Annex E: CERTIFICATE OF COMPLETION

Republic of the Philippines

City of Cagayan de Oro
Province of Misamis Oriental
OFFICE OF THE CITY BUILDING OFFICIAL
CERTIFICATE OF COMPLETION
SIMPLE COMPLEX
_______________________
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
provisions of the National Building Code of the Philippines, its Revised IRR, JMC 2018-01 and their Referral Codes.

NAME OF OWNER ________________________________________________________________________________________________________

(LASTNAME) (GIVEN) (M.I)
ADDRESS OF OWNER ______________________________________________________________ZIP CODE __________TEL. NO._________________
LOCATION OF CONSTRUCTION: LOT NO. ____BLK NO. ____STREET _________BARANGAY ________________CITY/MUNICIPALITY _________________________
USER CHARACTER OF OCCUPANCY _______________________________________________________GROUP __________________________________
PLANNED ACTUAL
DATE OF START OF CONSTRUCTION

DATE OF COMPLETION

TOTAL FLOOR AREA (Square Meters)

NO. OF STOREY(S)

NO. OF UNITS

SUMMARY OF ACTUAL COSTS

1. TOTAL COST OF MATERIALS: P __________________________
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: P __________________________
This includes compensation whether by salary or contract for project architect/engineer down to laborers.
3. TOTAL COST OF EQUIPMENT UTILIZATION: P __________________________
4. OTHER COSTS: P __________________________
This include professional services fees, permits and other fees
TOTAL COST OF BUILDING/STRUCTURAL P __________________________
FULL-TIME SUPERVISOR OR INSPECTOR OF CONSTRUCTION IF CONSTRUCTION WAS UNDERTAKEN BY CONTRACT

Contractor PCAB Lic. No.

_________________________________________________________ Validity
ARCHITECT OR CIVIL ENGINEER
(Signed and Sealed Over Printed Name) TIN
Date _______________________
Address

PRC No. Validity

PTR No. Date Issued

__________________________________________________Date__________
Issued at TIN AUTHORIZED MANAGING OFFICER
(Signature over Printed Name)
CTC No. Date Issued Issued at
CTC No. Date Issued Placed Issued

CONFORME: CTC No.

________________________________________________Date__________ Date Issued

OWNER/OERMITTEE
(Signature over Printed Name) Placed Issued

REPUBLIC OF THE PHILIPPINES ) S.S

CITY/MUNICIPALITY OF ________________________________________________)

BEFORE ME, at the City/Municipality of __________________________________________________, on__ ___________________________ personally appeared

the persons whose signature appear herein at the front and back of this page, 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.
NOTE: COPY WITNESS MY HAND THE
FURNISHED AND SEALPSAon the place above written.
Doc No.

Page No.

Book No __________________________________________________
NOTARY PUBLIC (Until December ____________)
Series of
NOTE COPY FURNISHED THE PSA
 DESIGN PROFESSIONALS, PLANS AND SPECIFICATION

ARCHITECTURAL CIVIL / STRUCTURAL

___________________________Date________ ___________________________Date________
( Signature Over Printed Name ) ( Signature Over Printed Name )
Address Address
PRC No. Validity PRC No. Validity
IOPOA No. O.R No. IOPOA No. O.R No.
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
IOPOA No. O.R No. IOPOA No. O.R No.
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
IOPOA No. O.R No. IOPOA No. O.R No.
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
IOPOA No. O.R No. IOPOA No. O.R No.
PTR No. Date Issued PTR No. Date Issued
Issued at TIN Issued at TIN

SUPERVISORS 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
IOPOA No. O.R No. IOPOA No. O.R No.
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
IOPOA No. O.R No. IOPOA No. O.R No.
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
IOPOA No. O.R No. IOPOA No. O.R No.
PTR No. Date Issued PTR No. Date Issued
Issued at TIN Issued at TIN