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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 _____________ )
