Professional Documents
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1 Unified Application For BLDG Permit
1 Unified Application For BLDG Permit
1 Unified Application For BLDG Permit
City/Mu
City/Municipality of Caloocan City
National Capital Region
UNIFIED APPLICATION FORM FOR BUILDING PERMIT
SIMPLE COMPLEX**
NEW RENEWAL AMENDATORY
LOCATION OF CONSTRUCTION: LOT NO. _______ BLK NO. ________ TCT NO. ______________ CURRENT TAX DEC. NO.____________________
STREET_____________________ BARANGAY __________________________ CITY/ MUNICIPALITY OF_
OF____________________________________
_______________________________
SCOPE OF WORK
NEW CONSTRUCTION RENOVATION RAISING
ERECTION CONVERSION ACCESSORY BUILDING/STRUCTURE
ADDITION REPAIR LEGALIZATION OF EXISTINGBUILDING
ALTERATION MOVING OTHERS (Specify)
USE OR CHARACTER OF OCCUPANCY
GROUP H : ASSEMBLY (OCCUPANT
GROUP A : RESIDENTIAL (DWELLINGS) GROUP E : COMMERCIAL LOAD LESS THAN 1,000)
SINGLE DUPLEX RESIDENTIAL R-1, R-22 BANK STORE SHOPPING THEATER, AUDITORIUM, CONVENTION HALL,
OTHERS ______________________________________ DRINKING / DINING CENTER / MALL GRANDSTAND/ BLEACHER
GROUP B : RESIDENTIAL ESTABLISHMENT OTHERS ______________________________
_______________________
HOTEL MOTEL TOWNHOUSE SHOP (i.e. DRESS SHOP, TAILORING,
DORMITORY BOARDINGHOUSE, BARBERSHOP, etc.) GROUP I : ASSEMBLY (OCCUPANT
RESIDENTIAL R-3, R-4, R-5 LODGING HOUSE OTHERS ______________________________ LOAD 1,000 OR MORE)
MORE
COLISEUM, SPORTS COMPLEX,
OTHERS ________________________________________ GROUP F : LIGHT INDUSTRIAL CONVENTION CENTER AND SIMILAR
GROUP C : EDUCATIONAL & RECREATIONAL FACTORY / PLANT (USING INCOMBUSTIBLE/ STRUCTURE
SCHOOL BUILDING SCHOOL AUDITORIUM
AUDITORIUM, NON-EXPLOSIVE MATERIALS OTHERS _______________________
CIVIC CENTER GYMNASIUM OTHERS ______________________________
CLUBHOUSE CHURCH, MOSQUE, GROUP J : (J-1)
(J AGRICULTURAL
TEMPLE, CHAPEL GROUP G : MEDIUM INDUSTRIAL BARN, GRANARY, POULTRY HOUSE,
OTHERS _______________ PIGGERY, GRAIN MILL, GRAIN SILO
STORAGE / WAREHOUSE (FOR HAZARDOUS/
GROUP D : INSTITUTIONAL HIGHLY FLAMMABLE MATERIALS OTHERS _______________________
______________
HOSPITAL OR SIMILAR STRUCTURE FACTORY (FOR HAZARDOUS/ HIGHLY GROUP J : (J-2)
(J ACCESSORIES
HOME FOR THE AGED FLAMMABLE MATERIALS PRIVATE CARPORT/GARAGE, TOWER,
GOVERNMENT OFFICE OTHERS _______________________________ 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. MM. MECHANICAL____________________________ P ______________________________
___________________________
LOT AREA ____________________________________ SQ. M ELECTRONICS___________________________ P ______________________________
___________________________
PLUMBING ___________________________ P ______________________________
___________________________
PROPOSED DATE OF CONSTRUCTION:_________________________
CONSTRUCTION:_______________________________EXPECTED DATE OF COMPLETION:____________________
:_______________________________
BOX 2
FULL-TIME
TIME INSPECTOR AND SUPERVISOR OF CONSTRUCTION WORKS (REPRESENTING THE OWNER)
Address
Date______________ Date______________
(Signature Over Printed Name) (Signature Over Printed Name)
Address Address
Gov’t Issued ID No. Date Issued Place Issued Gov’t Issued ID No. Date Issued Place Issued
BOX 5
REPUBLIC OF THE PHILIPPINES ) S.S
CITY/MUNICIPALITY OF _________________________________________)
BEFORE ME, at the City/Municipality of _____________________________________________________ , on _____
_________________________ personally appeared the
following:
______________________________________________________ _______________
_____________________ __________________________________________________
______________
APPLICANT Gov’t Issued ID No. Date Issued Place Issued
______________________________
______________________________________________________ ___________________________________
_______________ ___________________________________
LICENSED ARCHITECT OR CIVIL ENGINEER Gov’t Issued ID No. Date Issued Place Issued
(Full-Time
Time Inspector and Supervisor of Construction Works)
whose signatures appear hereinabove, known to me to be the same persons who executed this standard prescribed form and acknow
acknowledged to me that 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.____________ NOTARY PUBLIC (Until December _____________ )
Series of ____________
Copy 1: Owner Copy 2: OBO Copy 3: BFP Copy 4: Philippine Statistics Authority
*May
May require additional requirements
BOX 6 (TO BE ACCOMPLISHED BY THE PROCESSING AND EVALUATION DIVISION)
BASIS OF AMOUNT
ASSESSED FEES ACCOUNT ASSESSED BY
ASSESSMENT DUE
FOR ZONING (ZONING
ADMINISTRATOR):
LOCATIONAL / ZONING OF LAND
FENCING
ARCHITECTURAL
CIVIL / STRUCTURAL
ELECTRICAL
MECHANICAL
SANITARY
PLUMBING
ELECTRONICS
INTERIOR
SURCHARGES
PENALTIES
HOTWORKS
TOTAL
2. The fully accomplished prescribed Application Form, duly notarized, shall be submitted to the concerned Office of the
Building Official, 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 National Building Code of the Philippines (PD 1096), its Revised IRR and
all applicable referral codes and professional regulatory laws, together with the other documentary requirements
pursuant to Section 302 of PD 1096 and its Revised IRR.
I have read this form, understood its contents and consent to the processing of my personal data. I understand that my consent
does not preclude the existence of other criteria for lawful processing of personal data, and does not waive any of my rights under
the Data Privacy Act of 2012 and other applicable laws.
___________________________________________________
SIGNATURE OVER PRINTED NAME OF OWNER/APPLICANT