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Electrical Permit
TIEZA application form for business permit
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: NBC FORM NO. A - 02
Tourism Infrastructure and Enterprise Zone Authority
Office of the Building Official
CIVIL/STRUCTURAL PERMIT
BUILDING PERMIT NO.
C/SP NO
APPLICATION NO.
BOX 1 (TO BE ACCOMPLISHED IN PRINT BY THE OWNER/APPLICANT)
OWNER/APPLICANT
LAST NAME
FOR CONSTRUCTION OWNED
FIRST NAME
FORM OF OWNERSHIP
M.I.
TIN
USE OR CHARACTER OF OCCUPANCY
BY AN ENTERPRISE
ADDRESS:
NO.,
STREET,
LOCATION OF CONSTRUCTION:
BARANGAY,
CITY/MUNICIPALITY
ZIP CODE
TELEPHONE NO
LOT NO. _______________ BLK NO. ________________ TCT NO. ______________________ TAX DEC. NO.___________________
STREET___________________ BARANGAY ____________________________________________________ CITY/ MUNICIPALITY OF ______________________________
SCOPE OF WORK
NEW CONSTRUCTION
ERECTION
ADDITION
ALTERATION
RENOVATION ________________________
CONVERSION ________________________
REPAIR _____________________________
MOVING _____________________________
RAISING ______________________________________
DEMOLITION __________________________________
ACCESSORY BUILDING/STRUCTURE _____________
OTHERS (Specify) ______________________________
BOX 2 (TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL)
NATURE OF CIVIL/STRUCTURAL WORKS:
STAKING
ERECTION/LIFTING
PRESTRESS WORKS
EXCAVATION
CONCRETE FRAMING
MATERIAL TESTING
SOIL STABILIZATION
STRUCTURAL STEEL FRAMING
STEEL TOWERS
PILING WORKS
SLABS
TANKS
FOUNDATION
WALLS
OTHERS (Specify)___________________________
PREPARED BY _______________________________________________________________________________________________________________
BOX 3
BOX 4
DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS
SUPERVISOR/IN-CHARGE OF CIVIL/STRUCTURAL WORKS
CIVIL/STRUCTURAL ENGINEER
(Signed and Sealed Over Printed Name)
CIVIL/STRUCTURAL ENGINEER
(Signed and Sealed Over Printed Name)
Date________________________
Date________________________
Address
Address
PRC. No
Validity
PRC. No
Validity
PTR. No
Date Issued
PTR. No
Date Issued
Issued at
TIN
Issued at
TIN
BOX 5
BOX 6
BUILDING OWNER
WITH MY CONSENT: LOT OWNER
(Signature Over Printed Name)
Date___________________
Address
C.T.C. No.
(Signature Over Printed Name)
Date___________________
Address
Date Issued
Place Issued
C.T.C. No.
Date Issued
Place Issued
TO BE ACCOMPLISHED BY THE PERMITS AND LICENSES DIVISION
BOX 7
RECEIVED BY:
DATE:
FIVE (5) SETS OF 20”X30” & ONE (1) A3 OF CIVIL/STRUCTURAL DOCUMENTS
CIVIL/STRUCTURAL DESIGNS COMPUTATIONS, PLANS AND SPECIFICATIONS
COST ESTIMATES
BILL OF MATERIALS
OTHERS (Specify) __________________________________
BOX 8
PROGRESS FLOW
IN
DATE
OUT
TIME
DATE
TIME
PROCESSED BY:
CIVIL/STRUCTURAL
OTHERS (Specify)
BOX 9
ACTION TAKEN:
PERMIT IS HEREBY ISSUED SUBJECT TO THE FOLLOWING:
1. That under Article 1723 of the Civil Code of the Philippines, the engineer (or architect) who drew up the plans and
specifications for the building/structure is responsible for damages if within fifteen (15) years from the completion of the
building/structure, the same should collapse due to defect in the plans or specifications or defect sin the ground. The
engineer or architect who supervises the construction shall be solidarily liable with the contractor should the edifice collapse
due to defect in the construction or the use of inferior materials.
2. That the proposed civil/structural works shall be in accordance with the civil/structural plans filed with this office and in
conformity with the latest National Structural Code of the Philippines, the National Building Code and its IRR.
3. That prior to any construction activity, a duly accomplished prescribed “Notice of Construction” shall be submitted to the
Office of the Building Official.
4. That upon completion of the construction, the licensed full-time inspector and supervisor/in-charge of construction works
shall submit the entry to the logbook duly signed and sealed to the Building Official including as-built plans and other
documents and shall also accomplish and submit a certificate of completion stating that the civil/structural works conform to
the provisions of the National Structural Code of the Philippines, the National Building Code and its IRR.
5. That this permit is null and void unless accompanied by the building permit.
PERMIT ISSUED BY:
BUILDING OFFICIAL
(Signature Over Printed Name)
Date ___________________