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FSED 1F Application Form FSEC For Building Permit Rev02

This document is an application form for a Fire Safety Evaluation Clearance from the Bureau of Fire Protection's Buguey Fire Station in Cagayan, Philippines. The form requests information about the project owner, title, location and contact details. It also lists the required documents to be submitted with the application, including architectural, electrical, and fire protection documents. It notes that incomplete applications will be returned. The applicant certifies the accuracy and completeness of the information and documents. Spaces are provided for dates and signatures to track the application process.

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233 views2 pages

FSED 1F Application Form FSEC For Building Permit Rev02

This document is an application form for a Fire Safety Evaluation Clearance from the Bureau of Fire Protection's Buguey Fire Station in Cagayan, Philippines. The form requests information about the project owner, title, location and contact details. It also lists the required documents to be submitted with the application, including architectural, electrical, and fire protection documents. It notes that incomplete applications will be returned. The applicant certifies the accuracy and completeness of the information and documents. Spaces are provided for dates and signatures to track the application process.

Uploaded by

dyak bag-baga
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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BUREAU OF FIRE PROTECTION

Region 02
Cagayan Provincial Office
Buguey Fire Station
Centro, Buguey, Cagayan 09171659224 bugueyfs@yahoo.com
FSEC APPLICATION NUMBER

FIRE SAFETY EVALUATION CLEARANCE APPLICATION FORM


PROJECT OWNER
PROJECT TITLE
PROJECT LOCATION

OWNER ADDRESS
NAME OF CONTRACTOR/
GENERAL CONTRACTOR
AUTHORIZED REPRESENTATIVE

TOTAL FLOOR AREA (M2) : NO. OF STOREY :

CONTACT NUMBER : EMAIL ADDRESS:

ATTACHED DOCUMENTARY REQUIREMENTS

[ ] THREE (3) COMPLETE SETS OF THE FOLLOWING (PROPOSED PLAN):


[ ] ARCHITECTURAL DOCUMENTS [ ] PLUMBING DOCUMENTS
[ ] CIVIL/STRUCTURAL DOCUMENTS [ ] ELECTRONICS DOCUMENTS
[ ] ELECTRICAL DOCUMENTS [ ] SANITARY DOCUMENTS
[ ] MECHANICAL DOCUMENTS [ ] FIRE PROTECTION DOCUMENTS
[ ] ONE (1) SET OF FIRE SAFETY COMPLIANCE REPORT (FSCR) (IF NECESSARY)
[ ] ONE (1) SET OF COST ESTIMATES OF THE BUILDING INCLUDING LABOR COST SIGNED AND SEALED BY THE
DESIGNER/CONTRACTOR DULY NOTARIZED
[ ] FIRE SAFETY CLEARANCE FOR WELDING, CUTTING, AND OTHER HOT WORK OPERATIONS (IF REQUIRED)

NOTE: Incomplete documentary requirements will be returned to the applicant.


I hereby certify the correctness of the information provided above and the completeness of the attached documents.

______________________________________________ __________________
OWNER/AUTHORIZED REPRESENTATIVE’S SIGNATURE OVER PRINTED NAME DATE

____________/___________
DATE/TIME

VERIFIED BY BFP-CRO: ____________________________

FSEC MONITORING (To be filled-up by BFP Personnel only)


CRO FCA FCCA C,FSES BPE C,FSES CFM/MFM CRO
DATE: DATE: DATE: DATE: DATE: DATE: DATE: DATE:
IN OUT IN OUT IN OUT IN OUT IN OUT IN OUT IN OUT IN OUT

PAALALA: “MAHIGPIT NA IPINAGBABAWAL NG PAMUNUAN NG BUREAU OF FIRE PROTECTION SA MGA KAWANI NITO ANG MAGBENTA O
MAGREKOMENDA NG ANUMANG BRAND NG FIRE EXTINGUISHER”
“FIRE SAFETY IS OUR MAIN CONCERN”

BFP-QSF-FSED-001 REV.02 (08.24.20)

FSEC
BUREAU OF FIRE PROTECTION
Region 02
Cagayan Provincial Office
Buguey Fire Station
Centro, Buguey, Cagayan 09171659224 bugueyfs@yahoo.com APPLICATION NUMBER

CLAIM STUB

CERTIFIED BY:
_______________________ ___________________
CUSTOMER RELATION OFFICER DATE

NOTE: Authorized Representative must present an Authorization Letter and Copy of Owner’s Identification Card
BFP-QSF-FSED-001 REV.02 (08.24.20)
PAALALA: “MAHIGPIT NA IPINAGBABAWAL NG PAMUNUAN NG BUREAU OF FIRE PROTECTION SA MGA KAWANI NITO ANG MAGBENTA O
MAGREKOMENDA NG ANUMANG BRAND NG FIRE EXTINGUISHER”
“FIRE SAFETY IS OUR MAIN CONCERN”

BFP-QSF-FSED-001 REV.02 (08.24.20)

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