Application for Certificate of Occupancy

TIEZA application form for certificate of occupancy

Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: Tourism Infrastructure and Enterprise Zone Authority

Office of the Building Official
APPLICATION FOR CERTIFICATE OF OCCUPANCY
PARTIAL

FULL

BULDING PERMIT NO.

AREA NO

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

LAST NAME

FIRST NAME

M.I.

FOR CONSTRUCTION OWNED
ADDRESS:

NO.,

TIN

FORM OF OWNERSHIP

STREET,

BARANGAY,

CITY/MUNICIPALITY

ZIP CODE

TELEPHONE NO.

REQUIREMENTS SUBMITTED:
AS-BUILT PLANS DULY SIGNED AND SEALED BY RESPECTIVE
PROFESSIONAL DISCIPINE
NOTARIZED CERTIFICATE OF COMPLETION
SPECIFICATIONS

BUILDING INSPECTION SHEET SIGNED BY
WHOEVER IS THE CONTRACTOR (IF THE
CONSTRUCTION IS UNDERTAKEN BY CONTRACT)
AND SIGNED AND SEALED BY THE OWNER’S DULY
LICENSED ARCHITECT OR CIVIL ENGINEER WHO
UNDERTOOK THE FULL-TIME INSPECTION AND
SUPERVISION OF THE CONSTRUCTION WORKS

CONSTRUCTION LOGBOOK
NAME OF PROJECT
LOCATION:

NO.,

STREET,

BARANGAY,

CITY/MUNICIPALITY

ZIP CODE

TELEPHONE NO.

USE/CHARACTER OF OCCUPANCY:_________________________________
NO. OF STOREY: _________________________________________________
NO. OF UNITS: ___________________________________________________
TOTAL FLOOR AREA (M²): _________________________________________
DATE OF COMPLETION: _________________________________________

APPLICANT:

(Signature Over Printed Name)

Date______________

Address
CTC No

Date Issued

Place Issued

REPUBLIC OF
THE PHILIPPINES
)
CITY/MUNICIPALITY OF __________________________________________)
BEFORE ME, at the City/Municipality of _____________________________________________________ , on _________________________ personally appeared the
following:
______________________________________________________

_______________ ______________ ___________________________________________

______________________________________________________

_______________ ______________ ___________________________________________

whose signatures appear hereinabove, known to me to be the same persons who executed this standard prescribed form and 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.
Series of

________
________
________
________

________________________________________________________
NOTARY PUBLIC (Until December _____________ )