Ropubic of tha Phippinas CiyyMurveipaly of Provnce of UNIFIED APPLICATION FORM FOR CERTIFICATE OF OCCUPANCY Oru (learnt THIS ALSO APPLIES FOR: |_] FIRE SAFETY INSPECTION CERTIFICATE ‘Busing Permit No, | __ _ Date Issued Fsec — 7 Datetssued Name of AppicanvOwne: Getane) (Gren Name) (96 Name) ‘Adaross of AppicanvOwner: _ 21P Code: Contact No. _ Requirements submit 7 copies of Ceriicate of Completion, duly notarized [7 Construction Logbook, signed and sealed by the une’ Architect or Cv Engineer who undertook fulltime inspection and supervision [As Bult Pians, signed and sealed by the Owner's Architect o Cv Engineer who undertook fullime Inspection and supervision + photocopy of teva icnse oft vod Professionals [7 Centoned photogrophs of Ste and Completed Buling/Stucture showing font, sides and rer are Ly Yetow cat issued by tne Elects! Senice Provider [Name of Project Location of Project: UselCharacter of Occupancy: No, of Storeys: No, of Units ‘Tolal Gross Floor Area (Square meters): Date of Complet Submited: “APPLICANTIONNER: (Sinai Over red Name) ComeuniyTox Cerificate No, Date sue Phe ssued——— Mested by ‘BULL TIME INSPECTOR OR SUPERVISOR OF CONSTRUCTION "ARCHITECT OR CNL ENGINEER {Sipetand Sead Oreires Name) PRONO. [sity PIRNO, [ate sued issued at fw TC. Pat tsued [ssuedat