NBC FORM NO.
B – 21
Republic of the Philippines
City/Municipality of ________________
Province of _________________________
OFFICE OF THE BUILDING OFFICIAL
INSPECTION REPORT
_________________________
DATE OF INSPECTION
NAME OF OWNER ______________________________________________________________________________________
(Last Name) (Given Name) (Middle Initial)
ADDRESS OF OWNER ________________________________________________________ TEL. NO. __________________
LOCATION OF INSTALLATION: Lot No.______Blk. No.______ Street _______________ Barangay ____________________
City / Municipality ____________________________________________________________
USE OR CHARACTER OF OCCUPANCY / NO. OF STOREYS ___________________________________________________
AS TO ARCHITECTURAL WORKS:
Site Development Setting _______________________________ Light & Ventilation _____________________________________
____________________________________________________ ____________________________________________________
Fire Safety Requirements _______________________________ Accessories Control Location ____________________________
____________________________________________________ ____________________________________________________
Occupancy/Use & Functionalities _________________________ BP 344 Requirements__________________________________
____________________________________________________ ____________________________________________________
Architectural Deficiencies & Parking Requirements______________________________________________________________________
______________________________________________________________________________________________________________
Others ________________________________________________________________________________________________________
Inspected By:__________________________________
(Signature Over Printed Name)
AS TO CIVIL / STRUCTURAL WORKS:
Application for Building Permit ____________________________ Excavation & Foundation_______________________________
____________________________________________________ ___________________________________________________
Scaffolding & Sidewalk__________________________________ Structural Hazards ____________________________________
____________________________________________________ ___________________________________________________
Safety Requirements for Construction/Demolition ______________________________________________________________________
______________________________________________________________________________________________________________
Placement of Rebars/Pre-Pouring of Concrete _________________________________________________________________________
______________________________________________________________________________________________________________
Others _________________________________________________________________________________________________________
Inspected By:__________________________________
(Signature Over Printed Name)
AS TO ELECTRICAL WORKS:
General Requirements __________________________________ General Wiring Method ________________________________
____________________________________________________ ___________________________________________________
Services, Feeders & Branch Circuits _______________________ Grounding & Bonding _________________________________
____________________________________________________ ___________________________________________________
Hazardous Locations ___________________________________ Special Occupancies __________________________________
____________________________________________________ ___________________________________________________
Swimming Pools & Related Installations ______________________________________________________________________________
______________________________________________________________________________________________________________
Emergency & Standby Systems & Fire Pumps _________________________________________________________________________
______________________________________________________________________________________________________________
Others ________________________________________________________________________________________________________
Inspected By:_________________________________
(Signature Over Printed Name)
- CONTINUATION OF INSPECTION REPORT (NBC FORM NO. B-21) -
AS TO SANITARY/PLUMBING WORKS:
Drainage & Solid / Wastewater Disposal Installation _____________________________________________________________________
______________________________________________________________________________________________________________
Source of Water Supply & Plumbing Installation________________________________________________________________________
______________________________________________________________________________________________________________
Hazards & Pollution on Building & Premises ___________________________________________________________________________
______________________________________________________________________________________________________________
Others ________________________________________________________________________________________________________
Inspected By:____________________________________
(Signature Over Printed Name)
AS TO MECHANICAL WORKS:
Machinery Installations ___________________________________________________________________________________________
______________________________________________________________________________________________________________
Pumps, Pressure Vessels & Automatic Sprinkler _______________________________________________________________________
______________________________________________________________________________________________________________
Test / Rides, Elevators/Dumbwaiters, Escalators & Conveyors ____________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
Others ________________________________________________________________________________________________________
Inspected By:____________________________________
(Signature Over Printed Name)
AS TO OTHER WORKS (Electronics or Interior Installations):
Specific Works (itemize) _________________________________________________________________________________
____________________ _________________________________________________________________________________
____________________ _________________________________________________________________________________
____________________ _________________________________________________________________________________
____________________ _________________________________________________________________________________
____________________ _________________________________________________________________________________
Inspected By:____________________________________
(Signature Over Printed Name)
Comments/Recommendations: _____________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Building Official / Technical Inspectors:_______________________________________________________________________
________________________________________________________ Date of Inspection: _____________________________
NOTED BY:
__________________________________________________________
CHIEF, INSPECTION & ENFORCEMENT DIVISION
(Signature Over Printed Name)
Date:__________________
