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Mechanical Permit (FRONT)

This document is a mechanical permit application for construction work located in Dasmariñas City, Cavite, Philippines. It provides details about the owner, location of construction, scope of work, and involves the installation and operation of boilers. It requires signatures from the design professional, supervisor, building owner, and lot owner to grant approval for the mechanical work. The permit is subject to cancellation or revocation according to sections of the National Building Code.

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Ricardo Dalisay
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286 views1 page

Mechanical Permit (FRONT)

This document is a mechanical permit application for construction work located in Dasmariñas City, Cavite, Philippines. It provides details about the owner, location of construction, scope of work, and involves the installation and operation of boilers. It requires signatures from the design professional, supervisor, building owner, and lot owner to grant approval for the mechanical work. The permit is subject to cancellation or revocation according to sections of the National Building Code.

Uploaded by

Ricardo Dalisay
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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NBC FORM NO.

A - 04

Republic of the Philippines


City of Dasmariñas
Province of Cavite

OFFICE OF THE BUILDING OFFICIAL

MECHANICAL PERMIT
APPLICATION NO. MP NO BUILDING PERMIT NO.

BOX 1 (TO BE ACCOMPLISHED IN PRINT LAST


OWNER/APPLICANT
BY THE OWNER/APPLICANT)
NAME FIRST NAME M.I. TIN

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP USE OR CHARACTER OF OCCUPANCY


BY AN ENTERPRISE
ADDRESS: NO., STREET, BARANGAY, CITY/MUNICIPALITY ZIP CODE TELEPHONE NO

LOCATION OF CONSTRUCTION: LOT NO. _______________ BLK NO. ________________ TCT NO. ______________________ TAX DEC. NO.
____________________STREET___________________ BARANGAY _____________________________CITY OF DASMARIÑAS

SCOPE OF WORK
RAISING_______________________________________
NEW CONSTRUCTION RENOVATION ________________________ DEMOLITION ___________________________________
ERECTION CONVERSION ________________________ ACCESSORY BUILDING/STRUCTURE ______________
ADDITION REPAIR _____________________________ OTHERS (Specify) _______________________________
ALTERATION MOVING _____________________________
BOX 2 (TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL)

INSTALLATION AND OPERATION OF:

BOILER CENTRAL AIRCONDITIONING DUMBWAITER


PRESSURE VESSEL MECHANICAL VENTILLATION PUMPS
INTERNAL COMBUSTION ENGINE ESCALATOR COMPRESSED AIR, VACUUM, INSTITUTIONAL
REFRIGERATION AND ICE MAKING MOVING SIDEWALK and/or INDUSTRIAL GAS
WINDOW TYPE AIRCONDITIONING FREIGHT ELEVATOR PNEUMATIC TUBES, CONVEYORS
PACKAGED/ SPLIT TYPE PASSENGER ELEVATOR and/or MONORAILS
AIRCONDITIONING
OTHERS (Specify) _____________________ CABLE CAR FUNICULAR

PREPARED BY _____________________________________________________________________________________________________________

BOX 3 BOX 4
DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS SUPERVISOR / IN-CHARGE OF MECHANICAL WORKS
PROFESSIONAL MECHANICAL ENGINEER MECHANICAL ENGINEER

PROFESSIONAL MECHANICAL ENGINEER


(Signed and Sealed Over Printed Name) (Signed and/or 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) (Signature Over Printed Name)


Date__________________ Date__________________
Address Address

C.T.C. No. Date Issued Place Issued C.T.C. No. Date Issued Place Issued

NOTE: THIS PERMIT MAY BE CANCELLED OR REVOKED PURSUANT TO SECTIONS 305 AND 306 OF THE “NATIONAL BUILDING CODE”.

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