCCUPANCY

BY AN ENTERPRISE
ADDRESS: NO., STREET, BARANGAY, CITY/MUNICIPALITY ZIP CODE TELEPHONE NO

LOCATION OF CONSTRUCTION: LOT NO. _______________ BLK NO. ________________ TCT NO. ______________________ TAX DEC. NO. _____________________
STREET___________________ BARANGAY ____________________________________________________ CITY/ MUNICIPALITY OF ________________________________

SCOPE OF WORK
NEW CONSTRUCTION RENOVATION ________________________ RAISING________________________________________
ERECTION CONVERSION ________________________ DEMOLITION ____________________________________
ADDITION REPAIR _____________________________ ACCESSORY BUILDING/STRUCTURE ________________
ALTERATION MOVING _____________________________ OTHERS (Specify)_________________________________

BOX 2 (TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL)

FIXTURES TO BE INSTALLED
QTY. NEW EXISTING KIND OF QTY. NEW EXISTING KIND OF
FIXTURES FIXTURES FIXTURES FIXTURES FIXTURES FIXTURES
WATER CLOSET BIDETTE
FLOOR DRAIN LAUNDRY TRAYS
LAVATORY DENTAL CUSPIDOR
KITCHEN SINK DRINKING FOUNTAIN
FAUCET BAR SINK
SHOWER HEAD SODA FOUNTAIN SINK
WATER METER LABORATORY SINK
GREASE TRAP STERILIZER
BATH TUB OTHERS (Specify)
SLOP SINK __________________________
URINAL __________________________
AIR CONDITIONING UNIT __________________________
WATER TANK/RESERVOIR __________________________

TOTAL TOTAL
WATER DISTRIBUTION SYSTEM SEWAGE SYSTEM SEPTIC TANK STORM DRAINAGE SYSTEM
PREPARED BY: ______________________________________________________________________________________________________________________________

BOX 3 BOX 4
DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS SUPERVISOR / IN-CHARGE OF PLUMBING WORKS

Date_______________ Date_______________
MASTER PLUMBER MASTER PLUMBER
(Signed and Sealed Over Printed Name) (Signed and Sealed Over Printed Name)
Address Address
PRC. No Validity PRC. No Validity
PTR. No Date Issued PTR. No Date Issued
Issued at TIN Issued at TIN
BOX 5 BOX 6
BUILDING OWNER WITH MY CONSENT: LOT OWNER

(Signature Over Printed Name) (Signature Over Printed Name)

Date_________________ Date__________________
Address Address
C.T.C. No. Date Issued Place Issued C.T.C. No. Date Issued Place Issued
TO BE ACCOMPLISHED BY THE PROCESSING AND EVALUATION DIVISION

BOX 7

RECEIVED BY DATE

FIVE (5) SETS OF PLUMBING DOCUMENTS

PLUMBING PLANS AND SPECIFICATIONS COST ESTIMATES

BILL OF MATERIALS OTHERS (Specify)

_____________________________

BOX 8

PROGRESS FLOW

IN OUT PROCESSED BY:

DATE TIME DATE TIME

RECEIVING AND RECORDING

PLUMBING

OTHERS (Specify)

BOX 9

ACTION TAKEN:

PERMIT IS HEREBY ISSUED SUBJECT TO THE FOLLOWING:

1. That the proposed plumbing works shall be in accordance with the plumbing plans filed with this Office and
in conformity with the Revised Plumbing Code of the Philippines, the National Building Code and its IRR.

2. That prior to any commencement of plumbing works, a duly accomplished prescribed “Notice of
Construction” shall be submitted to the Office of the Building Official.

3. That upon completion of the plumbing works, the licensed supervisor/in-charge shall submit the entry to the
logbook duly signed and sealed to the building official including as built plans and other documents and shall
also accomplish the Certificate of Completion stating that the plumbing works of the building conform to the
provision of the Revised Plumbing Code, the National Building Code and its IRR.

4. That this permit is null and void unless accompanied by the building permit.

PERMIT ISSUED BY:

_____________________________________________
BUILDING OFFICIAL
(Signature Over Printed Name)
Date ___________________
NBC FORM NO. A- 05

Republic of the Philippines

City/Municipality of Bustos
Province of Bulacan

OFFICE OF THE BUILDING OFFICIAL

SANITARY PERMIT
APPLICATION NO. SP NO BUILDING PERMIT NO.

BOX 1 (TO BE ACCOMPLISHED IN PRINT BY THE OWNER/APPLICANT)

OWNER/APPLICANT LAST NAME FIRST NAME M.I. TIN

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP USE OR CHARACTER OF OCCUPANCY

BY AN ENTERPRISE
ADDRESS: NO., STREET, BARANGAY, CITY/MUNICIPALITY ZIP CODE TELEPHONE NO

LOCATION OF CONSTRUCTION: LOT NO. _______________ BLK NO. _________________ TCT NO. _____________________ TAX DEC. NO. ____________________
STREET___________________ BARANGAY _________________________________________ CITY/ MUNICIPALITY OF ___________________________________________

SCOPE OF WORK
NEW CONSTRUCTION RENOVATION ________________________ RAISING________________________________________
ERECTION CONVERSION ________________________ DEMOLITION ____________________________________
ADDITION REPAIR _____________________________ ACCESSORY BUILDING/STRUCTURE________________
ALTERATION MOVING _____________________________ OTHERS (Specify)_________________________________

BOX 2 (TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL)

INSTALLATION AND OPERATION OF:

WATER SUPPLY: SYSTEM OF DISPOSAL:

SHALLOW WELL WASTE WATER TREATMENT PLANT SURFACE DRAINAGE

DEEP WELL & PUMP SET IMHOFF TANK STREET CANAL

CITY/MUNICIPAL WATER SYSTEM SANITARY SEWER CONNECTION WATER COURSE

OTHERS (Specify) ______________ SUB-SURFACE SAND FILTER OTHERS (Specify) ________________

PREPARED BY: ______________________________________________________________________________________________________________________________

BOX 3 BOX 4
DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS SUPERVISOR / IN-CHARGE OF SANITARY WORKS

Date_____________ Date_____________
SANITARY ENGINEER SANITARY ENGINEER
(Signed and Sealed Over Printed Name) (Signed and Sealed Over Printed Name)
Address Address
PRC. No Validity PRC. No Validity
PTR. No Date Issued PTR. No Date Issued
Issued at TIN Issued at TIN

BOX 5 BOX 6
BUILDING OWNER WITH MY CONSENT: LOT OWNER

(Signature Over Printed Name) (Signature Over Printed Name)

Date_________________ Date_________________
Address Address
C.T.C. No. Date Issued Place Issued C.T.C. No. Date Issued Place Issued
TO BE ACCOMPLISHED BY THE PROCESSING AND EVALUATION DIVISION

BOX 7

RECEIVED BY DATE

FIVE (5) SETS OF SANITARY DOCUMENTS

SANITARY PLANS AND SPECIFICATIONS COST ESTIMATES

BILL OF MATERIALS OTHERS (Specify)

_____________________________

BOX 8

PROGRESS FLOW

IN OUT PROCESSED BY:

DATE TIME DATE TIME

SANITARY

OTHERS (Specify)

BOX 9

ACTION TAKEN:

PERMIT IS HEREBY ISSUED SUBJECT TO THE FOLLOWING:

1. That the proposed sanitary works shall be in accordance with the sanitary plans filed with this office and in
conformity with the latest Code on Sanitation of the Philippines, the National Building Code and its IRR.

2. That prior to any commencement of sanitary works, a duly accomplished prescribed “Notice of
Construction” shall be submitted to the Office of the Building Official.

3. That upon completion of the sanitary works, the licensed supervisor/in-charge shall submit the entry to the
logbook duly signed and sealed to the Building Official including as-built plans and other documents and shall
also accomplish the Certificate of Completion stating that the sanitary works conform to the provision of the
Code on Sanitation, the National Building Code and its IRR.

4. That this permit is null and void unless accompanied by the building permit.

PERMIT ISSUED BY:

_____________________________________________
BUILDING OFFICIAL
(Signature Over Printed Name)
Date ___________________
NBC FORM NO. A - 04

Republic of the Philippines

City/Municipality of Bustos
Province of Bulacan

OFFICE OF THE BUILDING OFFICIAL

MECHANICAL PERMIT
APPLICATION NO. MP NO BUILDING PERMIT NO.

BOX 1 (TO BE ACCOMPLISHED IN PRINT BY THE OWNER/APPLICANT)

OWNER/APPLICANT LAST NAME FIRST NAME M.I. TIN

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP USE OR CHARACTER OF OCCUPANCY

BY AN ENTERPRISE
ADDRESS: NO., STREET, BARANGAY, CITY/MUNICIPALITY ZIP CODE TELEPHONE NO

LOCATION OF CONSTRUCTION: LOT NO. _______________ BLK NO. ________________ TCT NO. ______________________ TAX DEC. NO. ____________________
STREET___________________ BARANGAY ____________________________________________________ CITY/ MUNICIPALITY OF________________________________

SCOPE OF WORK
NEW CONSTRUCTION RENOVATION ________________________ RAISING_______________________________________
ERECTION CONVERSION ________________________ DEMOLITION ___________________________________
ADDITION REPAIR _____________________________ ACCESSORY BUILDING/STRUCTURE ______________
ALTERATION MOVING _____________________________ OTHERS (Specify) _______________________________

BOX 2 (TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL)

INSTALLATION AND OPERATION OF:

BOILER CENTRAL AIRCONDITIONING DUMBWAITER

PRESSURE VESSEL MECHANICAL VENTILLATION PUMPS
INTERNAL COMBUSTION ENGINE ESCALATOR COMPRESSED AIR, VACUUM, INSTITUTIONAL
REFRIGERATION AND ICE MAKING MOVING SIDEWALK and/or INDUSTRIAL GAS
WINDOW TYPE AIRCONDITIONING FREIGHT ELEVATOR PNEUMATIC TUBES, CONVEYORS
PACKAGED/ SPLIT TYPE AIRCONDITIONING PASSENGER ELEVATOR and/or MONORAILS
OTHERS (Specify) _____________________ CABLE CAR FUNICULAR

PREPARED BY _____________________________________________________________________________________________________________

BOX 3 BOX 4
DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS SUPERVISOR / IN-CHARGE OF MECHANICAL WORKS
PROFESSIONAL MECHANICAL ENGINEER MECHANICAL ENGINEER

PROFESSIONAL MECHANICAL ENGINEER

(Signed and Sealed Over Printed Name) (Signed and/or Sealed Over Printed Name)
Date________________________ Date___________________
Address Address
PRC. No Validity PRC. No Validity
PTR. No Date Issued PTR. No Date Issued
Issued at TIN Issued at TIN

BOX 5 BOX 6
BUILDING OWNER WITH MY CONSENT: LOT OWNER

(Signature Over Printed Name) (Signature Over Printed Name)

Date__________________ Date__________________
TO BE ACCOMPLISHED BY THE PROCESSING AND EVALUATION DIVISION

BOX 7

RECEIVED BY DATE

FIVE (5) SETS OF SANITARY DOCUMENTS

MECHANICAL PLANS AND SPECIFICATIONS COST ESTIMATES

BILL OF MATERIALS OTHERS (Specify)

_____________________________

BOX 8

PROGRESS FLOW

IN OUT PROCESSED BY:

DATE TIME DATE TIME

MECHANICAL

OTHERS (Specify)

BOX 9

ACTION TAKEN:

PERMIT IS HEREBY ISSUED SUBJECT TO THE FOLLOWING:

1. That the proposed mechanical works shall be in accordance with the mechanical plans filed with this office
and in conformity with the latest Philippine Mechanical Code, the National Building Code and its IRR.

2. That prior to any mechanical installation, a duly accomplished prescribed “Notice of Construction” shall
be submitted to the Office of the Building Official.

3. That upon completion of the sanitary works, the licensed supervisor/in-charge shall submit the entry to the
logbook duly signed and sealed to the Building Official including as-built plans and other documents and shall
also accomplish the Certificate of Completion stating that the mechanical works conform to the provision of the
Philippine Mechanical Code, the National Building Code and its IRR.

4. That this permit is null and void unless accompanied by the building permit.

5. That a Certificate of Operation shall be issued for the continuous use of mechanical installations.

PERMIT ISSUED BY:

__________________________________________
BUILDING OFFICIAL
(Signature Over Printed Name)
Date ___________________
NBC FORM NO. A.-03
Republic of the Philippines
City/Municipality of Bustos
Province of Bulacan

OFFICE OF THE BUILDING OFFICIAL

ELECTRICAL PERMIT

APPLICATION NO. EP NO BUILDING PERMIT NO.

BOX 1 (TO BE ACCOMPLISHED IN PRINT BY THE OWNER/APPLICANT)

OWNER/APPLICANT LAST NAME FIRST NAME M.I. TIN

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP USE OR CHARACTER OF OCCUPANCY

BY AN ENTERPRISE
ADDRESS: NO., STREET, BARANGAY, CITY/MUNICIPALITY ZIP CODE TELEPHONE NO

LOCATION OF CONSTRUCTION: LOT NO. _______________ BLK NO. ________________ TCT NO. ______________________ TAX DEC. NO. ____________________
STREET___________________ BARANGAY ____________________________________________________ CITY/ MUNICIPALITY OF ________________________________

SCOPE OF WORK
NEW INSTALLATION RECONNECTION OF SERVICE ENTRANCE RELOCATION OF SERVICE ENTRANCE
ANNUAL INSPECTION SEPARATION OF SERVICE ENTRANCE OTHERS (Specify)___________________________________
TEMPORARY UPGRADING OF SERVICE ENTRANCE __________________________________________________

SUMMARY OF ELECTRICAL LOADS/CAPACITIES APPLIED FOR

TOTAL CONNECTED LOAD TOTAL TRANSFORMER CAPACITY TOTAL GENERATOR/UPS CAPACITY

___________________ kVA _____________________ kVA ____________________ kVA

BOX 2 (TO BE ACCOMPLISHED IN PRINT BY THE DESIGN PROFESSIONAL)

DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS

Address
PRC. No Validity
Date____________
PROFESSIONAL ELECTRICAL ENGINEER PTR. No Date Issued
(Signed and Sealed Over Printed Name)
Issued at TIN

BOX 3
SUPERVISOR / IN-CHARGE OF ELECTRICAL WORKS

PROFESSIONAL ELECTRICAL ENGINEER REGISTERED ELECTRICAL ENGINEER REGISTERED MASTER ELECTRICIAN

Date______________
(Signed and Sealed Over Printed Name)

PRC. No Validity
PTR. No Date Issued
Issued at TIN
Address

BOX 4 BOX 5
BUILDING OWNER WITH MY CONSENT: LOT OWNER

Date_____________ Date____________
(Signature Over Printed Name) (Signature Over Printed Name)
TO BE ACCOMPLISHED BY THE PROCESSING & EVALUATION DIVISION

BOX 6

RECEIVED BY DATE

FIVE (5) SETS OF SANITARY DOCUMENTS

ELECTRICAL PLANS AND SPECIFICATIONS EXPECTED DATE OF COMPLETION/INSTALLATION/CONSTRUCTION

SPECIAL FIXTURES AND EQUIPMENT
PROPOSED STARTING DATE OF INSTALLATION/CONSTRUCTION
________________________________________________________
__________________________________________________
OTHERS (Specify) ___________________________________
__________________________________________________

BOX 7

IN OUT PROCESSED BY:

DATE TIME DATE TIME

ELECTRICAL ENGINEER
(Signature Over Printed Name)
ELECTRICAL

OTHERS (Specify) PRC Reg. No.

Validity:

BOX 8

ACTION TAKEN:

PERMIT IS HEREBY ISSUED SUBJECT TO THE FOLLOWING:

1. That the proposed electrical works shall be in accordance with the electrical plans filed with this office and in
conformity with the latest Philippine Electrical, the National Building Code and its IRR.

2. That prior to any electrical installation, the Owner/Permittee shall submit a duly accomplished prescribed “Notice of
Construction” shall be submitted to the Office of the Building Official.

3. That for installed electrical capacity of 200 amperes and above at 230 volts nominal and above, a special electrical
contractor duly licensed by the Philippine Contractors Accreditation Board (PCAB) shall be required.

4. That a duly licensed electrical practitioner shall be in-charge of the installation, and that upon completion of the
electrical works, he shall submit the entry of the logbook duly signed and sealed to the OBO including as-built plans and
other documents. He shall also accomplish the Certificate of Completion stating that the electrical works conform o the
provisions of the Philippine Electrical Codes, the National Building Code and its IRR.

5. That this permit is null and void unless accompanied by the building permit except for projects involving purely
electrical works in which case only the building permit number of the existing building/structure shall be required.

6. That a Certificate of Final Electrical Inspection (CFEI) shall be secured prior to the actual occupancy of the building.

7. That this permit shall be posted at the door or site of work.

PERMIT ISSUED BY:

_______________________________________________
 BUILDING OFFICIAL
(Signature Over Printed Name)
Date ___________________

NBC FORM NO. A.-03

Republic of the Philippines
City/Municipality of Bustos
Province of Bulacan

OFFICE OF THE BUILDING OFFICIAL

ELECTRONICS PERMIT

APPLICATION NO. EP NO BUILDING PERMIT NO.

BOX 1 (TO BE ACCOMPLISHED IN PRINT BY THE OWNER/APPLICANT)

OWNER/APPLICANT LAST NAME FIRST NAME M.I. TIN

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP USE OR CHARACTER OF OCCUPANCY

BY AN ENTERPRISE
ADDRESS: NO., STREET, BARANGAY, CITY/MUNICIPALITY ZIP CODE TELEPHONE NO

LOCATION OF CONSTRUCTION: LOT NO. _______________ BLK NO. ________________ TCT NO. ______________________ TAX DEC. NO. ____________________
STREET___________________ BARANGAY ____________________________________________________ CITY/ MUNICIPALITY OF ________________________________

SCOPE OF WORK
NEW INSTALLATION ANNUAL INSPECTION OTHERS (Specify)___________________________________

BOX 2 (TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL)

NATURE OF INSTALLATION WORKS /EQUIPMANT SYSTEM

TELECOMMUNICATION SYSTEM ELECTRONICS FIRE ALARM SYSTEM ELECTRONICS COMPUTERIZE D PROCESS

BROADCASTING SYSTEM SOUND COMMUNICATION SYSTEM CONTROLS AUTOMATION SYSTEM
BUILDING AUTOMATION MANAGEMENT AND
TELEVISION SYSTEM CENTRALIZED CLOCK SYSTEM CONTROLSYSTEM
INFORMATION TECHNOLOGY SYSTEM SOUND SYSTEM BUILDING WIRING UTILIZATION
SECURITY ALAM SYSTEM ELECTRONICS CONTROL FIBER OPTIC CABLE OR OTHER MEDIAL
AND CONVEYORSYSTEM ELECTRONIC SYSTEM

ANY OTHER ELECTRONICS AND I.T. SYSTEM S, EQUIPMENT, APPARATUS, DEVICE AND/OR COMPONENT (Specify)_________________________
_____________________

PREPARED BY _____________________________________________________________________________________________________________

BOX 3 BOX 4
DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS SUPERVISOR / IN-CHARGE OF ELECTRONIC WORKS

PROFESSIONAL ELECTRONICS ENGINEER PROFESSIONAL ELECTRONICS ENGINEER

(Signed and Sealed Over Printed Name) (Signed and/or Sealed Over Printed Name)
Date________________________ Date___________________
Address Address
PRC. No Validity PRC. No Validity
PTR. No Date Issued PTR. No Date Issued
Issued at TIN Issued at TIN

BOX 5 BOX 6
BUILDING OWNER WITH MY CONSENT: LOT OWNER

(Signature Over Printed Name) (Signature Over Printed Name)

BOX 7 TO BE ACCOMPLISHED BY THE PROCESSING & EVALUATION DIVISION

RECEIVED BY DATE

FIVE (5) SETS OF ELECTRONICS DOCUMENTS

ELECTRONICS PLANS AND SPECIFICATIONS COST ESTIMATES

BILL OF MATERIALS OTHERS ( SPECIFY ) __________________________

BOX 8

IN OUT PROCESSED BY:

DATE TIME DATE TIME

ELECTRONICS

OTHERS (Specify)

BOX 9

ACTION TAKEN:

PERMIT IS HEREBY ISSUED SUBJECT TO THE FOLLOWING:

1. That the proposed electronics works shall be in accordance with the electrical plans filed with this office and in
conformity with the latest Philippine Electronic Code of the National Building Code and its IRR.

2. That prior to any electronic installation, the Owner/Permittee shall submit a duly accomplished prescribed “Notice of
Construction” shall be submitted to the Office of the Building Official.

3. Upon completion of the electronics works, the licensed supervision/ in-charge shall submit the entry to the logbook
duly signed and sealed to the building official including as-built plans and other documents and shall also
accomplish the Certificate of Completion stating that the electronic works conform to the provision of the
Electronics Code of the Phillippines, the National Building Code and its IRR.

4. That this permit is null and void unless accompanied by the building permit.

PERMIT ISSUED BY:

____________________________________________
BUILDING OFFICIAL
(Signature Over Printed Name)
Date ___________________