NBC FORM NO.

B-10

Republic of the Philippines

City of Bayawan
Province of Negros Oriental
OFFICE OF THE BUILDING OFFICIAL
CERTIFICATE OF COMPLETION

DATE

This is to certify that the building/structure covered by Building Permit No. ________________issued on _____________ has been
constructed and completed under our supervision, conforms with the plans and specification submitted and on file with the office of the
Building Official, and complies with the provision of the National Building Code and Accessibility Law (BP bldg. 344).
NAME OF OWNER
__________________________________________________________________________________________________________
(LAST NAME) (GIVEN) (M.I)
ADDRESS OF OWNER ___________________________________________ZIP CODE________________TEL NO._________________
LOCATION OF CONSTRUCTION: LOT NO.____BLK NO.____ STREET_______________BARANGAY___________________________
CITY OF BAYAWAN
USE OR CHARACTER OF OCCUPANCY _____________________________________________________________GROUP
________________________

PLANNED ACTUAL
DATE OF START OF CONSTRUCTION
DATE OF COMPLETION
TOTAL FLOOR AREA (Square meter)
NO. OF STOREY(S)
NO. OF UNITS
SUMMARY OF ACTUAL COSTS
1. TOTAL COST OF MATERIALS: PHP ____________________________
1.1. CEMENT (bags) __________________________
1.2. LUMBER(bd.ft.) __________________________
1.3. REINFORCING BARS (Kg) __________________
1.4. G.I SHEETS (sheets) _______________________
1.5. PREFAB STRUCTURAL STEEL (Kg) ____________
1.6. Other materials _________________________

2. TOTAL COST OF DIRECT LABOR: PHP _____________________________

This includes compensation whether by salary or contract for project architecture/ engineer down to laborers.
3. TOTAL COST OF EQUIPMENT UTILIZATION; PHP _____________________________
4. OTHER COSTS: PHP _____________________________
This includes professional services fees, permits and other fees
TOTAL COST OF BUILDING / STRUCTURE PHP _____________________________
FULL-TIME SUPERVISOR OR INSPECTOR OF CONSTRUCTION IF CONSTRUCTION WAS UNDERTAKEN BY CONTRACT
CONTRACTOR PCAB NO.:

________________________________________________ VALIDITY:
ARCHITECT OR CIVIL ENGINEER
(Signed and Sealed Over Printed Name) TIN:
Date________________
ADRESS: TEL. NO.

PRC No. Validity ____________________________________Date____________

PTR No. Date Issued AUTHORIZED MANAGING OFFICER
(Signature Over Printed Name)
Issued at TIN
CTC No. Date Issued Issued at CTC No. Date Issued: Place Issued:

CONFORME: CTC NO.

___________________________________________Date____________ DATE ISSUED

OWNER / APPLICANT
(Signature Over Printed Name) PLACE ISSUED

(REPUBLIC OF THE PHILIPPINES )S.S (CITY OF BAYAWAN )

BEFORE ME, at the City of Bayawan, on ______________________personally appeared the persons whose signatures appear
herein at the front and back of this page known to me 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. _____________ NOTARY PUBLIC (Until December __________)
Book No. _____________
Series No._____________
Note: COPY TO BE FURNISHED THE NSO
ARCHITECTURAL CIVIL / STRUCTURAL

_________________________________Date____________ _________________________________Date____________
(Signature Over Printed Name) (Signature Over Printed Name)
Address Address
PRC No. Validity
IAPOA No. O.R. No. Date Issued: PRC No. Validity
PTR No. Date Issued PTR No. Date Issued
Issued at TIN Issued at TIN

ELECTRICAL MECHANICAL

_________________________________Date____________ _________________________________Date____________
(Signature Over Printed Name) (Signature Over Printed Name)
Address Address
PRC No. Validity PRC No. Validity
PTR No. Date Issued PTR No. Date Issued
Issued at TIN Issued at TIN

SANITARY PLUMBING

_________________________________Date____________ _________________________________Date____________
(Signature Over Printed Name) (Signature Over Printed Name)
Address Address
PRC No. Validity PRC No. Validity
PTR No. Date Issued PTR No. Date Issued
Issued at TIN Issued at TIN

ELECTRONICS INTERIOR DESIGN

_________________________________Date____________ _________________________________Date____________
(Signature Over Printed Name) (Signature Over Printed Name)
Address Address
PRC No. Validity PRC No. Validity
PTR No. Date Issued PTR No. Date Issued
Issued at TIN Issued at TIN
SUPERVISOR OF SPECIALTY WORKS
ELECTRICAL WORKS MECHANICAL WORKS

_________________________________Date____________ _________________________________Date____________
(Signature Over Printed Name) (Signature Over Printed Name)
Address Address
PRC No. Validity PRC No. Validity
PTR No. Date Issued PTR No. Date Issued
Issued at TIN Issued at TIN

SANITARY WORKS PLUMBING WORKS

_________________________________Date____________ _________________________________Date____________
(Signature Over Printed Name) (Signature Over Printed Name)
Address Address
PRC No. Validity PRC No. Validity
PTR No. Date Issued PTR No. Date Issued
Issued at TIN Issued at TIN

ELECTRONICS WORKS INTERIOR DESIGN WORKS

 _________________________________Date____________ _________________________________Date____________
(Signature Over Printed Name) (Signature Over Printed Name)
Address Address
PRC No. Validity PRC No. Validity
PTR No. Date Issued PTR No. Date Issued
Issued at TIN Issued at TIN