ESTATE WORK PERMIT

3F Aseana Powerstation Bldg., PDMB. cor. BRADCO Ave., Aseana City, Paranaque City, 1701
Tel No. 8854-5711; 888-ABPEA Control Number:
www.abpea.com | permits@abpea.com Permit Validity:

PROJECT INFORMATION
Locator/Project/ Building Name
Tenant/Unit Name
Location
APPLICANT INFORMATION
Authorized Representative Name Contact Number
Designation Email Address
Company/Contractor’s Name
Office Address
DESCRIPTION OF WORKS / ACTIVITIES
SCOPE OF WORKS GENERAL REQUIREMENTS
1. Endorsement letter from Lot Owner/ Developer/ Lessee for their
Authorized Representative/ Contractor (as needed)
2. Location Plan / Key Plan
3. List of Key Personnel
4. List of Equipment/Tools/Vehicle Plate No.
5. Drawing/Engineering Plans duly signed by technical representative
(as needed)
Duration of Works New 6. Construction Methodology (as needed)
7. JHA (Job Hazard Analysis) signed by Safety Head
Renewal 8. Others (as per ABPEA’s instructions)

By submitting this application form, I accept and understand that this does not guarantee the approval of the work/activity I am applying for. I acknowledge
that any personal information and supporting documentation supplied to ABPEA is done voluntarily to facilitate the processing of this permit application.

Moreover, I hereby certify that the information I provided is to the best of my knowledge both true and correct, and that I understand that any incorrect or
inaccurate information and/or attachment submitted may adversely affect the manner in which ABPEA may comply with its obligations.

Further, I shall comply with all the requirements of ABPEA and LGU and that non-compliance therewith shall be a cause for the immediate cancellation of
this permit without prejudice to charges of fines, penalties, and actual damages to the common area.

PAYMENT ASSESSMENT REMARKS

Reference No
Date of Payment
OR/AR #
Mode of Payment
Amount (Php)
Received by
Notes

Recommending Approval By: Approved By: Released By:

Signature over Printed Name Date Signature over Printed Name Date Signature over Printed Name Date
ABPEA Utilities / Environmental Compliance ABPEA Authorized Representative ABPEA – Permit Representative

REMINDER: ABPEA’s approved work permit shall be on-site at all times. Locator/Contractor shall apply their renewal at least 3-working days prior to
mobilization/expiration of validity.

F-QM-15 06/19/2023