NBC FORM No B.

-03

Republic of the Philippines

City/Municipality of PAMPLONA
Province of CAMARINES SUR
OFFICE OF THE BUILDING OFFICIAL

FENCING PERMIT
APPLICATION NO. FP NO. BUILDING PERMIT NO.

BOX 1 (TO BE ACCOMPLISHED IN PRINT BY THE OWNER/APPLICANT)

OWNER/APPLICANT LAST NAME FIRST NAME M.I. TIN

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP

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//MUNICIPALITY OF

SCOPE OF WORK

 NEW CONSTRUCTION  REPAIR  OTHERS (Specify)

 ERECTION  DEMOLITION
 ADDITION
BOX 2 BOX 3

DESIGN PROFESSIONAL PLANS AND SPECIFICATIONS FULL TIME INSPECTOR AND SUPERVISOR OF CONSTRUCTION WORKS

Date Date
ARCHITECT OR CIVIL ENGINEER ARCHITECT OR CIVIL ENGINEER
(Signed and Sealed Over Printed Name) (Signed and Sealed 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
BOX 4 (TO BE ACCOMPLISHED BY THE APPLICANT)

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:

BOX 5
BOX 6 (TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL)

MEASUREMENTS LENGTH IN METERS HEIGHT IN METERS

TYPE OF FENCING  INDIGENOUS MATERIALS  R.C. STEEL MATTING

 R.C. (REINFORCE CONCRETE)  R.C. BARBED WIRE
 R.C. AND CONCRETE HOLLOW BLOCKS  OTHERS (Specify)
 R.C. AND BRICKS 
 R.C. AND INTERLINK/CYCLONE WIRE 
BOX 7 (TO BE ACCOMPLISHED BY THE PROCESSING AND EVALUATION DIVISION)

PROGRESS FLOW

IN OUT
PROCESSED BY
DATE TIME DATE TIME

LINE AND GRADE (GEODETIC)

CIVIL/STRUCTURAL

ELECTRICAL

OTHERS (Specify)

ASSESSED FEES

AMOUNT DUE O.R. NUMBER DATE PAID PROCESSED BY

LINE AND GRADE (GEODETIC)

FENCING

ELECTRICAL (IF ANY)

OTHERS (Specify)

TOTAL

BOX 8 (TO BE ACCOMPLISHED BY BUILDING OFFICIAL)

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 is liable for damages if within (15) years from
the completion of the structure, it should collapse due to defect in the plans or specifications or defects in the ground. The engineer or architect who supervises the construction
shall be solidarity liable with the contractor should the edifice collapse due to defect in the construction or the use of inferior materials.
2. That the proposed construction /erection/addition, etc. shall be in conformity with the provisions of the "National Building Code” (PD 1096) and it’s implementing Rules and
Regulations.
a. That prior to commencement/of the proposed projects and construction of the actual relocation survey shall be conducted by responsible licensed Geodetic Engineer.
b. That before commencing the excavation the person making or causing the excavation to be made shall verify in writing the owner of adjoining building not less than
(10) days before such excavation is to be made and show how the adjoining building should be protected.
c. That the owner of the fence shall engage the services of responsible licensed Architect or Civil Engineer to undertake the Full time inspection and supervision of the
construction work.
d. That there shall be kept at the jobsite at all times a logbook wherein the actual progress of construction including test con ducted, weather condition and other pertinent
data are to be recorded, same shall be made available for scrutiny and comments by the OBO representative during the conduct of his/her inspection pursuant to Section
207 of the National Building Code

PERMIT ISSUED BY:

ACTING BUILDING OFFICIAL

(Signature Over Printed Name)
Date