REPUBLIC OF THE PHILIPPINES
OFFICE OF THE CITY MAYOR
QUEZON CITY
(BUILDING OFFICIAL)
DO NOT FILL UP (NSO USE ONLY)
APPLICATION NO.
PERMIT NO.
BUILDING PERMIT
DATE OF APPLICATION
DATE ISSUED
ORIGINAL
RENEWAL
BOX 1 (TO BE ACCOMPLISHED BY DESIGNING ARCHITECT / CIVIL ENGINEER IN PRINT)
OWNER
LASTNAME
FIRSTNAME
FOR CONSTRUCTION OWNED BY
AN ENTERPRISE
FORM OF OWNERSHIP
M.I.
TAX ACCT. NO.
MAIN ECONOMIC ACTIVITY OF BUSINESS
ADDRESS
TEL. NO.
LOCATION OF CONSTRUCTION
SCOPE OF WORK:
OTHERS (SPECIFY)
1. NEW CONSTRUCTION
2. ADDITION OF _____________________
3. REPAIR OF ________________________
4. RENOVATION OF __________________
5. DEMOLITION OF ___________________
USE OR TYPE OF OCCUPANCY
RESIDENTIAL
11 SINGLE
12 DUPLEX
13 ROWHOUSE / ACCESSORIA
10 OTHERS (SPECIFY)____________________
6. __________OF______________
7. __________OF______________
INDUSTRIAL
31 FACTORY (PLANT)
32 REPAIR SHOP, MACHINE SHOP
33 REFINERY
34 PRINTING PRESS
35 WAREHOUSE
30 OTHERS (SPECIFY)____________________
COMMERCIAL
21 BANK
22 STORE
23 HOTEL / MOTEL, ETC.
24 OFFICE CONDOMINIUM / BUSINESS OFFICE BUILDING.
INSTITUTIONAL
26 SHOP (e.g. DRESS SHOP, TAILORING SHOP, BARBER SHOP, ETC.
41 SCHOOL
42 CHURCH OR OTHER RELIGIOUS STRUCTURES
43 HOSPITAL OR SIMILAR STRUCTURES
27 GASOLINE STATION
44 WELFARE & CHARITABLE STRUCTURES
28 MARKET
45 THEATER, AUDITORIUM. GYMNASIUM, COURT
29 DORMITORY OR OTHER LODGING HOUSE
40 OTHERS (SPECIFY)____________________
25 RESTAURANT, ETC..
30 OTHERS (SPECIFY)____________________
OTHER CONSTRUCTION
60 (SPECIFY)____________________
AGRICULTURAL
41 BRAN(S), POULTRY HOUSE(S), ETC.
42 GRAIN MILL
40 OTHERS (SPECIFY)____________________
www.quezoncity.gov.ph
OFFICE OF THE BUILDING OFFICIAL
STREET FURNITURE, LANDSCAPING & SIGNBOARDS
71 PARK, PLAZA’S, MONUMENT, POOLS, PLANT BOXES, ETC.
72 SIDEWALKS, PREMONADES, TERRACES, LAMPPOSTS, ELECTRIC POLES, TELEPHONE POLES, ETC.
73 OUTDOOR ADS, SIGNBOARDS, ETC.
74 FENCE ENCLOSURE
BOX 2 (TO BE ACCOMPLISHED BY RECEIVING & RECORDING SECTION)
BUILDING DOCUMENTS (FIVE SETS EACH)
SITE DEVELOPMENT & LOCATION PLAN
ARCHITECTURAL PLAN & SPECIFICATIONS
STRUCTURAL DESIGN & COMPUTATIONS
SANITARY/PLUMBING PLANS & SPECIFICATIONS
MECHANICAL PLANS & SPECIFICATIONS
LOGBOOK (1COPY)
OTHERS (SPECIFY)
ELECTRICAL PLANS & SPECIFICATION
BOX 3 (TO BE ACCOMPLISHED BY THE BUILDING OFFICIAL)
ACTION TO BE TAKEN:
PERMIT IS HEREBY GRANTED SUBJECT TO THE FOLLOWING CONDITIONS
1. THAT THE PROPOSED CONSTRUCTION/ADDITION/REPAIR/RENOVATION/
DEMOLITION/INSTALLATION ETC SHALL BE IN CONFORMITY WITH THE NATIONAL
BUILDING CODE (PD 1096) AND ITS CORRESPONDING IMPLEMENTING RULES AND
REGULATIONS
2. THAT A DULY LICENSED ARCHITECT/CIVIL ENGINEER HAS BEEN ENGAGED TO PLANS
AND SPECIFICATIONS AND TO UNDERTAKE THE SUPERVISION/INSPECTION OF THE
CONSTRUCTION OF THE PROJECT
ENGR. ISAGANI R. VERZOSA JR.
LOCAL BUILDING OFFICIAL
3. THAT A CERTIFICATE OF COMPLETION DULY SIGNED AND SEALED BY THE DESIGNING
ARCHITECT / ENGINEER IN-CHARGE OF CONSTRUCTION SHALL BE SUBMITTED NOT LATER
THAN SEVEN (7) DAYS AFTER COMPLETION OF THE CONSTRUCTION OF THE PROJECT
4. THAT A CERTIFICATE OF OCCUPANCY “SHALL BE SECURED PRIOR TO ACTUAL
OCCUPANCY OF THE BUILDING.
NOTE:
THIS PERMIT MAY BE CANCELLED OR REVOKED PURSUANT TO SECTIONS 305 & 306 OF THE “NATIONAL BUILDING CODE”.
DATE
BOX 3A (TO BE ACCOMPLISHED BY THE DESIGNING ARCHITECT/CIVIL ENGINEER IN PRINT
BUILDING
P_____________
COST OF
EQUIPMENT
INSTALLED
ELECTRICAL
P_____________
P____________
MECHANICAL
P_____________
PROPOSED DATE
OF CONSTRUCTION _____________
P____________
PLUMBING
P_____________
EXPECTED DATE
OF COMPLETION _______________
OTHERS
P_____________
TOTAL COST
P_____________
TOTAL ESTIMATED COST
P____________
DO NOT FILL (NSO USE ONLY)
NUMBER OF STOREYS___________
TOTAL FLOOR AREA____________
MATERIAL OF CONST. ____________
(WOOD, CONC, STEEL, MIXED)
BOX 4 (TO BE ACCOMPLISHED BY THE DIVISION CONCERNED
ASSESED FEES
AMOUNT DUE
ASSESSED BY
O.R. NUMBER
DATE PAID
LAND USE / ZONING
LINE and GRADE
BUILDING
PLUMBING
ELECTRICAL
MECHANICAL
OTHERS
REVIEWED:
TOTAL
CHIEF, PROCESSING DIVISION SECTION
BOX 5 (TO BE ACCOMPLISHED BY THE DIVISION CONCERNED
PROGRESS FLOW
NOTED:
IN
CHIEF, PROCESSING DIVISION
TIME
OUT
DATE
TIME
ACTION /
REMARKS
DATE
PROCESSED
BY:
RECEIVING and RECORDING
LAND USE and ZONING
GEODETIC (LINE and GRADE)
ARCHITECTURAL
STRUCTURAL
SANITARY
ELECTRICAL
MECHANICAL
WE HEREBY AFFIX OUR HANDS SIGNIFYING OUR CONFORMITY TO THE INFORMATION HEREIN ABOVE SETFORTH
BOX 8
www.quezoncity.gov.ph
SIGNATURE
OFFICE OF THE BUILDING OFFICIAL
BOX 6
ARCHITECT / CIVIL ENGINEER
PRC REG. NO.
SIGNED AND SEALED PLANS & SPECIFICATIONS
PRINT NAME
ADDRESS
COMMUNITY TAX CERT.
PTR NO.
PTR NO.
PTR NO.
PLACE ISSUED
PLACE ISSUED
SIGNATURE
WITH MY CONSENT:
BOX 9 (TO BE ACCOMPLISHED BY LOT OWNER)
BOX 7
ARCHITECT / CIVIL ENGINEER
IN CHARGE OF CONSTRUCTION
PRC REG. NO.
TCT / OCT NO.
PRINT NAME
PRINT NAME OF LOT OWNER
ADDRESS
ADDRESS
PTR NO.
SIGNATURE
PTR NO.
PLACE ISSUED
COMMUNITY TAX RECEIPT DATE ISSUED
SIGNATURE
PLACE ISSUED