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Application Form

HLURB application form for zoning certification

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Housing and Land Use Regulatory Board
Expanded National Capital Region Field Office
6th Floor, Sunnymede IT Center,
1614 Quezon Avenue, South Triangle, Quezon City

SITE INSPECTION REPORT/FACT SHEET FOR CONDOMINIUM
DATE
PROJECT NAME: ____________________________ DOCKET NO.: __________ DEVELOPMENT PERMIT ISSUED: _________
LOCATION: _______________________________________________________ DEVELOPMENT PERMIT NO.: _____________
OWNER/DEVELOPER: ______________________________________________ LICENSE TO SELL ISSUED: ______________
ADDRESS/TEL. NO.: ________________________________________________ LICENSE TO SELL NO.: __________________
LAND AREA: __________ NO. OF SALEABLE LOTS/UNITS: ________________ CERT. OF REGISTRATION ISSUED: _______
PROJECT TYPE: PD 957 [ ] BP 200 [ ] OTHERS (SPECIFY):______________ CERT. OF REGISTRATION NO.: __________
LATEST DATE OF INSPECTION: ______ CONDUCTED BY: _________________ TARGET COMPLETION DATE: ___________
PURPOSE OF INSPECTION: __________________________________________ LAST REPORTED STATUS OF
DEVELOPMENT: ______________________
DATE OF INSPECTION: _____________ CONDUCTED BY: _______________________________________________________
DEVELOPMENT
DESCRIPTION AS PER
APPROVED PLANS
1. EARTHWORKS
A. Clearing and Grubbing
B. Excavation
2. STRUCTURAL WORKS
A. Pile/Bored Pile Drive
B. Footing and Foundation
C. Diagram and Shear Walls
D. Columns, Girders and
Beams
E. Slabs and Stairways
F. Partitioning Walls
3. PLUMBING/SANITARY
WORKS
A. Drainage Pipings
B. Sewer Pipings
C. Septic Vault/STP
D. Fixture
4. WATER SYSTEM
WORKS
A. Water Lines/Valves/Etc.
B. Water Meters
C. Fixtures
D. Hydrants
E. Water Tank
F. Pumps & U.G.
Reservoir/Cistern
5. ELECTRICAL WORKS
A. Conduits/Pipings/Ducts
B. Wires/Cables/Fixtures
C. Electrical Meters
D. Generator Sets
E. Transformers Rooms
6. MECHANICAL WORKS
A. Elevator
B. Machine Room
C. Mechanical Room
7. ELECTRONICS AND

Total Cost
Per Item

%
Accomplishment

Cost of
Accomplishment

Remaining
Dev’t. Cost

Remarks/Evaluation

COMMUNICATION WORKS
A. Pipings/Conduits
B. Wires/Outlets/Fixtures
C. CAT/Telephone
8. FIRE FIGHTING WORKS
A. Water Sprinkler
B. Hydrants
C. Alarm System
D. Fire Escapes/Exits
9. FINISHING WORKS
A. Interior Painting
B. Exterior Paintings
C. Floor and Ceiling
10. SITE DEVELOPMENT
WORKS
A. Parking Slots
B. Play Area
TOTAL:
REMAING COST TO COMPLETE THE PROJECT:
EVALUATION/RECOMMENDATION:

Prepared by:

Project Engineer
Date:
_________________________________

VERIFICATION
I, _________________________________, of legal age, after having sworn, depose and say that I have
read and accomplished this form and contents herein are true and correct.

Name, Signature and Seal of the Project
Engineer/Architect
PRC No.:
PTR No.:

Date & Place Issued:
Date & Place Issued:

SUSCRIBED AND SWORN to before me in this ________ day of ______________________ affiant
exhibiting to me his/her ________________________________________ No. ____________________,
issued at ______________________ on _________________________ .

NOTARY PUBLIC
Doc. No.:
Book No.:
Page No.:
Series of ___________
 
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