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Application For Inspection

This document is an application for inspection of electrical installation in a building located in [ADDRESS]. It summarizes the electrical loads including a total connected load of [KVA], total transfer capacity of [KVA], and total generator/UPS capacity of [KVA]. The application requires signatures from the professional electrical engineer who signed and sealed the as-built plans, the in-charge of installation, and the contractor to certify that the electrical installation was completed according to plans and specifications.

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228 views1 page

Application For Inspection

This document is an application for inspection of electrical installation in a building located in [ADDRESS]. It summarizes the electrical loads including a total connected load of [KVA], total transfer capacity of [KVA], and total generator/UPS capacity of [KVA]. The application requires signatures from the professional electrical engineer who signed and sealed the as-built plans, the in-charge of installation, and the contractor to certify that the electrical installation was completed according to plans and specifications.

Uploaded by

glademier
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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DPWH FORM NO.

2003-005-E
Republic of the Philippines
Department of Public Works & Highways
Pamahalaang Lungsod/Bayan ng ___________________
Kalakhang Maynila/Lalawigan ng________________________________

TANGGAPAN NG PINUNONG PANGGUSALI


(Office of the Building Official)

APPLICATION FOR INSPECTION

This is to certify that the electrical installation of the building covered by the Building Permit No. ___________________________
located at _________________________________________________________________________________________________________
has been completed in accordance with the accompanying as-built plans duly signed and sealed by Professional Electrical Engineer.

NAME OF OWNER _______________________________________________________________________________________


(Last Name) Given Name Middle Name
ADDRESS OF OWNER _____________________________________________________________________________________
LOCATION OF CONSTRUCTION: Lot No._____Blk No. ______Street____________Barangay ___________________City/Municipality_______________
USE OR CHARACTER OF OCCUPANY/NO. OF STOREYS _____________________________________________________________________________________
DATE OF START OF CONSTRUCTION ___________________________________________________________________________________________________
DATE OF COMPLETION _____________________________________________________________________________________________________________
SERVICE ENTRANCE WIRE ___________________________________________________________________________________________________________

SUMMARY OF ELECTRICAL LOADS


TOTAL CONNECTED LOAD TOTAL TRANSFER CAPACITY TOTAL GENERATOR/UPS CAPACITY

_____________KVA _____________KVA _____________KVA

I HEREBY CERTIFY THAT THE ABOVE DATA AND INFORMATION ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
AND BELIEF.

PERSON WHO SIGNED & SEALED IN-CHARGE OF INSTALLATION FOR INSTALLED CAPACITY OF 200 A MAIN
AS-BUILT PLANS AT 230 VOLTS NOMINAL AND ABOVE

PROFESSIONAL ELECTRICAL ENGINEER PEE / REE /RME CONTRACTOR


(Signature Over Printed Name) (Signature Over Printed Name) (Signature Over Printed Name)

PRC No. ________________________ PRC No. ________________________ PRC No. ________________________


Validity ________________________ Validity ________________________ Validity ________________________
PTR No. ________________________ PTR No. ________________________ PTR No. ________________________
Date ___________Place ___________ Date ___________Place ___________ Date ___________Place ___________
CTC No._________Date ___________ CTC No._________Date ___________ CTC No._________Date ___________
Place __________________________ Place __________________________ Place __________________________
Address ________________________ Address ________________________ Address ________________________

CONFORMED:

OWNER/APPLICANT
(Signature Over Printed Name)

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