NOCTOAM NO.

A-04
Republic of the Philippines

City of Cebu
Province of Cebu

OFFICE OF THE BUILDING OFFICIAL

MECHANICAL PERMIT
BUILDING PERMIT NO:
APPLICATION NO:
DATE
DATE

(TO BE ACCOMPLISHED IN PRINT BYTHE OWNER/APPLICANT

BOX 1 MI.
owNER APPLucANT LAST NAME FIRST NAME TIN

USE OR CHARACTER OF OCCUPANCY

FOR CONSTRUCTION OWNED
FORM OF OWNERSHTP

BY AN ENTERPRISE CONTACT NO. & EMAILADDRESS

ADDRESS: NO.. BARANGAY. zIP CODE
STREET
CEBU 6000

TCT N TAX DEC. NO.

LOCATION OF CONSTRUCTION: LOT NO. BLK NO.
CEBU CTY.
STREET BARANGAY

sCOPE OF wORK
RAISING
CONSTRUCTION RENOVATION
ONEW ODEMOLITON
UERECTION cONVERSION.
DaCCESSORY BUILDINGSTRUCTURE
ADDITION REPAIR
OOTHERS (Specify).
UALTER ATION MOVING-
BOX 2TO BE ACCOMPLISHED BY THE DESIGN PROFESSiONAL)

INSTALLATIoN AND OPERATION OF:

BOILER CENTRAL AIRCONDITIONING DUMBWAITER

PRESSURE VESSEL MECHANICAL VENTILATION PUMPS
INTERNAL COMBUSTION ENGINE
ESCALATOR cOMPRESSED AIR. VACUUM. NSTITUTIONAL
AND ICE MAKING MOVING SIDEWALK and'orINDUSTRIAL GAS
REFRIGERATION
PNEUMATC TUBES. CONVEYORS
OWINDOW TYPE AIRCONDITIONING FREIGHT ELEVATOR
andor MONORAILS
PACKAGEDISPLIT TYPE AIR CONDITIONING PASSENGER ELEVATOR
OTHERS (Specify) . CABLE CAR FUNICULAR

PREPAREDBY

BOX3 BOX 4
DESIGN PROFESSIONAL. PLANS AND SPECIFICATION SUPERVISOR/ IN-CHARGE OF MECHANICAL WORKS
PROFESSIONAL MECHANICAL ENGINEER MECHANICAL ENGINEER

Date:
Date:
(Signed and Sealed Over Printed Name)
PROFESSIONAL MECHANICAL ENGINEER
Signed and Sealed Over Printed Name)

Address Address
PRC. No. Validity PRC. No. Validity

Date Issued Date Issued

PTR No. PTR No.
at
Issued a IN Issued TIN
BOX 5 BOX 6
BULDING OwNER WITH MY cONSENT: LOT OWNER

Signature over Printed Name) (Sagnalure ovr Printed Name)

Date: Dale

Address Address

C.TC. No. Date Issued

Place Issued C.TC. No. Date lssued Place Issued
ToBE ACCOMPLISHIEDBY THE PROCESSINGANDEVALUATION DrVISION

BOX7
RECEIVED BY DATE:

FIVE (5)
SETSs
OF MECHANICAL DOCUMENTS

MBCHANICAL PLANS AND SPECIRCATIONS cOST ESTIMATES

-
BILL OF MATERIALS OTHERS (5pecity)

BOX8

PROGRESS FLOW
IN DUT PROCESSED BY:

DATE TIME DATE TIME

MECHANICAL
OTHERS (Specify)

BOX 9

ACTION TAKEN:

PERMIT IS HEREBY ISSUED SUBJECT TO THE FOLLOWING:

. That the proposed mechanical works shall be in accordance with the mechanical plans filed with this Office and in conformity with

the latest Philippine Mechanical Code, the National Building Code and its IRR.

2. That prior to any Mechanical installation, a duly accomplished prescribed "NOTICE OF CONSTRUCTION"shall be

submitted to the Office of the Building Official.

3. That upon completion of the mechanical works. the licensed supervisor/in-charge shall submit the entry to the logbook duly

signed and sealed to the building official including as-built plans and other documents and shall also accomplish the

Cerificate of Completion stating that the mechanical works conform to the provision of the Philippine Mechanical Code. the National

Building Code and its IRR.

4. That this permit is null and void unless accompanied by the building permit.

5. That a Certificate of Operation shall be issued for the continuous use of mechanical installations.

PERMIT ISSUED BY:

CITY BUILDING OFFICIAL

(Signature Over Printed Name)
Date
NBC FORM ND. A-06
Republic of the Philippines
City of Cebu
Province of Cebu

OFFICE OF THE BUILDING OFFICIAL

PLUMBING PERMIT
BUILDING PERMIT NO:.
APPLICATION NO:,

DATE: DATE:

BOX1 (TO BE ACCOMPLISHED IN PRINT BY THE WNER/APPLICANT)

VIN
LAST NAME FIRST NAME M..
OWNER/APPLICANT

FORANCONSTRUCTON OWNED FORM OF OWNERSHIP USE OR CHARACTER OF OCCUPANCY

BY ENTERPRISE

CITYIMUNICIPALITY zIP CODE TELEPHONE NO.

ADDRESS NO. STREET. BARANGAY,
CEBU 6000
LOCATON OF cONSTRUCTION: LOTNO. BLK NO. TCT NO. TAX DEC. NO.
BARANGAY CITYOF.
STREET

scOPE OF WORK
NEW CONSTRUCTION RENOVATION RAISING
DEMOLITION,
ERECTION cONVERSION

ADDITION REPAIR ACCESSORYBUILDINGISTRUCTURE

OTHERS
ALTERATON MOVING (Spediy)-

BOX 2(TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL)

FIXTURES TOBE INSTALLED

QTY. KIND OF
QTY KIND DF NEW EXISTING
NEW FIXTURES FIXTURES FIXTURES FIXTURES
FIXTURES FIXTURES
BIDETTE
WATER CLOSET
LAUNDRY TRAYS
FLOOR DRAIN
LAVATORY DENTAL CUSPIDOR
KITCHEN SINK DRINKING FOUNTAIN
BAR SINK
FAUCET
SHOWER HEAD SODAFOUNTAN SINK
WATER METER SINK
LABORATrORY
GREASE RAP STERILZER
BATH TUB OTHERS

(Specily)
SLOP SINK

URINAL
AR CONDITIONING UNIT

WATER TANKRESERVOIR

TOTAL TOTAL

SYSTEM SYSTEM
WATER DISTRIBUTION SEWAGE SYSTEM SEPTIC TANK STORM DRAINAGE

PREPARED
BY

BOX3 BOX4
SUPERVISOR/ IN-CHARGE OF PLUMBING WORKS
DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS

Date Date
MASTER PLUMBER MASTER PLUMBER
(Signed and Sealed OverPrinted Name) (Signed and Sealed Over Printed Name)
Address Address
PRC. No. Validity PRC.No. Validity

PTR Date Issued PTR No. ate lssued

No0.
lssued at TIN Issued at TIN
BOX 5 BOX6
BUILDING OWNER WITH MY CONSENT: LOTOWNER

Sgnelure OverPinled Name) Over Pind Nema

Olurn

Address Address

CT.C. No. Date Issued Place Issued C.T.C. No. Date lssued ace bsued
BOX7 TO BE ACCOMPLISHEDBY THE PROCESSING & EVALUATiON DVISION

RECEVED BY DATE:

FIVE (5)SETS OF PLUMBING DOCUMENTS

PLUMBINGPLANS AND SPECIFICATIONS cOST ESTIMATES

BLL OF
MATERIALS oTHERS (Sspeily)

BOX8

PROGRESS FLOW
IN OUT
PROCESSEDBY
DATE TIME DATE TIME

RECEIVING ANDRECORDING
PLUMBING
OTHERS (Specify)

BOX9

ACTION TAKEN:

PERMIT ISHEREBY ISSUED SUBJECT TO THE FOLLOWING:

1 That the proposed plumbing works shall be in accordance with the plumbing plans filed with

this Office and in conformity with the Revised Plumbing Code of the Philippines, the Nationat

Building Code and its IRR.

2. That prior to any commencement of plumbing works, a duly accomplished prescribed

"Notice be submitted the Office the Building Official.

of Construction" shall to of

3. That upon completion of the plumbing works, the licensed supervisor/in-charge shalt submit

the entry to the logbook duly signed and sealed to the building official including as-built

plans and other documents and shall also accomplish the Certificate of Completion stating

that the plumbing works of the building conform to the provision of the Revised Plumbing9

Code, the National Building Code and its IRR.

That this permit is null and void unless accompanied by the building permit.

PERMITISsUED BY:

BUILDING OFFICIAL
Over Printed Name)
(Signature
Date