NBC FORM NO.
B - 03
Republic of the Philippines
Municipality of Magsingal
Province of Ilocos Sur
OFFICE OF THE BUILDING OFFICIAL
FENCING PERMIT
APPLICATION NO. FP NO BUILDING PERMIT NO.
BOX 1 (TO BE ACCOMPLISHED 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 CONTACT NO. / EMAIL ADDRESS
LOCATION OF CONSTRUCTION: LOT NO. BLK NO. TCT NO. TAX DEC. NO.
STREET _ BARANGAY________________________________________________ MUNICIPALITY MAGSINGAL.
SCOPE OF WORK
NEW CONSTRUCTION REPAIR OTHERS (Specify) _
ERECTION DEMOLITION
ADDITION
BOX 2 BOX 3
FULL-TIME INSPECTOR AND SUPERVISOR OF CONSTRUCTION
DESIGN PROFESSIONAL, PLANS AND SPECIFICATION WORKS
ARCHITECT OR CIVIL ARCHITECT OR CIVIL
ENGINEER ENGINEER
(Signed and Sealed Over Printed name) (Signed and 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 4 ( TO BE ACCOMPLISHED BY THE APPLICANT)
BUILDING OWNER WITH MY CONSENT: LOT OWNER
_ _
_ (Signature _ (Signature
over Printed name) 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
REPUBLIC OF THE PHILIPPINES ) S.S
MUNICIPALITY OF
Magsingal BEFORE
) ME, at the Municipality of Magsingal, on personally appeared the following:
APPLICANT CTC No. Date Place
Issued Issued
LICENSED ARCHITECT OR CIVIL ENGINEER CTC No. Date Place
(Full-Time Inspector and Supervisor of Fencing Works) Issued Issued
whose signatures appear herein above, known to me to be the same persons who executed this standard prescribed form and acknowledged to me
that the same is their
free and voluntary act and deed.
WITHNESS MY HAND AND SEAL on the date and place above written.
Doc. No. Page No. Book No.
NOTARY PUBLIC
Series No.
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. (Reinforced Concrete) R.C. BARBED WIRE
R.C. and CONC. 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
DATE TIME DATE TIME PROCESSED BY
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 THE BUILDING OFFICIAL)
ACTION TAKEN:
PERMIT IS HEREBY ISSUED/GRANTED SUBJECT TO THE FOLLOWING CONDITIONS:
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 fifteen (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 solidarily 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” (P.D. 1096)
and its Implementing Rules and Regulations.
a. That prior to commencement of the proposed projects and construction an 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 ten (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 fu ll 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 conducted, 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:
_________________________________
BUILDING OFFICIAL
Date
